Our 8th Congress is hardly behind us and we are already fully occupied with the arrangements for the 9th in Jerusalem. But a worldwide organization like WADEM is not simply a congress-to-congress gatherings, and the notes and news items in the following pages on this multitude of activities testify to our Association's vigor and constant growth. Indeed, true to its global nature, WADEM's action is increasingly present in all parts of the world and in all fields of emergency and disaster service.

Several of our members have worked, participated voluntarily, traveled or have been solicited to contribute to many aspects of natural and man-made disasters in multiple localities, as in the Los Angeles earthquake; as in the Czech Republic, for governmental reorganization; or war disasters in Sarajevo, as will be evident from the current special Supplement to our scientific journal Prehospital and Disaster Medicine; in educational matters, as with the World Health Organization; in thematic emergency studies, as with the Mediterranean and American Burn association; on fire disasters; in conference planning, as with the forthcoming Asia-Pacific Conference on Disaster Medicine, and many others. Far from being a mere token presence, these are valid involvements and serious occasions of multi-faceted action in a participatory, advisory, educational or other relevant capacity.

Members will have already sensed this elan of activity and they will be pleased to know that more and more organizations, specialists, workers and institutions are soliciting WADEM's collaboration and support. Such collaboration and support will be all the more effective, fruitful and meaningful with our growing membership and your increasing cooperation. In this and your other activities I wish you satisfaction and success.

William A. Gunn, MD, MS, FRCSC, President

WADEM has opened a door for worldwide emergency and disaster medicine to become truly collaborative, as its mission-our mission-requires.

Besides creating the formula of Federated or Associated Membership, WADEM has collaborated with many institutions over the past several months. Some examples from across the world:

The Czech Republic: The President of WADEM has been invited by the Minister of Health to advise on the formulation of innovative approaches in emergency and disaster management and civil protection, within the planned reorganization of the health services of the Republic.

International standardization: Dr. Ole Sundnes, energetic WADEM member from the home of the latest Winter Olympics, is coordinating action in favor of agreed standards in disaster evaluation and assessment - a much needed project. WADEM is a collaborating organization in this programme.

Los Angeles Quake: Congratulations and thanks to our President elect for his activities (and through him, WADEM) in the immediate response to the recent devastating earthquake Los Angeles. Dr. Steven Rottman, as Director for the UCLA center for Prehospital Care, was involved in this emergency and wrote a thought-provoking article (published in the Los Angeles Daily News), all about the public health concerns of over 25,000 displaced persons in the aftermath of the quake. The responses to this disaster will have considerable impact on further planning and preventive endeavors. Dr. Rottman, in collaboration with the World Health Organization, is working to develop an international training center at UCLA in humanitarian assistance. Chemical accidents:The Swedish Poison information Center's Dr. Per Kullin, who so ably looked after the finances of our Stockholm World Congress, has been a key figure in the United Nation's Interage IPC/OECD/UNEP/WHO programme on chemical accidents and their health aspects. In these tasks he also represented WADEM and we are proud to be a part of this significant international project. WADEM members will be receiving a copy of this important Guideline, another advantage of membership in the Association.

Anyone reading the notes on these pages (and in our scientific journal Prehospital and Disaster Medicine) will realize how useful (and pleasant) it is to be a part of WADEM. If you have not joined yet, you are cordially invited to come over; and if you are a member we encourage you to recruit a colleague among your like-minded friends. It will prove to be an agreeable and useful gesture.

Jerusalem, May 28-June 2 1995, Mediterranean Cruise, June 3-9, 1995

It is never too early to plan for this important Congress of our Association, with its significant scientific program and social activities. The organizing committee has been busy with the preparations of the Congress. A preliminary announcement has been distributed at the 8th World Congress in Stockholm and announcements have been published in several Emergency journals and publications. The Organizing Committee has finalized the Scientific Programme of the Congress and the "First Call for Papers" will soon be published and distributed. An International Advisory Committee has been established and many very useful comments and suggestions have been received. We are now in the process of identifying and approaching key speakers who will be invited to present some main issues. A contract between "Kenes" (the congress organizers), the local Organizing Committee and WADEM has been signed.

Many may wish to combine their trip to Jerusalem with the WADEM cruise that the Mediterranean Burns Club and the American Burn Association have organized. The Third International Conference on Burns and Fire Disasters that will take place on board ship as a 7-day cruise, from 3 to 9 June 1995. WADEM and ITACCS (the international Trauma Anesthesia and Critical Care Society) are collaborating in this important scientific and touristic event.

