Annals of Burns and Fire Disasters - vol. XIX - n. 2 - June 2006

MBC NEWS

Mediterranean Council for Burns and Fire Disasters
(MBC)
Who Collaborating Centre for Prevention and Treatment of Burns and Fire Disasters

Fourteenth MeetingGeneral Assembly

Casablanca, Morocco
18-20 May 2006
Report of the Meeting of the Mediterranean Council for Burns and Fire Disasters

The Mediterranean Council for Burns and Fire Disasters (MBC) held its biennial meeting this year in Casablanca.

This was its 14th congress, in collaboration with the Association Marocaine de Brûlologie (AMB) and the International Association for Humanitarian Medicine (IAHM), under the patronage of the Pan-Arab Association for Burns and Plastic Surgery (PABPS).

The congress was organized by Professor Hassan Boukind, head of the important new “Moroccan Centre National des Brûlés”, with the help of Professor Naïma Bahechar (Casablanca) and Professor Samir Siah (Rabat).

It was the first meeting of the youthful Association Marocaine de Brûlologie, which was created early this year under the presidency of Professor Ihraï, Colonel of the Military Health Services (Rabat), and of which Hassan Boukind is Secretary.

This was a high-level scientific meeting, with perfectly planned welcome and technical facilities which delighted the numerous participants from abroad, who came as always from the Mediterranean periphery and also from even more distant countries, such as Romania and Turkey. Compliments to Saad Lahbadi for all his efforts. The congress venue, the Royal Mansour Hotel, which welcomed the participants, was extremely pleasant and comfortable and situated in the very centre of Casablanca.

The scientific programme arrranged by our friend Hassan had had some difficulties in getting under way and had, it is true, given us some anxious moments, but we were soon reassured. The programme was a very full one, as befitted the spacious conference hall, which accommodated over 200 participants and was perfectly equipped for projection; all went without a hitch.

The congress opened with three conferences: one on humanitarian medicine and burn disasters (Professor Gunn, Honorary President of the MBC), then on organization of burn rescue and first aid in mass disasters (Professor Masellis, President of the MBC), and lastly on personal experience of treatment of burn sequelae in children in Saigon, Vietnam (Professor Michel Costagliola).

The inaugural session was placed under the aegis of the Ministers of Health and of Energy and Mining; from the very first session, considerable importance was in fact given to the theme of hydrocarbons and fire disasters (regulation of the use of LPG, safety and storage of hydrocarbons, the dangers of butane gas bottles).

The presentations were all of high quality and it is difficult to cite them all.

Our Romanian friends (Professors Lascar, Enescu, and Florescu) gave a very interesting presentation on the current state of paediatric plastic surgery, especially burns surgery, in Bucharest.

Professor Kaid-Slimane (Algeria) emphasized the two scourges of Algeria: accidents due to butane gas and electricity. This was a moving and vibrant plea for prevention of these accidents, which exact a heavy tribute, mainly from children. The subject of electrical burns was also addressed by various Moroccan, Greek, and also Albanian speakers (Professor Belba).

An entire session was devoted to infection in the burns patient, with interesting presentations by Professor Deveci of Turkey and Professor Siah of Rabat, and by Dr Messadi of Tunis on antibiotic resistance.

We also noted and appreciated a presentation on rehabilitation, orthotics and prosthetics in the burns patient by Dr Boumahdi (Rabat).

Professor Lior Rosenberg (Israel) demonstrated the efficacy of Debridase for burn debridement, and also an ingenious external fixation system for the fingers.

Our friend Hamza Essadam (Tunis) described the interesting “rail plasty” in burn sequelae.

Also noteworthy were the very practical presentations of our Portuguese colleagues, Drs Serafim and Costa, on summer camps for burned children and the value of functional rehabilitation.

The place of skin cultures in the treatment of severely burned patients and the organization of a skin bank were described with remarkable clarity and precision by Dr Aurélie Hautier (Department of Professor Magalon, Marseilles).

“Cutting edge” papers on the cytokine, interleukin, and other growth factors were presented by the Italian team (Dr Conte, Palermo).

They were closely followed by the French team with Dr Stephanazzi (Hôpital Cochin, Paris) on volume replacement and on anaesthesia in severely burned patients, while Jacques Latarjet, President of the Société Française des Brûlures, gave us an update on nutrition in these patients.

We particularly appreciated the remarkable presentation by Dr Yves Lambert on inhalation injury of the lungs (SAMU, Versailles).

