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In the past two decades, Mumbai has witnessed several mass-casualty incidents. Somehow, it seems that the city has missed some important lessons from these events. Mumbai has no formal structure for emergency medical services (EMS). Although EMS may seem to be a much-desired necessity, scholars have raised questions on the practicality and feasibility of having such a system in Mumbai. Factors such as population congestion, traffic volume, and lack of coordination among existing hospitals, the success of such a system in a city like Mumbai is jeopardized. In spite of having similar challenges in some other regions of the country, EMS systems (e.g., in Gujarat) have achieved substantial success. This paper deals with the planning and organization of EMS in Mumbai. It evaluates the performances of the existing EMS systems in other Indian cities. The paper also discusses the advantages of having such a system, particularly during the events such as disasters, accidents, acts of terrorism, etc. The paper also discusses the possible consequences of the absence of EMS, such as delayed ambulance dispatch, improper distribution of patients, overcrowding at certain hospitals thereby leading to poor triage, and several similar problems that can worsen a crisis. It studies the potential challenges for the establishment of such a system in Mumbai, and suggests a model for an effective EMS system for the city.
On September 29, 2009, an earthquake-caused tsunami struck American Samoa with only 20 minutes warning. Personnel successfully evacuated patients from the hospital within 20 minutes. The organization and transportation of medical supplies required for patient care took 90 minutes.
Objective
To describe a hospital evacuation exercise designed to identify critical medical supplies, and test their transport, and use in a field-hospital setting.
Methods
A retrospective review of hospital emergency preparedness and Boy Scout Eagle Project minutes, participant surveys, and key-informant interviews was performed. Descriptive statistics were used to evaluate data.
Results
Unit supervisors hospital-wide were tasked with designing portable supply caches for the care of typical unit patients for 72 hours. Nine hospital units participated (ED, Surgery, Medicine, Pediatrics, Labor & Delivery, Maternity, Nursery/NICU, ICU, Hemodialysis) in the exercise. Unit evacuation teams (1 physician & 2 nurses) carried caches by foot to a nearby field clinic site (1/4 mile). Cache transport times ranged from 3 minutes (maternity ward) to 15.5 minutes (hemodialysis), averaging 11.2 minutes. Hospital leadership arrived in 4 minutes, and maintenance staff with portable power and oxygen in 23 minutes. Fifty-seven community volunteers (age 9 months – 60 years) under Eagle Scout candidate leadership were prepared as moulaged mock patients. Unit teams used evacuated supplies to provide medical care for 6 mock patients each, listing missing or insufficient supplies at exercise end. Cache supply deficits noted by participating teams included: portable oxygen (66%), blood pressure cuffs (44%), thermometers (44%), select pharmaceuticals (44%), and others. Reported cache deficits and exercise lessons learned were reported hospital-wide for incorporation into preparedness planning.
Conclusion
The hospital unit medical supply cache exercise was effective in addressing prior evacuation deficits. Hospital collaboration with community service volunteers provides exercise realism for participants and increases community awareness for emergency preparedness.
80% of children are seen in non-Pediatric Emergency Departments (EDs). In a disaster, most children and their caregivers will go to the closest or their regularly identified ED for treatment. In disasters, the preservation of the Pediatric Tertiary Infrastructure for the sickest and most injured children is critical. Surge capacity for pediatrics may involve both ante-grade and retrograde distribution of pediatric patients and health care staff to preserve Tertiary capacity. Reverse Triage of stable pediatric patients to other hospitals with adapted units and staff can decompress tertiary facilities. General hospitals can allow an expanded care for pediatric patients. Surge capacity needs to be addressed to allow non-pediatric facilities to surge for pediatric patients. Disaster Credentialing by immediate cross-credentialing of appropriate health care staff needs to be reciprocal and internet based to allow appropriate staff to attend pediatric patients. Pediatric consultants can augment healthcare staff to allow input into expanded care roles. Pre-hospital providers should have more pediatric training. Rotated regional caches of pediatric equipment would expedite safe pediatric disaster site care and pre-hospital transportation to definitive care. Pediatric patients should routinely be included in disaster drills and in all-inclusive disaster plans, rather than in separate drills and plans. Pediatric patients are usually accompanied by caregivers who may need care as well. Secure tracking and reunification of unaccompanied minors needs to be addressed to allow tracking across jurisdictional boundaries. Limited access to data on children, and credentialing of shelter staff would preclude access by anyone without a specific need to know. There are no clear uniform liability statutes for care in declared disasters as well as no uniform agreements for reimbursement for medical care. These issues are an important facet of disaster care that still needs to be addressed.
