MINUSTAH PRESENTATION

Medical Support for UN Peace Missions: a Military Doctor's experience in Haiti

Lieutenant Colonel Renata Cristina de Almeida Martins Schmidt August 2021

The Mission

Lessons Learned

Summary

Role of language in the mission

Debates

MINUSTAH

United Nations Mission for Stabilization in Haiti - 2004 to 2017

In April 2004, when MINUSTAH was established, by the UN Security Council Resolution 1542, Haiti was experiencing great instability, political violence, human rights violations and impunity.

During the 13 years of operation, Brazil commanded the peace force, being responsible for commanding the international troops operating in the country.

MINUSTAH's performance in relation to humanitarian assistance and to natural disasters contributed to making it very successfully.

LOCALIZATION

Haiti is a Caribbean country located in Central America

Located on the island of Hispaniola in the Caribbean Sea. Its only land border is to the east with the Dominican Republic.

The predominant climate is tropical, the average temperature is 33 degrees Celsius and the relative humidity is 49%.

2nd half 2007-Jan 12, 2010

2004-1st half 2005

Great interaction between Miliary, Police and Civil components

Beginning of Brazilian participation. Installation, operacional and population assistance activities.

2010-2017

2005-2007

Interagency work after the earthquake. Highlight to logistical aspects. Quick Reaction Force was created.

Military activities of the MINUSTAH mandate, facing armed gangs.Important engineering work.

BRABAT 26

Activation: June 2nd

"Ini Pou Lapé" (United For Peace)

Between September 22 and 27, during an operational period called the "Main Body", 85% of the military returned to Brazilian soil, with the remainder, the "Rear Party", to return after October 1, 2017.

To carry out the demobilization mission, several UN memorandums and bilateral agreements between Brazil and Haiti were signed on what would stay and return to Brazil.

The BRABAT 26 members began arriving in Port-au-Prince on May 16, 2017. Four echelons were transported in a Boeing KC-137 (767) aircraft of the Brazilian Air Force. Composition - 970 military (15 women)

Considered important points in the doctrine of employment of troops under the aegis of the United Nations - preparation on rules of engagement, protection of civilians, zero tolerance to sexual exploitation and abuse, gender equality, civil-military coordination actions (CIMIC), creole classes, situational awareness and gradual use of force, in addition to other procedures.The exercise was supported by soldiers from the 12th Light Infantry Brigade (Aeromobile), by academics from the University of Vale do Paraíba (UNIVAP) and by members of the city's public security agencies. Army Aviation and the Army Training Assessment Center (CAAdEx) were also present, providing operational support to the APOE. In all, the exercise was attended by more than a thousand people.

Preparation

Advanced Peace Operations Exercise (APOE)

Held in Caçapava-SP between April 17 and 28, the Advanced Peace Operations Exercise (APOE), conducted by CCOPAB, assessed the operational efficiency of BRABAT 26 members in the context of a multidimensional peace mission.

DNA bank and Immunization (vaccines like yellow fever, hepatitis, oral cholera)

Medical and psychological evaluation

Physical evaluation

Zero tolerance to sexual exploitation and abuse; and gender equality talks

Rules of engagement

Situational Awareness

Civil Military Coordination (CIMIC)

Shooting test

Driving lessons

Simulated military problems

Humanitarian Help

Aeromedical evacuation and START method

Strengthening the team - to overcome the difficulties

Individual preparation

Knowledge of specific manuals - to function effectively in a UN peacekeeping operation.

mission medical cell

CMO - CHIEF MEDICAL OFFICER

Officer responsible for all medical and health matters within the force and in the civilian staff structure.

When Level 1 Hospital capabilities were extrapolated, contact should be made with the UN Chief Medical Officer (UN CMO) or UN doctor on duty at the UN Clinic to discuss the case and then receive guidance on which hospital the military would be evacuated .

