Observer’s Feedback
Please identify any overall strengths and weakness of the exercise. Give specific examples on how we may improve the educational value of the exercise .
Yerevan2:
The classes were very well organized. I would like to see more balance between the plan and the practical training of the classes (considering the data presented). It is necessary to organize such exercises with the open source.
Yerevan 3:
ÿThe strengths of the exercise are professionalism and impressiveness of presentation. There were problems with the connection with Russia.
Yerevan 4:
I would like to take part in the practical exercises.
Yerevan 5:
ÿStrength: preparedness of the medical staff to possible accidents. Weakness: possible variations have not been considered, for example, the source of radiation was not found in its place (it was thrown out with the trash) or there were occasions when the place became dirty (contaminated) from other sources.
Yerevan 10:
ÿStrengths: interaction (cooperation) of several countries with free discussion on each point. There were representatives from different countries.
Weaknesses: During the exercise, it is important to indicate definitely the source of radiation (when, where, which). The discussion was around this topic:ÿ the participants assumed that it was radiation disease without knowing anything about the source.
Yerevan 12:
The main goals of the exercise were achieved. We think that the most complex and basic aspects of radiation accident were considered:
The work of medical institutions before the identification of the source
Measurement of the radiation dosage received by the body (as by dosimetry and also by other methods)
Definition of the contingent of the patients who need the treatment and control
There were given practical skills, what to do when there is a technical disruption of telecommunication.
Yerevan 13:
Decision-making requires written substantiation on the basic criteria.
Countries, while making their reports about the basic decisions on situation, have to substantiate them in written form. It will help to figure out the main mistakes in their work (actions) and criteria.
To use more visual materials.
A comprehensive international collaboration must be developed: a) information exchange among countries; b) scientific conferences; c) create the first common steps for the emergency departments, radiologic centers, the groups of radiological investigators, when a radioactive accident occurs; d) implementation of the common (uniform) protocol of the work for the participating countries; e) approval of the national protocols; f) publishing new text-books for the doctors of radiation medicine.
Yerevan 16:
The exercise classes were very accurately organized, on the highest level, which allowed learning the material well. It is very important that colleagues from CIS and USA took part on these classes. The strength of the exercise was the simultaneous participation of several centers and their communication. There was no weak aspect.
Yerevan 17:
The strengths were:
Well-prepared program of exercise classes
Preliminary information and communication of all the participating countries
The technical supplement of the classes was very good
Active involvement of all of the participants in discussions
Excellent organization and active participation of the Armenian Center
Chisinau:
ÿThe experience from this experience will improve the quality of our Regional EMS Center instructors, which teach emergency personnel and students from medical university to handle professional problems in this field.
It was very important that authorities responsible for prompt response in case of such accidents in our country were involved in this exercise. The implementation of high level telecommunication technologies allowed us to have comprehensive information in short time.
Kiev:
Very interesting, instructive and useful.
Very dynamic.
Turai, IAEA:
Telephone contact with Moscow was ineffective throughout the exercise. We could hardly hear them from a distance of a few centimeters (<1”) only. The telephone connection with Boston and Estonia was usually fine, but the voices from Moldova and Ukraine were frequently very weak.
In some cases the information (duration of exposure) was insufficient for dose calculation. In understand it is usually the case in real situation, however, in a drill—when precise dose calculations were provided by the facilitators—a more precise presentation of the scenario (and exposure circumstances) would have helped a better, more successful solution of the task by the participants.
IAEA:
ÿ Note:……… In the beginning of the exercise there was not enough co-ordination between the teams in Boston and Yerevan. There seemed to have been no rehearsal before the exercise, which could help in defining the roles of the teams and ensuring a better co-ordination.
The exercise was successful, especially bearing in mind that it was the first activity of the type. It is an important addition to the programme of training courses, and sets the stage well for a bigger exercise next year.
We were pleased to hear teleconference’s participants giving useful suggestions on what can be added to the future Harmony II. They seem to be motivated which means that the programme on Medical Education for Nuclear Accident Preparedness is useful to them. We would like to thank the staff of the Boston University School of Medicine for its continuous efforts in making the programme a success.
As discussed before, in the future it is important to combine a medical preparedness exercise with a general emergency preparedness exercise dealing with all aspects of an emergency. In this respect, the two IAEA Technical Co-operation Projects, RER/9/049 on medical preparedness and RER/9/050 on harmonization of nuclear emergency preparedness are planned to be better co-ordinated in 2000 and to be continued in the 2001 – 2002 cycle.
Tallinn:
ÿThe organization of the Harmony I exercise was very good. To participate in a medical teleconference together with many other different countries – this is a new experience for Estonia, something that we haven’t tried before. Estonian Disaster Medicine Center is very grateful for the possibility to have participated in the program.
