Well after a couple years of meetings, months of intense planning, and hundreds of man hours Tenwek finally saw it’s first planned disaster. As many of you are aware, during my two year EMS fellowship I had a primary focus of emergency preparedness/disaster management. Honestly I wasn’t sure if or how this would be useful on the mission field. After arriving here, however, I found that there was a disaster management committee that was working on plans and procedures for a mass casualty incident (MCI).
Fast-forward two+ years and we have a completely revised disaster manual, we have performed risk/vulnerability assessments for the hospital, we have given numerous hours of education to staff, we have completed 9 table top drills, and we have now completed a full-scale live drill. I definitely wouldn’t say that it was a complete success but we did identify several areas of weakness, topics that will need reeducation, and changes/additions needed to our current plan. And we are absolutely much further along than we were this time last year.
Here is a brief photographic summary of Tenwek’s first live MCI drill.
One challenge of a live drill is finding mock patients. We were able to partner with Tenwek Boys High School Scout Club. Both the principal and the leader of scouts were fully behind our drill as a means to strengthen Tenwek’s ability to respond to a local disaster. Myself and several committee members met with the boys on several occasions for information giving, recruitment, and education on how to act as a mock patient. They did an amazing job! (In fact, we had real patients and visitors who were concerned about what happened at the school to cause so many injuries.)
We met at 7 am on Saturday morning to give final instructions, to get the boys changed, apply our fake blood (tomato sauce) and bruises, and to make sure everyone knew their character roles. We had 45 patient profiles for them to act out plus police, press, and family members.
At 7:30 we called the hospital to notify them of the bus accident that had just occurred outside of Bomet. Meanwhile we continued to prepare for the first wave of patients to be transported to the hospital (we utilized both a hospital ambulance and a missionary vehicle to simulate bystanders transporting victims).
Within minutes victims began to arrive at the front entrance. They were met by several staff who were prepared with our Tenwek specific triage tags.
Soon patients began being taken to casualty for treatment and stabilization.
It is obvious on regular working days that our current casualty department is far too small for the number of patients we regularly see. This was painfully apparent during the drill as people struggled to maneuver stretchers and wheelchairs from one location to another. At times, you couldn’t even walk from one patient to another. (This is one reason why we are actively planning an expansion of casualty.)
When the press and police arrived, administration and casualty staff had to give an update on the current situation.
At one point, family members managed to get into the patient care areas and were quite upset about the deaths and injuries of their loved ones. Security had to maintain order and the chaplains worked to calm them down.
We were sure to include lab and radiology services as well as they had to help provide ancillary services for our patients.
Overall, their was great collaboration among the staff as they worked hard to care for the huge influx of patients.
We even included the morgue workers as they had to manage the care of the deceased.
When the drill concluded, staff members were treated with chai and mandazi and our mock patients were given bread and soda, with certificates to follow.
While we hope we never had to put into practice the lessons we learned from this drill, we know that there is a good chance we will. Small scale incidents are pretty common here and only ~7 years ago there was a major bus accident which caused many deaths and severe injuries. Pray for us as the committee continues to work on improving our response to incidents like this. Also be praying for a real victim who arrived as the drill was taking place. A gentleman presented as our mock patients were being dropped off. He suffered severe facial/head injuries after a motorbike accident. Thankfully with the extra staff already being ready and available, he received rapid care and was said to be improving throughout the day yesterday.
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30 Comments
Delores Thomas
Mar, 1, 2015Holding a mock disaster, if done correctly, can certainly show weak places in the system. Good job!
Miriam Wert
Mar, 1, 2015It shows the real love and concern that you and the other staff members have for the people where you serve. Congratulations on a job well done. Obviously it took a lot of time and effort to make this successful, and I am proud of all of you who had a part in it. No doubt God is pleased also!
Sheri Parker in New Hampshire
Mar, 2, 2015It is amazing that God doesn’t waste anything in our lives. Praise Him for helping you to be trained the way you were and for the ability to help Tenwek do the MCI with success. Praise God for willing subject/victims. Praying for you all!
Caren
Mar, 2, 2015Good job!
Kennedy
Mar, 2, 2015Disaster preparedness / Mass Casualty Prepared should always be part and parcel of hospital’d continuous quality improvement (CQI). Well done Aaron Kelley and Tenwek team, system deficiencies can only be known through rigorous simulation and stimulation.
Kennedy
Mar, 2, 2015Disaster preparedness / Mass Casualty Incident Preparedness should always be part and parcel of hospital’d continuous quality improvement (CQI). Well done Aaron Kelley and Tenwek team, system deficiencies can only be known through rigorous simulation and stimulation.
Borniface kirimi
Mar, 2, 2015Am really impressed by what You did. Emergency and disaster preparedness are key in reducing mortality resulting from mass accidents. keep up the good work.