FMO - FORCE MEDICAL OFFICER

Directly subordinate to the Force Commander

Col Aguirre - a Colonel from Brazilian Air Force, who acted on behalf of the Forces Commander in all medical matters and controls all UN medical units on the ground.

medical evacuation chain

Medical regulation was carried out by UN CLINIC.

Basic level - First aid and preventive medicine

Level 1 - Primary care, emergencies, reanimation, stabilization and evacuation within the mission area. Hospitalization up to 72 hours

Level 2 - The second line of care, emergency and reanimation, amputations, emergency thoracic and abdominal surgery, intensive care, basic dental care and evacuation capacity to the next step.

Level 3 - More delicate situations and surgeries with a greater degree of specialization and complexity were transferred, by Aeromedical Evacuation, to contracted civilian hospitals.

Level 4 - In more complex removals, with no imminent risk of death, and which required greater care, a transfer to MIAMI – United States was performed. From there, the procedure for repatriation to Brazil was carried out.

TCC = Troop Contributing Country

medical SUPPORT LEVELS - MINUSTAH

MEDEVAC was carried out by Bangladesh Aviation and by ARGHOSP health staff and supplies.

LEVEL I

LEVEL II

Battalion, Contingent, Company

ARGHOSP

LEVEL III

LEVEL IV

CEDIMAT (Santo Domingo)

Jackson Memorial Hosp. (Miami,Fl)

General bacellar base

In honor of General Urano Teixeira da Matta Bacellar, Force Commander who committed suicide in January 2006.

The General Bacellar Base was built in 2007 in Camp Charlie, in an unoccupied camp in the Tabarre region.

Main entrance

General bacellar base

Sports and parking area for military vehicles

monument to those killed in the earthquake

Nowadays, the monument in honor of the18 soldiers who lost their lives in the earthquake is located in the courtyard of the CCOPAB, in Rio de Janeiro

BRABAT 26

Major renata

Senior Medical Officer of UMN1, cardiologist

LT IWAKURA

LT SCHIRMER

LT SAFATLE

LT LIZANDRA

CCAP Medical officer, general practitioner

CCAP Medical officer, orthopedist

2 Cia Fz Medical officer, general practitioner

1 Cia Fz Medical officer, general practitioner

medical unit level 1 - BRABAT 26

Located at the General Bacellar Base, inside the Charlie Field, it was responsible for providing medical, dental, pharmaceutical and physical therapy services to the military personnel.

Main entrance

Command Section and S1 Section

Reception

medical unit level 1 - BRABAT 26

Located at the General Bacelar Base, inside the Charlie Field it was responsible for providing medical, dental, pharmaceutical and physical therapy services to the military personnel.

Sterilization section

Hospitalization

Dental services

medical unit level 1 - contbras

Located at the General Bacelar Base, inside the Charlie Field it was responsible for providing medical, dental, pharmaceutical and physical therapy services to the military personnel.

Doctor's office

Hospital pharmacy

Surgery room (Red room)

medical unit level 1 - contbras

Located at the General Bacelar Base, inside the Charlie Field it was responsible for providing medical, dental, pharmaceutical and physical therapy services to the military personnel.

Laundry Section

"Urutulância"

Operational ambulances

HEALTH team

The BRABAT 26 health service consisted of 26 militaries: 5 doctors, 3 dentists, 1 pharmacist, 1 physiotherapist, 8 health sergeants, 5 corporals and 3 soldiers

ROUTINES

Supervised the care and application of preventive medicine measures. Local citizens were NOT of medical interest unless it was a medical emergency. Coordinated the evacuation of casualties / MEDEVAC within the area of ​​responsibility. Ensure adequate medical supplies and equipment for your sector of responsibility. Supervise the medical information, training and education of medical personnel and personnel of the sector. Prepare reports as required by the S1, FMO and CMO in addition to ensuring their presentation timely weekly and monthly. Provide medical coverage for special events: Military Skills, Shooting, Sport

Senior Medical Officer (SMO)

I was the point of contact of S1 with the FMO and was the lead medic for our unit and led medical advisor to the Sector Chief.