For further information, please contact:

Jerusalem: Secretariat, 9WCEDM
P. O. Box 50008, Tel Aviv 61500, Israel
Tel: +972-3-5140014, Fax: +972-3-660325 / 5175674

Cruise:M. Masellis
Division di Chirurgia Plastica e Terapia delle Ustioni
Ospendale Civico U.S.L. 90127 Palermo, Italy
Tel: +3991-666-363, 666-3634, Fax: +3991-596-404

Those who visited Stockholm's Soeder Hospital last year will recall its impressive underground emergency medical facilities dug into rock and the modern facilities on the surface. This institution is celebrating its 50th anniversary this year with an important International Conference on Emergency and Intensive Care in Disasters, November 27-29. For details write to Prof. Be Brismar, Soedersjukhuset, S-118 83 Stockholm, Sweden. As of now Insight presents its best wishes and good continuity. WADEM is proud to be among the sponsoring organizations.

Professor Peter Safar is not only one of the initiators of the Club of Mainz and founders of WADEM, and Past-President, he is also one of the pioneers in resuscitology and disaster reanimatology and founder of the International Resuscitation Research Center at the University of Pittsburgh.

On May 5th the University and the IRRC held a celebratory conference in honor of their mentor and friend, distinguished scientist, researcher, humanist, internationalist and disastrologist. On this occasion WADEM had the privilege to be present as Prof. Marvin Birnbaum conducted one of the discussion panels and Prof. Gunn gave the 15th Special Peter and Eva Safar Lecture.

Heartiest congratulations, Peter, from all at your WADEM. (See Vol.1, No.1 of Insight for a highlight on Professor Safar)

Our Affiliated associate, the Mediterranean Burns Club, provides ten scholarships annually to young doctors and nurses who deserve assistance to advance their knowledge in burns management and fire disasters. As a gesture of collaboration the MBC has earmarked one of its 10 annual scholarships to WADEM. The 1994 MBC/WADEM Scholar is Dr. Liri Poma of Tirana, Albania. She will extend her training in burns-related anesthesia and reanimatology at the Burns Center of Palermo under Prof. Masellis, who is a member of the Board of Directors of WADEM. With goodwill obviously constructive international collaboration takes many forms.

Congratulations to our President who has been elected Vice-President of the International Federation of Surgical Colleges. The IFSC is the principal worldwide coordinating body of all the main national surgical organisms, with one main representation per country, such as the American College of Surgeons for the U.S., the Hellenic Surgical Society for Greece or the Polish Association of Surgeons for Poland. The Federation is in official relations with the World Health Organization to which it acts as principal advisor on all surgical matters of care and education. As a surgeon Dr. William Gunn has been active in the IFSC for almost three decades.

Many distinguished specialists in EMS and Disaster Medicine are members of WADEM and have contributed significantly to the basic and growing literature of these two interrelated disciplines. Besides numerous articles and other publications, and the solidly established Prehospital and Disaster Medicine journal of our Association, several books have been written by our colleagues, a recent sampling of which is given below. We would appreciate being informed by our members of any books they have published. Please forward your information to the membership office for publication.

Chinese Textbook of Disaster Medicine:
Complete textbooks on disaster medicine are rare in any language and until now, none existed in Chinese. Together with Prof. Ehou Guo-Tai and Zhang Hong Xi, Professor Gunn is senior co-editor and has contributed three chapters to this comprehensive book, especially on the international aspects of disaster medicine. In its rapid development China is paying increasing attention to its emergency health services, and the book was formally released on 29 October 1993 at a special official and scientific ceremony at the Chinese Academy of Medical Sciences. ISBN No. 7-81034-259-2/R

Health Aspects of Chemical Accidents:
The International Program on Chemical Safety, the Organization for Economic Cooperation and Development, the United Nations Environments Program and the World Health Organization have jointly produced this valuable guide of 147 pages, in the preparation of which WADEM was present through member Dr. Per Kulling of Sweden. WADEM endorses this valuable book of "Guidance on chemical accident awareness, preparedness and response for health professionals and emergency responders." Congratulation to Dr. Kulling, and members of WADEM will be receiving a copy of this useful tool.

WADEM has been invited to collaborate with the University of New Mexico's "Second Annual Disaster Medical Issues of America" conference to be held in Albuquerque, New Mexico from October 13-15, 1994. WADEM members will participate and co-sponsor this program as faculty members and scientific program advisors. The conference will concentrate on clinical, academic, and medical response issues, and there will also be a panel discussion addressing controversial topics in disaster Medicine. For the first time, WADEM will sponsor a special pre-conference workshop on the very special area of disaster research methodologies. This will be conducted under the supervision of Dr. Marvin Birnbaum, the Editor of our journal, Prehospital and Disaster Medicine. WADEM members will receive a special reduction in registration fees for this conference. For more information, please contact John Gaffiney, Chief of Education, Center for Disaster Medicine at the University of New Mexico. His FAX is (505) 272-6503. We hope to see many WADEM members at this exciting conference.

