WELCOME I Made Winarta SKM M Epid

WELCOME I Made Winarta SKM. , M. Epid , MEDICAL PLANNER

Chief Medical Officer Admin Officer Medical Officer (vacant) FORCE MEDICAL OFFICER (Deputy CMO) Lt. Col. (Dr) Chief Hygiene Officer Lt. Col. (Dr) Force Admin Assistant Medical Officer (OPS) Maj. (Dr) Force Pharmacist IC Local Nurse Medical Planner Lt Col (Dr) Force International Nurse Local Nurse Ambulance Driver Warehouse Clerk 4 Naval MOs 9 MTF Ships Maritime Task Force Battalion - SMOs 18 Senior M. O. Level 1 Clinic Force C. O. of Level II and 1+ Hospitals CHINMCEDOY UNIFIL HQ Hospital Force

UNIFIL MEDICAL FACILITIES 3

Referral Hospitals BEIRUT Rafik Hariri Hospital, Beirut St George Hospital Beirut SAIDA TYRE Hammoud Hospital, Saida ISRAEL UNIFIL MEDICAL SECTION Jabal Amel Hospital Tyre

Rafik Hariri Hospital (L 4), Beirut 5

St George Hospital (L 4), Beirut 6

UNIFIL MEDICAL FACILITIES RHH ST GEORGE HAMMOUD HOSPITAL UNIFIL HOSPITAL LEVEL 1+ CHINESE HOSPITAL LEVEL 2 18 HOSPITAL LEVEL - 1 7

Overview UNIFIL Medical Resources in AO • 316 medical personnel • 79 medical doctor officers(include 7 dentists) • 135 beds of which 5 are ICU beds • 85 ambulances with emergency equipment of which 32 are hard skin • Helicopters with 2 x AMET standby 24/7 for CASEVAC

LEVEL 1 HOSPITAL n n Primary Health Care Emergency Resuscitation and Stabilization Minor Surgeries under local anesthesia Hospitalize up to 5 patients for 2 days • 18 Level 1 Hospitals as on date.

LEVEL 1 HOSPITAL R O K B A TT N E P B A T I T A L B A T T G H A N B A T T O T A L 0 0 0 3 0 0 2 0 0 0 12 2 3 1 3 2 3 0 2 2 1 2 2 2 30 0 0 1 0 1 4 2 2 2 3 3 3 6 17 2 17 4 3 4 9 94 4 10 10 8 3 4 16 3 6 4 3 3 0 9 10 3 0 0 0 0 1 1 0 0 1 5 B E L U B A T T C A M B C O Y C H I N B A T T FCR 9. 1 FCR 2. 45 I R I S H B A T SPECIALIST 0 2 3 1 1 0 0 0 GENERALIST 1 0 2 1 1 DENTIST 0 0 NURSE 1 2 4 PARAMEDIC 6 7 HYGIEN 1 0 PERSONNEL OTHERS 0 3 0 0 0 S P A N B A T P O R TC O Y 0 3 0 T U R C O Y I N D B A T I N D O B A T 0 0 9 4 1 I T A L C S S M A L C O Y M A L B A T 1 0 4 1 0 0 2 27 10

LEVEL 2 HOSPITAL n n n Emergency Resuscitation and Stabilization Limb and Life Saving Surgery under General Anesthesia Dental Services Hospitalize up to 20 patients for 7 days ICU care for 2 patients • Chinese Level 2 at UNP 7 -2 • Level 1+ at Naqoura

LEVEL 2 HOSPITAL PERSONNEL OF LEVEL 2 & 1+ HOSPITAL Sp Genera list Dentist Chinese 14 2 2 UNIFIL 10 0 1 Nurse HO Others Total Param edic Pharm 20 3 1 1 16 60 9 8 0 1 4 33 12

LEVEL 2 & 1+ HOSPITAL CHINNESE LEVEL 2 n n n 3 x SURGEON 4 x INTERNIST 1 x OPHTALMOLOGIST 1 x ENT 1 x RADIOLOGIST 1 XGYNAECOLOGIST 1 x DERMATOLOGIST 1 x ANAESTHETIST 1 XPATHOLOGIST 2 XGENERALIST 2 XDENTAL SURGEON 20 X NURSES UNIFIL L 1+ Hospital n n n 1 x ENT 1 X OPHTHALMOLOGIST 1 X ANAESTHETIST 1 X INTERNIST 1 X ORTHOPEDIC 2 X RADIOLOGIST 2 X SURGEON 1 X DENTIST GYNAECOLOGIST (NOT) 9 x. NURSES 8 XPARAMEDICS 13

