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Where There Is No Trauma System: A Successful Patient Evacuation in the Republic of Kiribati

Published online by Cambridge University Press:  10 January 2019

Carmen A. Cueto ,
John Tekanene ,
Teraria Bangao ,
Baranika Toromon ,
Adam L. Kushner  and
Lydia Lam
Carmen A. Cueto
Affiliation:
Keck School of Medicine, University of Southern California, Los Angeles, CA
John Tekanene
Affiliation:
Ronton Hospital, Kiritimati, Kiribati
Teraria Bangao
Affiliation:
Ronton Hospital, Kiritimati, Kiribati
Baranika Toromon
Affiliation:
Ronton Hospital, Kiritimati, Kiribati
Adam L. Kushner
Affiliation:
Surgeons Overseas, New York, NY Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lydia Lam*
Affiliation:
Keck School of Medicine, University of Southern California, Los Angeles, CA Pacific Island Medical Aid, Brownsboro, TX
*
Correspondence and reprint requests to Dr Lydia Lam, 2051 Marengo St., IPT C5L100, Los Angeles, CA 90033 (e-mail: [email protected]).
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Abstract

Research is lacking around how best to approach trauma care in resource poor settings, particularly in remote areas such as the islands of the South Pacific. Without examples of successful treatment of high-risk cases in these settings, countries are unable to move forward with developing policies and standardized procedures for emergency care.

The Republic of Kiribati is a Pacific Island nation composed of 33 islands spanning over 2,000 miles in the central Pacific Ocean. With the only hospital located on Kiritimati Island and inadequate boat transportation, the government recently committed to providing an aircraft for patients to receive appropriate medical care. In 2016, a 20-year-old female, primigravida, on a neighboring island, failed to progress in labor for 24 hours and needed an emergency cesarean section. A radio call was made to Kiritimati, and a team consisting of a general surgeon, nurse, and a laboratory technician was dispatched. The patient was brought to the local clinic and flown to Kiritimati where a team was prepared to perform the cesarean section.

The successful patient evacuation emphasizes the importance of a dedicated health care team, government commitment, and the constant quality communication when approaching feasibility of trauma and emergency care. (Disaster Med Public Health Preparedness. 2019;13:774–776).

Keywords

global healthlow income settingspatient evacuationtrauma system strengthening
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 4 , August 2019 , pp. 774 - 776
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

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References

REFERENCES

Gosselin, RA, Charles, A, Joshipura, M, et al. Essential surgery. In: Debas HT, Donker P, Gawande A, et al., eds. Disease Control Priorities. 3rd ed. Washington, DC: World Bank Group; 2015:1.Google ScholarPubMed
Callese, TE, Richards, CT, Shaw, P, et al. Trauma system development in low- and middle-income countries: a review. J Surg Res. 2015;193(1):300-307. doi:10.1016/j.jss.2014.09.040.CrossRefGoogle ScholarPubMed
Hashmi, ZG, Haider, AH, Zafar, SN, et al. Hospital-based trauma quality improvement initiatives: first step toward improving trauma outcomes in the developing world. J Trauma Acute Care Surg. 2013;75(1):60-68, discussion 68. doi:10.1097/TA.0b013e31829880a0.CrossRefGoogle ScholarPubMed
Kushner, AL, Kamara, TB, Groen, RS, et al. Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone. J Surg Educ. 2010;67(4):270-273. doi:10.1016/j.jsurg.2010.05.004.CrossRefGoogle Scholar
Celso, B, Tepas, J, Langland-Orban, B, et al. A systematic review and meta-analysis comparing outcome of severely injured patients treated in trauma centers following the establishment of trauma systems. J Trauma. 2006;60(2):371-378, Discussion 378. doi:10.1097/01.ta.0000197916.99629.eb.CrossRefGoogle ScholarPubMed
Dare, AJ, Lee, KC, Bleicher, J, et al. Prioritizing surgical care on national health agendas: a qualitative case study of Papua New Guinea, Uganda, and Sierra Leone. PLoS Med. 2016;13(5):1-25. doi:10.1371/journal.pmed.1002023.CrossRefGoogle ScholarPubMed
Mock, C, Lormand, J, Joosen, J, et al. Guidelines for essential trauma care. Geneva World Heal Organ. 2004. http://www.who.int/violence_injury_prevention. Accessed January 4, 2017.Google Scholar
Stewart De Ramirez, S, Doll, J, Carle, S, et al. Emergency response in resource poor settings: a review of a newly implemented EMS system in rural Uganda. Prehosp Disaster Med. 2017;29(3):311-316. doi: 10.1017/S1049023X14000363.CrossRefGoogle Scholar
Natuzzi, ES, Kushner, A, Jagilly, R, et al. Surgical care in the Solomon Islands: a road map for universal surgical care delivery. World J Surg. 2011;35(6):1183-1193. doi:10.1007/s00268-011-1097-4.CrossRefGoogle ScholarPubMed
Mock, C, Nguyen, S, Quansah, R, et al. Evaluation of trauma care capabilities in four countries using the WHO-IATSIC guidelines for essential trauma care. World J Surg. 2006;30:946-956. doi:10.1007/s00268-005-0768-4.CrossRefGoogle ScholarPubMed
Spiegel, DA, Abdullah, F, Price, RR, et al. World Health Organization global initiative for emergency and essential surgical care: 2011 and beyond. World J Surg. 2013;37(7):1462-1469. 10.1007/s00268-012-1831-6.CrossRefGoogle ScholarPubMed
Kwon, S, Kingham, TP, Kamara, TB, et al. Development of a surgical capacity index: opportunities for assessment and improvement. World J Surg. 2012;36(2):232-239. doi:10.1007/s00268-011-1385-z.CrossRefGoogle ScholarPubMed
Meara, JG, Leather, AJM, Hagander, L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386:569-624. doi:10.1016/S0140-6736(15)60160-X.CrossRefGoogle ScholarPubMed
Pitt, E, Pusponegoro, A. Prehospital care in Indonesia. Emerg Med J. 2005;22(2):144-147. doi:10.1136/emj.2003.007757.CrossRefGoogle ScholarPubMed
Mock, CN, Adzotor, KE, Conklin, E, et al. Trauma outcomes in the rural developing world: comparison with an urban level. J Trauma. 1993;35(4):518-523.CrossRefGoogle ScholarPubMed
Tarighi, P, Tabibi, SJ, Motevalian, SA, et al. Designing a model for trauma system management using public health approach: the case of Iran. Acta Med Iran. 2012;50(14):9-17. doi: 20026 [pii].Google Scholar
Grimes, CE, Bowman, KG, Dodgion, CM, Lavy, CBD. Systematic review of barriers to surgical care in low-income and middle-income countries. World J Surg. 2011;35:941-950. doi:10.1007/s00268-011-1010-1.CrossRefGoogle ScholarPubMed