Keywords: mass casualty, field hospital, communications equipment,
radio
Introduction
The deployment, installation and management of a field hospital is a
intricate mission. When such a hospital is set up overseas, it is
complicated further. One of the major problems in this kind of mission is
various types of communication. This includes communication with home
base, communication between various members in different sections of the
team, communication with other delegations, and communications with local
authorities, including ambulance services and the military for air
evacuation. Mass casualties, where there are hundreds or thousands of
casualties are frequently complicated by complete collapse of all local
support systems. This can be due to different reasons including war or
guerilla activity industrial accident and natural event. The case of a
massive earthquake is probably the most destroying, since underground
facilities, including electricity, communications, water and sewage are
crushed. This set-up dictates that for a field hospital to be most
effective, it must be able to set itself up completely independently of
the local infrastructure, including communications. Drawer plans are
necessary to enable prompt deployment of a field hospital, also regarding
communications equipment and plans. Using standard and even pre-agreed
equipment can improve communications between delegations.
The purpose of
this paper is to discuss the experience of the Israeli field hospital team
regarding the communications. This was the fifth medical delegation sent
from Israel to crisis areas. Even though no crisis is similar to another,
several common factors allow us to learn from previous experience in
organizing the next delegation.
Methods
The mission definition of the IDF field hospital was to set up a field
hospital capable filling in the vacuum created by the damage to the city
hospitals of Adapazari. The hospital was to be able to receive patients
within 24 hours of deployment. The demanded capabilities were: triage,
resuscitation, life saving surgery including laparotomy and other major
surgery, intensive care treatment and monitoring, general hospital
admission and treatment, and evacuation/referral to medical centers
elsewhere.
A communications tent was erected. This served all communications
including any members of the media. It had its own separate backup
generator and 12 volt car batteries. This tent was manned around the clock
for incoming message receipt. The chargers of the mobile equipment were
also kept here. The staff responsible for the operation of the tent and
equipment were an electronics engineer with specialization in radio
communications, a communications officer, and 2 trained soldiers.
Overseas communication was made available by three different sets of
equipment. The most obvious type was by high frequency (HF) radio
transceiver (standard commercial equipment) in range of 3-30 MHz, using a
standard SD 214 Dipole omni-directional antenna with wide band width. The
home station was equipped and manned so as to be able to make telephone
calls in Israel.3 satellite phones (2 Mini M and a standard B) were taken,
the latter with a fax and connection. Several standard GSM cellular phones
were also taken.
Communications between team members was achieved by standard Motorola
"walkie talkies" working at 130-170MHz. These were issued to managers of
the hospital and of ward, head nurse, admission desk and to the liaison
person (a Turkish surgeon who volunteered for the job the whole duration
of the team's stay). A stationary model was positioned in the
communications tent with a tall antenna. A second set (on a different
frequency) was used for auxiliary services. This band had no "central
station". A loud speaker was also set up so that any person without a
personal radio in the camp could be called.
A military type VHF radio (30-87MHz) was set up for communications
with neighboring hospitals. A UHF transceiver (225-400MHz) for ground to
aircraft contact was also taken.
Results
With this equipment, the hospital was able to provide the services
necessary, without any main communication problem. During the first 3 days
of the mission, use of GSM cellular phone was not possible due to problems
in the local network, relating to the earthquake. Once the network was
working again, these became the main mode of home contact. During most
hours of the day use of the HF radio, though the interference was slightly
troubling to the unaccustomed. It's need for PTT was also a slight bother,
particularly for people at the other end. Operating this type of radio
demands setting frequency protocols in advance and having personnel
trained to follow them. The main advantage of this radio was it's
relatively inexpensive use. The satellite phones gave good service, but a
delay in answer transfer was a slight problem. Their main problem is their
extremely high tariff. They were used for fax, and are an indispensable
backup.
Communications in the camp was superb. People leaving the camp in the
close vicinity were also in good contact, including the liaison person who
traveled around the city. Radios on the auxiliary band (with no central
station with tall antenna were out of contact beyond 1-2Km (in built
area). Communications from further away (as on escorted evacuations) was
performed with GSM cellular phones. As stated above, this is dependent on
the integrity of the local network. A stationary Motorola radio belonging
to the local authorities set up at the admission tent enabled contact for
notification of urgent cases about to arrive for calling in necessary
staff.
The standard military radio was invaluable in contacting neighboring
hospitals. After a co-ordination meeting, during which a joint frequency
was set, almost all contact with the Canadian team was by this method,
each side using their own equipment.
The aircraft transceiver was not needed.
Conclusions
Setting up a field hospital overseas is not a simple task even for the
experienced. With careful planning good choice of communications
equipment, this task can be made easier. Our conclusions are that the
above equipment was adequate (with the exception of the need for another
stationary Motorola radio with a high antenna). It would probably not be
wise to cut down on any of the equipment, particularly as the conditions
can vary greatly, and there is no way to know what to expect on a mission
of this kind in advance.
Acknowledgements
We are indebted to the communication crew and to all the physicians,
nurses, paramedics, medics and logistic personnel in the IDF field
hospital mission team. This article is devoted to better communication
between people all over the world.
Competing interests:
No competing interests
12 September 1999
A S Finestone
IDF Field Hospital Mission Team, Adapazari
Y Bar-Dayan, M Stein, K Aydunuraz, D Mankuta, Y Wolf, M Lynn, A Eldad, P Benedek, G Martinovitz
Rapid Response:
Communications Equipment in a Field Hospital: Experience from the Israeli Delegation to Turkey,1999
Communications Equipment in a Field Hospital: Experience from the
Israeli Delegation to the site of the Turkish Earthquake
AS Finestone, Y Bar-Dayan, M Stein, K Aydunuraz, D Mankuta, Y Wolf, M
Lynn, A Eldad, P Benedek & G Martinovitz.