The Moroccan team (N. Bahechar, H. Boukind) gave an overview on sequelae of trunk burns and the Rabat team (Professor Belmahi) reminded us of the value of the posterior interosseous flap in the treatment of post-burn hand contractures.

We must also mention the contributions of our Greek friends (Professor Tsoutsos), always excellent, on electrical burns which are also a calamity in Greece, and on the role of the cardiovascular factor in the prognosis of severe burns.

A full session on resuscitation was, in the opinion of the specialists, perfectly argued and led to fruitful debate between our Greek, Moroccan, Turkish, and Nigerian colleagues.

Lastly, a session on dyschromias and prevention of sun damage was attentively followed (Professor Leguyadec, Hôpital Percy, Paris, and Dr Yvon Gauthier, Bordeaux).

To conclude, Professor Kadry (Cairo), Professor Chani (Rabat), and Georgia Koulermou (Cyprus) each described the organization of burns treatment and prevention in their countries, while Professors Boukind and Siah (Morocco) shared with us their experience of the organization of a national programme for the management of burns patients in Morocco.

We must also emphasize the excellence of the repasts offered by Shell (Morocco) and the “Office National d’Electricité”, and lastly the quality of the gala dinner on the boulevard de la Corniche, when we were able to relax completely and sometimes even to dance to oriental music (thanks once more to Hassan and Saad).

The scientific sessions were highly concentrated and did not allow us to escape often. Nevertheless, we were able to rediscover the charm of the Medina and the beauty of the Hassan II Mosque, whose minaret is the highest in the world (210 m). Built on water, it is impressive in its proportions, covering an area of 12 hectares. It is constructed in the Arab-Andalusian tradition, a jewel of Moroccan craftmanship with its polychromatic woodwork in geometric designs, the remarkable cedar and beech-wood cupola of the prayer room, and the carved travertine stone and inlaid mosaics of the façades.

Of course Casablanca also came to mind, the legendary film of 1942, and the undying memory of Humphrey Bogart and Ingrid Bergman. The organizers had had the attractive idea of using this as a delicate filigree background to the first page of the programme.

We will keep excellent memories of this meeting, guided as always by the principles of friendship and tolerance, and of this city which is both modern and traditional. Once again, we are happy to compliment Hassan Boukind and his team.

P.S. Prior to the congress, the participants in the Burnet Project held a working meeting to review the situation and progress of the work of the various partners.

M. Costagliola

President’s Report 2004 – 2006

I am very pleased to open the proceedings of this General Assembly of the Mediterranean Council for Burns and Fire Disasters, which is being held on the occasion of the Fourteenth Meeting, and I welcome everyone present.

Before starting the proceedings, please allow me to extend the warmest of wishes to William Gunn, who guided the MBC for over twenty years and is still today a point of reference in our never simple action of managing the MBC.

In the last two-year period, the MBC’s activity has developed yet further, not only because all the objectives that our constitution prescribes have been achieved but also because the international programmes initiated in previous years have been brought to a satisfying conclusion and new initiatives have been undertaken.

In this Report I will limit myself to an outline of the activities I have just mentioned and I will make a few personal reflections, leaving to our very active General Secretary the task of going into detail.

In March 2005 the World Health Organization confirmed the designation of the MBC as “WHO Collaborating Centre for Prevention and Treatment of Burns and Fire Disasters” for the coming period of four years.

This confirmation certainly reflects WHO’s appreciation for the work done in the previous four-year period.

MBC’s activity as a Collaborating Centre has been developed along lines aiming:

• to prepare tests and to implement means and methodologies of health education for the prevention of burns and the reduction of fire disasters: production of videos, CD ROM, pamphlets, television spots, prevention courses, etc.;
• to train burns specialists and to collaborate with fire-fighting authorities for the improvement of burns therapy and humanitarian response in fire disasters: scholarships, instructional courses, collaboration with the International Association for Humanitarian Medicine (IAHM);
• to collaborate with industries and National Civil Defence Departments for the prevention and mitigation of industrial fires, explosions, and toxic accidents for the protection of health and the prevention of industrial and tunnel fire disasters: realization in coll. with the Italian Civil Defence Department of a CD ROM on “Medical First Aid in industrial disasters”, and participation as partner in the UPTUN Project;
• to organize and implement research in essential surgery for newly independent states and developing countries: organization in coll. with IAHM of the international symposia and meetings;
• to prepare, in collaboration with the European Union and the Council of Europe, computerized teaching hypertexts material and telemedical technology for disaster learning and distant management in disasters: see coll. with CEMEC and realization BURNET Project of EUMEDIS Programme;
• to assist WHO by acting as a Coordinating Point for the WHO Collaborating Centres for Emergency Humanitarian Action: Mr. Alessandro Loretti, of the Department of Emergency and Humanitarian Action of WHO, was a speaker at the IAHM-Pugwash Interorganizational Conference on “Current Problems of Health and Society” organized with the participation of the MBC. MBC would like to propose to organize the next Meeting of WHO Collaborating Centres for Emergency Humanitarian Action.
• to implement other terms and programmes of WHO: Annals for Burns and Fire Disasters carries “The WHO Page”, a regular feature that provides international health information to readers who would not otherwise have access.