Special Needs of the Elderly During Disasters – Suggested Strategies and Lessons Learned from the 2007 Tulsa, Oklahoma Ice Storm. On the evening of December 7, 2007 an ice storm occurred in the south central United States causing severe power outages in Tulsa, Oklahoma. In Oklahoma alone, 900,000 people were without power for periods of up to 3 weeks. Approximately 13.2% of the population in Oklahoma aged 65 + live in institutional care (2000 US Census Report). There are 498 nursing home facilities in Oklahoma serving this majority of this population (a small percentage live in other types of care facilities). Of these facilities 143 lost electrical power for up to six days, 88 lost power but had generators available within 24 hours or less, and 55 had no alternative source of power. Of the 55 without power, 42 relocated residents. Critical infrastructure failures during natural disasters can create a cascade of direct and indirect losses due to a number of physical, social and economic interdependencies that exist (Rinaldi, Peerenboom & Kelly 2001). The elderly present some unique characteristics that make them more vulnerable during natural disasters. Chronic health problems, physical mobility and cognitive limitations make them unable to adequately prepare for disasters (Aldrich & Benson 2008) making them entirely dependent on the facilities. In the three years since the storm the Oklahoma Disaster Institute has focused its efforts on developing and implementing mitigation strategies to address power loss in nursing homes. These strategies included discussions with the Department of Health, Emergency Medical Services Authority and local hospital officials. As a result of these discussions, table-top exercises were conducted in multiple venues, and speakers from the Department of Health, EMSA, and emergency management were arranged in an Extended Care Facility Workshop. This paper will look at lessons learned, mitigation strategies and successes in protecting the elderly in nursing homes during natural disasters.
Emergency nurses have key roles in responding to healthcare disasters. Emergency nurses often complete postgraduate qualifications in their area of specialty to equip them with a breadth and depth of knowledge to respond to the challenges and complexities of emergency nursing care. However, little is known about the disaster preparedness of emergency nurses in Australia. More specifically, the educational preparedness and training for disaster nursing roles is not well understood. This purpose of this study is to describe the disaster content of Australian postgraduate tertiary emergency nursing courses as a means of better understanding emergency nurses' educational preparedness for disaster. An exploratory, descriptive approach was used to survey postgraduate tertiary emergency nursing course convenors. Data were collected from course convenors by structured telephone interview. Questions included: (1) nursing background; (2) demographics and disaster experience of course convenors; (3) course type, duration and mode of delivery; and (4) the type and amount of disaster content. Currently, 12 universities in Australia offer postgraduate courses specific to Emergency Nursing, ranging from Graduate Certificates to Masters Degree level. Of these universities, 10 participated in this research project. This presentation will report on the demographics of course convenors, including their disaster education and experience. However, the focus of the presentation will be on the review of the course content. Seven courses had some disaster content, while three had none. The disaster content in these courses varied in both content and duration. Three had learning objectives, and one had an assessment item related to disasters. Five had recent modifications relating to disaster content; this was in response to real-world events, such as terrorism and communicable diseases. This research highlights that the disaster content in Australian postgraduate emergency nursing courses varies. This finding supports the need for national consistency and supporting framework for disaster content in post-graduate courses. The 2009 Ben Morley Scholarship, a financial award sponsored by the College of Emergency Nursing Australasia, supported this research.
Disaster response and emergency preparedness has taken a bigger role in our daily operations since the advent of events of September 11 2001. It is essential that nurses be prepared and trained to respond to disaster incidents. Nonetheless, we are largely unaware of how our nurses feel about their readiness to respond to these disaster incidents. This study aims to understand our nurses' knowledge, skills and perception towards disaster response and emergency preparedness.
Method
A self administered structured questionnaire survey was conducted for the nurses in our hospital. Using a 5 point Likert scale, the questionnaire covered knowledge, skills and perception of institutional and individual preparedness towards a disaster incident. The data was analyzed using SPSS 17.
