Lessons from the frontline: Documenting the pandemic emergency care experience from the Pacific region - Infrastructure and equipment

Megan Cox; Deepak Sharma; Georgina Phillips; Rob Mitchell; Lisa-Maree Herron; Claire E Brolan; Gerard O'Reilly; Sarah Körver; Mangu Kendino; Penisimani Poloniati; Berlin Kafoa

doi:10.1016/j.lanwpc.2022.100516

Lessons from the frontline: Documenting the pandemic emergency care experience from the Pacific region - Infrastructure and equipment

Lancet Reg Health West Pac. 2022 Aug:25:100516. doi: 10.1016/j.lanwpc.2022.100516. Epub 2022 Jul 6.

Authors

Megan Cox^{1

2

3}, Deepak Sharma⁴, Georgina Phillips^{5

6}, Rob Mitchell^{5

7}, Lisa-Maree Herron⁸, Claire E Brolan^{8

9}, Gerard O'Reilly^{5

7}, Sarah Körver⁵, Mangu Kendino¹⁰, Penisimani Poloniati¹¹, Berlin Kafoa¹²

Affiliations

¹ Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
² The Sutherland Hospital, Sydney, NSW, Australia.
³ NSW Ambulance, Sydney, Australia.
⁴ Colonial War Memorial Hospital, Suva, Fiji.
⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
⁶ Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia.
⁷ Emergency & Trauma Centre, Alfred Health, Melbourne, Australia.
⁸ School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
⁹ Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia.
¹⁰ Port Moresby General Hospital, Papua New Guinea.
¹¹ Emergency Department, Vaiola Hospital, Nuku'alofa, The Kingdom of Tonga.
¹² Public Health Division, Secretariat of the Pacific Community, Suva, Fiji.

Abstract

Background: The COVID-19 pandemic highlighted challenges for all health systems worldwide. This research aimed to explore the impact of COVID-19 across the Pacific especially with regards to emergency care (EC) and clinicians' preparations and responses.

Methods: A collaboration of Australia and Pacific researchers conducted prospective qualitative research over 18 months of the pandemic. In this three phase study data were gathered from Emergency Clinicians and stakeholders through online support forums, in-depth interviews and focus groups. A phenomenological methodological approach was employed to explore the lived experience of participants. This paper discusses the findings of the study regarding the EC building block of 'Infrastructure and Equipment.'

Findings: Pre-existing infrastructure and equipment were not sufficient to help control the pandemic. Adequate space and correct equipment were essential needs for Pacific Island emergency clinicians, with donations, procurement and local ingenuity required for suitable, sustainable supplies and facilities. Adequate personal protective equipment (PPE) conferred a sense of security and increased Health Care Workers willingness to attend to patients.

Interpretation: Investing in adequate infrastructure and appropriate equipment is crucial for an effective response to the COVID-19 pandemic. The sustainability of such investments in the Pacific context is paramount for ongoing EC and preparation for future surge responses and disasters.

Funding: Phases 1 and 2A of this study were part of an Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding for this research was received from the Australasian College for Emergency Medicine Foundation via an International Development Fund Grant.

Keywords: Building blocks; COVID-19; Donations; Emergency care; Health equipment; Health infrastructure; Oxygen; PICTs; PPE; Pacific; Ventilators.

Grants and funding

WT_/Wellcome Trust/United Kingdom