FACILITY & EQUIPMENT CHINNESE LEVEL 2 n n n n 1 X 7 X 2 X 1 X 1 X 1 X 5 X 1 X OPERATING THEATER WARDS (20 X BEDS) ICU X-RAY LABORATORY DENTIST ROOM SPECIALIST ROOM PHYSIOTHERAPY ROOM UNIFIL HOSPITAL n 1 X 5 X 3 X 1 X 1 X 1 X 5 X 1 X n NOT AVAILABLE : n n n n 1. OPERATING THEATER WARDS (11 X BEDS) ICU X-RAY ROOM LABORATORY DENTIST ROOM SPECIALIST ROOM PHYSIOTHERAPY ROOM OPHTHALMOLOGIST SURGERY INSTRUMENT AND OPERATING MICROSCOPE 14

LEVEL 3 HOSPITAL Advanced field Hospital HAMMOUD Hospital in SAIDA covers all Area of Operation in the case of emergency (Casevac) Comprises a fully equipped and staffed multi-disciplinary (advanced) field hospital which provides all major medical and surgical specialities Provides advanced services in surgical, intensive care, dental (emergency dental surgery), laboratory, x-ray, ward and pharmaceutical capabilities 15

LEVEL 4 HOSPITAL Outside the Area Operations, Covers the entire mission Area A Level Four medical facility provides definitive medical care and specialist medical treatment unavailable or impractical to provide for within a Mission area. This includes specialist surgical and medical procedures, reconstruction, rehabilitation and convalescence. RHUH (no Helipad) – Beirut St. George Hospital (Helipad) - Beirut Rambam Hospital (Helipad) – Haifa, ISRAEL 16

AERO MEDICAL EVACUATION TEAM (AMET) The AMET is a highly mobile medical unit of six staff that is configured and equipped to provide short-term medical support during air evacuation within the country and outside. The AMETs are divided into 2 parts: French’s AMET (Naqoura HQ) & Chinnese’s AMET (HQ Sector East : 7 -2) French’s AMET have 2 groups, but they only have 1 (one) medical equipment. 17

Incident Medical Management Principle : 20 min life saving : maximum 20 min before doctor sees a casualty Principle : GOLDEN HOUR : maximum 60 min before surgery if necessary

Level IV Hosp’s BEIRUT 4 5’ Level III Hosp 4 SAIDA 0’ 45’ 40’ H 20’ 40’ 30’ 25 20’ H H 15’ UNIFIL MEDICAL SECTION 19

Casevac/Medevac Level - II POI Level – III/IV DEPEND ON CASE Referral hospitals L 3/4 Lebanon, ISR or CYP

CASEVAC (2010): 6 1. Hotel Deu Hospital, Beirut : 4 2. Hammoud Hospital, Saida : 2 n CASEVAC (2011) : 29 (80% Injury) 1. Rafik Hariri Hospital, Beirut : 4 2. Hammoud Hospital, Saida : 25 n 21

UNIFIL HOSPITAL NAQOURA

Chinese Level II Hospital

MEDICAL STAFF AID 3 A Jan - Dec 2011 Jan - Dec 2012 60, 948 42, 477

OUTPATIENT PERSONEL FREQ 2010 FREQ 2011 UNMO 231 243 Civ. Pol 388 7 TROOP 61175 56945 Int’l Staff 1609 1868 Local Staff 2133 1885 25

MEDICAL STAFF AID 3 B OUTPATIENTS Jan - Dec 2010 Jan - Dec 2011 43, 922 49, 483 26

OUTPATIENT BY DISEASE IN 2010 BY DISEASE IN 2011 27

MEDICAL STAFF AID 3 A Jan - Dec 2010 Jan - Dec 2011 852 1, 205

INPATIENT PERSONEL FREQ 2010 FREQ 2011 UNMO 5 2 Civ Pol 3 30 TROOP 802 1170 Int’l Staff 38 2 Local Staff 4 1 29

INPATIENT BY DISEASE 2010 BY DISEASE 2011 30

SURGERY SURGERIES IN 2011 HOSPITAL MAJOR MINOR L-2 HOSP 21 75 L-1+ HOSP 32 0 SURGERIES IN 2012 SURGERY MAJOR L-2 HOSP 18 L-1+ HOSP MINOR 73 32 31

ADMISSION IN L 2 &1+ HOSPITAL 2010 2011 Chinese L-2 51 66 Unifil L -1+ 272 279 32

