Medical Humanitarian Programme MEDEVAC

MEDEVAC is a permanent government programme of the Czech Republic, which focuses on providing medical care and assistance for vulnerable groups of persons in the countries affected by migration or burdened by a large number of refugees. The care provided is free of charge and exclusively for civilians - persons, who are in dire of such medical care or whose condition prevents them from leading a dignified life. 

MEDEVAC in 2016

Implementation of the MEDEVAC Programme in 2016

With its Resolution No. 956 of 20 November 2015, the government of the Czech Republic approved establishment of the Permanent Medical Humanitarian Programme MEDEVAC. Under this resolution, a Working Group was formed to implement the MEDEVAC Programme, including the representatives of the Ministry of the Interior, the Ministry of Health, the Ministry of Foreign Affairs, the Ministry of Defence (the General Staff of the Army of the Czech Republic) and the Ministry of Industry and Trade.

The first meeting of the interdepartmental working group on the implementation of the Permanent Medical Humanitarian Programme MEDEVAC was held at the Ministry of the Interior on 22 February 2016. It approved the annual framework priorities of the Permanent Medical Humanitarian Programme MEDEVAC as well as individual priorities and projects planned for 2016, including the proposed budget.

In 2016, the Permanent Humanitarian Medical Programme is implemented through the following projects and activities: deployment of medical teams abroad, medical humanitarian evacuations of persons for treatment in the Czech Republic, training of the medical staff and newly also through financial donations abroad to support and develop the health care infrastructure in the countries affected by war, humanitarian and natural disasters.  

The programme is implemented in seven countries: Jordan, Iraq - the Iraqi Region of Kurdistan, Ukraine, Cambodia, Kenya, Morocco and Nepal with the participation of six hospitals under the direct authority of the Ministry of Health: Motol University Hospital, General University Hospital in Prague, Bulovka Hospital, Olomouc University Hospital, Hradec Králové University Hospital, University Hospital in Ostrava and Central Military Hospital that is under the direct authority of the Ministry of Defence.

The budget for the implementation of the MEDEVAC Programme in 2016 is CZK 60 million.
 

Jordan / Bulovka Hospital - Orthopaedics (March 2^nd - March 11^th,  2016)

A team from the Orthopaedic Clinic of Bulovka Hospital was sent to Al-Khalidi Hospital in Amman at the beginning of March. The medical team comprising two surgeons (orthopaedists), an anaesthesiologist, a scrub nurse and a mission administrator provided surgeries and treatment of war injuries of Syrian refugees from refugee camps as well as surgeries in children and adult patients with acquired and congenital defects of the musculoskeletal system. The MEDEVAC Programme in Jordan has been focusing on treatment and surgeries of vulnerable groups of inhabitants on a long-term basis, i.e. it focuses both on Syrian refugees in Jordan and on the socially weak Jordanians who mostly cannot afford health care services.

The team examined 45 patients with post-traumatic, congenital and degenerative disorders of the musculoskeletal system. Twenty patients were selected for a surgery, sixteen of which were operated. Upon departure of Czech doctors, all patients were stabilised and without any apparent complications. Cooperation with Al-Khalidi Hospital in Amman has been at a very high level for a long time, whether it includes the accommodating approach of the local staff to the requirements of the Czech doctors or instrumentation and equipment of operating theatres and sanitary conditions.
 

Morocco / Interior Ministry, Motol University Hospital, Bulovka Hospital - Reconnaissance Trip (March 13^th - March 16^th, 2016)

A reconnaissance mission to Morocco took place between 13 and 16 March 2016 in order to find partner hospitals for the MEDEVAC Programme. It also mapped out the situation in the health care provision in Morocco and chose preferences and conditions to activate the MEDEVAC Programme in Morocco. Czech hospitals were represented by a team of doctors from Bulovka Hospital and the Children's Heart Centre of Motol University Hospital.