WADEM's biennial World Congresses are well established and constitute the international emergency/disaster medicine continuity's major meeting every two years. The Board of Directors has felt that interim activities, in the even years, would be a welcome addition to the training and interchange opportunities among specialists and associations. Therefore, pending the 9th World Congress in May 1995, an important Course/Conference is scheduled for Novernber 8-10, 1994. It will take place at the King Faisal University, Al Khobar, Saudi Arabia, jointly organized by WADEM, the University, the Continuing Education Department and an international Faculty of experts. Abstracts should reach the Organizing Committee by September 1. For more details contact Prof. Ahmed Ammar, King Faisal University Hospital, P.O. Box 40040, Al Khobar 31952, Saudi Arabia. Fax +996-3.895-27-87.

The ever increasing activity of WADEM members in countries and regions and the need to facilitate international collaboration has led the Association to strengthen its national and regional structures. The WHO's geographic regionalization is the pattern for WADEM's Regional Sections ... Africa, the Americas, Asia, Eastern Mediterranean, Europe, and the Pacific. More details in the next Insight.

The 10th World Congress on Emergency and Disaster Medicine will be held June 11th-15th, 1997 in Mainz, Germany on the occasion of the 20th Anniversary of the World Association for Disaster and Emergency Medicine, WADEM (founded in 1976 as The Club of Mainz).

RESUSCITATION '94
Second Congress of the European Resuscitation Council (ERC) will be hosted by the Clinic of Anaesthesioloy, University Hospital Mainz, 21-22 October 1994, University Campus, Mainz, Germany
For further information, contact Prof. W. Dick Ph: 49-6131-177116, Fax: 49-6131-236028.

By now you should have received the premiere edition of our International Directory of Members. This special WADFM member benefit is designed specifically to help you locate colleagues around the world who share your interest in emergency and disaster care. Please contact our administrative offices with your comments on the directory. We'll attempt to incorporate suggestions which might improve the directory's utility in next year's updated edition.

At the February Board of Directors meeting in Seattle, Washington, the Board selected Osaka, Japan as the site of the 1999, 11th World Congress on Emergency and Disaster medicine. We anticipate strong collaboration with the three leading disaster medicine organizations in Japan, the Japanese Association of Acute Medicine (the national emergency/disaster organization), the Japan Medical team for Disaster Relief (providing International relief activities) and the recently established research group on disaster medicine, the Japanese Association for Disaster Medicine. We look forward to a successful 11 WCDEDM!

On the request of the Belgian Ministry of Health, we have been asked to participate in a study concerning the organization of the emergency medical services in case of disaster.

The concepts of medical disaster management vary from county to country; while in some countries, the practice is to "scoop and run" to the nearest hospitals (minimizing medical first aid on the site), in other countries the operation mode is to bring and deliver medical care to the victims on the site. This depends on the daily organization of medical services, availability of medical teams, training of the ambulance personnel, distances to well-equipped hospitals, local ambulances and helicopter resources.

The first aspect being investigated is the role and the desirable preparation of a Medical Director on the site. The second aspect concerns the methodology in planning disaster exercises and simulations to prepare or to test the potential services. Last we are interested in the various tag-systems used for medical triage, in order to be able to evaluate a national tag for Belgium.

We would appreciate if you could inform us about your experience in these three fields. We are interested in the references of publications you have in use or reports you published. If these publications are unavailable in our university libraries, please let us know how to obtain them and at which cost (and how to pay if). Also, we would appreciate if you could send us a sample of the emergency triage tag you have in use.

Please send information to: Dr. P. Guerissc, Clos de Valognes, 11, B-1410-Waterloo, Belgium.

Dr. P. Guerissc, University Libre de Bruxelles

At the 7th Congress of the World Association for Emergency and Disaster Medicine in Montreal, Canada, the International Task Force Committee on Pediatric Disaster Medicine was formed and charged with developing a plan to inventory existing resources for pediatric disaster medicine and to organize the efficient use of these resources.
Specifically, the Committee has the following goals:

(1) Identifying and training medical specialists, both doctors and nurses, in all regions of the world, to provide urgent medical help to children.

