After returning from a medical relief trip to Haiti four years ago, Bob Norris, MD, and Paul Auerbach, MD, recognized the need for an international medical response team that could deploy rapidly. Although Norris and the seven other SHC doctors and nurses who joined him in Haiti were among the first international medical responders to arrive, three days elapsed between the quake and their departure for the island. Norris wondered: What if they had been able to get there even a day or two earlier? How many more people would have survived?
Those nagging questions led Norris and Auerbach to develop the Stanford Emergency Medicine Program for Emergency Response (SEMPER). "We recognized the need for a small, nimble team — one that stayed in a state of readiness with pre-planned equipment and pharmaceuticals so it could be out the door within six hours," says Norris.
Today, SEMPER has 50 volunteers, all of whom use their own paid time off to train and deploy. The SEMPER program holds regular training workshops that allow its members to develop and hone the skills needed to treat large numbers of victims in the austere, chaotic environment of a disaster area. The team also participates in two local and one state disaster drill each year, and keeps pre-packed bags of medical supplies and pharmaceuticals ready at all times.
Many members of the SEMPER team are also volunteers with federal disaster relief programs such as the FEMA Urban Search and Rescue Team (USAR) and the Disaster Medical Assistance Team (DMAT). In the event of a national disaster, a number of SEMPER volunteers would respond individually as part of their federal affiliation rather than through SEMPER.
"It's hard to quantify SEMPER's value to the organization," says Colin Bucks, MD, associate director of SEMPER and clinical assistant professor of emergency medicine. "But I believe having people trained in this regard makes the institution stronger." A lot of people who deployed to Haiti or worked with SEMPER were in the emergency department the day of Asiana 214, he recalls. "You can't quantify what it is to have those folks working at that time. These are the people you want on your side when an earthquake happens."
Ready to deploy
When Norris and Bucks get the call to help an international relief effort, assembling a team of ten can be tricky. "We need a balanced set of medical skills, disaster experience and cultural knowledge, and then we have to identify who is most available," says Bucks, who is also assistant medical director for the Office of Emergency Management. The call for help is usually for more than one deployment, he adds, and the percentage of people who are actually available to drop everything and go at any given time is probably just 20 percent.
SEMPER is looking to round out its volunteer pool with additional physicians such as surgeons (trauma, general and ortho), OB/GYNs, pediatricians, internists and critical care specialists. Although first deployments will be primarily staffed with emergency medicine specialists, subsequent teams will need to have varied medical skills, and may even be asked to help staff the International Medical Corps trauma field hospital, which is on the ground in Idaho but ready to deploy anywhere.
"The deeper the bench, the more likely we are to fulfill a request from our partners at any given time," says Bucks. "Having the ability to send a group out and be prepping a second group to go in and replace them is very beneficial."
Last year's deployment to the Philippines was SEMPER's first official mission since its creation, and it differed from traditional medical relief because the team saw very little major trauma. Instead, the SEMPER crew provided support to the disrupted health care system, giving the local staff the opportunity to recover and regroup. "We set up underneath tarps in front of their clinics and took care of their patients," says Bucks, who estimates that the team saw more than 4,500 patients in just eight days.
For more information about SEMPER, go to http://semper.stanford.edu/.
By Grace Hammerstrom