The Economic and Social Council, at its Organizational Session of May 2001, decided to grant Special Consultative Status to the Mediterranean Council for Burns and Fire Disasters–WHO Collaborating Centre. The MBC designated official representatives to the United Nations at the United Nations Headquarters in New York and the United Nations offices in Geneva and Vienna. The regular presence of the MBC implemented effectively and fruitfully the provision for this consultative relationship. The MBC is the only professional organization concerned with burns and fire disasters in the world with such a UN accreditation and its activity is much appreciated: Mrs. Hanifa Mezoui, Chief NGO Division, UN Economic and Social Council, participated as a speaker in the IAHM-Pugwash Interorganizational Conference on “Current Problems of Health and Society”, held in Palermo in October 2005.

The MBC is also an institutional member of ACUNS – the Academic Council on the United Nations System.

In 2001 the MBC was the winner of the prestigious BURNET Project, announced and 80% financed by the European Commission in the framework of the vaster EUMEDIS Programme.

This Project, now in the concluding stages, will make available an operative instrument that can be used by all burns centres in countries belonging to the MBC in order to develop, in a more exhaustive and coordinated manner, the activity of collaboration in the sectors of prevention, treatment, the functional and psychological recovery of burn patients, and the management of fire disasters. The seventeen countries stipulated in the original announcement that set the Project into motion in 2002 may now be joined by other MBC Member Countries not initially included (Libya, Portugal, Albania, Croatia, Slovenia, Republic of San Marino), plus three other non-MBC Members (Palestine, Austria, Romania) that have applied to join.

I firmly believe that the fulfilment of this Project has placed the MBC in a prestigious position in the sector of this specialization. At this point in time no other international professional societies appear to possess a similar instrument of connection and coordination of their institutional activities.

The ties of collaboration between the MBC and the IAHM are based on a common set of ideals, i.e. a strictly humanitarian vision of medicine intended not as an act of pity towards people who are suffering but as the “duty to help those who have the right to ask”. More concretely this means: respect for human dignity according to the principles of the World Health Organization.

These ties have been strengthened by the organization of various meetings with close collaboration between the two societies and by the active participation of the MBC in congresses organized by the IAHM, and vice versa. In October 2005 in Palermo, the IAHM and Pugwash Conference, with the participation of the MBC, organized the IAHM-Pugwash Interorganizational Conference on “Current Problems of Health and Society - The Right to Ask, the Duty to Help and the Resurgence of Nuclear Violence” and in November 2005 in Beirut our General Secretary Bishara Atiyeh, in collaboration with the IAHM, organized the “Basil Fuleiham Seminar for Burns”.

Also this Fourteenth Meeting of MBC sees the active participation of the IAHM.

The Journal of Humanitarian Medicine has the Honorary President and the current President of the MBC as its editors and is published as a supplement to Annals of Burns and Fire Disasters.

The MBC has been a specialty member of this prestigious federation since 1992. Each year the MBC provides one IFSC/MBC scholarship to a deserving young surgeon. The MBC has twice hosted the IFSC Executive at its headquarters in Palermo. The Honorary President of the MBC is Secretary General of the IFSC.

Though a completely separate organization/foundation, the Whitaker Foundation has close ties with the MBC. It celebrated its fifteenth anniversary in 1998 and the MBC, as always, takes part in the prize-giving of the International G. Whitaker International Burns Prize. The winners of this important award were present and lectured at the Second International Conference on Burns and Fire Disasters. In 2005 the Prize was awarded to Prof. Michel Costagliola, Chairman of Coordination of Scientific Activities Committee of the MBC, on the occasion of the IAHM-Pugwash Interorganizational Conference.

