This initiative was supported by the regional Ministry of Health and was initially targeted towards the management of mass casualty incidents, following principles described in MIMMS training and the Framework for Emergency Management. The first visit was focused on delivery of training to 120 local healthcare staff. In addition presentations were made at the Police HQ to senior operations officers as well as first aid courses run in the evenings for staff from a local hotel. This hotel was partially destroyed by a large truck bomb some time later, resulting in a number of fatalities and large numbers of injuries.
Exercise/Car Bomb Incident.
A mass casualty exercise was also conducted, feeding patients directly into the Emergency Department of Lady Reading Hospital, thereby testing both the pre hospital and the hospital capacities.
The city of Peshawar is close to the Afghan border and also the tribal area of Khyber, leaving the city familiar with car bombs and IED attacks. Within a week of one training visit the Lady Reading Hospital dealt with a car bomb incident less than half a kilometre from its doors, resulting in a number of fatalities and over 60 casualties arriving unannounced at the ED. Staff utilised the provided training as though the ED was the site of the incident and found benefits in the preparations.
In all there have been three further visits to Peshawar to deliver a range of training, including further mass casualty training, First Responder training, instructor training and resuscitation training which was delivered in association with staff from Cavan General Hospital.
Disaster Relief by Irish and Pakistanis (DRIP)
Following the first visit to Peshawar, NASC was contacted by a number of Pakistani Doctors who are currently working in Ireland. This meeting led to a programme which is supported by NASC personnel utilising annual leave, along with a number of Pakistani Doctors who are employed in the Irish Health System, many of whom are part of an organisation called Disaster Relief by Irish and Pakistanis (DRIP). This organisation was established in Ireland following the earthquake that occurred in northern Pakistan in 2005.
Drip Projects - CFR
The programme has overseen the development of a number of projects. One project involved the development of a Cardiac First Responder faculty in the Azad Jammu Kashmir province initially followed by an expansion to other provinces including Punjab, Sindh, Balochistan and Khyber-Pakhtunkhwa over time. This initial Pakistani faculty offers a sustainable option in the provision of Basic Life Support training to the Pakistani Healthcare Community. Recently the Ministry of Health for the Punjab province, with a population of 86 million, has accepted CFR as an integral element of all medical, nursing and paramedical education. The CFR project is working to meet the demands of such a significant body of training.
||Drip Projects - CFR (Continued)
Training initiatives ranges from healthcare training to community training in rural areas. Over 3000 people have been trained since 2008 in basic life support, including first aid training in a mixture of setting using both certified and uncertified training courses.
Partnership - CFR/EFR
In 2010 a partnership was developed between NASC, DRIP and the University of Health Sciences in Lahore which resulted in the formal introduction of CFR programmes into Medical, Nursing and allied healthcare education programmes throughout the Punjab. Following development of the earlier CFR faculty a small EFR faculty was subsequently developed to assist two of the biggest ambulance providers, Recue 1122 and EHDI Ambulance Service, in building a capacity to train their staff. This programme has been accredited and supported by PHECC where appropriate. EDHI opened their first ambulance training school in Lahore in 2010 and have begun to run CFR and EFR level training for some of their 4000 volunteers and staff who operate ambulance services in remote and rural areas of Pakistan, as well as many of the cities, including some that are within the tribal areas.
University of Health Science (UHS)
In 2011 personnel from NASC and UCD assisted in the delivery of immediate caretraining for Doctors and other healthcare professionals, facilitated through the UHS. A local faculty was developed to ensure ongoing training for healthcare professionals. This initiative led to a range of discussions that are on-going between governance and educational organisations in both countries. A visit to Ireland late last year by the College of Physicians and Surgeons of Pakistan explored opportunities for medical education of students and also opportunities for medical students and post graduate interns.
In 2012 the University of Health Science will commence running an Emergency Medical Technician programme in association with the National Ambulance Service College and its Pakistani Partners. A future article will outline this programme which reflects the PHECC EMT Standards but has been extended to take into account local health needs.
NASC personnel and other Irish healthcare educators have been visiting Pakistan in a voluntary capacity on a number of occasions each year since the first visit in 2007. The programmes have principally been supported locally through the work of Disaster Relief by Irish and Pakistanis and local health organisations. Throughout all of the visits over the last five years the visitors have been offered enormous hospitality and life time friendships have developed. Whilst security issues do need to be considered the people of Pakistan and Ireland have more in common than might first be obvious and Irish personnel have been warmly received. Very few who have visited Pakistan once have not revisited this exciting and diverse county. It is most likely that the current programmes will continue for many years to come with all involved learning from each other, so that services in both countries may learn and develop.