Ambulance and Medical Team in Mass Action
The medical team is very much needed in maintaining health and safety in every mass action, especially the action with a high risk of riots as happened lately. In the perspective of the Medical Mass Gathering Management, the number of victims in a mass action coupled with the damage to the health team's facilities showed a lack of preparation and design of a medical team.
At least there are four important things that must be prepared carefully by the provider of the medical team to serve the crowd, especially the demonstration.
First, related to quantity and capacity. The number of medical teams must be in accordance with needs that can be calculated based on ten main variables, namely: type of event, estimated duration of the event, location profile, whether mass sitting or standing or moving, profiles of people gathered, number, history of similar events, conditions climatology, availability of dangerous goods, and profile of the referral hospital. Each of these variables has a certain value which, after scoring, will get its value. From this value we can determine the number and type of medical teams and all the facilities needed.
In the mass action after the KPU's decision, it was found that the duration of the event exceeded 12 hours, the location was open, the mass stood and moved, the age of children to adulthood, the number of thousands estimated, history of riots and casualties, hot weather conditions, the possibility dangerous like sharp weapons and stones, profiles of hospitals that can be mapped. When done scoring, the profile of the event with high scores is obtained, which means that it requires a large and structured medical team, which is a minimum of 15 ambulances and their support in each work cycle.
Second, related to competence and facilities. The more risky an event, of course the competencies and facilities possessed by each medical team are also more complex. In large and vulnerable riots, the type of transportation ambulance is not adequate. Ambulances that are assigned must be those who have the ability and facilities to carry out advanced life-saving or Advanced Life Support (ALS), for example having a breathing machine, monitor, logistics complete with personnel who can operate it properly.
As an example related to the May 22 action, along with the 15 ambulances I mentioned, at least 15 personnel who have ALS expertise and 120 volunteers with Basic Life Support competencies needed more than 12 doctors, 24 nurses, 3 field coordinators and 3 sets of supporting facilities such as the center other communication and logistics. With enough personnel deployed, it is necessary to arrange work schedules to keep officers in top condition.
Third, the coordination system and referral network. All the teams and health facilities that I roughly calculated were not enough if I just watched and worked in a scattered manner. The coordination system and structure must be developed in advance so that the work of the medical team is directed and effective. In addition, the placement of each medical team needs to take into account the situation and conditions in coordination with the security officer.
Not only with the internal medical team, the coordination system must also be built with other officers such as the security forces, firefighters, volunteer groups and network hospitals with the aim that each party recognizes the medical staff, the work system, and can work together. Network hospitals need to be prepared in such a way that they are ready to receive referrals. Coordination can lead to misunderstandings between institutions, it can even cause undesirable things like what happened yesterday, namely the destruction of a fleet of one humanitarian organization.
Fourth, procedures and ethics. The medical team must be strict in maintaining standard procedures that remain well implemented, both preparation procedures including risk assessment, coordination and communication procedures, and service procedures including referral systems to health facilities or hospitals. Can the medical team enter Hot Zone? Of course this must be agreed upon and prepared from the start with security officers. Officers and appropriate facilities to enter the area certainly have special specifications, specifically related to safety standards.
I pay special attention to medical ethics, especially in the political atmosphere where people experience wide divisions like today. Inevitably, each member of the medical team who is in charge of health services in mass action is very likely to have interest and attachment to certain political choices. This can lead to personal bias during the execution of tasks or some kind of conflict of interest. In conditions like this it is easy to violate medical ethics about political independence and neutrality. Therefore, the selection of each personnel should be applied, selected officers who have the minimum political attachment.
At least there are four important things that must be prepared carefully by the provider of the medical team to serve the crowd, especially the demonstration.
First, related to quantity and capacity. The number of medical teams must be in accordance with needs that can be calculated based on ten main variables, namely: type of event, estimated duration of the event, location profile, whether mass sitting or standing or moving, profiles of people gathered, number, history of similar events, conditions climatology, availability of dangerous goods, and profile of the referral hospital. Each of these variables has a certain value which, after scoring, will get its value. From this value we can determine the number and type of medical teams and all the facilities needed.
In the mass action after the KPU's decision, it was found that the duration of the event exceeded 12 hours, the location was open, the mass stood and moved, the age of children to adulthood, the number of thousands estimated, history of riots and casualties, hot weather conditions, the possibility dangerous like sharp weapons and stones, profiles of hospitals that can be mapped. When done scoring, the profile of the event with high scores is obtained, which means that it requires a large and structured medical team, which is a minimum of 15 ambulances and their support in each work cycle.
Second, related to competence and facilities. The more risky an event, of course the competencies and facilities possessed by each medical team are also more complex. In large and vulnerable riots, the type of transportation ambulance is not adequate. Ambulances that are assigned must be those who have the ability and facilities to carry out advanced life-saving or Advanced Life Support (ALS), for example having a breathing machine, monitor, logistics complete with personnel who can operate it properly.
As an example related to the May 22 action, along with the 15 ambulances I mentioned, at least 15 personnel who have ALS expertise and 120 volunteers with Basic Life Support competencies needed more than 12 doctors, 24 nurses, 3 field coordinators and 3 sets of supporting facilities such as the center other communication and logistics. With enough personnel deployed, it is necessary to arrange work schedules to keep officers in top condition.
Third, the coordination system and referral network. All the teams and health facilities that I roughly calculated were not enough if I just watched and worked in a scattered manner. The coordination system and structure must be developed in advance so that the work of the medical team is directed and effective. In addition, the placement of each medical team needs to take into account the situation and conditions in coordination with the security officer.
Not only with the internal medical team, the coordination system must also be built with other officers such as the security forces, firefighters, volunteer groups and network hospitals with the aim that each party recognizes the medical staff, the work system, and can work together. Network hospitals need to be prepared in such a way that they are ready to receive referrals. Coordination can lead to misunderstandings between institutions, it can even cause undesirable things like what happened yesterday, namely the destruction of a fleet of one humanitarian organization.
Fourth, procedures and ethics. The medical team must be strict in maintaining standard procedures that remain well implemented, both preparation procedures including risk assessment, coordination and communication procedures, and service procedures including referral systems to health facilities or hospitals. Can the medical team enter Hot Zone? Of course this must be agreed upon and prepared from the start with security officers. Officers and appropriate facilities to enter the area certainly have special specifications, specifically related to safety standards.
I pay special attention to medical ethics, especially in the political atmosphere where people experience wide divisions like today. Inevitably, each member of the medical team who is in charge of health services in mass action is very likely to have interest and attachment to certain political choices. This can lead to personal bias during the execution of tasks or some kind of conflict of interest. In conditions like this it is easy to violate medical ethics about political independence and neutrality. Therefore, the selection of each personnel should be applied, selected officers who have the minimum political attachment.
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