BASIC DISASTER MEDICAL SUPPORT COURSE – WORKSHOPS

Introduction

The City of Makassar neighbours the Regency of Gowa with a combined population of over 2,000,000 people.
These are the two most populous regencies in the province of South Sulawesi. The new Regent (Bupati) of Gowa
and the new Walikota of Makassar, together being concerned about the potential for disasters in their areas,
have together called for joint action to draw up a plan to deal with disasters occurring in any part of their
regencies. The Incident Manager for the area, Badan Penanggulangan Bencana Daerah (BPBD), has identified the
following planning scenario. As the Health Department for these two areas sit together, your task is to draw up a
medical support plan for the Operational Support Plan drawn up by BPBD.

Planning Scenario

A Boeing 747-400 from Salah Airlines carrying 300 passengers and crew misses the runway at Makassar airport
and lands near the junction of Jalan Salodong and Jalan Prof Dr Ir Sutami, hitting some buildings . A few
explosions were heard by the residents there and there are reports about people running out of the plane. Total
estimated casualties = 500

The BPBD was called to action and has established an outer cordon in an area 500 metres radius from the
junction mentioned. Inner cordon is 200 metres radius around the junction. It is estimated there are nearly 5,000
residents in that area. The number of casualties is unknown. BPBD is dividing the area into two sectors, divided by
Jalan Prof Dr Ir Sutami. The Health Departments of Gowa and Makassar have been asked to help provide medical
support.

Your tasks are given below.

WORKSHOP A:

1. Work out the requirements for medical support for the disaster in terms of care at the disaster site in
terms of medical teams, ambulances, sources of medical support
2. What arrangements would you make for the following:
a. on-site medical support (Team A)
i. Facilitator: Dr Gene Ong (Workshops A, B)
ii. Facilitator: Dr Wong TH (Workshops C, D)
b. evacuation arrangements (Team B) Facilitator: Dr Vincent Lum
c. hospitalization arrangements (Team C): Facilitator: Dr Lim Jia Hao
d. Logistics and Stretcher Plan (Team D) for the disaster: Facilitator: Dr Pek Jen Heng
3. Write out the Medical Support Plan for these in the following paragraphs:
a. Assigned Task
b. Resources available
c. Principal considerations
d. Options for support
e. Suggested plan
f. Written plan is to be submitted to BPBD Commander (Facilitator)
WORKSHOP B
You had previously never had to mobilize your healthcare resources to support a disaster. BPBD is
concerned that you will not be able to mobilize the resources required to support the disaster
management effort.

The health service facilities you have in your area of operations are as follows:
 Rumah Sakit Pendidikan Universitas Hasanuddin
 Rumah Sakit Dr Wahidin Sudirohusodo
 Rumah Sakit Kota Makassar
 Dinas Kesehatan Kota Makassar
 Rumah Sakit Syekh Yusuf
 Rumah Sakit Ibnu Sina
 Rumah Sakit Haji Makassar
 Rumah Sakit Bhayangkara Makassar
 Rumah Sakit Labuang Baji
 Rumah Sakit Pelamonia
 Rumah Sakit Stella Maris
 Rumah Sakit Salewangang
 Puskesmas Jumpandang Baru
 Puskesmas Kaluku Bodoa
 44 other Puskesmas
 Palang Merah Indonesia (PMI)
4. Work out the activation and mobilization plan in the following areas:
a. Activation and Mobilizaton Plan for manpower and logistics by a general hospital (Team A)
b. Activation and Mobilization Plan for manpower and logistics by Dinas Kesihatan Kota Makassar from
Puskesmas (Team B)
c. Activation and Mobilization for manpower and logistics by Palang Merah Indonesia local branches
(Team C)
d. Demonmstrate how you organize the mobilization of your hospital to support the disaster effort
using your team members as your recall and mobilization staff (Team D)
5. Your plan must address the following components:
a. Disaster field team personnel, logistics, vehicle and instructions for them
b. Staff needed to support your UGD, Operating Theatre, ICU, Disaster Ward
c. Staff needed to support casualties going to Puskesmas for urgent care
d. Show us what resources PMI can mobilize. Go through these step by step so that all can see how this
is done.
e. Team D to organize the Operations Room in the UGD to activate other hospitals and their own
hospital staff
f. What other resources would be available in these regencies that you can mobilize to address medical
support needs.
WORKSHOP C