Results
A convenient sample of 1143 nurses (response rate 95.5%) was studied over a 2-month period from 1st August to 30th September 2010. 55.7% of the surveyed nurses have not attended any training in disaster response. Despite that, more than 50% of them scored correctly in term of their knowledge in different types of disaster incidents. 75.3% of them have not been trained to don the HAZMET suite within the last 2 years. 72.9% do not know where to get the HAZMET suit in the event of a chemical incident. While 80.2% felt that the institution is able to respond to any disaster incident, only 41.3% felt that they were ready. In addition, 83.6% were willing to participate in future disaster incident response training. 77.1% agreed that being able to respond to a disaster incident should be part of their professional competency.
Conclusions
There is a need for the hospital to incorporate disaster preparedness into nursing education curriculum as a clinical core skill to ensure that nurses are ready to respond to disaster incidents.
The purpose of this study was to find the change in knowledge regarding disaster management among nurses after educational intervention.
Methods
One group pretest and post test design was adopted for the study. The study was carried out in B.P. Koirala Institute of Health Sciences, Nepal. Forty Nurses were selected from emergency, orthopedics, medicine, and surgical ward by using non-probability convenience sampling technique. A self-administered semi-structured questionnaire was used to collect the data. Data was collected before and after the educational intervention. The collected data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation) and inferential statistics (Chi-square and Z test) were used to identify the difference in knowledge between pre-test and post-test, at 0.05 level of significance.
Results
Study findings revealed that in the pre-test, grand mean of the means of the nurses' knowledge on different aspects of disaster management as a whole was 2.39 with the standard deviation of 0.87. Similarly the grand mean of means of knowledge on different aspects of disaster management was 3.2 with the standard deviation of 0.47 in the post-test. The difference between pre-test and post-test in respondents' knowledge in different aspects of disaster management as a whole was calculated by using “Z” test (p < 0.05) The result showed that the educational intervention was effective in bringing changes in knowledge in all aspects of disaster management.
Conclusions
Study findings revealed that there was significant increase in knowledge in the post-test after the educational intervention. Therefore, it can be concluded that education plays an important role in increasing awareness. It is recommended that awareness programs on disaster management should be carried out periodically as in-service education.
This proposal considers the recent events in the Gulf of Mexico during the British Petroleum MC 252 explosion and subsequent spill. It will discuss the challenges and innovative solutions applied by those involved in the Safety and Pre-hospital medical branch of the Deepwater Horizon spill response. First, it examines the logistical and practical challenges faced by emergency medicine planners working with a large temporary workforce on a HAZMAT scene for many months. It will also discuss the geographic challenges with working on dock sites that existed in local communities with mostly a rural medicine and hospital system, while also considering the potential for ambulance and further pre-hospital support. Impacts resulting from the public/private Incident Command Structure (ICS) will also be discussed liberally throughout the presentation. The author is the former Emergency Response Coordinator for one of BP's largest contractors in charge of the Vessels of Opportunity (VOO) and Near-Shore Skimming (NSS) programs. He was in charge of coordinating all emergency medicine in multiple US states throughout the response. It will analyze the multi-layered approach taken by on-site contractors in addressing these issues from a planning and operational perspective. Planners discovered that a uniform, one-size-fits-all approach applied by the Unified Area Command in New Orleans was virtually inapplicable to sites that had unique geographic and personnel characteristics. Furthermore those who involved in cleanup work in the Gulf had very different requirements than those on-shore. Therefore, site-specific personnel had to adapt to conditions while working within the framework established in New Orleans in order to satisfy ICS guidelines and ensure that emergency medicine in local communities was not overwhelmed. Lessons for future responses will be discussed, as there will be an examination of both the land-based NSS and the water-borne VOO programs.
Psychological First Aid (PFA) has become the choice of mental health intervention and integration with the current disaster relief protocols during emergencies by the Institute of Medicine, NIMH and the WHO. It can be used during or immediately after disaster. People without mental health specialized training, including public health practitioners and emergency responders can learn and apply to everyone in need. Whilst being used extensively, few studies have evaluated the effectiveness of PFA and its field applicability.
Methods
A prospective randomized controlled study. 800 emergency medical responders were recruited. Participants were randomly assigned to the control/intervention arms to receive a one-day training of PFA based on the protocol developed by the National Child Traumatic Stress Network (2006). A pilot study was conducted to evaluate the screening tools and training material and all training was provided by trained clinical psychologist. Repeated measures analysis of covariance was used to evaluate the efficacy of PFA program in changes in various outcome measures between PFA intervention and control group. All analyses were conducted on the intent-to-treat and completer groups. Ethical approval was approved by the CUHK-NTEC Clinical Research Ethics Committee.
