Emergency Medical Teams (EMTs) are often the first responders when a disaster or outbreak hits – deploying immediately to provide high-quality medical care in affected areas. To be able to do this, EMTs must be equipped, trained and coordinated. In Pacific island countries and areas (PICs), establishing national EMTs is a critical part of country preparedness and response for a wide range of hazards.
“When a crisis strikes, Emergency Medical Teams rapidly deploy to wherever they are needed and provide crucial clinical care. In the Pacific, we are seeing worsening natural disasters due to climate change and the emergence of infectious disease outbreaks such as measles, dengue and now COVID-19. Having well-prepared and well-equipped EMTs ready for immediate deployment can make the difference between life or death,” explained Sean Casey, World Health Organization’s (WHO) EMT Focal Point in the Western Pacific Region and Pacific COVID-19 Incident Manager.
Throughout the COVID-19 pandemic, national EMTs in the South Pacific have contributed to clinical and public health response efforts. But even before COVID-19, Pacific island countries had been investing in national EMT capacity, with the support of WHO and the Governments of Australia, New Zealand, and the United States.
Harnessing global expertise and standards
Since 2017, experts from WHO, the Australian Medical Assistance Team (AUSMAT), and the New Zealand Medical Assistance Team (NZMAT) have joined forces to provide technical support and hands-on training to Pacific Emergency Medical Teams, applying established global EMT standards to ensure that all teams are prepared to provide high-quality medical care in the most austere and remote settings as part of an outbreak or disaster response.
EMTs are comprised of multi-disciplinary health professionals from doctors, nurses, and pharmacists, to logisticians and administrative support. With team members trained, national EMT rosters are developed and maintained, ensuring that teams are always ready to deploy the right personnel with the right skills at the right time.
“The people are the lifeblood that makes up the emergency medical teams, so they must be provided with the training and equipment that they need to be able to do their job,” said Casey.
Equipping national EMTs
To provide the highest level of care and to avoid becoming a burden on crisis-affected communities, EMTs must be self-sufficient when deployed. They must be able to bring their own accommodation and food, be able to provide water for patients and staff, be able to communicate when phone and internet networks are down, and have everything they need to provide high-quality medical care in places where local clinics may have been destroyed.
All EMTs maintain a ‘cache’ of critical equipment and supplies to allow them to provide the highest standard of care when almost nothing is available locally. EMT cache typically includes a wide range of items like tents, tables and chairs, collapsible beds, food stocks, water treatment systems, cleaning supplies, medicines, medical devices, generators, communication equipment and office supplies, among many other items. This cache must also be light and compact enough to send to remote Pacific islands on small aircraft or seacraft.
National EMTs in the Pacific have been equipped by leveraging national resources and equipment/supplies through partners like WHO, Australia and the United States. Pacific EMT cache is carefully planned to ensure that patients can be well cared for, that deployed staff are able to meet their basic needs, and to be sure that the equipment and supplies can be sent on local transport with just a few hours’ notice.
The Fiji Emergency Medical Assistance Team (FEMAT) setting up an intermediate care facility for COVID-19 in Suva.
Deploying teams across the Pacific
National EMTs have proved to be crucial in deploying surge capacity for COVID-19 and in other emergencies in the Pacific.
To date, EMTs have been established in a number of Pacific countries and areas: Cook Islands Medical Assistance Team (KukiMAT), Fiji Emergency Medical Assistance Team (FEMAT), Solomon Islands Medical Assistance Team (SOLMAT), Tonga Emergency Medical Assistance Team (TEMAT), and Vanuatu Medical Assistance Team (VanMAT). Teams are currently in development in several other PICs, including Kiribati, the Republic of the Marshall Islands, Federated States of Micronesia, Commonwealth of the Northern Mariana Islands, Palau, Papua New Guinea and Tuvalu.
Pacific EMTs have been deployed to support national and international emergencies since 2019. The Fiji Emergency Medical Assistance Team (FEMAT) has deployed for the measles outbreak in 2019 in response to multiple tropical cyclones, as well as for COVID-19. The Solomon Islands Medical Assistance Team (SOLMAT) has deployed as part of the national response to an oil spill and for COVID-19 at the national level, in addition to an international deployment to support Samoa’s measles response. The Vanuatu Medical Assistance Team (VanMAT) led the health response to Tropical Cyclone Harold in 2020. When the COVID-19 pandemic struck in 2020, EMTs in Tonga and the Cook Islands also supported national preparedness and response efforts, including for clinical surge, repatriation and quarantine support, and vaccination. COVID-19-related deployments have been ongoing throughout 2021.
Vanuatu Medical Assistance Team (VanMAT) provide medical assistance during an outreach activity. Photo: WHO/P. Metois
Tapping local knowledge and experiences
In-person training for Pacific EMTs has proved to be challenging due to the travel restrictions introduced by many countries to prevent the spread of COVID-19. To meet the demand for the training and to encourage more Pacific countries to develop their own national EMTs, WHO and its partners recently have provided substantial remote support to Pacific EMTs, including through an 11-week online webinar series in 2021.
“The goal of the webinar series was to go over the key concepts with current and prospective teams across the Pacific and to share ideas and best practices,” explained Anthony Cook, EMT Consultant at the WHO Representative Office for the South Pacific. “The webinar series included technical briefings on specific topics, but also included talanoa sessions – the Pacific way of sharing stories and having a discussion. And in every webinar session, Pacific EMT leads and team members provided guidance to their Pacific counterparts around EMT development and operationalization in the small island context.”
“It was great to go through the webinar series and for KukiMAT to be included as we are still developing the team in the Cook Islands. It made sense to see what other Pacific countries went through with their own health emergencies and how they approached it for their country context,” said Mary Kata, Chief Nursing Officer at Te Marae Ora - Cook Islands Ministry of Health. “We extracted the bits and pieces that we can apply in our context when the time comes that we are faced with an outbreak.”
Presenters and participants discuss during the webinar series.
Looking ahead for EMTs in the Pacific
While training and technical support continue to be provided remotely, once travel restrictions are eased, WHO and partners plan to re-start face-to-face trainings and simulation exercises with Pacific EMTs. In addition, the procurement of equipment and supplies for new and existing teams is ongoing. In the coming years, more Pacific island countries and areas will be developing national EMTs, further expanding the initiative in the region.
Palau Ministry of Health’s Professional Development Coordinator Sunshine Garcia shared the plans for the EMT in her country: “We would continue with training across the board with all our first responders to better improve our emergency response to dealing with various casualties and provide more community awareness on how to be better prepared.”
“COVID-19 has highlighted the importance of preparedness for health emergencies. Pacific island countries had the foresight to invest in health security early and we can see how this investment has saved lives and will continue to be useful for the future. We are grateful to our Ministry of Health colleagues for their commitment and to our donors – the Governments of Australia, New Zealand, and the United States – for supporting the EMT initiative in the Pacific,” said Dr Mark Jacobs, Director of Pacific Technical Support and WHO Representative to the South Pacific.