Although Morocco is not a country affected by war or another humanitarian disaster, there are huge social differences in the country. Foundation hospital Centre Hospitalier Universitaire Hassan II in Fez was selected as a partner hospital. It was established and is financed by the Lalla Salma Foundation managed by a wife of the Moroccan king. This hospital provides health care services to socially weaker groups of inhabitants and it is the only hospital focused on paediatrics in its region (serving approx. 120,000 people). Following the visit of the medical team from the Children's Heart Centre of Motol University Hospital, future cooperation was agreed in the field of paediatric heart surgery with a focus on congenital heart defects in children from the socially weak groups of inhabitants.
 

Jordan / Olomouc University Hospital - Traumatology + Physiotherapy (March 29^th - April 9^th, 2016)

A medical team from Olomouc University Hospital comprising two surgeons (specialising in trauma surgery of limbs), one anaesthesiologist and a physiotherapist (specialising in rehabilitation of hand and musculoskeletal system traumas) was deployed at Palestine Hospital, a charity hospital in Jordan, between 29 March and 9 April. They performed a total of twelve surgeries in ten patients. The interventions mostly included secondary surgeries after war injuries that could not be primarily sufficiently treated or where complications occurred during the healing process. The follow-up rehabilitation supervised by an experienced physiotherapist was perceived as a very important part of the entire treatment process.

Olomouc University Hospital worked at a new partner hospital, Palestine Hospital, for the first time. It was chosen during the reconnaissance trip of a MEDEVAC Programme coordinator and the representatives of the Czech cooperating hospitals at the end of 2015. After experience of this first mission, this hospital suits the needs of Czech doctors, in particular with respect to personnel. The team highly appreciated the professional approach of all members of the medical staff which helped prevent the everyday vices such as unpunctuality, organisational chaos in patient admission and long delays between individual interventions. Cooperation with Jordanian doctor Watheq Al-Qsous who arranged communication between the Czech team, patients and the hospital management was an important contribution for the entire mission.
 

Cambodia / Motol University Hospital - Paediatric Heart Surgery (March 29^th - April 13^th, 2016)

The medical mission from the Children's Heart Centre of Motol University Hospital under the MEDEVAC Programme was for the second time sent to Calmette Hospital in Phnom Penh, the capital of Cambodia. The team examined 23 pre-selected patients (children), 13 of which were operated. It also selected three children for preferable treatment in the Czech Republic due to their health condition (complicated congenital heart defects). During surgeries and post-operative care, the Czech doctors closely cooperated with the Cambodian staff, surgeons, anaesthesiologists, perfusionists, cardiologists and scrub nurses. Two Czech nurses focusing on post-operative care were also involved and they also provided education to the local paramedical staff.

Considering the care for children with congenital heart disease, post-operative care for small children and children after lengthy and complicated surgeries remains the main problem at Calmette Hospital. That is why expert supervision of a Czech specialist and targeted ECHO examinations are necessary before any surgery and early after the surgery. Other problems include a lack of special medical supplies, some instruments for paediatric heart surgery (sternal saws, headlamps, fine vascular clips and tweezers) and especially a lack of blood derivatives, vasodilatations and other preparations. It is also a big problem that not all doctors and nurses can speak good English, which complicates fast and accurate communication during operations and in post-operative care.
 

Jordan / Central Military Hospital - Reconnaissance Trip (April 17^th - April 21^st, 2016)

Between 17 and 21 April 2016, a team of doctors from Central Military Hospital in Prague-Střešovice conducted a reconnaissance trip to Jordan in order to assess possibilities of the future mission in traumatology, ophthalmology and ENT. During this mission, doctors visited four hospitals (Al Khalidi Medical Center, Palestine Hospital, Eye Shami Center, Princess Iman Hospital), three of which suit the doctor requirements and meet sanitary and other standards of European hospitals. The state hospital in the Ghor Province was included in the selection in order to understand the contrast between the quality of the selected hospitals and state-run medical facilities. During the trip, the team was accompanied by a Jordanian medical expert of the Czech MEDEVAC Programme who helped the doctors familiarise themselves with the Jordanian health care infrastructure and lead talks with the Jordanian hospitals. The Czech ambassador to Amman also officially received the delegation of Czech doctors.

The representatives of individual medical teams agreed to take part in medical missions to Jordan in the upcoming months.
 

