Logistical Experience in Health Will Be the Largest Lesson in the Exchange

first_imgFor physicians who would like information on a military career, Cima would invite his colleagues to learn more about the Air Force’s activities in healthcare. “There is a section that serves service members and their dependents, but there are also sections for search and rescue, humanitarian missions, disaster response and air medical transportation. I am certain that very good people will arise who are trained to help,” he said. In Belize, the first stop for 2015 Continuing Promise, an eight-year-old boy had been in a car accident and had two severe fractures in his arms and legs. He had surgery at the time, but because more advanced equipment was not available – a fluoroscope is the most-often used instrument to observe organs within the body – one of the two breaks did not heal properly. The original, local orthopedist submitted the case and attended the new surgery on board the ship together with the family. Experience By the middle of the mission, they had provided more than 40,000 treatments. Patients also receive medication. The number of surgeries has already exceeded 500; 60 in orthopedics alone. By Dialogo July 30, 2015 “The main thing we learned, one of the strong points, is understanding how logistics are handled for a large-scale, international health mission. I know of no other humanitarian mission as large as this one,” said Cima about the amount of materials and the bureaucratic procedures involved in preparing credentials for professionals from different countries and organizations. He said he believes that the lessons learned during the exchange can help improve the Air Force’s systems for humanitarian and disaster response missions. The largest hospital ship in the world features a level of healthcare infrastructure that many cities do not even have. There are nearly 800 beds, 12 operating rooms and 80 beds in the intensive care unit. “They needed to use their full capacity just once, when it traveled in response to the earthquake in Haiti [in 2010],” he said. The Comfort, a modified oil tanker, has a “twin”: the Mercy, which is based out of San Diego, on the US west coast, and which performs similar missions to countries in the Pacific. After concluding the treatments in Colombia on July 18, Medical Lieutenant César Cima traveled at sea for eight days before arriving in the city of Dominica, in El Seibo, Dominican Republic. The city is the next stop in the itinerary for the world’s largest hospital ship, the USNS Comfort, which is hosting the United States Southern Command’s 2015 Continuing Promise mission. In addition to healthcare personnel, the ship needs to accommodate the entire crew. “It is practically a city,” he said. “On board, there is a gym, a chapel, a supermarket and a restaurant to support the team.” The 182-day mission, which will visit11 countries, carries 1,100 people on board, including 80 physicians and approximately 200 nurses, in addition to veterinarians and engineers. In addition to a cardiologist from Brazil’s Army and a pediatrician from the country’s Navy, Cima, an orthopedist from the Air Force, is part of the first group sent by Brazil’s Ministry of Defense to participate in the exchange. In July, after completing three months of the mission, the physician returned to Brazil for a five day break – R&R, in military parlance – and spoke with the Air Force News Agency. The Brazilian orthopedist works together with one from the United States. “I participate effectively as a member of the mission, discussing cases and learning how plans for global projects are made,” he said. The two orthopedists’ routine, which may be reinforced by residents for a month, included performing triage for the first two days after arriving at a new country. When asked about the cases that made the biggest impressions on him, as a doctor, Cima told the story of a situation that, according to him, truly reflects the reason for the mission, which spends 10-15 days at cities near small ports along the coast of countries in Latin America and the Caribbean. Read the story of Medical Lieutenant César Cima, who works at Brazil’s Fortaleza Air Base (BAFZ) and narrates another aspect of the professional life of military doctors. He is participating in an exchange program as part of the 2015 Continuing Promise mission, on board the largest hospital ship in the world. “This is training and diplomacy. In almost all countries, the country’s president has visited,” Cima said. His account “It is an aid mission, because the ship has the equipment. It is not that the healthcare professionals are better or worse than the local ones, but simply, sometimes, they have more technology on board, and they provide it. Everyone was very happy because it was one of the most complex cases,” he said. last_img read more

Explainer: How the next WTO chief will be chosen and the task ahead

first_imgThe WTO is a members-driven organization with decisions reached by consensus among 164 countries. Three WTO ambassadors who chair leading committees will lead the process, seeking to establish which candidates have the widest support.In so-called “confessionals”, members will tell this “troika” their preferences, without ranking them and without vetoes in a process expected to last two months. The first phase will be on Sept 7-16. Voting on the next director-general is seen only as a last resort if consensus cannot be reached.The process does not always work smoothly. In 1999, former New Zealand prime minister Mike Moore and Thailand’s Supachai Panitchpakdi divided WTO members, with a compromise finally found to give each a term, shortened to three years from four.Azevedo’s term will finish before his replacement takes office, but WTO members failed to agree on a temporary caretaker director-general, meaning the four deputies will stay on in their current roles.More soft than hard powerThe Marrakesh Agreement that established the WTO in 1995 does not give a detailed description of the director-general role. The responsibilities should be “exclusively international in character”.The incoming chief would be expected to appoint four new deputies, present budget proposals, and chair the trade negotiations committee which oversees multilateral accords such as on fishing subsidies.The director-general can also intervene in trade disputes, in very rare cases offering mediation, more often by appointing people to adjudicating panels when parties cannot agree.Otherwise, the director-general does not forge global trade policy, but is meant to act as a neutral broker: part administrator, part peacemaker.  Eight candidates from Mexico to Moldova are bidding to become the next director-general of the World Trade Organization to replace Roberto Azevedo, who steps down at the end of August.ChallengesThe next chief would broker international trade talks in the face of widening US-China conflict, protectionism increased by the COVID-19 pandemic and pressure to reform trade rules. US President Donald Trump’s “America First” policies have upended the global trading order and presented an existential threat to the WTO. Trump has called the institution “broken” and “horrible”. Washington has blocked appointments to the WTO’s Appellate Body that settles trade disputes, which now no longer has the minimum number of judges to convene.How the director-general is chosenThe candidates have been given two months to campaign until September 7. Normally this would involve trips to national capitals, but with the pandemic much of that is being done in a virtual format.The next phase involves whittling down the field, initially to five then two, before a final decision is taken.center_img Topics :last_img read more

