Open Access Open Access  Restricted Access Subscription or Fee Access

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

Deganit Kobliner-Friedman, RN, MPH, Ofer Merin, MD, Eran Mashiach, MD, Reuven Kedar, MD, Shai Schul, MHA, Evan Avraham Alpert, MD

Abstract


Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.

The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FHs efforts to protect the patients healthcare rights in a disaster zone based on the Sphere Principles.

These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.


Keywords


patient rights, disasters, World Health Organization

Full Text:

PDF

References


Lind K, Gerdin M, Wladis A, et al.: Time for order in chaos! A health system framework for foreign medical teams in earthquakes. Prehosp Disaster Med. 2012; 27(1): 90-93. doi:10.1017/S1049023X11006832.

Dori F, Iadanza E, Miniati R: DSS for field hospitals planning. Technological and functional aspects. Conf Proc IEEE Eng Med Biol Soc. 2007; 2007: 3589-3592. doi:10.1109/IEMBS.2007.4353107.

Mallia P: Towards an ethical theory in disaster situations. Med Health CarePhilos. 2015; 18(1): 3-11. doi: 10.1007/s11019-014-9584-7.

Simm K: Ethical decision-making in humanitarian medicine: How best to prepare? Disaster Med Public Health Prep. 2020; Apr 13: 1-5. doi:10.1017/dmp.2020.85.

Sphere Handbook. 2019. Geneva, Switzerland: Sphere; Available at https://www.spherestandards.org/handbook. Accessed July 1, 2019.

Institute of Medicine of the National Academies: Crisis standards of care: A systems framework for catastrophic disaster response. 2012. Available at http://books.nap.edu/openbook.php?record_id=13351. Accessed July 1, 2019.

Classification and minimum standards for Foreign Medical Teams in sudden onset disasters. Geneva, Switzerland: WHO, Global Health Cluster; Available at http://www.who.int/csr/resources/publications/ebola/foreign-medical-teams/en/. Accessed July 1, 2019.

Alpert EA, Weiser G, Kobliner D, et al.: Challenges in implementing international standards for the field hospital emergency department in a disaster zone: The Israeli experience. J Emerg Med. 2018; 55(5): 682-687. doi: 10.1016/j.jemermed.2018.07.019.

Kreiss Y, Merin O, Peleg K, et al.: Early disaster response in Haiti: The Israeli field hospital experience. Ann Intern Med. 2010; 153(1): 45-48. doi: 10.7326/0003-4819-153-1-201007060-00253.

Merin O, Kreiss Y, Lin G, et al.: Collaboration in response to disaster—Typhoon Yolanda and an integrative model. N Engl J Med. 2014; 370(13): 1183-1184. doi: 10.1056/NEJMp1315960.

Merin O, Yitzhak A, Bader T: Medicine in a disaster area: Lessons from the 2015 earthquake in Nepal. JAMA Intern Med. 2015; 175(9): 1437-1438. doi:10.1001/jamainternmed.2015.3985.

Strickland NH: PACS (picture archiving and communication systems): Filmless radiology. Arch Dis Child. 2000; 83(1): 82-86. doi:10.1136/adc.83.1.82

Weiser G, Ilan U, Mendlovic J, et al.: Procedural sedation and analgesia in the emergency room of a field hospital after the Nepal earthquake. Emerg Med J. 2016; 33(10): 745-747. doi: 10.1136/emermed-2015-205297.

Lehavi A, Meroz Y, Maryanovsky M, et al.: Role of regional anaesthesia in disaster medicine: Field hospital experience after the 2015 Nepal Earthquake. Eur J Anaesthesiol. 2016; 33(5): 312-313. doi:10.1097/EJA.0000000000000424.

Levy G, Blumberg N, Kreiss Y, et al.: Application of information technology within a field hospital deployment following the January 2010 Haiti earthquake disaster. J Am Med Inform Assoc. 2010; 17(6): 626-630. doi:10.1136/jamia.2010.004937.

State of Israel, Ministry of Health: Patient’s bill of rights. Available at https://www.health.gov.il/English/Topics/RightsInsured/Pages/patient_rights.aspx. Accessed January 28, 2019.

Merin O, Ash N, Levy G, et al.: The Israeli field hospital in Haiti—Ethical dilemmas in early disaster response. N Engl J Med. 2010; 362(11): e38. doi:10.1056/NEJMp1001693.

Baer B, Bhushan A, Taleb HA, et al.: The right to health of older people. Gerontologist. 2016; 56(Suppl 2): S206-S217. doi: 10.1093/ geront/gnw039.

Bothe DA, Olness KN, Reyes C: Overview of children and disasters. J Dev Behav Pediatr. 2018; 39(8): 652-662. doi: 10.1097/DBP.0000000000000600.

Shilkofski N, Agueh M, Fonseka M, et al.: Pediatric emergency care in disaster-affected areas: A firsthand perspective after typhoons Bopha and Haiyan in the Philippines. J Pediatr Intensive Care. 2017; 6(1): 19-27. doi:10.1055/s-0036-1584910.

Kelly F: Keeping PEDIATRICS in pediatric disaster management: Before, during, and in the aftermath of complex emergencies. Crit Care Nurs Clin North Am. 2010; 22(4): 465-480. doi: 10.1016/j.ccell.2010.10.005.

Bothe DA, Olness KN, Reyes C: FAAP† overview of children and disasters. J Dev Behav Pediatr. 2018; 39(8): 652-662.

Jin Y, Deng H, An J, et al.: The prevalence of PTSD symptoms and depressive symptoms and related predictors in children and adolescents 3 years after the Ya’an Earthquake. Child Psychiatry Hum Dev. 2019; 50(2): 300-307. doi:10.1007/s10578-018-0840-6.

Cheng J, Liang YM, Zhou YY, et al.: Trajectories of PTSD symptoms among children who survived the Lushan earthquake: A four-year longitudinal study. J Affect Disord. 2019; 252: 421-427. doi:10.1016/j.jad.2019.04.047.

Peek L, Stough LM: Children with disabilities in the context of disaster: a social vulnerability perspective. Child Dev. 2010; 81(4): 1260-1270. doi:10.1111/j.1467-8624.2010.01466.x.

Disaster Preparedness Advisory Council; Committee on Pediatric Emergency Medicine: Ensuring the Health of Children in Disasters. Pediatrics. 2015; 136(5): e1407-1417. doi: 10.1542/peds.2015-3112.

Ilan U, Davidov A, Mendlovic J, et al.: Disaster zones-should we be clowning around? Eur J Pediatr. 2018; 177(2): 247-249. doi: 10.1007/s00431-017-3018-5.

WHO: Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. Available at https://www.who.int/reproductivehealth/publications/violence/9789241548595/en/. Accessed August 9, 2020.

Bartels SA, Scott JA, Leaning J, et al.: Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo. Disaster Med Public Health Prep. 2012; 6(4): 393-401. doi:10.1001/dmp.2012.66.

Gyawali B, Keeling J, Kallestrup P: Human trafficking in Nepal: Post-Earthquake Risk and Response. Disaster Med Public Health Prep. 2017; 11(2): 153-154. doi:10.1017/dmp.2016.121.




DOI: https://doi.org/10.5055/ajdm.2021.0387

Refbacks

  • There are currently no refbacks.