Refining Our International Medical Capabilities

David W. Callaway

Learn more about the extensive work TR is undertaking to become classified as a World Health Organization (WHO) Emergency Medical Team.

Medical response is in our DNA. It is our origin story. In the early days, we deployed action-oriented, mission-focused problems solvers in the field. And, they got shit done. We were rebellious rule-breakers. Sometimes, because rules needed breaking, other times, we didn’t know better.

Over the past eight years, TR has become a major force in disaster response and veteran service. We have run medical operations in South Sudan, the Philippines, Nepal, Greece, Ecuador, Dominica and Puerto Rico. Along the way, we learned important lessons about the global humanitarian architecture and began shaping a new reputation. Alongside this, our growth has brought greater responsibility and greater impact. The challenge for Team Rubicon is to uphold the service principles that paved the way for the organization’s inception while integrating more deeply into the international humanitarian and disaster response infrastructure

Our vision is to be the fastest on scene and go the farthest. We can deploy within hours. Coordination has always been an operational challenge. In order to improve coordination, expand TR’s reach, and expedite partner nation requests for assistance, we developed a three-part medical strategy.

  • First, we are building partnerships with academic institutions and private healthcare systems that have existing international programs. These relationships will allow us to conduct resilience operations in non-disaster periods, create scheduled international engagements and improve our awareness of partner nation’s systems. In addition, we’ll have access to a new pool of medical professionals.
  • Second, we are deliberately working with the U.S. Government Global Health Engagement (GHE) interagency group. This group is led by the DoD but includes USAID, Department of State, Department of Health and Human Service and other governmental entities. Engagement with the USG is designed to add additional mechanisms for deployment and expand the TR footprint globally. The Continuing Promise 2018 operation is the first, large-scale, collaborative humanitarian mission TR will perform with the USG. During this series of deployments, we will refine our approach to USG engagement, ensuring clarity of our commitment to the humanitarian principles of neutrality, independence, impartiality, humanity, and voluntary service, and their impact on public-non-profit partnerships.
  • Finally, and perhaps most critical to scale our ability to deliver medical care to populations in need, is the extensive work TR is undertaking to become classified as a World Health Organization (WHO) Emergency Medical Team, Type 1 Mobile (EMT-1 Mobile).

The birth of the WHO EMT process started at the same time as the origin of Team Rubicon – the Haiti earthquake in 2010.

This event presented an opportunity to develop and ensure a new set of standards for international medical disaster response. Leaders from the WHO and humanitarian community developed a minimum set of standards for international medical disaster response, creating the WHO Emergency Medical Team initiative.

The main objectives for EMT initiative are to:

  1. Expand global/regional coordination and partnerships
  2. Set minimum standards and collect best practices for disaster response medical care, team safety, and self-sufficiency
  3. Implement capacity building and training in low-income countries for disaster response
  4. Deliver response coordination with the WHO, the health cluster, the ministry of health, and other responding organizations
  5. Ensure supplies and medications meet international standards

There are multiple types of teams, with increasing capabilities, minimum standards, and requirements with the EMT initiative. Given TR’s strength in emergency care in remote areas, we will be classified as an EMT Type 1 Mobile. A Type 1 Mobile team is capable to provide outpatient initial emergency care of injuries and other significant health care needs to a minimum of 50 outpatients/day.

Key services provided include: triage, first aid, stabilization, referrals, and care for minor injuries and illness. Type 1 Mobile Teams do not work out of a fixed structure, instead they seek to treat those in difficult to reach areas, sometimes only accessible by foot. The team and equipment can be easily moved throughout the duration of the operation.

The EMT classification process has allowed TR to reflect on our strengths and identify key areas in our medical disaster response that needed improvement. This is critical in ensuring that we can better serve affected populations. Currently, TR is in the final stages to become an EMT Type 1 mobile, pending a classification review in June 2018.

With this classification, TR will be able to engage in more international medical operations with better coordination with the international community. Rest assured, we will push for improvement and professionalization in disaster response and ultimately “get shit done.”


Dr. Erin Noste, Deputy Medical Director

Dr. David Callaway, Chief Medical Officer and Medical Director

Please visit this website for more information on the WHO EMT initiative.

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