The plan has been activated. The Medical Services were activated at 1000 hours. You are to report at the junction
of the two major, decide on where to set up your two First Aid Posts. You will then organize your medical teams
and set up the two FAPs, one in each sector. For methodical reasons the whole class will form one single FAP.
Your appointments are as follows:

i. Disaster Medical Commander with 4 staffEquipment to be carried by Teams

Facilitators
ii. FAP Comd Staff Aids Chart Board + Comms
Staff Aids Board Dr Wong TH
iii. FAP 2i/c with 2 staff
Comms
iv. Triage Point with 2 staff Triage cards, Airway, splint, CrepeDrBandages
Vincent Lum
v. P1 i/c with 4 staff P1 Bags with comms + SB Dr Lim JH
vi. P2 i/c with 4 staff P2 Bags with comms + SB
vii. P3 i/c with 4 staff P3 Bags with Comms Dr Pek JH
viii. Ambulance Point i/c with 3 staff Paper with hard file and comms +Dr asst
Gene
+ SBOng

6. Collect the equipment allocated to each of you and move into the FAP.
7. Report to your FAP Commander once you are ready
8. Casualties are already arriving even when the FAP is being organized. How do you handle this
9. The following reports must be presented:
a. DSMS Commander’s Initial Report (use map of area to denote locations of FAPs)
b. FAP Commander – how do you organize the area allocated to you
c. Triage point: how is the Triage point organized. Describe START triage system? How do you make use
of the members of your Triage Team? Show us how you use the Mettag card.
d. P1 I/C: How would you organize the P1 area. How will casualties be distributed within P1. What
problems would you anticipate? How do you release casualties to the Ambulance Point. How are
your supplies organized. How is your communications managed?
e. P2 i/c: How do you organize the P2 area. How will casualties be distributed within P2. How do you
release casualties to the Ambulance Point
f. P3 i/c: How do you organize the P3 area? The casualties are very demanding. How do you manage
them? You have a few acutely anxious and very demanding casualties. What do you do? Do you have
enough triangular bandages and wound dressings?
g. Ambulance Point I/C: How do you coordinate the transfer of casualties from the care areas to the
Ambulance Point? Do you have staff to take care of and monitor the sick casualties brought to the
AP. You need ambulances. How do you mobilize them? How do you organize the loading of
casualties into the ambulances? How many stretcher bearers do you need? Where do you get them
from? How do they report to you. How do you organize them? How many ambulances can you load
at any one time? will this affect the duration of stay of the P1, P2, P3 casualties at your FAP. How do
you use the Mettag Card? Do you know how many and where casualties have been evacuated to.
How do you report to your FAP Comd ?
h. FAP Commander: How do you maintain command and control over your FAP? Do you know what’s
happening in each of your areas? How do you address the problems that can occur in P1, P2, P3,
Triage, AP? What do you report to your Disaster Medical Commander? Do you have any shortfalls?
How do you know? Who helps you monitor? There are some casualties trapped in the danger zone
and need medical attention? What do you want to do?
WORKSHOP D:

10.Prepare 22 casualty cards.

a. Give 11 to each of the 2 teams with arrival times given and ask them to triage these giving reasons.
i. Priority 1 = 4 casualties
ii. Priority 2 = 6 casualties
iii. Priority 3 = 10 casualties
iv. Priority 0 = 2 casualties
b. Then ask each of the 2 teams to present how triage classification to be made
c. Teams should outline care of patient in the FAP
d. There are only 4 ambulances available, each capable of carrying maximum 2 stretcher casualties or 1
stretcher + 3 sitting casualties. How will evacuation be organized and prioritized?
e. State where to evacuate casualty and why
f. Ask the other two teams to comment on decision made
i. Team A comments on Team C
ii. Team B comments on Team D

11.Get the other two teams to describe how the medical bags and equipment will be organized. The objective
of this exercise is to address the following:

a. Each medical team from hospital has to come with one organized list of medical supplies and
equipment in organised format.
b. The equipment should be appropriately shared by all medical teams at the disaster site
 c. State how the equipment will be organized at the First Aid Post.
d. The teams should decide if the medical teams should be mobile (i.e. manpacked) or should use large
boxes of supplies with vehicles to transport, and give reasons for their choice.
e. Ask the other two teams to comment on each decision:
i. Team D to comment on Team A’s design
ii. Team C to comment on Team B’s design

12.Summing up of Workshop

Facilitation and Supervision Plan

a. Team A

i. Facilitator: Dr Gene Ong (Workshops A, B)

ii. Facilitator: Dr Wong TH (Workshops C, D)

b. Team B Facilitator: Dr Vincent Lum

c. Team C Facilitator: Dr Lim Jia Hao

d. Team D Facilitator: Dr Pek Jen Heng