Results
Preliminary results from the post-training and 3 month follow-up data indicated participants in the training group have reported a significantly more substantial knowledge in disaster mental health, improve self-efficacy in delivering help in times of emergencies, high frequency of actual helping behavior as well as better self-reported psychological well-being when compared with waitlist control group.
Conclusion
This study examines and reports findings of clinical effectiveness of PFA 3 months post training in Chinese emergency responders. Preliminary results provided empirical evidences on the effectiveness of the approach.
Following the devastating earthquake in Haiti last January, the International Fund for Animal Welfare (IFAW) and the World Society for the Protection of Animals (WSPA) developed the Animal Relief Coalition of Haiti (ARCH). 19 animal welfare agencies from around the world joined IFAW and WSPA to provide a $1.04M managed fund to the Minstery of Agriculture, Natural Rescources, and Rural Development (MARNDR).
Discussion and Observations
The relief and recovery efforts were based around six objectives: 1. Mobile veterinary clinic 2. Public Outreach emphasizing disaster preparedness, disease prevention, and animal welfare 3. Educational outreach to include an animal welfare curriculum for school-aged children 4. Cold-chain: to provide solar-powered refer/freezer units in remote sections of Haiti to keep vaccines cold 5. Dog and cat survey in Port-au-Prince 6. Rebuilding of the National Laboratory The purpose of this presentation will be to discuss how ARCH was developed and Best Practices and Lessons Learned from a collaborative approach to animal relief and recovery.
Trauma is the leading cause of death in the age group 15–44 years in Nigeria. The burden of trauma has continued to increase in the subregion. It is estimated that a significant proportion of trauma deaths occur prehospital. The role of the EMT-Paramedics in trauma and emergency care is well established. However the profession has been absent in the West African subregion. There was no training centre for EMT Paramedic professionals until the UBTH established one in 2008.
Objective
To review the UBTH EMT-Paramedic training programme and the implications for trauma and emergency care.
Method
The programme onset, implementation and challenges so far is reviewed in detail with illustrations.
Conclusion
The injection of the EMT-Paramedic professionals into our health system will surely improve our emergency care. The support of the Government at all levels as well support for the training from all Medical professionals is urgently neede.
Simulation is a major part of the training process for emergency medical professionals. The scenery, sounds, smells, situations, etc. all have been replicated for the benefit of the student. These simulation factors prepare the student to react according to the trainings they received in a controlled environment, but what about germ simulation? The premise of this research is to determine if the outcome of treatment changes when germ simulation is added as a factor. The majority of emergency medical simulations do not factor germs into the situation, and potentially leave the emergency responders exposed, which causes liability, complications, side effects, etc. Generally, the current standards for care and certification include lessons on blood-borne pathogens, disease prevention, personal protective equipment, etc., but there still is a shortcoming between the classroom lessons and a real situation. This research helps answer the following questions: What is the simulation method that can best replicate a real situation? How much potential disease exposure can an emergency medical responder expect? Does the level of treatment increase with the introduction of a germ simulation? What behavior changes occur when germs become a main factor in a simulation? The goal of this research and presentation is to find out if the amount of risk can be reduced with more comprehensive simulations. Ultimately, researchers hope to diminish the risk of disease and illness spreading among responders and at the same time increase the level of care among disaster victims.
Neurosurgical patients require frequent Computed Tomographies (CTs) of the head, usually at short notice. A mobile CT may prove to be invaluable for these patients.
Objectives
To review the usefulness of mobile CT in intensive care unit (ICU).
Methods
This review was carried out over a 14 month period (18 July 2009 till 31 August 2010). Administrative and clinical data were reviewed and analyzed. For the first 6 months, only the number of CT's done was available. However, data were collected prospectively starting 01 Jan 2010 to include variables such as Glasgow Coma Scale (GSC) ventilator status and pressor support at the time of CT scan. The average time to do a CT was 150 minutes (range 60–240 minutes). The mean number of people required for shifting the patient was 4(range 3–6). For, mobile CT the average time to do a CT was 27.4 minutes (range 7.8–47 minutes) and mean for manpower was 3 (range 3–4).
Observations
The mobile CT was installed and became functional in the neurosurgery ICU on 18 July 2009. A total of 1,752 head CTs were performed during the study period, with an average of 4.8 CTs daily. Detailed prospective data were available (since 01 January 2010) on 1,023 patients. Of these patients, 75.9% (n = 776) were on ventilator, 72.3% (n = 740) were on sedation, and 5.6% (n = 57) were on pressor support at the time of CT. The mean GCS at the time of CT was 8.1 (range 3–15).