Jordan / Hradec Králové University Hospital - Ophthalmology (April 17^th - April 26^th, 2016)

A team of ophthalmologists comprising two specialists and a nurse was sent to Jordan for the second time where they mostly operated Syrian refugees under the MEDEVAC Programme. Following the experience from the previous year, this mission again focused on eye cataract surgeries as a highly efficient and effective help without any lengthy follow-up care. The team performed 118 surgical interventions (advanced, mature and very complicated cataract cases).

Photo gallery: Jordan / Hradec Králové University Hospital - Ophtalmology 
 

Kenya / Motol University Hospital - Paediatric Heart Surgery - Surgeries and Training (April 19^th - May 19^th, 2016)

Three Kenyan girls aged between one and three years accompanied by their mothers arrived to the Heart Centre of Motol University Hospital in the spring of 2016. Their physician and nurse from The Mater Hospital in Nairobi came together with them.

The girls were selected by the doctors from Motol University Hospital during their mission in Kenya in autumn 2015 due to their diagnosis of congenital heart disease that could not be operated under the local conditions. It was therefore decided that the children should be brought to the Czech Republic for treatment where a successful heart surgery was performed. Both girls quickly recovered after the operation and could return home without any complications almost after one month. The action was carried out with assistance of the Caritas of the Archdiocese of Prague that provided the mothers and children with social assistance and interpreting services.

During their hospitalisation and the follow-up post-operative treatment outside the hospital, Motol University Hospital also provided education to the Kenyan doctor and nurse from the hospital in Nairobi. Motol University Hospital has been cooperating with this medical centre for five years, with the last two years of cooperation being implemented under the MEDEVAC Programme. A team of doctors from the Heart Centre of Motol University Hospital is sent to Kenya every year to operate children with congenital heart defects. This form of assistance to a developing country is more cost-efficient than evacuations of patients to the Czech Republic. That is why it receives continued support from the Czech government.

Photo gallery: Kenya / Motol University Hospital - Paediatric Heart Surgery 
 

Iraq - the Iraqi Kurdistan Region / General University Hospital - Training of Kurdish Doctors (May 2^nd - May 30^th, 2016)

Following the experience from 2015, a training course was held in May 2016 for six Kurdish doctors and six members of the paramedical staff specialising in traumatology. The training course was organised in cooperation with the First Surgical Clinic of Thoracic, Abdominal and Injury Surgery of General University Hospital in Prague and the First Faculty of Medicine of Charles University. The nominees for this type of training must have been doctors under 40 years of age who have not decided for their traumatology specialty yet. The training programme included lectures and simulations on digital models in the simulation centre of the Institute of Physiology of the First Faculty of Medicine of Charles University. The interns also took part in a three-day course at the Centre for Hand Surgery in Vysoké nad Jizerou. Depending on the specialty of the Kurdish doctors, an internship and seminars were organised at the First Surgical Clinic of General University Hospital and the First Faculty of Medicine of Charles University and Královské Vinohrady University Hospital which offered an internship at the Burn Clinic. The training also included a visit to the MEDIN training centre in Nové Město na Moravě where the Kurdish doctors could try work with bone implants during a practical workshop.

Photo gallery: Iraq / General University Hospital - Training of Kurdish Doctors 
 

Prague Surgical Days Conference (May 17^th, 2016)

On 16 and 17 May 2016, the 23rd annual Prague Surgical Days conference, organised by General University Hospital in Prague, took place. One day of this important medical conference was devoted to the MEDEVAC Programme and its activities. This government-run medical humanitarian programme is coordinated by the Ministry of the Interior, which founded it in 1993.

The first speeches were given by ministry representatives (Ing. Jiří Nováček, First Deputy Interior Minister; PhDr. Tomáš Haišman, Asylum and Migration Policy department director; and Petr Hladík, Czech Ambassador to Jordan, on behalf of the Ministry of Foreign Affairs) and management representatives of the hospitals that participate in the MEDEVAC Programme by sending their medical teams abroad, providing treatment to foreign patients, or training foreign doctors and medical staff in the Czech Republic and abroad.

