Critical Care Disaster Foundation

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About The Critical Care Disaster (CCD) Foundation

In this picture:

Members of the CCDF in the Dominican Republic

 

 

The Critical Care Disaster Foundation ("CCD Foundation") was founded in 2010 with two purposes:

1.  To educate in-country healthcare providers from developing countries in disaster and crisis medical management; and

2.  To develop an infrastructure of critical care services empowering local institutional organizations and governments in the event of a disaster or humanitarian crisis.

     The CCD Foundation seeks to enable readiness and preparedness among healthcare institutions and providers in developing countries either before disaster strikes or immediately after an event has occurred.  The programs of the CCD Foundation are intended to cover a complete spectrum of medical care and health management along a continuum from prevention and mitigation to response and recovery.
 
Background
 

     Dr. Marie R. Baldisseri, M.D. founded the CCD Foundation after many years of humanitarian mission work throughout the world.  Her efforts were joined by several professionals with critical care medicine, disaster management and community advocacy experience.  These supporters, who comprise the initial board of the CCD Foundation, also have contacts as some of the highest levels of world-wide and localized disaster relief, public health and security organizations.  They have worked with, among other organizations, the Red Cross, the FBI, the United Nations, the U.S. Department of State, U.S. AID and the U.S. Office of Foreign Disaster Assistance.  They are often called upon as experts when disaster strikes or to provide contingency planning in potential crisis situations.  Examples of the latter include the Pan American Games and the Dominican Republic Presidential Transfer of Power Ceremonies.
 
     Dr. Mary Jane Reed has worked with Dr. Baldisseri for many years in providing humanitarian assistance for Project Hope South America, Project Africa in Switzerland and most recently for the January 12, 2010 earthquake in Haiti.  They joined this effort at the request of Dr. Alejandro Baez from the Dominican Republic who was working under the auspices of the United Nations and the Pan American Health Organization.  As members of the Society of Critical Care Medicine, they taught disaster medical management to the local healthcare providers in the Dominican Republic who were experiencing a tremendous influx of serious and critically ill patients from Haiti.  The physicians also helped to organize a current infrastructure in the Dominion Republic designed to build on and expand existing critical care services, first, to accommodate the tremendous influx of earthquake survivors, and secondly, to leave a lasting improvement in place.
 
     Since this first effort, Drs. Baldisseri and Reed have been actively working with Dr. Baez on a project partly funded by the Pan American Health Organization called the "Bed Augmentation Critical Care" (BACC) project.  The project involves the teaching of local doctors and nurses in a small intermediate care/intensive care unit at the Jaime Moto hospital in Barahona, Dominican Republic coupled with an upgrade of intensive care ("ICU") equipment.  The project has led to the expansion and effectiveness of this hospital's ICU, not only for the recent treatment of Haitian patients, but for the creation of a long-standing site with optimal critical care resources.
 
     The positive outcome of the efforts in Barahona underscore the fact that education is a valuable component in disaster medical management performance.  Although many nongovernment organizations ("NGO's") exist which offer and deliver valuable and necessary medical and surgical assistance in the event of disaster, very few NGO's are devoted solely or even largely to education.  Education is key to maintaining the longevity of critical care services and for creating the infrastructures that allow developing countries to be better prepared in the event of disasters or humanitarian crises.
 

Goals for Present and Future Activities

     The CCD Foundation will begin its nonprofit activities by building upon the experiences of its initial Board of Directors in medical disaster preparedness.  It will promote two goals:  education and critical care services infrastructure development.
 
Education
 

     Because of well-learned lessons from the Haitian earthquake disaster of 2010, two initial courses will be taught to healthcare providers in deveolping countries.  Both of these courses are copyrighted by the Society of Critical Care Medicine.  Drs. Baldisseri, Jimenez, and Reed helped to design and create these courses with other members of the Society.  The courses are called the Fundamentals of Critical Care ("FCCS") course and the Fundamentals of Disaster Management ("FDM") course.  These courses together teach healthcare providers how to deal with seriously ill patients and how to cope with patients in the face of a crisis.  Ideally, these courses will be taught by the CCD Foundation before a calamitous event occurs, but the courses can be taught, as well, after such an event occurs.
 
     In the first year of the CCD Foundation's activities, it is anticipated that one to three week-long training sessions can be held.  Instructors will provide the time and expertise, paying for their own expenses and being reimbursed by the CCD Foundation.  In subsequent years, two to five week-long FCCS and FDM courses per year will be taught.  This number may increase depending upon demand.
 
     Courses in Basic Life Support (BLS), Advanced Life Support (ALS) and basic monitor and EKG-reading courses will also be used to teach both nurses and physicians.  All of these courses are designed to educate a critical cadre of nurses and physicians who will then in turn teach other local and regional healthcare providers.  This group of local experts are expected to become a stable force in areas where disasters are prone to occur, often rural areas where professionals trained at large university healthcare centers are a rarity and where nurses and physicians are often ill-prepared to manage seriously and critically ill patients.
 
     The normal course of activity for a seriously ill patient in such an area would be a transfer to the more plentiful and higher levels of care available in larger cities.  However, this scenario usually collapses during a crisis or disaster.  In a crisis, patients need to be treated immediately for wounds and injuries and there are scarce resources to handle the transfer of multiple patients.  Receiving hospitals are often already full and unable to accept more patients.  Even if transportation is available, an immediate need to stabilize patients is essential.
 
     A large-spread educational effort to educate healthcare professionals in all areas of developing countries can prevent much loss of life and function following a disaster or crisis and can better the healthcare services left in place following training.
 
Critical Care Infrastructure Development

     Most developing countries have a poorly equipped or nonexistent infrastructure of critical care services able to respond to catastrophic disasters and humanitarian crises.  The far reaching contacts of Dr. Baldisseri and the Board of Directors of the CCD Foundation will continue to work with local, regional and national organizations, institutions and governments to augment any existing services.
 
     As a model of how the CCD Foundation can be effective in critical care infrastructure development, Drs. Baez, Reed and Baldisseri recently met with regional and national leaders to augment efforts designed to increase critical care units ("ICUs") and intermediate level care units ("IMCUs") that were completely overwhelmed in the Dominican Republic during the 2010 Haitian earthquake.  There are currently less than 100 ICU beds available to serve 10 million Dominican residents.  The physicians were able to effect some positive change.  The CCD Foundation plans to repeat and improve upon the model used in the Dominican Republic in their attempts to help others bolster critical care infrastructure.
 
Sumary
 
     All members of the Board of Directors of CCD Foundation, including Drs. Baldisseri, Reed, Jimenez and Baez, have numerous personal, societal, national and international associations and contacts which will allow them to create a large workforce of volunteer educators, able to help communities in developing countries solve the problems associated with disaster and crises.  They also have first hand knowledge and experience.  This circle of influence and expertise will allow the CCD Foundation the opportunity to make contact with key regional and national leaders before and during times of great need.
 
     The World Federation of Societies of Intensive and Critical Care Medicine ("WFSICCM"), headed by Dr. Jimenez and the Society of Critical Care Medicine (SCCM) also have extensive international contacts.  These organizations will closely work with the CCD Foundation.  The WFSICCM and the SCCM are always contacted in the event of a disaster and will promote the CCD Foundation as a means for world communities to respond to disasters and humanitarian crises with educational tools and critical care capacity building strategies.