Filipinas G. Ganchoon, MD Chair, Philippine Academy of Rehabilitation Medicine Disaster Rehabilitation Relief Committee (PARM CARES)

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1 PARM CARES TYPHOON HAIYAN TO PRESENT MODEL ISPRM NATIONAL SOCIETY DISASTER REHABILITATION PROGRAM Filipinas G. Ganchoon, MD Chair, Philippine Academy of Rehabilitation Medicine Disaster Rehabilitation Relief Committee (PARM CARES) International Society of Physical Rehabilitation Medicine 9th World Congress Maritim Hotel, Berlin, Germany June 21, 2015

2 Highest - storm surge recorded in East Asia of 9.14m due to strong winds, resulting in the majority of deaths due to drowning and catastrophic damage - intensity of a Category 5 tropical cyclone with sustained winds of 315 kph (above the 252 kph threshold for a Category 5 hurricane, the highest category on the Saffir-Simpson scale) - Reference: Meteomedia

3 ANIBONG, TACLOBAN, LEYTE REUTERS/ROMEO RANOCO IMPACT Significant national impact: 6,268 confirmed deaths, 28,689 injured, and 1,061 missing, with 3.4 million families (over 16 million persons) affected in 44 provinces, 57 cities, and 591 municipalities. Reference: National Disaster Risk Reduction & Management Council (NDRRMC)

4 P A R M Philippine Academy of Rehabilitation Medicine Membership: 340 PMR Centers: 412 Chapters North Luzon (46) National Capital Region (178) Visayas (22) Mindanao (20)

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6 The Role of the Philippine Physiatrist in a Large-Scale Natural Disaster Provide descriptive epidemiology of Typhoon Haiyan Compare rehabilitation injury data from two affected populations Summarize aid missions conducted by PARM members in the primarily-affected Visayas region Describe the strategic development of PARM s disaster rehabilitation program Elaborate the potential role of a local physiatrist in a large-scale natural disaster using the example of the Philippine physiatrist in Typhoon Haiyan

7 Medical Missions Conducted by PARM CARES (Nov 2013 Feb 2015) NCR (Manila) Philippine Orthopedic Center Villamor Airbase Region VI Antique Capiz Iloilo Lakawon Island Northern Negros Occidental Region VII Northern Cebu Bantayan Island Region VIII Leyte Ormoc 31 MISSIONS 31,884 kits distributed 8934 patients served

8 PM & R CONDITIONS EVALUATED IN PHILIPPINE ORTHOPEDIC CENTER (POC) (NOV 10, 2013 DEC 18, 2014)

9 TABLE 1: PM & R Conditions Evaluated at Philippine Orthopedic Center (POC) (November 10, December 18, 2013) Diagnosis Number Total Percentage of 79 Persons Percentage of 125 Conditions MSK 73 92% 58% Fractures 68 86% 54.4% Upper Limbs 16 Ribs 8 Spine 18 Pelvis 4 Lower Limbs 22 Amputations (Traumatic) 2 2% 1.6% Other MSK Conditions 3 4% 2.4% Soft Tissue Injuries 19 24% 15.2% Wound/Skin Infections 15 19% 12% Neurological 18 23% 14.4% TBI 2 2.5% 1.6% SCI 15 19% 12% Ulnar Neuropathy 1 1.3% 0.8% Total

10 PARM CARES MEDICAL MISSION TO BURAUEN, LEYTE (FEB 18, 2014)

11 Graph 1. Medical Conditions seen in Burauen, Leyte (100 Days Post-Haiyan) Graph 2. Musculoskeletal Diagnoses 2% 5% 3% 3% 11% UE DJD LE DJD Neck OA 37% Lumbar OA Low Back Strain 34% Fibromyalgia Myofascial pain 5% Fracture (Osteoporotic)

12 3 1 R E L I E F & M E D I C A L M I S S I O N S O F PARM CARES (NOV 10, 2013 FEB 1, 2015)