The other lectures were given by the representatives (physicians) of the respective teams that were sent on a mission abroad within the MEDEVAC framework (in particular to Jordan, Kenya and Cambodia) and who presented to the professional public their deployment in hospitals abroad whose standards are often far from those in Europe, be it in equipment or the treatment itself. The final lecture was given by Watheq Al-Qsous, a Jordanian orthopaedist who studied in Czechoslovakia in the 1980s. Apart from professional medical information, his lecture also dealt with the wider context of the MEDEVAC Programme in Jordan, where the assistance of Czech physicians focuses primarily on operating war injuries suffered by Syrian refugees or on congenital defects in socially disadvantaged Jordanian citizens.
 

Jordan / Bulovka Hospital - Plastic and Reconstructive surgery (May 25^th - June 3^rd, 2016)

For the fourth time, the Bulovka Hospital plastic surgery team, consisting of two plastic surgeons, a surgical nurse and the mission administrator, was sent to Amman, the Jordanian capital. In the local charity hospital – Palestine Hospital – they operated Syrian refugees, primarily reconstructing post-injury conditions on the arms, operating congenital defects of the upper and lower extremities, and correcting deforming and contracting post-injury scars. Within the framework of the mission, 31 patients were treated during pre-operative examinations, 18 of whom (nine children and nine adults) were selected for surgery.

The Bulovka Hospital team performed surgeries at Palestine Hospital for the first time. It was selected during the previous missions in cooperation with the Ministry of the Interior coordinator, representatives of other hospitals, and a local Jordanian specialist. This hospital is suitably equipped for the medical interventions performed by the physicians of the plastic-surgery team. The Czech doctors also appreciated the very welcoming approach of the hospital management and the medical staff with which they collaborated during the surgeries.
 

Morocco / Visit by Moroccan Physicians to the Czech Republic - Reconnaissance Trip (May 31^st - June 4^th, 2016)

Following the reconnaissance trip by Czech doctors (cardiologists from Motol and other specialists from Bulovka Hospital) to Morocco on 13-16 March 2016, Moroccan colleagues visited two Czech medical facilities under the MEDEVAC Programme: Bulovka Hospital and Motol Hospital.

A total of nine Moroccan physicians participated in consultations in the Czech Republic. They were led by the director of the Hassan II University Hospital and the business counsel from the embassy in Rabat as the companion and interpreter for this group of doctors.

During their visit to Motol Hospital’s Children’s Heart Centre, the Moroccan physicians met Prof. MUDr. Tomáš Tláskal, CSc. and MUDr. Peter Kubuš, the chief of the paediatric cardiology ward. Apart from preparing the Czech cardiologists’ mission to Morocco (in the second half of September 2016), the possibility of training nurses, the numbers and types of surgeries performed in the Motol heart centre, heart transplants, the issue of organ donations, waiting times, etc. were discussed.

Bulovka Hospital presented individual specialised wards to the Moroccan delegation, which was primarily impressed by the state-of-the-art laboratory and the hospital pharmacy. One possibility for future cooperation with the Moroccan hospital is based on the need for professional training for surgical nurses and nurses and for the use of professional knowledge in the field of paediatric orthopaedics.

The visit by the Moroccan physicians was very positively evaluated by all the participating parties - by the delegation from the Hassan II University Hospital in Fez and by the Czech hospitals involved in the activities of the MEDEVAC Morocco Programme.
 

Morocco / Motol University Hospital - Paediatric Heart Surgery (September 18^th - September 30^th, 2016)

This September, the team from Motol Hospital’s Children’s Heart Centre was sent on its first Czech-Slovak heart surgery mission to Morocco. There, it focused on operating children with congenital heart defects, stemming from socially disadvantaged families, at the Centre Hospitalier Universitaire Hassan II in Fez.

Since these were the very first activities within the MEDEVAC Programme in Morocco, this mission was implemented based on two reconnaissance trips – by Czech physicians to Morocco and by Moroccan physicians to the Czech Republic this spring. Both medical teams had the opportunity to learn about the situation in each other’s country in the field of paediatric heart surgery. The embassy in Rabat played an irreplaceable role in the overall organisation and planning and communication between both parties.