Gilbert Sigei
Mar, 2, 2015Good job Daktari and the team!bravo.
joseph mboke
Mar, 2, 2015Dr. Kelly I was almost getting to panick mode when I saw the article title.I love the way you organised and made it to be almost real. A final year medical student at Kenyatta University and had my elective term at Tenwek- trusting God to come there for internship. I miss Tenwek
peter Lucheli
Mar, 2, 2015What a drill & lesson learned. Nxt time organise also for a fire drill.
Frank Martin
Mar, 2, 2015Aaron,
So happy you all learned a lot! Don’t forget the old adage—“practice makes perfect!” Or better yet—“practice makes better!” (or at least we hope so!) Blessings to one and all!
Tobias
Mar, 2, 2015Hey..good task Aaron.
congrax God provide u abundantly.
kipkirui Geoffrey
Mar, 2, 2015well done!this is meant to improve the speed at which the dissaster will be handled.continue saving the precious lives of our people
samuel
Mar, 3, 2015Excellent. Always proud n of this hospital. Keep up m
Peter Sigei
Mar, 3, 2015Good work Kelly.
Congraulations team and keep up the fight.
wesley cheruiyot
Mar, 3, 2015GOOD WORK, KEEP IT UP, NEXT FIRE DRILL and BOMB SCARE DRILL.
Annette Eichhorn-Wiegand
Mar, 3, 2015Awesome Dr.Kelley, I assume you sie one of the online faith based and goverment hospital in Kenya which Haß eher done that. Please keep up with all your effords. Looking forword to meet you at Tenwek. Be bleesed
mathew towett
Mar, 3, 2015Wow! happy for tenwek… i was an intern there… thanks for using my former school, tenwek boys as mock patients… thats my home!!!
anne gatuire
Mar, 3, 2015great job guys
Mike Chupp
Mar, 4, 2015Monumental but incredible job Aaron and Tenwek staff. So delighted that you accomplished this drill and trust that it will be used to prepare for the real thing that could be coming someday. God bless all the staff and patients at Tenwek Hospital.
Dr. Mike Chupp
Tenwek surgeon and Missionary
Terer
Mar, 4, 2015Thank you for the excellent drill. It goes a long way to inform policy makers of our disaster preparedness and response.
Did you incorporate other ambulance services around the area ie. the county government.?
What challenge did you experience from the members of the public and how did you handle it?
Thanks
Aaron Kelley
Mar, 4, 2015For this drill we did not incorporate any outside agencies. Perhaps in the future that would be a possibility. There were not too many challenges from the general public. Mostly, they were just curious about what was going on. Some were concerned about what happened to so many students (our actors were pretty convincing). After informing them that this was just a drill to test our readiness, they then relaxed and simply watched our staff members work.
hillary
Mar, 4, 2015Congratulations to all Tenwek Hospital for the well organised preparedness, am a pharmacist by proffesion and i was involved in an accident some time back in bomet but although i was treated and admitted in the hospital the casualty services and preparedness was poor, imagin breaking ua Tibia and fibular bones on a sunday morning only to arrive there by 8.30am and to be given a gown only and then be attended by 3pm without iven pain killers till i had to request for, and be booked for operation on tuesday but with the situation now, give it up comrades ua motto WE TREAT GOD HEALS explains alot. Kudos.
Faith lang'at
Mar, 4, 2015This is amazing. I remember and speak about Tenwek with Pride. God bless you all.
Chepngeno Roseline
Mar, 4, 2015Isn’t this awesome? I like dealing with emergencies, i wish i knew this was happening, i would have joined you guys. Good.
Picoty Ng'eno Rotich
Mar, 4, 2015Good assurance of preparedness! Bravo Kelly and team Tenwek!
dennis wamae
Mar, 5, 2015am a third year clinical medicine student at kmtc kisii campus. and i would wish to do my internship at tenwek. due to the good word i have heard and also the highly qualified personnel from all over the wild.. mock drills for disaster management are always good to evaluate the level of disaster preparedness personnel teaining is of good importance particually in developing countries like Kenya .Congrats Dr Aaron for the good work
Aaron Kelley
Mar, 5, 2015Be sure to keep in touch with us Dennis. Would love to interview you and give you a chance here at Tenwek!
Victor kibet
Apr, 25, 2015Thank you very much Aaron for this good work. It is very important to note that tenwek hospital has been giving services to the entire south rift region and every step to improve its service delivery is quite commendable and as a member of that region I appreciate this good work.
Be A Trice
May, 20, 2015This is so amazing. I never knew this happened and i am around.Thanks to Dr.Kelly and the disaster management committee for the job you are doing.God bless Tenwek Family