LETTER FROM THE PUBLISHER
Into the Field
W
e left the Kumbh’s wide dusty avenue and made our way through an entryway of corrugated metal into the sector 4 health clinic. We stepped from the heat of the mid-morning sun into the pleasant in-patient tent and I quickly noticed two things. First, the beds were neatly made, each carefully topped with a red army blanket and marked with a numbered placard. Second, the room was empty save for one elderly woman with dehydration. The first observation left me optimistic; the second left me scratching my head. The Kumbh Mela, after all, isn’t just a Hindu festival held in northern India. It’s the largest human gathering on the planet. On any given day, there were literally millions of pilgrims coming to take a holy bath at the confluence of the Ganges and Yamuna rivers. Yet for all of these pilgrims there were merely 11 small health clinics. And this one was empty. Why? One of the outstanding things about emergency medicine is that it can never be confined within the walls of an emergency department or A&E. Whether it’s a traffic accident on the side of a road or a woman going into labor at a shopping mall, emergency physicians are trained to handle the unexpected, and they thrive within the unpredictable. This readiness makes EPs perfect for leading the healthcare at mass gatherings, so I wasn’t surprised when an EP friend from India invited me to join him at the Kumbh Mela. What could be more exciting to an emergency physician than tens of millions of people camping on the banks of a river chock full of E. coli? We traveled to the city of Allahabad for the festival with a team from Harvard’s FXB Center for Health and Human Rights. We went to study the festival’s healthcare infrastructure (full story on page 24), and to test a hypothesis. The team believed that even in a resource-poor setting, a simple iPad-based electronic medical record could be deployed, and that by doing so, a small team could bring life-saving syndromic surveillance where it had never existed before. The results were unprecedented. The dedicated team of local medical students were able to gather more than 40,000 data sets, arguably the largest healthcare data collection ever accomplished on a transient population. The results have the ability to improve resource allocation at future Kumbhs as well as at mass gatherings around the world, insuring that empty beds are well utilized, and that spikes in disease are identified before they reach epidemic proportions. This work is not traditional emergency medicine, but it is practical, innovative and life-saving healthcare and it represents the best of what emergency care systems thinking can bring to the world. Here’s to the next innovation, and to the emergency physician who will imagine it.
Logan Plaster Publisher
editorial director C. JAMES HOLLIMAN, MD executive editors PETER CAMERON, MD TERRY MULLIGAN, DO, MPH LEE WALLIS, MD MARK PLASTER, MD publisher LOGAN PLASTER logan@epijournal.com On Twitter @EPIJournal editorial interns DR. RASHMI SHARMA REBECCA CORDER PEREL BERAL regional corespondents CONRAD BUCKLE, MD MARCIO RODRIGUES, MD CARLOS RISSA, MD KATRIN HRUSKA, MD SUBROTO DAS, MD MOHAMED AL-ASFOOR, MD JIRAPORN SRI-ON, MD editorial advisors ARIF ALPER CEVIK, MD KATE DOUGLASS, MD HAYWOOD HALL, MD CHAK-WAH KAM, MD GREG LARKIN, MD PROF. DONGPILL LEE SAM-BEOM LEE, MD ALBERTO MACHADO, MD JORGE OTERO, MD print advertising LOGAN PLASTER logan@epijournal.com
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Spring 2013 // Emergency Physicians International
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