Disaster physicians: Dr. Victor Matos, Dr. Alejandro Baez, Dr. Juan Rodriguez SCCM Disaster Field Team: Dr. M.J. Reed, Dr. Marie Baldisseri, Dr. Randy Wax, Dr. Dana Braner, Gervaise Nicklas, Province of Ontario Emergency Medical Assistance Team: Dr. Bruce Sawadsky

The SCCM Disaster Field Team met today with multiple representatives from different disaster-related organizations in the Dominican Republic, including the Pan American Health Organization, Project HOPE and the DR Ministry of Health. Dr. Lucas, Director of Special Services for the Public Health System in the DR, provided an overview of the current ICU bed capacity in the public hospital system in country.  75% of the population in the DR relies on the public hospital system for care. There are a limited and inadequate number of ICU beds in the public health system at varying states of readiness meant to serve a population of 7.5 million on the island. It was agreed that there was a need to increase bed capacity for patients with or at risk of critical illness within the DR public hospital system. ICU bed occupancy and availability will be added to the daily briefing for leadership in the Ministry of Health.  A patient tracking system is being evaluated in a pilot project to see if better real time situational awareness can be improved to better allocate resources and move patients to the right place at the right time.

Evaluation of the process for caring for patients, moving patients from makeshift health facilities to more definitive care, was conducted. After mapping out a very complicated existing system, attempts were made to simplify the command and control structure for critical care resources in the country with advice from the groups.  Three regions in the country will be targeted for efforts to increase ICU capacity to better serve patients in hard hit areas. Need for additional work in clarifying the referral process and transport system was identified.

Working together to move patients back in as a storm approaches. Fearing another quake Hatians had built a tent city at the steps of the Jimani Clinic.

The SCCM team has moved from initial reconnaissance activities to assisting with brainstorming solutions along with the leading organizations on the ground to improve efficiency of the critical care system.

“Swallow your egos…this is the REAL world"

As the staff on the front lines in Jimani so eloquently stated, “Swallow your egos…this is the REAL world”. This sentiment was seen at the strategic and leadership level as well. The team was impressed with the willingness of the different organizations to work together in a constructive and creative manner to make a difference.