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Preparing for the worst: training health workers to deal with the influx of war victims in Ukraine

Figures from the Office of the United Nations High Commissioner for Human Rights (OHCHR) put more than 4,000 victims of the war in Ukraine to date. Yet, as OHCHR acknowledges, the true number is likely much higher given that it is difficult to access accurate information on areas where intense hostilities are taking place and other reports await corroboration. .

It is therefore crucial to ensure that hospitals are prepared for a sudden increase in the number of victims during this emergency. Much of this involves fully training health professionals in these institutions not only in theory but, more importantly, in the practice of organizing and mobilizing resources to deal effectively with these crises.

Training in the Republic of Moldova

Recently, WHO, at the request of the Moldovan Ministry of Health, organized a three-day course on mass casualty management (MCM), developed in collaboration with the Ministry of Health and the Karolinska Institutet in Sweden. A total of 32 surgeons, traumatologists and facility managers from 13 hospitals benefited from the training.

The Republic of Moldova, a country neighboring Ukraine, has already seen 400,000 refugees cross its border for protection. Preparing its medical professionals for a potential increase in war casualties has been a key consideration.

And as Ion Chesov, head of the department of integrated services at the Ministry of Health, pointed out, the benefits of this training go far beyond the current emergency: “We must ensure that the health system as a whole and institutions in particular are ready to deal with any unforeseen emergency or disaster. Basic and advanced trauma resuscitation knowledge is crucial and forms the foundation of medical skills for physicians.

Training in Ukraine

This month, WHO also began rolling out the course in Ukraine. The first participants were the staff of an ambulance substation in the Lviv region. Such training of paramedics will enable them to provide appropriate assistance to victims even before they reach hospitals. WHO has hired Ukrainian emergency physicians to deliver the training and plans to hold further sessions across the country.

Speaking about the course, Johan von Schreeb, coordinator of the WHO emergency medical team in Ukraine, said: “In the country today, this type of training is unfortunately very much needed. We see a lot of mass casualty situations where many people have been injured simultaneously. It is very difficult for the health system and for the staff who have to make quick and critical decisions to prioritize the evacuation of the injured. Practicing patient triage is a very useful exercise, and we need to do more of it. We can’t just do it using presentations. You need to be exposed to stress, decision making, organization and chaos, and we try to simulate that as much as possible through training.

About the course

The MCM course was developed in collaboration with the WHO Emergency Medical Team, Karolinska Institutet (a WHO Collaborating Centre) and the WHO Academy. The designers of the course recognized that massive casualties from major disasters and incidents, often characterized by a large number of serious and diverse injuries, can quickly overwhelm the capacity of healthcare facilities to provide adequate medical care.

The training covers the organization and actions of personnel working in emergency units, with a focus on the first 30 minutes after a mass casualty incident is announced. Taking a hands-on, hands-on approach, the training emphasizes stabilizing injured patients and triage, as well as teamwork, learning new skills and evolving work methods. In addition, specific MCM trainings are provided to emergency personnel working in hospitals.

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