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Georgia: getting medical care to isolated people in and around Gori

28-08-2008 Interview

The ICRC is actively working throughout Georgia to meet the needs of tens of thousands of people displaced or isolated by the armed conflict. Most recently, a mobile health clinic was set up and sent out to remote villages around the Georgian town of Gori and treated over 80 primarily elderly patients. Interview with an ICRC surgeon, Marco Baldan, who has just returned from Georgia.


  Marco Baldan    
     What was the health care situation like in the early days of the conflict, when you first arrived?  

The Georgian authorities had put in place an efficient strategic plan with regard to medical needs. Local ambulances were used to transfer the bulk of patients, who had been wounded in the fighting, from Gori to Tbilisi, although in the first few days it was difficult for them to move around bec ause of the insecurity. The Gori main hospital kept functioning as a first aid post, with a reduced number of staff whose task was to stabilize emergency patients prior to referring them to Tbilisi. The hospital director confirmed they could manage in terms of staff, so no additional doctors or nurses were needed, but they lacked medical supplies so we promptly provided them with war wounded kits.

We had been informed by authorities in Gori about wounded and sick patients, as well as dead bodies, in some villages near South Ossetia, but it was practically impossible to reach these people in the early days of the conflict, due to the insecurity.

A similar first aid post and referral setup was put in place in western Georgia using Kutaisi as the reference hospital.

 What's in a war wounded kit?  

Each kit has all the medical supplies needed to surgically treat 50 seriously injured patients, including'front line'injuries such as bomb and bullet wounds.

The kits include antibiotics and analgesics, gauze and bandages, plaster of Paris, intravenous fluids, a variety of drains, disinfectants, syringes, needles, surgical gloves and sutures, urinary catheters and drugs for anaesthesia. Supplementary sets are available, depending on specific needs, containing additional laboratory and blood transfusion reagents and apparatus, x-ray supplies, tetanus vaccine and immunoglobulins, special drugs and devices for anaesthesia.

The kits have been designed based on more than 20 years of experience and the treatment of over 100,000 war wounded patients at ICRC hospitals in different contexts across the globe.

 During a conflict of this type, how do the medical needs evolve after the initial emergency phase?  

From what I saw in Georgia, the vast majority of bomb and bullet injuries were rapidly treated and evacuated to referral hospitals in cities unaffected by the fighting. A large part of the population, who were willing and able to flee their homes, moved southward towards Tbilisi. Among them were children, pregnant women and elderly people in need of access to safe water, food, shelter and basic medical care. Providing assistance and health care to displaced people in the collective centres or shelters has been a top priority for the ICRC since the conflict broke out.

From what we could see in Gori, those who remained behind were for the most part elderly. Some of them need treatment for chronic illnesses, such as hypertension, diabetes, and heart disease. They had no access to the town pharmacies as these were closed. In addition, when people fled, they took their cars so many older people, who rely on their relatives to take them to the doctor, still have no way to get to the hospital or health facilities in Gori. Reaching out to these isolated elderly and chronically ill people is a key function of the mobile health clinic.

We're also responding to requests for supplies of medicine to treat these diseases.

 Did the ICRC deploy any field hospitals during the conflict?  

Not long after the crisis started, the Norwegian Red Cross sent a team of medical staff and a field hospital to Georgia as part of the ICRC's rapid deployment system. Over the past couple of weeks, the team has been helping with everything – from evaluating hospital conditions to distributing assistance at the collective centres.

It was really great to see everyone roll up their sleeves, pitch in together and help out in any way they could. It shows just how important it is to work together in an emergency. Now that we have a better sense of the needs in the isolated villages, the Norwegian team is forming part of the mobile health clinic in Gori. The local authorities were very positive about the idea of a mobile health unit for areas that their ambulances can't reach, so we're pleased that the clinic was able to get up and running earlier this week.