Conclusions
Mobile CT was found to be easy to use, with fast scanning time and excellent image quality. It proves to be beneficial for nurses as it requires less time, energy and manpower. The mobile CT is strongly recommended for any high volume neurosurgery department in the country.
Background Recently the number of disaster and mass casualty incident (MCI) is increasing in Korea, but there have been few administrative reports or technical reports for disaster and MCI. An ad hoc basis data collection method is usually incomplete and outdated. This study was conducted to investigate the new surveillance system composed of EMS based real time survey and medical records based in-depth survey.
Methods
A retrospective review was conducted of the 119 fire department call center database and ambulance running sheets in one metropolitan city. The data on all transported patients with non-medical reasons (fire, rescue and others) between May 2006 and December 2008 was reviewed. We selected all data from the accidents which had more than 2 casualties to exam the feasibility and conducted in-depth surveillance based on medical records.
Results
The total number of accidents was 2,027 with 2,625 patients. The number of accidents which had more than 2 patients was 307 (total 898 patients) and more than 6 patients was 19 (total 176 patients). Among the “MCI” events, 15 cases were traffic accidents (125 patients, 71.0%), 4 cases were fire (51 patients, 29%). Total 142 medical records (80.7%) were reviewed. Admission rate was 32.4% (46 patients) and overall mortality was 3.5% (5 patients).
Conclusion
This nationwide public EMS system could contribute to the establishment of the systematic disaster database.
Training for disaster responsiveness for veterinarians includes Incident Command System (ICS) and National Incident Management System (NIMS) comprehension, euthanasia, bio-security, all-hazards emergency preparedness, business continuity training, responder training, and incident de-briefing, Public and emergency management officials at all levels agree that saving animal lives saves human lives. Despite the recognition of the importance of veterinarians and other animal caretakers in animal disaster response and incident de-briefing, there has been less than adequate targeting of these groups for training opportunities leaving many veterinarians and other animal care takers vulnerable and unsure of their role when presented with a call to action in the midst of a disaster scenario in their home communities. The Louisiana State University School of Veterinary Medicine (LSU-SVM) has taken advantage of its physical presence amidst a disaster prone region of the United States to form response teams made up of students, faculty, and staff for actual training events termed disaster response experiential learning. Through a solid partnership with the Louisiana State Animal Response Team (LSART) and other response groups, the LSU-SVM has developed a disaster response program that includes animal response planning, evacuation, sheltering, emergency triage, and technical rescue expertise. Five specific response activities that occurred between 2001 and 2010 where LSU-SVM partnered with local and regional emergency responders enabled veterinary students and veterinarians to provide the work force and engage in experiential learning in a “hand-over-hand” environment with certified emergency responders. The response activities and partnerships demonstrate a successful model for veterinary student and veterinarian training in disaster response, have provided robust training experiences for hundreds of veterinary students and veterinarians, and have resulted in the subsequent development of courses to address identified gaps in veterinary disaster response training.
The world must be resilient against major disasters, whether they are caused by natural hazards or human-related mechanisms. Nowadays, outbreaks of emerging infectious diseases, such as new strains of influenza, are a world wide problem. Special consideration is necessary against chemical, biological, radiological, or nuclear (CBRN) hazards.
Results
The hardware/mechanical preparedness, measurements of the severe influence in mental/psychological aspects, official public system, incident command system, public education system, and the needs of vulnerable populations should be established prior to a disaster. It is also important to prepare the necessary medical resources. The technical skills needed for triage, emergency care, and appropriate transportation should be trained for.
Discussion and Conclusion
Measures should be prepared both from the macroscopic viewpoint as well as microscopic approach. A “Disaster Medicine Compendium” consisting of 20 volumes with more than 5,000 pages, was developed in 2005. Currently, a new version is being prepared.
Between February 2002 and January 2004, a total of 51 terrorism-related mass-casualty incidents (MCIs) occurred in Israel.
Objective
The objective of this study was to analyze data provided in After Action Reports (AAR) held by Magen David Adom (MDA), after each MCI.
Methods
Information relating to the type of MCI, location, number of ambulances dispatched in five-minute intervals from time of notification, and number of casualties evacuated by urgency in five-minute intervals from the start of the incident was analyzed.