ROUTINES

Control of water purification (control, cleaning and change of filters as needed). Control and supervision of food hygiene in the kitchens and of the personnel who take care of the food. Daily temperature control of refrigerators and cold rooms in the sector. Take preventive health and hygiene measures in the field (accommodation, common bathrooms, kitchen, garbage, sewage). Pest, rodent and insect control tasks. Control and supervision of the animal situation: keep a record of documentation on the animals and the owners. Send mandatory monthly reports to the FHO and immediate as necessary on hygiene and health environmental for strength.

Hygiene Officer

DEMOBILIZATION

Everyone from health team, without exception, worked on packaging the material

All material and health equipment to be repatriated was cleaned, packed, placed in boxes and then in containers

demobilization

environmental concern

All barrels of oil used to run the smoking machines were repatriated. All medications too. They could not be donated

cimic

Social civic actions were carried out during the mission

CIMIC

There was a planning of the materials that would remain in Haiti and would be donated to partner institutions.

physical health

TFM

Physical training was done daily and sometimes collectively

mental & Spiritual health

The chaplain of BRABAT 26 was actively involved in the spiritual health of all.

aerial reconnaissance

Made in the CHIBAT AND URUPERBAT areas before their demobilization

Search for local sanitary conditions and support from local clinics and hospitals.

terrestrial reconnaissance

Local health conditions

Conducted by the Immediate Response Detachment primarily during hurricane hazards. In case of collapse of cities and health systems.

Health instruction - personal protection

LQFEx provided the individual kits

we exhaustively provided guidance on individual protections against insects, use of sunscreen, repellent and condom use.

Health instruction - public health

We were tireless in fighting pests

Guidance on the hygiene of accommodation, placement of mattresses in the sun, cleaning of bed frames, use of mosquito nets.

58

106

516

Total amount

total diagnoses

MOST COMUM

There were 516 different medical appointments, in a period of 4 months, between June and September 2017

106 different international disease codes

The most common illness was the cold, 58 cases

lESSONS lEARNED

United Nations Mission for Stabilization in Haiti - 2004 to 2017

Importance of individual preparation, resilience, motivation and knowing how to deal with cultural differences.

Study United Nations peace support, humanitarian relief, and security operations with self-paced e-learning from POTI. https://www.peaceopstraining.org/

MINUSTAH's performance in relation to humanitarian assistance brought great learning about the integration of the Forces Armed with the community between civilians and military.

IMPORTANCE OF LANGUAGE

United Nations Missions

All reports made to the FMO and CMO were in English, using technical terms.

All meetings held at UN facilities were in English, regardless of the participating nations.

During their leaving many military personnel went to Miami and many had difficulties with the language. No nursing technician on the mission was qualified in English.

MOU is an agreement between the UN and each Troop Contributing Country (TCC) and is a key document that defines: what capacity / effect the TCC should bring to the Mission and how the sustainment of this force will be conducted defines responsibilities of support by the UN or TCC and the method or reimbursement.

ORI

OPERATIONAL READINESS INSPECTION

MOU details the major equipment, self-sustainment services (equipment and services provided by a TCC and personnel which the contributing country is asked to deploy, and for what it is entitled to be financially reimbursed.

MILITARY HEALTH PROBLEMS

MINUSTAH

The entire description of the clinical case for the UN clinic, the nine lines, body parts involved, types of injuries and actions taken and to be taken during official communications were done in English.

During MEDEVAC communication was established in English.

Simulated field exercises with the UN were also conducted in English.

Tour

Port-au-Prince

IIlustrative video

"It was up to the Military Force to maintain the safe and stable environment, interacting with the other components of the mission so that they could achieve the goals set in the political and human rights fields".

Gen Bda Alexandre Oliveira Cantanhede Lago

DEBATES

thank you!