_ The technologies used for the teleconference were good; our only real problem was poor phone communication that made it very difficult to follow the conversation in Armenia and in some other places. Another problem we had was that we did not have information if the faxes and emails we sent to Armenia for answering some questions and participating in the conference were actually received and how they were evaluated. We think it may have been easier for us to follow the conversation if the presentations and discussions of radiation specialists were illustrated with computer slides – telewriter programme was switched on all the time.
ÿÿÿ This was a very interesting medical programme on radiation disasters. Another interesting topic would be the organization of security and medical help if the country receives information that a radiation disaster with contamination has occurred in another country and some people with potential contamination and radiation injury (who don’t know about this themselves) will arrive (or have arrived). In such a situation many organizations will be involved: Rescue Service, Radiation Protection Centre, airport security personnel and administration, police service and medical service etc. We did not know how the Harmony I exercise was going to be arranged and therefore representatives of these services were invited to participate and many potential problems were discussed. These people could have participated with interest if the essential problems of this programme were organizational.
Boston:
Strengths:
Having a CD back-up
Discussion seemed strong in Armenia
Reliability of fax and email
Having command line and having Connex handle faxing and communication lines since we do not have equipment for such tasks; also for status of various countries
Video was well-produced, edited
Weaknesses:
Not enough discussion with certain countries
Not enough visuals/graphics
Infrastructure in some countries, for ex phone lines
Not sure about level of interactivity
Translations
Video inaccurate to exercise/not necessary; participants seemed to focus on video
Please make any additional comments or suggestions 1.
Yerevan 2:
ÿIn the future it will be nice to develop a program for medical doctors of all specializations.
Yerevan 3:
The exercise classes were very useful and informative. It is the first step of the exercise. In future it will be possible to organize more complex classes.
Yerevan 10:
It is necessary to define exactly the function of each participant, in order not to be repeated the same action by several participants (the definition of the accident place, measurement of the radiation dosages). It is necessary to do maximum unification of each participant’s action/role: it will be a physicist, a radiologist, or other staff. It is important to define the purpose of the classes, first, independent of the source of radiation, and then after knowing the source (using international units to measure radiation). It is important mainly to pay attention and emphasize the time of finding the source, and also why the emergency physician will ask for the radiologist consultant.
Yerevan 12:
To continue the practice of exercises
Suggest participating countries to make their own plans for exercises by themselves (taking into consideration the accidents in their countries, with the different sources of radiation, in different seasons and different types of climate)
In future exercises to pay attention mainly on these items: a) the practical work of the medical staff when the skin and clothing are contaminated; b) decontamination of the skin and clothing; c) the method of measuring the dosage of radiation; d) accurately plan the exercise; e) work out the medico-psychological aspect; f) create uniform protocols, structure of reports.
Yerevan 17:
ÿFor the improvement of the educational program:
To organize exercise classes in each country (1 or 2 accidents with different radiation sources) before the general (main) classes and also to organize exercise classes by email
Exercises must have a practical course on how to write and fill in protocols.
Chisinau:
Having the back-up CD permitted us to follow the exercise in spite of the fact that because of local technical problems we were not able to connect to host computer. We would be glad to join other exercises like this one in the future. Thank you for your efforts.
Kiev:
To carry on similar exercises more often.
Tallinn:
We enjoyed having been able to participate in Harmony I and we really wish that it were possible for you to arrange this kind of teleconferences again. This kind of exercises make international communication and co-operation realistic and it also explains what information and what problems are most important and difficult to solve if these accidents really happen. Thank you very much. Rein Paberit, Ellen Vosumaa, Kalev Timberg, Kaja Pukk, Teet Lainevee
Boston:
More consideration should have been given to translations: who will translate, from where?
If video is to be useful, needs to be more accurate. Video is strong medium, powerful; needs to match objectives
Difficult to understand how exercise unfolded to participants: interested in other responses especially how others felt about how information was revealed
Unsure about timing of certain information; would have to ask the content experts
Turai, IAEA:
ÿSimilar drills on medical assistance of radiological emergencies in the future will be useful; I’ll participate in their preparation and conduct, whenever requested, also, as a part of general accident exercises. All the Estonian, Moldovan, Russian, Ukrainian, and Armenian participants evaluated the drill as useful.
Moldova: authorities for radiation emergency situations should participate, info on radiation source should be reliable ASAP, and telecommunication possibilities should be improved!
Russia: discrepancies in scenario: in video only 2 persons were near the source but on schema almost 10.
Ukraine: a drill with contamination, assessment of inhalation dose, methods of decontamination and decorporation will be very useful.
Yerevan, 18-08-1999
I. Turai, TO, RER/9/049, IAEA