IDF Field Hospital Mission Team , IDF Medical Corps, Israel
Email: asff@internet-zahav.net
Keywords: mass casualty, field hospital, communications equipment,
radio
Introduction
The deployment, installation and management of a field hospital is a
intricate mission. When such a hospital is set up overseas, it is
complicated further. One of the major problems in this kind of mission is
various types of communication. This includes communication with home
base, communication between various members in different sections of the
team, communication with other delegations, and communications with local
authorities, including ambulance services and the military for air
evacuation. Mass casualties, where there are hundreds or thousands of
casualties are frequently complicated by complete collapse of all local
support systems. This can be due to different reasons including war or
guerilla activity industrial accident and natural event. The case of a
massive earthquake is probably the most destroying, since underground
facilities, including electricity, communications, water and sewage are
crushed. This set-up dictates that for a field hospital to be most
effective, it must be able to set itself up completely independently of
the local infrastructure, including communications. Drawer plans are
necessary to enable prompt deployment of a field hospital, also regarding
communications equipment and plans. Using standard and even pre-agreed
equipment can improve communications between delegations.
The purpose of
this paper is to discuss the experience of the Israeli field hospital team
regarding the communications. This was the fifth medical delegation sent
from Israel to crisis areas. Even though no crisis is similar to another,
several common factors allow us to learn from previous experience in
organizing the next delegation.
Methods
The mission definition of the IDF field hospital was to set up a field
hospital capable filling in the vacuum created by the damage to the city
hospitals of Adapazari. The hospital was to be able to receive patients
within 24 hours of deployment. The demanded capabilities were: triage,
resuscitation, life saving surgery including laparotomy and other major
surgery, intensive care treatment and monitoring, general hospital
admission and treatment, and evacuation/referral to medical centers
elsewhere.
A communications tent was erected. This served all communications
including any members of the media. It had its own separate backup
generator and 12 volt car batteries. This tent was manned around the clock
for incoming message receipt. The chargers of the mobile equipment were
also kept here. The staff responsible for the operation of the tent and
equipment were an electronics engineer with specialization in radio
communications, a communications officer, and 2 trained soldiers.
Overseas communication was made available by three different sets of
equipment. The most obvious type was by high frequency (HF) radio
transceiver (standard commercial equipment) in range of 3-30 MHz, using a
standard SD 214 Dipole omni-directional antenna with wide band width. The
home station was equipped and manned so as to be able to make telephone
calls in Israel.3 satellite phones (2 Mini M and a standard B) were taken,
the latter with a fax and connection. Several standard GSM cellular phones
were also taken.
Communications between team members was achieved by standard Motorola
"walkie talkies" working at 130-170MHz. These were issued to managers of
the hospital and of ward, head nurse, admission desk and to the liaison
person (a Turkish surgeon who volunteered for the job the whole duration
of the team's stay). A stationary model was positioned in the
communications tent with a tall antenna. A second set (on a different
frequency) was used for auxiliary services. This band had no "central
station". A loud speaker was also set up so that any person without a
personal radio in the camp could be called.
A military type VHF radio (30-87MHz) was set up for communications
with neighboring hospitals. A UHF transceiver (225-400MHz) for ground to
aircraft contact was also taken.
Results
With this equipment, the hospital was able to provide the services
necessary, without any main communication problem. During the first 3 days
of the mission, use of GSM cellular phone was not possible due to problems
in the local network, relating to the earthquake. Once the network was
working again, these became the main mode of home contact. During most
hours of the day use of the HF radio, though the interference was slightly
troubling to the unaccustomed. It's need for PTT was also a slight bother,
particularly for people at the other end. Operating this type of radio
demands setting frequency protocols in advance and having personnel
trained to follow them. The main advantage of this radio was it's
relatively inexpensive use. The satellite phones gave good service, but a
delay in answer transfer was a slight problem. Their main problem is their
extremely high tariff. They were used for fax, and are an indispensable
backup.
Communications in the camp was superb. People leaving the camp in the
close vicinity were also in good contact, including the liaison person who
traveled around the city. Radios on the auxiliary band (with no central
station with tall antenna were out of contact beyond 1-2Km (in built
area). Communications from further away (as on escorted evacuations) was
performed with GSM cellular phones. As stated above, this is dependent on
the integrity of the local network. A stationary Motorola radio belonging
to the local authorities set up at the admission tent enabled contact for
notification of urgent cases about to arrive for calling in necessary
staff.
The standard military radio was invaluable in contacting neighboring
hospitals. After a co-ordination meeting, during which a joint frequency
was set, almost all contact with the Canadian team was by this method,
each side using their own equipment.
The aircraft transceiver was not needed.
Conclusions
Setting up a field hospital overseas is not a simple task even for the
experienced. With careful planning good choice of communications
equipment, this task can be made easier. Our conclusions are that the
above equipment was adequate (with the exception of the need for another
stationary Motorola radio with a high antenna). It would probably not be
wise to cut down on any of the equipment, particularly as the conditions
can vary greatly, and there is no way to know what to expect on a mission
of this kind in advance.
Acknowledgements
We are indebted to the communication crew and to all the physicians,
nurses, paramedics, medics and logistic personnel in the IDF field
hospital mission team. This article is devoted to better communication
between people all over the world.
Competing interests: No competing interests