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Recovery: Definition. Actions taken to re-establish a community following an event, including construction of permanent housing, health facilities, telecommunications and other infrastructure with the objective of full restoration and resumption of services to a pre-disaster state.
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Recovery: Definition Actions taken to re-establish a community following an event, including construction of permanent housing, health facilities, telecommunications and other infrastructure with the objective of full restoration and resumption of services to a pre-disaster state.
No phase of an event can be considered in isolation. Reconstruction during the recovery phase must be informed by lessons learned from the event, including how, in the future, a similar event might be prevented, or its effects mitigated.
Humanitarian Telemedicine “Spacebridge” to Armenia A Humanitarian Response/Recovery Initiative In the wake of the 1988 earthquake Presented to the World Bank John Scott Center for Public Service Communications October 2008
Spacebridge to Armenia and Ufa In December 1988, a severe earthquake struck the Soviet Republic of Armenia, resulting in 25,000 early deaths, over 150,000 casualties, and widespread destruction estimated at $20 - $40 billion. In support of the former Soviet Government NASA's Communications and Life Sciences divisions initiated a four-month "Telemedicine Spacebridge" demonstration between the Soviet Union and the United States to provide long-distance medical assistance, via satellite, to earthquake-stricken Armenia.
Spacebridge to Armenia and Ufa (2) Initial satellite links consisted of one-way video, two-way audio, data, fax and telex (public and private sector involved) Clinical sites included: locations in Yerevan, Moscow, Ufa, as well as Utah, Maryland and Texas
Spacebridge to Armenia and Ufa (3) The US physicians and specialists that participated in the spacebridge project provided consultative support to more than 200 Soviet physicians --primarily in the areas of reconstructive surgery, rehabilitation and psychiatric care for post-traumatic stress disorder.
Spacebridge to Armenia and Ufa (4) During the Spacebridge's four months of operation, over 400 American and Soviet medical professionals participated in clinical conferences. Of the more than 200 cases discussed, 25 percent of the diagnoses were altered, and many modifications in diagnostic studies and treatment plans were formulated. The spacebridge project demonstrated both the values of such a system and the need to institutionalize this capability nationally and internationally.
U.S.-India-Pakistan Disaster Telehealth Spacebridge Assumption 1: The U.S. And India are supportive of Pakistan in the response, recovery & reconstruction phases of recent earthquake. Assumption 2: Cooperation between India and Pakistan would be positive, for immediate disaster relief and long-term relations. Assumption 3: A non-governmental consortium of health professionals acting on behalf of America and India, with support from their respective governments, would be a useful model to explore as part of the current response efforts. Assumption 4: The Government of Pakistan would welcome a disaster telehealth “Spacebridge” initiative during the current crisis.
Background for Concept This proposal draws on the experience of the 1989 Telemedicine Spacebridge to Armenia and Ufa. Similarities between the Armenia and Pakistan disasters include: • Request for international assistance, including from India (because of magnitude of disaster) • Lack of communications and health technology infrastructure (because of devastation and remote location) • Interest of foreign prospective partners in supporting earthquake victims and regional Peace Process • Strain in national political relationships
Short List of Prospective Collaborators From Pakistan: • Ministry of Health, Emergency Medical Facilities and Academic Health Centers From U.S.: • National Aeronautics and Space Administration, Academic Health Centers, USAID From India: • Indian Space Agency, Ministry of Health, Academic Health Centers International Organizations: • WHO (EMRO, SEARO, PAHO) • World Bank, IFRC Others: • Private Sector (telecom, health technology, etc)
Future, broader, opportunities include: • Maintain capability to mobilize portable/deployable telehealth resources to support areas hit by natural and other disasters. • Design/evaluate models for integrating public and private sector partners into resource sharing consortia for effective delivery of healthcare to target populations in medically underserved regions. • Develop strategies to transition temporary telehealth initiatives to national/local government and civilian health providers, as capacities are developed to sustain them. • Develop/evaluate operational protocols for providing clinical and public telehealth services to target populations in a timely way • Identify/address critical regulatory, legislative and other policies affecting delivery of healthcare to target populations via telehealth.
Other Scenarios for Emergency Telehealth • Health information, distance learning and “mentoring” in Afghanistan for new community health workers, midwives and clinic staff • Prevention, preparedness, and response for disease outbreak (i.e., Avian Flu) • Improving health services and health screening for refugees • Mid- Long-term clinical support and health system reconstruction support to Nicaragua and Honduras after Hurricane Mitch