Medical needs documented by Emergency Medical Services (EMS) responders to areas affected by Typhoon Haiyan in the Philippines: Implications on disaster response policy

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite existing disaster preparedness policies in the Philippines, there has not been any validated assessment of the quality of disaster medical response, which would require reliable aggregate data on patient diagnoses and management.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This mixed-methods study documented the diagnoses, triage classification and case management of patients seen by Philippine EMS groups who responded to the Typhoon Haiyan disaster in the Philippines in November and December 2013, as well as difficulties associated in gathering these data, using the Utstein-style Template for Uniform Data Reporting of Acute Medical Response in Disasters as framework.</p><p style="text-align: justify;"><strong>METHODS:</strong> Three hundred (300) individuals vetted by EMS organizations were invited to answer a survey modeled after the Utstein-style template, and submit tallies of patients seen. Out of 52 responses received, policy recommendations were subsequently generated on concerns assessed by the template using the nominal group technique.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The submitted data yielded a total of 41,202 patients with information on age, sex, and diagnosis; 19,193 with triage classification; and 27,523 with information on case management. The focus group discussion underlined the absence of a standard communication and information management system. Participants recommended establishing such a system and highlighted the role of the Department of Health - Health Emergency Management Bureau in coordinating disaster medical response efforts and information management.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study underlines the importance of effective communication, and multisectoral coordination, to generate reliable data and thus, facilitate resource allocation for disaster medical response.</p>

Enabling factors, hindrances, and self-perceived level of preparedness of Typhoon Haiyan Emergency Medical Services (EMS) responders

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite the implementation of policies related to disaster risk reduction and management in the Philippines, the response after Typhoon Haiyan in November 2013 was hampered by operational challenges.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The purpose of this study was to document disaster response experiences of Typhoon Haiyan from field level emergency medical service (EMS) responders, a key component of the disaster response, specifically the enabling factors and hindrances to disaster medical response activities, including their self-perceived level of preparedness in these activities.</p><p style="text-align: justify;"><strong>METHODS:</strong> In this mixed-methods study, 52 respondents identified enabling factors and hindrances to their disaster response and their corresponding self-perceived level of preparedness. In a subsequent focus group discussion, the researchers used the nominal group technique to process the respondents' experiences.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The respondents identified factors that enabled or hindered their response activities such as coordination, stress debriefing, infrastructure, and preparedness. Furthermore, an average of 33% of the respondents said they were adequately prepared to deliver the necessary medical services during the disaster response, thus validating previous studies on preparedness and disaster response operations.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The government should critically examine its cluster approach to disaster response and consider an integrated, inclusive, and proactive approach in disaster planning.</p>

Ethnomedicinal uses of tawatawa (Euphorbia hirta Linn.) in selected communities in the Philippines: A non-invasive ethnographic survey using pictures for plant identification

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> There is a growing interest in the use of Euphorbia hirta Linn. as herbal remedy for dengue, supposedly based on folkloric practice. However, there has been no ethnobotanical documentation of such use in the Philippines. Because of this, the medical community cautions the public against the sole use of E. hirta in treating dengue.</p><p style="text-align: justify;"><b>OBJECTIVE:</b> To describe the ethnomedicinal uses of Euphorbia hirta Linn. In selected communities in the Philippines. Specific Objectives. (1) To identify the vernacular names of the plant; (2) to identify the earliest known use of the plant against dengue infection and for other indications; (3) to document the methods of preparation and administration, side effects, and contraindications of use.</p><p style="text-align: justify;"><strong>METHODS:</strong> Cross-sectional descriptive design using the snowball sampling of interviewer-guided key informants for the ethnobotanical interview.</p><p style="text-align: justify;"><strong>LIMITATIONS:</strong> The results of this study may be limited by its convenient sampling design and the use of plant pictures with different magnifications.</p><p style="text-align: justify;"><strong>RESULTS AND CONCLUSION:</strong> Majority of the respondents were female (93%), 41-60 years old (39%), had high school education (43%), and resided in Quezon City (31%). The plant is locally known as tawatawa, butobutonesan, malagatas, and mangagaw. It has been used to treat fever in the Philippines as early as 1948. Its use as a treatment for dengue started only in the 1980s. The plant is either squeezed, crushed, or boiled, and is administered topically or orally. The only reported side-effect is increased urinary frequency.</p><p style="text-align: justify;"><b>RECOMMENDATIONS:</b> It is recommended that more comprehensive and large scale studies be conducted, including (1) identification of folkloric uses of E. hirta for the treatment of other diseases; (2) determination of different concentrations of extract (crude or semicrude) using the various reported preparations for optimal outcomes for the different reported medicinal uses.</p>