Spieth well placed for final charge

first_img Press Association “It’s surreal I’m leading The Open, but I can easily believe that I shot the three scores that I shot. If we were playing an amateur event here, I wouldn’t be too surprised by the scores I shot. It’s just lucky that it happens to be in the biggest event in the world! “Hopefully I can do it again tomorrow, but whether I do or not, I’ll survive either way.” Spieth is looking to become the first player to win the first three majors of the year and just the third to win any three in a single season – Ben Hogan won the Masters and US Open in 1953 but missed the US PGA to compete in, and win, the following week’s Open at Carnoustie, while Tiger Woods won the US Open, Open and US PGA in 2000 and completed the ‘Tiger Slam’ in the 2001 Masters. “It hasn’t come up in my head while I’ve been playing yet,” said the 21-year-old, who would also replace Rory McIlroy as world number one with victory. “I can’t speak for tomorrow given it’s the last round and if I have a chance coming down the stretch, if it creeps in, I’ll embrace it. I’ll embrace the opportunity that presents itself. “I don’t look at it as a negative thing, I look at it almost as an advantage. Why should it add more pressure in a negative way? If it adds more pressure, it just makes me feel like this is something that’s a little more special, let’s go ahead and get the job done. “I know it’s easier said than done, but when you say added pressure, most people associate that with negativity or something that can hinder what’s comfortable. For me, I think it could be advantageous. You hit the ball a little bit further, you can really get your mind around a more specific target and block out other things.” American Dustin Johnson, who three-putted the 72nd hole in the US Open last month to finish a shot behind Spieth, found his overnight lead intact when he teed off at 3pm, but struggled to a third round of 75 in ideal conditions. The big-hitting 31-year-old was only two off the lead when he finally carded his first birdie of the day on the 15th, but bogeyed the last three holes to fall five behind. “I don’t feel like I played that bad, it’s definitely frustrating,” the world number four said. “I’m goin g to have to put together a special round together tomorrow to have a chance.” Dunne will not be entitled to any prize money, however well he performs on Monday. The rules of the R&A state: “An amateur golfer must not play golf for prize money or its equivalent in a match, competition or exhibition. “However, an amateur golfer may participate in a golf match, competition or exhibition where prize money or its equivalent is offered, provided that prior to participation he waives his right to accept prize money in that event.” A top prize of £1.15million is on offer to the Open champion, providing he is a professional. Jordan Spieth’s bid for the third leg of an unprecedented calendar grand slam remains firmly on track after a breathless third round of the 144th Open Championship. But the Masters and US Open champion could be denied a place in the record books by an equally remarkable performance after 22-year-old Irish amateur Paul Dunne claimed a share of the lead at St Andrews. Days after being mistaken for Spieth by fans seeking autographs due to their identical clothing, Dunne carded a flawless 66 on the Old Course to finish 12 under par alongside playing partner Louis Oosthuizen – who won the 2010 Open at St Andrews – and Australian Jason Day. Spieth also shot 66 to lie just a shot behind, with 2007 and 2008 champion Padraig Harrington on 10 under after a superb 65. Nine players were tied for sixth on nine under, including another amateur in American Jordan Niebrugge, Justin Rose, Sergio Garcia and Adam Scott, along with England’s Danny Willett, who led outright after 10 holes but drove out of bounds on the 14th. University of Alabama student Dunne – whose coach Alan Murray is also his caddie this week – is the first amateur since the legendary Bobby Jones to lead the Open after 54 holes, the American going on to lift the Claret Jug at St Andrews in 1927. Three years later, Jones became the last amateur winner of the Open to date at Royal Liverpool and went on to complete the “Impregnable Quadrilateral” of Amateur Championship, Open Championship, US Open and US Amateur titles. Dunne, who came through final qualifying at Woburn for the second year running, was in the second group out on Thursday and joked after birdies on the first two holes that he hoped someone had taken a screenshot to prove he had led the Open. Three days later he had no such worries and could turn his attention from trying to win the silver medal for leading amateur to the Claret Jug. “I don’t see why not,” said Dunne, who is a lowly 80th in the world amateur rankings. “I mean, I’m well capable of shooting the scores that I need to win if everyone else doesn’t play their best. “Whether it happens or not, I can’t really control. I can just go out and try to play my game and see where it leaves me at the end of the day. Hopefully I play great again and post a good number. last_img read more