Violence Violence - - related Injury Surveillance related Injury Surveillance (VIS) (VIS) Deep South, Thailand, 2007 Deep South, Thailand, 2007 Vorasith Sornsrivichai, MD, PhD, FETP Cert. Epidemiology Unit, Prince of Songkla University, Hat Yai, Thailand http://medipe2.psu.ac.th/~vis , [email protected]
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Violence -related Injury Surveillance (VIS) Deep South ......• During 2004-2007, there were 5.4 violent events, 4.6 injured victims (1.8 dead) per day • 3rd rank of DALYs among
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ViolenceViolence--related Injury Surveillance related Injury Surveillance
(VIS)(VIS)
Deep South, Thailand, 2007Deep South, Thailand, 2007
Vorasith Sornsrivichai, MD, PhD, FETP Cert.Epidemiology Unit,
• Up to 2006, estimated 20,000 dependants of the victim
• < 70% coverage of relief activity, thousands waiting for the essential support from the government
• PSU’s Deep South Coordination Center-DSCC(http://medipe2.psu.ac.th/~dscc/) was established in mid 2006 under the National Reconciliation Committee Fund to coordinate academic activities to support the victims & their dependants
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Humanitarian Relief
• At DSCC, VIS data was linked withmilitary, police & media news clipping to create integrated database
• Then supplied to every hospital’s Mental Health Crisis Center to help its community psychologists & psychiatric nurses in identifying the people in need
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Deep South Integrated Database
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Humanitarian Relief
• Not only as essential rehabilitation/tertiary prevention, but also a reconciliation and peace making--it is a primary preventionfor the new generation of neglected person taking revenge
Multidisciplinary Cooperation
• Cooperation with Military College of Medicine to utilize VIS data to improve the high CFR (~ 30%) of soldiers
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Multidisciplinary Cooperation
• The Deep South Watch project (http://www.deepsouthwatch.org) was set up by academics, rural doctors and the Thai Journalists Association to serve in the area of situation analysis, investigative journalism and balanced information for right understanding of the Deep South situation
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www.deepsouthwatch.org
Deepsouth Bookazine
Vol.2
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Conclusions
• VIS is used to improve violence-related health services and facilitate humanitarian relief
• However, the physical and psychosocial health burden of Deep South violence is enormous and increasing
• Multidisciplinary peace and reconciliation programs are urgently needed
VIS Web 2.0 MindMap(http://medipe2.psu.ac.th/~vis/mindmap)
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VIS Web 2.0 MindMap(http://medipe2.psu.ac.th/~vis/mindmap)
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VIS Web 2.0 WebStat: http://medipe2.psu.ac.th/~vis/webstat
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How Do Epidemiologists Get Involved?
• A survey conducted in Mid 2004 showed little effect on health care service, however 85-98% of local health professions were concerned most about their security
• So far, 28 health care officers were attacked (9 dead) 12 health centers and 10 health center officer’s houses were burned down, 5 hospitals were shot/bombed/mobbed
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• A group of volunteer epidemiologist, rural doctor & Medecins Sans Frontieres (MSF) developed a package of security preparedness in the health care setting
• We subsequently cooperated with Military College of Medicine in development of Incidence Action Plan and Emergency Incident Command System
How Do Epidemiologists Get Involved?
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Online Security &
Safety Resourcehttp://medipe.psu.ac.th/
security&safety/
What’s Next?
• Collaboration with WHO Collaboration Centre for Research on the Epidemiology of Disasters, Belgium (CRED) and Karolinska Institute, Sweden to study impact from Deep South violence on public health system
• Method
– Secondary data linkage
– Comparative analysis: before VS after, high VS low violence area
– Associative analysis
What’s Next?
Public health system indicators
1. Surveillance system: coverage, completeness, validity and timeliness of notifiable disease surveillance system
2. Disease prevention: vaccine coverage, vaccine management system
3. Disease control: TB’s cure rate, default rate; Malaria’s active case finding, residual spray
4. Health care service utilization: inpatient hospitalization,length of stay, direct medical cost
5. Burden of disease: TB, malaria, vaccine preventable disease incidence, DALY of violence-related injury