(2) Coordinating the efforts of medical teams in cases of natural, technological or political disasters and directing specialized medical teams in the field.

(3) Establishing specific medical programmes for injured children, including methodology.

(4) Moving teams of specialists in the affected zones, and providing them with necessary equipment, instruments and medicine.

(5) Organizing transportation of children to the specialized hospital or another facility if a child's condition requires more help than can be provided in the field.

(6) Analysis of the results of treatment and activity as well as the research in pediatric disaster medicine.

To fulfill its goals, the Task Force created a structure of auxiliary institutions including those which provide financial support of its activity and initiatives, the Childrens Center for Disaster Medicine and the International Charitable Fund for Children in Disasters.

The Task Force maintains two offices, in Moscow and New Jersey, USA and keeps active correspondence with UNICEF, WHO, International Federation of Red Cross and Crescent, International Committee of Red Cross, Doctors without Borders, CARE, Project Hope, Pharmaceutists without Borders and other societies involved in the problerns of disaster medicine. The Committee regularly informs these organizations of its steps and decisions.

The International Childrens Center for Disaster Medicine was conceived as a non-governmental, non-profit institution, the goal of which is to provide medical help to children without regard for their nationality, religion, or political considerations during natural, technological or military disasters.

In June 1992, The International Charitable Fund for Children in Disasters was officially registered in Moscow, Russia. The Fund is to provide the financial basis for the Task Force Committee and the International Childrens Center for Disaster Medicine. It also gives donations to various projects which could benefit the field of pediatric disaster medicine. Several branches of the Fund are currently being organized in different countries with existing offices in Russia and the US. The Fund is governed by the Board of Administrators.

The Task Force has begun to establish the foundation of a Mobile Brigade to work with children in disasters. In Autumn 1992, more than 80 letters were sent internationally to pediatric specialists with the invitation to join the activities of the Task Force. To date, positive responses were received for future practical help from 40 specialists from many countries. The Task Force has begun to acquire equipment and medicine for this Mobile Brigade.

A special letter was sent to UNICEF, WHO, International Red Cross and Crescent, the International Committee of Red Cross and many other non-governmental agencies with the suggestion to organize a special meeting to discuss the practical problems of coordinating help to children. This initiative is under the director of WADEM President, Dr. Gunn.

Based on the real experience of our specialists on site in Nagomo-Karabakh and Armenia, the task force filmed a documentary entitled, "War Through the Eyes of Children" and has already shown it on the Central Television Channel of the CIS countries.

The process of finding funding is new to the Task Force, but we have begun to write letters to banks and charitable organizations to find sponsors to support our activities.

Additionally, we are constantly in touch with non-governmental agencies and organizations concerned about the problem of giving assistance to children in disasters and have tried hard to explore possibilities of coordinating our effort and in cooperating on this priority problem.

(May 1991 - Jan 1994) Dr. Leonid Roshal, Russia

The aim of the WADEM education committee is to establish an international training programme that is sufficiently flexible to accommodate local needs while at the same time able to ensure a uniform basic proficiency. The problems are numerous. Although emergency medicine has reasonably uniform requirements in any situation, disaster medicine varies widely from situation to situation. There are also the problems of fulfilling the needs of the various groups involved in Emergency and Disaster Medicine. These groups include Medical Directors and coordinators, doctors, paramedical staff and support staff. In order to produce a viable programme which can be integrated into local disaster plans, all of these factors must be taken into consideration. The following is one proposal:

The programme should be based on a credit system. There should be a minimum requirement for each of the categories of participants. This minimum requirement will be in fixed subjects for each category of participant. The remaining credits can be gained from a more flexible curriculum, divided into fields such as natural disasters, warfare, industrial accidents, transportation disasters, public health, etc. For each of the categories of participants, there will be three levels of qualification.

(1) Basic qualification will require only the basic credits

(2) Specialist will require the basic qualification plus extra credits, possibly in one field only.

(3) Instructor will require the first two qualifications plus credits in each of the fields.

Obviously this is only an outline of what is proposed as a method for implementing any standard international training programme. It will also be necessary to devise an examination and a team to oversee at least the first few courses and examinations. In view of the fact that Emergency and Disaster Medicine is a relatively new field and we are learning rapidly from situations as they arise, there is also a need for participants to take refresher courses and requalifying examinations, possibly at five year intervals.

Please send your inputs to:

Dr. Ahmed Ammar, Chairman, Location Committee,
WADEM Chairman, Department of Neurosurgery
King Faisal University College of Medicine
King Faisal University Hospital, P. O. Box 40040, Alkhobar 31952, Saudi Arabia