Last month, the World Health Organization (WHO) held a Global Forum on Trauma Care in Rio de Janeiro, Brazil on October 28-29. The aims of the Forum were sixfold: 1) to establish a set of priorities and goals for future advocating about trauma, so that the same messages would be sent out globally on sustainable, affordable improvements in care; 2) define a 10-year plan of action for a united front across organizations world-wide; 3) create key messages and means of disseminating them internationally; 4) write a consensus statement about the Forum's proceedings; 5) start forging tools for advocacy, such as press releases and meetings with governments; 6) consolidate a global network for advocacy with a far-reaching network of people and organizations that actively advocate for trauma care.
Approximately 150 participants from over 100 countries were present at the Forum, many of them representing national and international societies. At the request of Nathan Zasler, I was there as the IBIA representative. Participants were divided into 5 task forces, each responsible for preparing proposals aimed at increasing and strengthening governmental attention to trauma, both domestically and internationally. Of primary concern were advocacy and four of its fundamental aspects: prevention, emergency care, acute care and rehabilitation. The proposals drawn up by the individual task forces were then discussed by the whole forum and voted on, anonymously, at the end of the meeting.
The Forum debated and discussed many topics, with a special emphasis on issues related to advocacy and increasing the attention that governments and populations give to trauma, in its entire spectrum - from the moment of onset, all the way through to rehabilitation and social re-insertion. The task forces aimed to create a) an international trauma day (some countries already observe it as October 17th); b) an international trauma prevention and treatment campaign; c) key messages that could be transmitted internationally, such as "Nine people die from injuries every minute...4 could be saved"; "One third of deaths can be prevented" or "Two million deaths can be prevented"; "Simple cost effective measures are available"; "Everyone has the right to health"; "The first 15 minutes after an accident/injury determines your future"; "Quicker, better, faster"; "Timely, effective, adequate, optimal trauma care saves lives"; d) use of the media (TV, radio, web), newsletters, scientific journals, online communities, etc. to disseminate these campaigns and messages; and e) a package of training materials for students (undergraduates, doctoral candidates).
This Forum was a continuation of the World Health Assembly's last trauma-centered event, which took place in 2007 and generated Resolution 60.22 on trauma and emergency care. Resolution 60.22 called for greater attention by the World Health Organization and made specific recommendations for reducing the incidence and impact of trauma in the world. However, two years later much still needs to be done in the quality and quantity of trauma services. Thus, the goals of this assembly in Rio included garnering increased attention to "affordable and sustainable improvements in trauma care services globally by promoting greater uptake of the recommendations of WHA Resolution 60.22".
The international nature of the debates and the many involved voices and concerns made it clear to all present that this important issue needs ongoing attention and discussion. Because of the very large diverse group of representatives from many countries, with widely varying areas of interest (brain, spinal cord, orthopedics, etc.) it was not possible to reach a consensus and draw up a final definitive document. Consequently, it was determined that further meetings will be held to advance the issues pertaining to trauma care and prevention all over the world, until a consensus and unified resolution could be reached.
IBIA weighed in on topics such as sustainable prevention and emergency care, as well as education, long-term rehabilitation, and re-insertion at work, school and community. The international focus was particularly pertinent to IBIA, which was honored with special notice at the opening ceremony by Brazil's Ministry of Health, one of the officiating governmental authorities.
The World Health Organization's endeavor to gather forces and work towards increasing advocacy in trauma care, improving the plight of those who have sustained trauma, and to preventing deaths and disability from further incidences of trauma, underscores the importance of international unity in bringing about change. There will be many opportunities to IBIA to get involved in this work, and I believe that we are uniquely positioned to make a real difference.