In cooperation with the Moroccan doctors, more than 25 patients were pre-selected from a database of 123 children waiting for surgery and examined. The cohort primarily contained patients with serious congenital heart defects and serious cyanosis, symptoms of heart disease, pulmonary hypertension, and/or overall dystrophy. In the end, thirteen children were selected and operated.

During the surgeries and post-operative care, the Czech physicians closely collaborated with the Moroccan staff, surgeons, anaesthesiologists, perfusionists, cardiologists, surgical nurses and ICU nurses. Contributing to these activities significantly were two Slovak nurses who, apart from post-operative care, also focused on educating allied medical staff.
 

Jordan / Hradec Králové University Hospital - Ophthalmology (September 25^th - October 4^th, 2016)

For the third time, a team of ophthalmologists, consisting of two specialists (led by Prof. Jirásková) and a nurse, was sent to Jordan where they performed 192 surgical interventions. The mission again focused on cataract surgeries that are very efficient and helpful without long-term follow-up care. At the Al Khalidi Medical Centre, a brand new eye centre with two operating theatres was built for MEDEVAC purposes and is also used by the locals. The physicians appreciated the approach of the hospital and the local medical staff as well as the lack of delays between individual surgeries, which resulted in operations being performed on a record number of patients in the two operating theatres.

Photo gallery: Jordan / Hradec Králové University Hospital - Ophtalmology 
 

Jordan / Bulovka Hospital - Plastic and Reconstructive Surgery (September 28^th - October 7^th,  2016)

The medical team, consisting of two surgeons (led by MUDr. Molitor), a nurse and the mission administrator, focused primarily on reconstructing post-injury conditions on the arms (joints, tendons), correcting post-injury scars (mainly burns), and operating acquired and congenital developmental defects of the extremities. At Palestine Hospital, a total of 40 patients were examined and thirty were operated. The surgeries were without larger complications, and the patients received follow-up examinations by Jordanian expert physician Watheq Al-Qsous.

Photo gallery: Jordan / Bulovka Hospital - Plastic and Reconstructive Surgery 
 

Jordan / General University Hospital - Traumatology (October 4^th - October 15^th, 2016)

On October 4, mission head MUDr. Burget pre-selected patients at Palestine Hospital and subsequently 21 patients were successfully operated. The traumatology mission comprised four physicians, a physiotherapist and a nurse. The medical team focused primarily on reconstructive surgery cases with an emphasis on the musculoskeletal system. For some of the surgeries, instruments from Czech company MEDIN were used. Similarly to the previous missions, the post-operative follow-up care was provided by a Jordanian physician who has been successfully collaborating with the Czech teams for two years.

Photo gallery: Jordan / General University Hospital - Traumatology 
 

Iraq - Iraqi Region of Kurdistan / Hradec Králové University Hospital - Training Kurdish Ophthalmologists (October 16^th - October 28^th, 2016)

In cooperation with Hradec Králové University Hospital, Kurdish eye specialists were trained for the first time in the second half of October. The objective of their internship at Hradec Králové Hospital’s Eye Clinic was to improve and deepen the knowledge level of individual ophthalmology segments for resident physicians from the Kurdish Duhok Eye Hospital. During the internship, two female and two male Kurdish physicians had the opportunity not only to encounter all ophthalmological areas (diagnostic, treatment and surgical), but also to learn about the management of the eye centre and its systematic organisation, which is very efficient due to its high level of specialisation and its planning system and which does not exist in their country yet.

The city of Duhok is located less than 100 km from Mosul in Iraq, which in recent months has seen military operations to liberate the city from ISIL. In Duhok, ophthalmology patients are therefore not only common patients, but also refugees, civilians with serious war injuries. The hospital, due to its equipment and mainly its lacking in staff, is not sufficient to cope with such a high number of patients in need of medical treatment. The Kurdish health care system is overburdened by the influx of refugees from Syria and internally displaced citizens within Iraq, and many physicians have left for abroad. For the young Kurdish doctors, the experience and new knowledge acquired during their internship are very valuable; they have the possibility of applying them during their everyday medical practice and sharing them with their colleagues.

