With the help of local residents, Dr. Karch (left) rescues an injured patient who was trapped on the side of a mountain after a 2015 earthquake in Nepal.
Courtesy of Omar Havana/International Medical Corps


Published 7/1/2017
Maureen Leahy; Crystal A. Wells

Wanted: Disaster-Relief Orthopaedists

International Medical Corps seeks volunteers
Orthopaedic surgeons are often among the first to respond when a disaster occurs and massive relief efforts are needed. In the wake of the Haiti earthquake in 2010, for example, more than 500 AAOS members volunteered their services and many were on the ground within 48 hours. This unparalleled response led to the creation of an AAOS formal disaster preparedness plan designed to enable an effective and efficient volunteer response when future disasters strike.

Around the same time, the AAOS also began collaborating with International Medical Corps, a global humanitarian nonprofit organization founded in 1984 by an emergency physician and other healthcare providers, including an orthopaedic surgeon. Over the years, International Medical Corps has expanded its ability to provide health care on the frontlines of multiple crises. As a result, it is looking to bolster its roster of nearly 300 emergency medical professionals. In particular, the organization is seeking volunteers from among AAOS-registered disaster responders.

Answering the call
According to International Medical Corps, disasters—both natural and man-made—are on the rise and affect approximately 217 million people each year. Moreover, 75 percent of survivors' injuries are orthopaedic in nature, explained Michael M. Karch, MD, who began volunteering with International Medical Corps 2 years ago. "However, all our years of study to become orthopaedic surgeons do not prepare us to manage mass casualties. The onus for caring for these patients is on us, yet we haven't been properly trained," he said.

It was this realization that inspired Dr. Karch to study mass casualty management—and to deploy as a volunteer healthcare provider to war zones and natural disasters around the world. In April 2015, following a devastating 7.8-magnitude earthquake in Nepal, he was asked to join International Medical Corps' emergency response team. He was on a plane to Kathmandu that same day and spent the next few weeks leading the organization's search-and-rescue efforts by helicopter to earthquake-shattered villages deep in the Himalayas.

One of those mountain villages is Laprak, located 9 hours from the closest road. Dr. Karch and a fellow responder were the first medical personnel to reach Laprak, arriving 9 days after the quake. One of the most critically injured survivors was a male villager who had sustained a spinal injury and was trapped some 2,000 feet down the mountain. After traversing rough terrain for close to an hour, Dr. Karch and his colleague reached the man and managed to transport him back to the helicopter. "It was a remarkable experience—very quickly two people turned into four, then four turned into eight, and soon we had a whole village carrying this man up the mountain," recalled Dr. Karch.

As the rescue in Laprak illustrates, disaster-relief physicians provide more than simple medical care, according to Dr. Karch. That's why much of his time in the United States is dedicated to working with medical practitioners to share what he has learned through years of disaster management study and on-the-ground experience. Every year he also offers an intensive 3-day course on international disaster medicine in austere environments through a charity he co-founded, as well as the lecture series "Mass Casualty, Mass Shootings, and Terrorist-Inflicted Injury Patterns for the Orthopaedic Surgeon."

"We are only in these areas for a few weeks, but the locals spend years rebuilding their communities and putting their lives back together," said Dr. Karch. "We need to help them jump-start those efforts."

With the help of local residents, Dr. Karch (left) rescues an injured patient who was trapped on the side of a mountain after a 2015 earthquake in Nepal.
Courtesy of Omar Havana/International Medical Corps
International Medical Corps' emergency response field hospital can be deployed within 24-48 hours of a natural disaster.
Courtesy of International Medical Corps
Dr. Karch in Nepal after the 2015 earthquake.
Courtesy of Omar Havana/International Medical Corps
International Medical Corps' emergency response field hospital includes a fully functioning operating room.
Courtesy of International Medical Corps

Improving access to emergency care
Since its inception, International Medical Corps has provided aid in more than 75 countries on six continents, treating approximately 8.4 million people directly and an estimated 52.5 million indirectly in one year alone. One of its more recent initiatives, conceived in the aftermath of the 2010 Haiti earthquake, is the development of an emergency response field hospital.

The 66-bed hospital is made up of 12 modular shelters and includes a fully functioning emergency room, operating room, intensive care unit, recovery unit, radiology unit, pharmacy, and laboratory. It deploys with sufficient equipment and supplies, including medicine, food, water purifiers, tents, generators, communication equipment, and basic necessities to be self-contained for approximately 4 weeks. The hospital is also equipped with documentation and data collection systems as well as sanitation and hygiene systems.

The first 72 hours following a disaster are the most critical for patients; however, local hospitals can easily become overwhelmed and understaffed. The emergency response field hospital fills the void for critically injured patients requiring immediate care. Designed to provide surge capacity for the largest emergencies requiring trauma care and surgical interventions, the hospital can be rapidly deployed—within 24 to 28 hours—anywhere in the world. In the event of deployment, it is staffed by teams of experienced medical and trauma professionals from academic and medical institutions with whom International Medical Corps has partnered.

For more information about International Medical Corps, including volunteer opportunities, visit www.internationalmedicalcorps.org

For more information on the 2017 International Disaster and Austere Medicine Conference, visit http://www.mammothmedicalmissions.org/idamc-registration-2017/

For more information on scheduling the lecture series, call 760-799-2507.

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org

Crystal A. Wells is Roving Communications Officer, International Medical Corps.