Results
There were 34 MCIs in 2002, 15 in 2003, and two in 2004. More MCIs (24%) occurred on Wednesdays, and more MCIs occurred during the 05:30–08:59 (18%), 12:00–14:59 (20%), and 17.00–19.59 (24%) time slots. More MCIs occurred in the Jerusalem (24%) area, followed by Tel Aviv (16%). Twenty-six percent of the MCIs resulted from explosions in open areas, 22% in buses, 20% from shootings, and 28% from explosions in semi-closed and closed areas. The mean dispatch time of the first ambulance after notification was 48 seconds. An average of 14.25 ambulances were dispatched in the first five minutes, followed by eight, three, and three in the five-minute slots following. An ANOVA indicated a significant difference in dispatch times by towns/cities (p = 0.05). The average arrival of the first ambulance was 6.4 minutes, and evacuation of the first urgent casualty was 13.6 minutes, the last evacuation was 26.5 minutes after arrival. More urgent casualties (45%) compared to 20% non-urgent were evacuated in first 15 minutes; the majority of non-urgent victims (79%) were evacuated after 16 minutes. The mean number of dispatched ambulances ranged from 37.9 to 26 in urban versus rural areas, respectively. The number of ambulances actually used for evacuation in urban and rural areas was 55% and 44%, respectively.
Conclusions
Information analyzed from AAR is useful for improving Standard Operating Procedures and structuring continuing education interventions for MCIs.
An activity or situation that produces conditions which are not real, but have the appearance of being real, used especially for testing something. Longman Dictionary of Contemporary English. Simulation has evolved over the centuries but has not been applied to medicine until the 20th century with the introduction of virtual reality and computers. Prior to the 20th century simulation took the forms of physical models and cadavers. With the introduction of flight simulation there was an effort to move similar approaches into medicine. This was pushed by the demands of minimally invasive surgery and the introduction of robotics in surgery. In the 21st century in addition to cognitive task analysis tools we are beginning to see the migration of advanced intelligence tools to simulation. We are just at the beginning of how we will use adversarial reasoning in the medical environment and in high risk time constrained situations like Emergency Medicine. The practitioner of emergency medicine is at high risk for errors because of multiple factors including high decision density, high levels of diagnostic uncertainty, high patient acuity, and frequent distractions. Some authors have suggested that instructing physicians in “cognitive forcing strategies” or “metacognition” will help reduce the amount of cognitive error in medical practice. It has been said ‘‘[There is an] ethical obligation to make all efforts to expose health professionals to clinical challenges that can be reasonably well simulated prior to allowing them to encounter and be responsible for similar real-life challenges.’' TYPES OF SIMULATION • Verbal • Tactile • Visual • Situational • Environmental TYPES OF SIMULATION TRAINING • Standardized patients (role play) • Basic models (partial task trainers) • Simple level • Higher level • Mannequins • Low fidelity • High fidelity • Virtual patients • Screen-based; computer-based • COMBINATIONS • Augmented sp encounters with technology • Crises management HUMAN PATIENT SIMULATION • Realistic • Suitable for all levels • Safe • Wide variety of training programs • Expensive ADVANTAGES OF SIMULATION • Patients are never at risk • Serious but infrequent events, in predictable times and places • Errors can be allowed to occur, and play-out • Rehearsal, repetition, mastery • Crisis management simulation, planning • Reduces institutional liability • Increases operational confidence • Produces rapid results • Allows team training • Increases institutional prestige The use of high fidelity simulations to train multidisciplinary teams in critical environments is well established.
This presentation explores the nexus between collective violence (in the form of violent civil conflict) and health and human rights in Sri Lanka, focusing specifically on persons displaced during the most recent conflict in Northern Sri Lanka beginning in November 2008. After exploring the normative framework in relation to the right to health, the local legal framework governing internal displacement, and the related component on healthcare access, service provision, and standards will be described. By examining health cluster reports, health surveys, and case-studies, this presentation describes how the health sector responded in providing healthcare services to those war displaced living in internally displaced people (IDP) camps in Vavuniya District. The “rights based approach to health” is examined in relation to the health sector response, and key issues and challenges in meeting health protection needs are highlighted. A conceptual framework on the right to health for IDPs in Northern Sri Lanka is presented. This presentation also explores how some health interventions in the post-conflict Sri Lankan context may have acted as a bridge for peace building and reconciliation.