"Afghanistan presents mountainous terrain, deep valleys and a climate that varies from snow-laden areas to extreme heat. Our MERT teams are equipped and trained to operate in these extreme environments in order to provide health services that support deployed missions." Dr Simon Bagumahu, Medical Director Afghanistan, Iqarus.

Background

In 2004, Iqarus (formerly ‘Exmed’) helped design and deliver the MERT concept with the United Nations in Afghanistan. This was in support of the reconstruction process and inaugural presidential and parliamentary elections.

The MERT contract was subsequently run in 2005, 2009, 2010, 2016 and 2017, with Iqarus running this capability in all but one of these years.

The MERT concept provided embedded medical professionals, complete with fully scaled equipment modules, in seven key UN hubs, namely:

  • Kabul
  • Kandahar
  • Faizebad
  • Gardez
  • Kunduz
  • Bamyan
  • Jalalabad
  • Heart
  • Mazar

The MERT was designed to be capable of providing routine health management and emergency care, with a Kabul-based surge/evacuation capability, utilising UN aircraft.

Challenges

Some of the challenges faced and overcome by the Iqarus team included:

  • Surge request made by the UN on contract award, to deploy within 30 days to Full Operational Capability (FOC), but due to increasing threat levels the UN requested a proactive response to establish an Intermediate capability (IOC). An IOC was achieved within 7 days, the FOC was achieved within 18 days, ahead of contracted KPI’s.
  • Inducting and embedding Iqarus personnel into existing UN medical structures, whilst operating in remote regions

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  • Developing health awareness programmes and first aid training within the seven hubs to create local capability and mass casualty planning
  • Reducing patient mortality and morbidity through improved patient care and outcomes and appropriate medical travel, in acute trauma cases.
  • Ensuring the teams were appropriately equipped, resupplied and skilled for the MERT capability needs. Achieved through a robust selection process, proactive team management, and a dedicated equipment logistics team.

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Solutions

Some of the solutions Iqarus provided in order to deliver on time and on budget:

  • A robust and capable team were deployed with a mix of UK, Australian, Ugandan, Kenyan and South African personnel, most of whom remained for the whole project lifecycle. Iqarus’s personnel are its best assets, and enabling our personnel to perform professionally in difficult and challenging environments is key, through:
    • Routine continuous professional development programmes supporting our clinical personnel
    • Dedicated project management based in Dubai and Kabul, with clinical background, able to engage with the Iqarus MERT team and the UN medical and contracts team in a highly proactive and professional manner
  • With a highly specialised medical logistics team, totally focussed on the delivery of medical supplies and equipment into Iqarus projects globally MERT could deploy a capable solution within seven days.

Outcome

Iqarus provided a fully operational capability on-the-ground within three weeks of contract award.

The MERT were able to support the health of the UN’s mobilsed staff and its broader workforce and this capability was maintained in its entirety for the whole life of the project.

This included a fully-integrated supply chain and a dynamic, robust team well-versed in finding solutions for the UN; from first aid training to intensive care casualty evacuations, internationally.

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Through the provision of first aid training and health awareness programmes, Iqarus was able to improve the UN’s capacity to deal with the unexpected and develop preventative health awareness. These efforts reached over 75% of the UN’s total workforce in the hub locations, Iqarus’s MERT programme reduced unnecessary travel to medical facilities in Kabul, reduced risk and costs, as well as delivered tangible improvements to the health and wellbeing of UN personnel.

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