General Considerations for Disaster

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a. GENERAL CONSIDERATIONS
(1) Topic: Measures of Performance (MOP) and Measures of Effectiveness (MOE) (a) Discussion: During MEDCAP and DENCAP missions there is a need for an appropriate matrix to ascertain measures of effectiveness. Due to the fact that from one PHIBLEX to the next we do not revisit prior sites there is no way to adequately determine the measures of effectiveness that the MEDCAP/DENCAP had on the overall health of the population over a period of time. MOE’s in the Philippines are hard to determine because there is no one standard that can be applied to all locations in the Philippines. The fact that we do not do MEDCAP/DENCAP’s in the same location makes it near impossible to determine any measure of effectiveness from one MEDCAP/DENCAP to the next. The standard of medical treatment and documentation of care varies greatly in each Barangay. Some Barangay’s maintained filing systems similar to what we utilize in the U.S. military utilizing family name or some other unique identifier to document each patient encounter. Other Barangay’s had only a log book with names, dates and chief complaint’s. This makes it extremely difficult to obtain any individual or collective patient data. Inconsistency in patient documents also poses a threat to quality data collection. All Barangay’s that we trained at collected medical data and submitted it to the municipal health center in their prospective region. It was identified that medical history, diagnosis and treatment from local hospitals and their local rural health clinics is never shared between the two so both medical entities have incomplete medical history and data on the patients that they have seen. (b) Recommendation: Future missions must continue the development of a patient health record and data collection system. The MOE’s needed to demonstrate mission success requires greater understanding of the population’s needs and health promotion programs currently in place. This understanding will aid in selecting the appropriate data sets that allow us to demonstrate mission success. An individual or family patient health record will allow for more easily collectable data. It is recommended that a simple health record be developed to standardize demographic data, medical information and improve diagnosis and treatment of chronic illness affecting the area. Future missions consider Excel training and data entry to aid in this collection. Final Recommendation is provide basic medical gear and equipment i.e. baby scales, thermometers, stethoscopes, blood pressure cuffs and laptops for data collection. This gear and equipment could be obtained via Title 10 funds. (2) Topic: Training Host Nation medical personnel to conduct MEDCAP/DENCAP to the level that the U.S. Medical Forces. (a) Discussion: The Armed Forces of the Philippines have the potential to conduct MEDCAP’s/DENCAP’s at the same level as the U.S. forces during PHIBLEX and BALIKATAN. The biggest issue that they face is funding for medical medications. To be able to conduct a SMEE on the proper execution of a MEDCAP/DENCAP and then have them conduct the MEDCAP/DENCAP with U.S medical forces supporting will enable Philippine Military medical personnel along with local civilians to become comfortable conducting their own MEDCAP/DENCAP’s while U.S forces focus on more capacity building projects like medical facility renovations, health promotion training, disaster response, and equipment donation/training. (b) Recommendation: It would be extremely beneficial to the host nation populace if the U.S. Medical forces could focus on capacity building projects instead of MEDCAP/DENCAP’s. The problem with MEDCAP/DENCAP’s it two fold. First issue is that most individuals that receive medications from these types of missions do not take the medications the way that they are supposed to because either they start to feel better and want to save...
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