Emergency Medical Teams (EMTs) are WHO-classified teams of health-care professionals who can be deployed to provide immediate assistance to countries and territories during natural disasters, outbreaks and emergencies. During the COVID-19 pandemic, demand for EMTs surged across different regions, and WHO facilitated the transfer of knowledge and practices in the spirit of solidarity.
In the WHO European Region, 8 EMTs have responded to requests for assistance from 6 different countries to help with the COVID-19 response in 2020. The Region has 50% of global EMT capacity, with 15 WHO-classified teams and more than 30 others under mentorship, ready to be deployed in the coming years.
Dr Oleg Storozhenko, Partnerships Officer at WHO/Europe, highlights a new twinning programme that encourages experienced EMTs to partner with interested Member States and nongovernmental organizations to help them strengthen national emergency response capacities.
“During COVID-19, we have seen how EMT response activities can inspire governments across the WHO European Region and beyond to provide a stronger national medical response to emergency situations through improving skill exchange with local health-care workers and establishing local EMT capacities,” he notes.
Twinning builds national capacity
Georgia and Germany were the first to collaborate in this way. Georgia benefitted from German EMT expertise to train its own national team, which then became heavily involved in the country’s COVID-19 response. Azerbaijan and Turkey are now adopting the same formula. Demand for homegrown EMTs has increased during the pandemic, with support from national governments or nongovernmental organizations.
Dr Harald Veen, a mentor for the WHO EMT initiative, says the focus is on building national teams that can respond rapidly in a crisis. “The health professionals in these teams used to be focused on packing up to leave for another country, but with COVID-19 everything changed, and there was an immediate need for their expertise at a national level.”
Alongside the twinning programme, a mentorship scheme enables a greater number of teams to quickly reach the required standards for WHO classification and subsequent deployment. The WHO scheme encourages established EMTs to offer advice and support to newer, yet-to-be-classified teams. There are currently 65 teams under mentorship globally, and a further 28 teams have declared an interest in starting the process.
Mentorship: providing advice and hope
Team leader Dr Wojtek Wilk describes how mentors from Spain helped his EMT from Poland develop their skills related to issues of water supply, water treatment and sewerage. Teams must demonstrate competence outside their specialist areas and, he says, “mentorship is therefore a major part of the global classification process. A mentor provides advice and hope and is of immense help in overcoming obstacles.”
After deployments to Ethiopia, Italy, Kyrgyzstan and Tajikistan, Dr Wilk’s team of professionals returned to Poland to help respond to a rise in COVID-19 cases on home soil. They also mentor other nascent EMTs to achieve WHO certification.
As a mentor and technical adviser to the WHO Secretariat, the body responsible for making sure that each EMT reaches an agreed minimum standard, Dr Veen oversees the progress of each team towards this goal. “We push them to write down their procedures so that these are clear and can be followed by any new team members,” he explains, adding that he is proud to be promoting WHO’s high standards. “Everything should be written out succinctly so that EMTs are able to prevent harm, work in the most efficient way for patients and be humanitarian role models.”
A new role for EMTs
During the COVID-19 pandemic, EMTs have adapted to provide on-the-job COVID-19 training and support to ministries of health. They aim at strengthening triage and hospital referral procedures and improving infection prevention and control measures, including proper patient flow and treatment protocols for COVID-19 patients.
Dr Wilk explains that this reflects a shift in the way EMTs operate. For example, professionals with expertise in treating patients directly in field hospitals and intensive care units and dealing with trauma and surgical interventions have found themselves needing to employ a different range of skills during the pandemic. The training and capacity-building component of their work has come to the fore during this time.
“Strengthening preparedness for the COVID-19 response is a new and quite unexpected role for the EMTs,” he observes. “Not all doctors are skilled trainers or have the necessary interpersonal skills to be effective in this role. However, training and knowledge-sharing are both critical as EMTs are only present in any country for a finite period of time, while the COVID-19 pandemic is probably set to last.”
Assistance and solidarity
During final certification, an independent WHO team along with peers from other EMTs check that the required standards have been reached. Mentors undertake regular phone calls, video meetings, visits and protocol checks to keep teams motivated in difficult circumstances, interspersed with reminders to eat and rest well.
Dr Veen highlights the long-term benefits of providing peer support and training to EMTs. As well as being cost-effective, he says that swapping expertise gives EMTs “an immense opportunity to improve humanitarian assistance”, enabling governments to select the types of teams best suited to respond to a particular set of circumstances.
The message of solidarity is strong, agrees Dr Wilk, who also notes that EMTs are on the frontline of the global response to COVID-19. “I was asked recently if there is fear associated with working in a COVID-19 hospital,” he muses. “The only answer I could think of was, ‘there is fear, of course, but somebody has to do it’. The world needs teams that can deploy to wherever there is a need, if the situation in their home country permits. This is assistance, but also solidarity.”