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THE ROLE OF THE PHILIPPINE PHYSIATRIST IN A LARGE-SCALE NATURAL DISASTER THE PARM EXPERIENCE IN TYPHOON HAIYAN 8th International Society of Physical Rehabilitation Medicine World Congress Cancun, Mexico June 4, 2014 Ganchoon, FG, Martinez RR, Dy RT, Gosney JE

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Highest -intensity of a Category 5 tropical cyclone with sustained winds of 315 kph (above the 252 kph threshold for a Category 5 hurricane, the highest category on the Saffir-Simpson scale) -Reference: Meteomedia -storm surge recorded in East Asia of 9.14m due to strong winds, resulting in the majority of deaths due to drowning and catastrophic damage

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GUIUAN, EASTERN SAMAR AFP CENTRAL COMMAND November 8, 2013 First Landfall Guiuan, Easter Samar Population 47,047 (est)

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ANIBONG, TACLOBAN, LEYTE REUTERS/ROMEO RANOCO IMPACT Significant national impact: 6,268 confirmed deaths, 28,689 injured, and 1,061 missing, with 3.4 million families (over 16 million persons) affected in 44 provinces, 57 cities, and 591 municipalities. Reference : National Disaster Risk Reduction & Management Council (NDRRMC)

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PARM Philippine Academy of Rehabilitation Medicine Membership: 340 PMR Centers: 412 Chapters North Luzon (46) National Capital Region (178) Visayas (22) Mindanao (20)

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The Role of the Philippine Physiatrist in a Large-Scale Natural Disaster Provide descriptive epidemiology of Typhoon Haiyan Compare rehabilitation injury data from two affected populations Summarize aid missions conducted by PARM members in the primarily-affected Visayas region Describe the strategic development of PARMs disaster rehabilitation program Elaborate the potential role of a local physiatrist in a large-scale natural disaster using the example of the Philippine physiatrist in Typhoon Haiyan

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Medical Missions Conducted by PARM CARES (Nov 2013 Feb 2014) NCR (Manila) Philippine Orthopedic Center Villamor Airbase Region VI Antique Capiz Iloilo Lakawon Island Northern Negros Occidental Region VII Northern Cebu Bantayan Island Region VIII Leyte Ormoc 23 MISSIONS 31,609 kits distributed 7035 patients served

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PM & R CONDITIONS EVALUATED IN PHILIPPINE ORTHOPEDIC CENTER (POC) (NOV 10, 2013 DEC 18, 2014)

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TABLE 1: PM & R Conditions Evaluated at Philippine Orthopedic Center (POC) (November 10, 2013 - December 18, 2013) DiagnosisNumberTotalPercentage of 79 Persons Percentage of 125 Conditions MSK 7392%58% Fractures 6886%54.4% Upper Limbs16 Ribs8 Spine18 Pelvis4 Lower Limbs22 Amputations (Traumatic) 22%1.6% Other MSK Conditions 34%2.4% Soft Tissue Injuries 1924%15.2% Wound/Skin Infections 1519%12% Neurological 1823%14.4% TBI2 2.5% 1.6% SCI15 19% 12% Ulnar Neuropathy1 1.3% 0.8% Total125

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23 RELIEF & MEDICAL MISSIONS OF PARM CARES (NOV 10, 2013 FEB 18, 2014)

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TABLE 2: PARM CARES Missions (Nov.10, 2013 Feb. 18, 2014) DateLocationMission TeamRelief KitsPatients Served November 10 Brgy Tapilon, Daan, Bantayan; Northern Cebu PARM(V)/Cebu (40 MDs, AMRO) 500 300 November 12 Brgy (4), Cadiz City; Brgy (4), Sagay City; Northern Negros PARM(V)/Bacolod (1MD, 30 Volunteers) 3000 November 15-17 Brgy Libertad, Cagbuhangin,Mabato, Linao, Valencia; Ormoc City; Leyte PARM(V)/Ormoc (3 MDs, 5 nurses, 12 HWs, HELP for Ormoc) 3500 2000 (Brgy Libertad) November 17-30 Villamor Air Base, Manila; Luzon PARM National420 December 28-29 Brgy Marasbaras, RTR; Tacloban, Leyte PARM CARES (National) ISPRM (12MDs, 30 HWs) 2000 (Brgy Marasbaras, RTR ) 50 (children (ASP, Tacloban) 400 February 17 Tent City, San Jose; Tacloban, Leyte Abuog General Hospital, Abuog; Franciscan Clinic, Baybay; Leyte PARM( CARES (National) (6 MD, 40HW, ISPRM, PAPA) ISPRM, PFP, PSPO 1300 1085 (basic needs/medical screening survey) 16 (P&O evaluations) February 18 Burauen, Leyte RTR, Tacloban, Leyte PARM CARES (National) PAPA ISRPM, PFP, PSPO 288 (basic needs/medical screening survey) 283 (344 diagnoses) 1 (P&O) Total Missions23 31,609 kits distributed 7035 patients served

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PARM CARES MEDICAL MISSION TO BURAUEN, LEYTE (FEB 18, 2014)

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Clinical First Responder Triage/ER Inpatient and Outpatient Rehabilitation Medical Mission Volunteer Provider Trainer Physiatrist Roles in Disaster Response Non-Clinical Rehabilitation Needs Assessor Medical Mission Volunteer: leader, coordinator, relief distributor Trainer Disaster Rehab Program Developer Researcher

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International Society of Physical Rehabilitation Medicine (ISPRM) Japan Association of Rehabilitation Medicine (JARM) Korean Academy of Rehabilitation Medicine (KARM) Royal College of Physiatrist of Thailand (RCPT) Philippine American Physiatrist Association (PAPA) World Rehabilitation Fund (WRF) United Auburn Indian Community Tribe (UAICT) Philippine National Day Association (PNDA) All Donors and Volunteers

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MARAMING SALAMAT (Thank You) MERON BA KAYONG TANONG? (Questions?)

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