13 TABLE 2: PARM CARES Missions (Nov.10, 2013 Feb. 1, 2015) Date Location Mission Team Relief Kits Patients Served November 10, 2013 Brgy Tapilon, Daan, Bantayan; Northern Cebu PARM(V)/Cebu (40 MDs, AMRO) November 12, 2013 Brgy (4), Cadiz City; Brgy (4), Sagay City; Northern Negros PARM(V)/Bacolod (1MD, 30 Volunteers) 3000 November 15-17, 2013 Brgy Libertad, Cagbuhangin,Mabato, Linao, Valencia; Ormoc City; Leyte PARM(V)/Ormoc (3 MDs, 5 nurses, 12 HWs, HELP for Ormoc) (Brgy Libertad) November 17-30, 2013 Villamor Air Base, Manila; Luzon PARM National 420 December 28-29, 2013 Brgy Marasbaras, RTR; Tacloban, Leyte PARM CARES (National) ISPRM (12MDs, 30 HWs) 2000 (Brgy Marasbaras, RTR ) 50 (children (ASP, Tacloban) 400 February 17, 2014 Tent City, San Jose; Tacloban, Leyte Abuog General Hospital, Abuog; Franciscan Clinic, Baybay; Leyte PARM( CARES (National) (6 MD, 40HW, ISPRM, PAPA) ISPRM, PFP, PSPO (basic needs/medical screening survey) 16 (P&O evaluations) February 18, 2014 Burauen, Leyte RTR, Tacloban, Leyte PARM CARES (National) PAPA ISRPM, PFP, PSPO June 27, 2014 RTR, Tacloban, Leyte PARM Cares/ PARM (V) PFP 25 Lower Limb Prostheses (20 BK & 5AK) 288 (basic needs/medical screening survey) 283 (344 diagnoses) 1 (P&O) 24

14 TABLE 2: PARM CARES Missions (Nov.10, 2013 Feb. 1, 2015) Date Location Mission Team Relief Kits /Mobility Aids Patients Served June 28, 2014 Brgy Abukay Relocation Site, Tacloban PARM Cares/ PARM (V) 250 Clothes and Sleeping Mats 250 families Tacloban City Gym PARM Cares/ PARM (V) 25 Sleeping mats and clothes, 8 wheelchairs, 10 crutches and 10 canes 25 Families for Relief 28 Patients for Mobility Aids July 20, 2015 RTR, Tacloban, Leyte PARM Cares/PARM (V), World Rehabilitation Fund October 18, 2014 RTR, Tacloban, Philippines PARM Cares/ PARM (V) Buddhist Tzu Chi Foundation, PARM CARES Physical Therapy volunteers October 19, 2014 RTR, Tacloban, Philippines PARM Cares/ PARM (V),PFP, PARM CARES Physical Therapist Volunteers (20) PARM CARES Physiatrist in Tacloban received the WRF donated Physical Rehabilitation Equipment and donated it to the 3 hospitals: Remedios Trinidad Romualdez Hospital, Divine Word Hospital and Eastern Visayas Regional Medical Center 47 Haiyan Amputee Survivors were casted for 50 Lower Limb prostheses 20 PT Volunteeers were trained for casting of amputee stumps and gait training 25 Lower limb prostheses were fitted and distributed October 25, 2014 Estancia, Panay island, Philippines PARM Visayas Roxas/PARM CARES,Balay Mindanao and JDC American Jewish Joint Distribution Committee 16 wheelchairs 16

15 PARM CARES WRF REHAB CENTER PROJECT

16 PARM CARES LEGS FOR LIFE PROGRAM:

17 TABLE 3: PARM CARES Haiyan Disaster Response Outcome (Nov.10, 2013 Feb. 1, 2015) Date Nov 2013-Feb 2014 Mar 2014-Feb2015 Outcome Missions Relief Goods Distributed 31, ,884 No. of Mobility Aids distributed (74 wc, 17 Cruthes, 13 Canes) 104 No. of artificial legs distrubuted Patients Served 7, (missions) 1720 ( 450 at RTR, 858 at DW, 431 at EVRMC) 8934 No. of Rehabilictation Centers provided with new equipments 0 3 Rehab Centers 3 Rehab centers repaired and given rehab equipments No of Volunteers trained

18 PARM CARES PROJECTS FOR Establishment of a community based rehabilitation center and evacuation center for PWDs in Tacloban by December 2015 (Disaster Rehabilitation & Community Integration) 2. Establishment of Orthotics and Prosthetics shop at RTR Hospital by Feb 2016.( Disaster Rehabilitation & Community Integration) 3. Training of PMRs who are interested in Disaster Rehabilitation at AOSPRM in Cebu on Feb (Disaster Prevention & Preparedness) 4. Establishment of a Local disaster response coordination and training center by Feb (Disaster Prevention & Preparedness)

19 Physiatrist Roles in Disaster Response Clinical First Responder Triage/ER Inpatient and Outpatient Rehabilitation Medical Mission Volunteer Provider Trainer Non-Clinical Rehabilitation Needs Assessor Medical Mission Volunteer: leader, coordinator, relief distributor Trainer Disaster Rehab Program Developer Researcher

20 ACKNOWLEDGMENTS: Dr. James Earl Gosney Jr. Dr. Romil R. Martinez Dr. Renald T. Ramiro ISPRM & ISPRM CRDR PARM Executive Board and members PARM CARES Donors & Volunteers

21 MARAMING SALAMAT (Thank You) MERON BA KAYONG TANONG? (Questions?)

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