多国协作国际医学救援实践与研究

Practice and Research on Multinational Collaboration of International Medical Rescue

目的探讨国际救援医疗行动中多国协作的类型及进一步提升国际协作成效的方法。方法对中国国际救援队出队10年以来,12批次参加国际救援行动中的多国协作类型、协作内容等数据进行回顾性分析。结果在国际救援医疗行动中,联合国层面开展协作的概率为100%,联合国人道主义事务协调办公室成立现场协调分中心,组织各国救援队伍会议,通报灾情,通报各国救援队伍到达与撤离计划,协调行动,在现场发挥指导与协调作用;国家层面协调概率为91.7%,协调确定救援内容与队伍规模;地方政府层面出面协调的概率为75.0%,协调内容包括组织会议,提供灾情,提供运输与起重机械等。社区志愿者层面开展协作的概率为83.3%,包括提供翻译、向导、通讯与运输等多方面协作;非政府层面提供协作的机率为50.0%,包括提供运输服务与救援物品发放等内容。Fisher精确检验示国际、国家、地方政府、社区及非政府组织间的协作存在差异(P=0.032)。结论 (1)多国协作在国际医学救援行动中普遍存在,层次多样,内容丰富,影响国际救援队伍的指挥层与执行层,从而对救援成效产生积极影响。(2)不同层面的协作特性不一,但具有互补性。(3)多国协作中的主要困难仍然是来自于双边政府层面,协调困难将迟滞救援队伍到达灾区时间。(4)联合国推荐的城市搜救队组织结构及培训方式为协作提供了良好的组织学基础。(5)当前多国协作机制仍然难以满足国际救援的需求,发展多国协作任重道远。

Objective To explore different types of multinational collaboration in the international medical rescue,and further enhance the effectiveness of international collaboration. Methods Since the Chinese International Search and Rescue Team( CISAR) was founded,it deployed 12 batches of international rescue operations; the data collected from these operations will be analyzed in retrospective methods. Results During the procession of international medical rescue,the percentage of the collaboration with United Nations is up to 100%. United Nations Office for the Coordination of Humanitarian Affairs establishes sub-centers for coordination in the field,organizes meeting with different national rescue teams,circulates the information of a disaster,briefs the arrival and evacuation plans of national rescue teams,unifies action programs,plays the role of guidance and coordination in the field. The Percentage of the collaboration at national level is up to 100%. And the percentage of the collaboration under the coordination of local government is 100%. It involves organizing meeting,sharing information of disaster,providing transportation and lifting machinery,etc. The Percentage of the collaboration with local government is 83%,which includes translation,guide,communication and transportation,and many other areas. The percentage of the collaboration with NGO is 50%. It includes transportation services and relief items distribution. Fisher's exact test shows a statistically significant difference among the five layered collaboration( P = 0. 032). Conclusions( 1) Multinational collaboration is widespread in international medical relief operations,with diversified level and area. It can influence both the command level and the executive level,thus producing a positive impact on the effectiveness of relief work.( 2) Complementary collaboration is special at different levels.( 3) The largest collaborative problem faced by the international search and rescue teams comes from bilateral government level. The coordination problem can delay the speed of rescue teams to reach the disaster affected areas.( 4) The organizational structure and training model for urban search and rescue teams recommended by the United Nations provides a good foundation for carrying out multi-layered collaboration. And this management model is worthy for local rescue team to learn from.( 5) The current multilateral cooperation mechanism is still difficult to meet the needs of international aid,development of the multinational cooperation has a long way.