Photo gallery: Hradec Králové University Hospital - Training Kurdish Ophthalmologists 
 

Iraq - Iraqi Region of Kurdistan / Olomouc University Hospital - Reconnaissance Trip, Training, Traumatology (October 24^th - November 4^th, 2016)

Based on the successful traumatology training of Kurdish physicians and medical staff in the spring of 2016 at General University Hospital in Prague, a multidisciplinary team (two surgeon-traumatologists and an anaesthesiologist) was sent on a reconnaissance mission from Olomouc University Hospital, connected with direct aid by Czech physicians in the Duhok Governorate in Iraqi Kurdistan. During their trip, the physicians got to know two local hospitals – the Emergency Teaching Hospital and the Emergency Hospital in Zakho, which provide treatment to patients with acute injuries, both civilian and war-related. In collaboration with local physicians, the Czech doctors participated in the triage, diagnostics and stabilisation of injured patients in the emergency ward and in the surgical treatment of these injuries, both during the day and at night. They were “on call” at all times during their stay. In cooperation with the local Directorate General of Health, the Czech physicians also participated in the Life Support training programme for graduates of the University of Duhok’s Faculty of Medicine. The Consulate General in Erbil also participated in the planning and organisation of the entire mission.
 

Jordan / Military University Hospital - Orthopaedics, ENT (November 1^st - November 12^th, 2016)

At the beginning of November, two teams from the Military University Hospital in Prague, a participant in the MEDEVAC Programme since January 2016, were sent to the Jordanian capital Amman for the first time. The ENT medical team focused on surgeries in young children – Syrian refugees living in refugee camps in Jordan – with long-term respiratory-system problems, such as chronic rhinitis, nasopharyngitis and bronchitis. Thanks to the surgeries on their adenoids and tonsils, which are relatively non-demanding interventions for children, the overall health condition of the young patients significantly improved shortly after the surgery. Overall, 68 surgeries were performed without subsequent post-operative complications. The second team consisted of orthopaedic specialists (three surgeons, an anaesthesiologist and a surgical nurse) and focused on surgeries on the musculoskeletal system of older patients of Syrian origin, mainly total knee replacements and knee arthroscopies. During their mission, fifteen patients were operated.

Photo gallery: Jordan / Military University Hospital - Orthopaedics, ENT 
 

Jordan / Bulovka Hospital - Orthopaedics, Ophthalmology (November 30^th - December 9^th, 2016)

For the fourth time, a team of orthopaedists from Bulovka Hospital, under the leadership of Doc. Chomiak, was sent to Jordan, and for the first time, an eye specialist, accompanied by a nurse, joined the mission. Both medical teams worked at Al Khalidi Hospital. The Czech ophthalmologist performed 62 cataract surgeries in seven surgery days, and a Jordanian ophthalmologist is taking care of the post-operative follow-up care. Due to the approach of the local hospital, the surgeries are performed smoothly and without unnecessary delays. Cataract surgeries last fewer than 30 minutes on average and are almost without any subsequent post-operative complications.

The orthopaedic team, consisting of two orthopaedic surgeons, a female anaesthesiologist, a surgical nurse and the mission administrator, again dealt with surgeries and treatment of war injuries on Syrian refugees from refugee camps and with surgeries on Syrian paediatric and adult patients with acquired and congenital defects of the musculoskeletal apparatus. On 1 December, pre-selection took place, during which 39 patients were examined. On 24 of them, a total of 30 surgeries were performed. They mainly consisted of total joint replacements (knees, hips), for which material and instruments from the company BEZNOSKA were brought along. There has been a high level of cooperation with Al Khalidi Hospital in Amman for a long time, be it the welcoming attitude of the local staff with regard to the requirements of the Czech physicians, the instruments and equipment in the operating theatres, or the sanitary conditions.

A total of 14 patients suffering from osteoarthritis of the knee joint were given 42 Intragel injections. During the treatment, three injections were gradually applied to one knee joint. The application by injection was chosen as an alternative to total knee replacement surgery.

  

Department of Asylum and Migration Policy, January 5th, 2024

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