MDs and RNs from 17 countries come to Haifa to learn how to set up and manage the most efficient systems for saving lives.

Photo by Pioter Fliter/RHCC
Trauma seminar participants from 17 countries during a simulation at Rambam Health Care Campus in Haifa.

Jesse Kinyua is a paramilitary officer in charge of medical emergencies in Kenya. He also volunteers on a first-aid squad formed by the Kenya Council of Emergency Medical Technicians after a 1998 terrorist attack.

But it wasn’t until a November course at Haifa’s Rambam Health Care Campus (RHCC) that he learned the most critical components of an emergency medical system.

“In Kenya we don’t have a good way of managing trauma,” Kinyua tells ISRAEL21c. “After the bombings in 1998, the IDF [Israel Defense Forces] came to our aid and later when we had a building collapse and were not able to deal with all the injuries and trauma, again the IDF came to our rescue.”

The eighth seminar on Developing and Organizing a Trauma System and Mass Casualty Event (MCE) Organization, jointly sponsored by RHCC and the Israeli Ministries of Foreign Affairs and Health was, says Kinyua, “an eye-opener.”

“I learned we do not have to have a lot of money to have a good system in place. The Israelis started from almost nothing, too, and I see all we are lacking is management.

We can now combine pre-hospital care with a trauma system and come up with a workable structure. I believe my colleagues and I can put this into place and save thousands of lives.”

Photos by Pioter Fliter/RHCC
The hands-on course gave a range of information on how to treat mass casualty victims in an organized way.

Sponsored by MASHAV, Israel’s international development agency, the seminar trained 27 doctors and nurses from Albania, Ecuador, Ethiopia, Burma, Georgia, India, Vietnam, Jordan, Nepal, Kenya, Nigeria, Chile, Peru, Kosovo, Thailand, Ghana and New Zealand — as well as Indonesia, the largest Muslim country in world, which has no formal diplomatic relations with Israel.

Organization is the key

“Most of these countries, including Indonesia, don’t have a trauma system, and their pre-hospital care and hospital care is not organized,” says Rambam’s trauma coordinator Gila Hyams, director of the hospital’s Teaching Center for Trauma, Emergency and Mass Casualty Situations. “Most don’t have a central ambulance service and some have just a van with a bed inside.”

But she stresses that budget and equipment are secondary.

“If you want to treat patients well, you need to organize a team to work together, and parts of that system are missing in many of the countries,” she tells ISRAEL21c. “We expose them to the way it should be, and we teach them how to educate their teams. If they know how to treat one trauma patient then they will be ready for mass casualties.”

The five Indonesian participants told Hyams that the Asian country is “a hypermarket for mass casualties, since they have tsunamis and terror attacks,” she says. “They brought pictures of one emergency room, and it is totally disorganized. Now that they have learned what to do, I am hopeful that they will continue their connection with us.”

The seminars, in fact, aren’t meant to be just a one-shot deal. Previous students from countries including India, Costa Rica, Thailand and Chile have often asked the Israelis to come and help them set up their systems on the ground.

Hyams was in India leading such a workshop in November 2008 when a terror attack hit Mumbai. “We were immediately transferred there and helped the Israeli embassy locate Israelis who were injured,” she recalls, “so sometimes reality and education come together.”

First-time student from Vietnam

Rambam is a regional trauma center for nine area hospitals, making it the busiest center for trauma in Israel and an obvious choice for nationwide and international training seminars, which are conducted in English.

Over the past 10 years, Hyams has seen some 600 physicians and nurses from myriad countries coming to learn how to organize emergency medical teams, courtesy of MASHAV. In addition to classroom sessions directed by Dr. Moshe Michaelson, medical director of the Teaching Center, they are taken on field trips to IDF simulation centers and to the headquarters of Israel’s national ambulance service, Magen David Adom.

Most of the students come from developing nations, but not all. “Even Italy uses knowledge they got here,” says Hyams.

This year was the first time the 13-day seminar had a participant from Vietnam, Dr. Thiens Bui.

“We have eight million people in my city, and we see a lot of trauma from accidents but we don’t have a trauma unit,” Bui tells ISRAEL21c, “so the most important thing I learned is the way Rambam organizes the system. I will show my colleagues how to set up a trauma unit and we’ll try. I’m not sure I can change things but I have ideas that I hope will be accepted.”

Andi Asadul Islam, a professor of neurology at Hassan Udim University in Makassar, East Indonesia, said Indonesia’s geography presents challenges in supplying medical care to 250 million citizens scattered among five large islands and thousands of smaller ones. “Rambam’s system for trauma is the best there is, and we can learn a lot from it,” said Islam.

“After they go home, our students are good ambassadors for Israel,” adds Hyams.