ADMISSION L 3/L 4 HOSPITAL ASSESSMENT 2011 2012 ADMIT 86 86 INVESTIGATION 148 33

Jan - Dec 2011 65 Cases Jan - Dec 2012 70 Cases

Repatriation by Caused BY CAUTION TABLE CHART 50 Caution 2011 2012 45 INJURY 19 26 35 40 30 NONINFECTIOUS 46 40 25 20 2012 10 5 TH D EA S FE C IN CT FE IN TI O IO U U S RY 0 O N 1 15 JU 0 3 N DEATH 0 IN INFECTIOUS 2011 35

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Jan - Dec 2011 274 Cases Jan - Dec 2011 222 Cases Exclude : Dental & Routine examination

MEDICAL PROBLEM 1. 2. 3. 4. Medical structure is unclear Timely replacement of doctor/nurse/SO Surgery team should be from one country Medical section need one more vehicle to support medplan & Chief hygiene for ORI and COE inspections. 38

THANK YOU

MEDICAL PLANNER Major I Made Winarta, SKM. , M. Epid

INTRODUCTION n n n Name Rank Age Status Last Posting Unifil Job : I Made Winarta, SKM. , M. Epid : Major : 39 years old : Marriage/ 4 DAUGHTER : Eastern Fleet Command, Jkt : Medical Planner

JOB DESCRIPTIONS n n n n ASSIST FMO TO ARRANGE THE MEDICAL SUPPORT PLAN ASSIST FMO TO MAKE DECISION IN MASCAL CASUALTY ASSIST FMO TO CONDUCT CASEVAC AND ORGANIZE BASIC LIFE SUPPORT ASSIST FMO TO CONDUCT SMO CONFERENCE COLLECT WEEKLY MEDICAL REPORT ASSIST TO CONDUCT INSPECTION L 1 &2 UNIFIL HOSPITALs in AO. COORDINATION WITH ALL SMO IN AO

JOB DESCRIPTIONS n n ASSIST FMO PREPARING AND EXECUTING THE MEDICAL SUPPORT PLAN TAKE PART TO UPDATE OF UNIFIL MEDICAL SOP COORDINATE WITH CIMIC PLANNER DURING MEDICAL ASSIST PROGRAM FOR LOCAL PEOPLE ASSIST CMO AND FMO IN PLANNING UNIFIL PREPAREDNESS TO TACKLE H 1 N 1 PANDEMIC THREAT

Duty Performed n n n n HAVE CONDUCTED WEEKLY MEDICAL REPORT CONDUCTED CASEVAC/MEDEVAC AND EXERCISE CONDUCTED EXERCISE OF CASEVAC IN SEAGULL TRAINING (MTF PROGRAM) CONDUCTED SMOs CONFERENCE in MCC NAQOURA CONDUCT ED HYGIENE INSPECTION WHEN HYGIENE OFFICER IS LEAVING CONDUCTED INSPECTION OF L 1&2 HOSPITAL IN AO ARRANGE FOR AMET TRAINNING WITH MAOC MAKE MOP, DUTY ROASTER and ATTENDANCE SHEET FOR FMO, MED OPS AND HYG OFF

DUTY PERFORMED n COORDINATION WITH SMO ABOUT RESULT OF DISEASE IN THEIR AO (MSA 3 B)& THEIR PROBLEM

PLANNING IN 2014 n n TO ARRANGE SMOs CONFERECE, Wednesday, 22/08/2014 in Naqoura. TO ARRANGE TRAINING BASIC LIFE SUPPORT FOR SMO & NURSES SUCH LIFE AID, USING INSTRUMENTS SUCH AS LARYNGOSCOPE, INTUBATION, DEFIBRILATOR, INFUS PUMP, USING OPHTHALMOSCOPE etc in L 1+ & L 2. TO CONDUCT SMOs MEETING EVERY ONCE/ MONTH IN L 1&2 UNIFIL HOSPITAL. TO CONDUCT MULTIPLE CASEVAC EXERCISE IN AO

PLANNING 2014 n n TO MAKE GUIDELINE BOOK OF CASEVAC FOR SMO TO PERFORM ORI AND COE INSPECTION TO MAKE REPORT OF MEDICAL WEEKLY, MONTHLY MEDICAL (3 MONTH) AND YEAR MEDICAL REPORT TO ASSIST FMO FOR UP DATE MEDICAL SOP AND AMANDEMENT CASEVAC/MEDEVAC SOP

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