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Adapting Health Services in Forced Displacement: Operationalizing Surge Capacity Framework in the EMT Barco San

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Summary

Emergency Medical Teams (EMTs) adapted flexible models to provide healthcare for both internally displaced persons and Venezuelan refugees in Colombia. Mobile platforms like hospital boats ensured continuity of care in challenging displacement settings.

Keywords:
adaptation of health servicesconflictcross border displacementforced displacementmigration crisesmixed migrationurban violence

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Area of Science:

  • Public Health
  • Disaster Medicine
  • International Health

Background:

  • Colombia faces a significant mixed-displacement crisis, involving internal displacement and Venezuelan migrants.
  • Examining the adaptation of Emergency Medical Team (EMT) service delivery in response to concurrent displacement.
  • Utilizing the WHO EMT Surge Capacity Framework to analyze health service adaptations.

Purpose of the Study:

  • To analyze how the EMT Hospital Barco San Raffaele (HBSR) adapted its service-delivery model.
  • To assess health service adaptations across internal displacement and refugee contexts.
  • To evaluate the operationalization of service adaptation using the WHO EMT Surge Capacity Framework.

Main Methods:

  • Mixed-methods comparative case study.
  • Data collection via mission reports, surveillance data, policy, and institutional documents (Nov 2020 - May 2021).
  • Thematic analysis structured around the WHO EMT Surge Capacity Framework's four domains: Staff, Structure, Supplies, and Systems.

Main Results:

  • EMT HBSR successfully adapted staffing, supply chains, infrastructure, and operational systems.
  • A hybrid model combining a hospital boat with mobile outreach teams was implemented.
  • Continuity of primary care, mental health, maternal/child health, and community services was achieved in isolated, diverse communities.

Conclusions:

  • Flexible EMT operational models can enhance health service adaptation and reduce inequalities in displacement.
  • Mobile platforms, such as hospital boats, are effective for ensuring care continuity along migratory routes.
  • This approach is viable in geographically isolated areas with protracted instability and limited health capacity.