The collaboration between MBC and PABPS continues to be active. Many members of MBC are members of PABPS and often are invited to participate in seminars, meetings and courses respectively organized. The PABPS gave its special endorsement to our 14th Meeting.

• Since 1970 the MBC has collaborated with CEMEC-Centre Européen pour la Médecine des Catastrophes, based in the Republic of San Marino. The MBC has participated in the organization of training courses on burns disaster management. The Honorary President and the President of the MBC are on the CEMEC Scientific Committee.
• The MBC has maintained a relationship of collaboration with the Department of Italian Civil Protection and with the National Group for Defence from Chemical, Industrial, and Ecological Risks of the Italian National Research Council. In 2005, on behalf of these organisms, the MBC produced (in Italian) a “Teach yourself multimedia module of information and training in the management of primary health action in industrial fire disasters”. This instrument will be translated into English and will be available to all those who apply for it.
• The MBC was a partner in the UPTUN Project (Cost-Effective, Sustainable and Innovative Upgrading Methods for Fire Safety in Existing Tunnels) financed by the European Community in the framework of the European Programme “Competitive and Sustainable Growth – GROWTH 2001”, developing the topic “Human Response”. This Project terminated in 2006. The material produced will also soon be available.
• In 2005 the Italian Society of Burns applied to become an Associated Society of the MBC.
• In November 2005 the MBC was officially invited to participate in the International Symposium on “Actual concepts in burns treatment” organized by the Romanian Association of Plastic Surgeons. The RAPS has applied to become an Associated Society of the MBC.
• On 25 February 2006 the President of the MBC was invited by the Hellenic Society of Plastic Surgery to participate in a post-graduate seminar in plastic surgery on “Modern trends in the surgical treatment of burns”.
• In 2006 the MBC established links with the Jordanian Society of Plastic Surgery and on 30 March 2006, in Amman, it organized an “MBC Instructional Course on Burns” in collaboration with our Jordanian colleagues.
• In 2006 the MBC was pleased to greet the constitution of the Association Marocaine de Brûlologie (AMB). The MBC enthusiastically accepted the proposal of the President, H. Ihrai, to organize this our Fourteenth Meeting in association with the AMB. The MBC will be glad to count also the AMB among its Associated Associations.

Annals of Burns and Fire Disasters, the MBC’s official organ, is now in its nineteenth year of publication, appearing regularly as a quarterly with an average run of over 3000 copies per issue. Annals includes “The WHO and UN pages”, an instrument of dissemination of important information regarding these two international organisms, as well as the Journal of Humanitarian Medicine, the only journal in the sector and now in its sixth year of publication, having reached vol. VI, no. 1.

March 2006 saw the publication of vol. XIX, no. 1, of Annals.

As the Editorial Board has a large number of articles to publish, some years ago it set up a specific session called “Medit Line” in the site www.medbc.com, presenting the articles in their entirety, pending publication in Annals.

For years now, the site www.medbc.com/annals has made it possible to read, free of charge, all articles published in Annals

The publication free of charge of Annals of Burns and Fire Disasters has provided all Members of the MBC with an instrument with which they have been able to make their voice heard and thus enter the field of international science.

The complete collection of Annals of Burns and Fire Disasters is present in the Alexandrine Library in Alexandria (Egypt) and is continually updated.

Thanks to the particular wisdom of the Parliament of the Sicilian Region, which appreciates programmes of close collaboration on the cultural, scientific, and cooperation level between countries in the Mediterranean area, united by ancient bonds of friendship and civilization, the MBC has since the year 1985 enjoyed financial support decreed by Act of Parliament. It is with these funds that the MBC, every year, makes available to young doctors and nurses from Member countries ten scholarships to enable them to attend Centres of Plastic Surgery and Burns Therapy with the intention not only of helping them to further their technical and scientific training but also of strengthening the ties of friendship between single countries and peoples, which is a fundamental instrument of reciprocal understanding and respect.

The same funds have been used to develop the campaign to arouse public awareness to burns prevention and to organize the numerous training seminars.

The work developed by the MBC in these last years has been considerable and the prestige acquired by our Association has notably risen, as confirmed by the various recognitions obtained: WHO Collaborating Centre, NGO in consultative status with ECOSOC of the United Nations, and last but not least the assignment of the BURNET Project by the European Community.

I firmly believe that with everyone’s participation the MBC will be able to attain yet more achievements. And for that, I thank you in advance.

Respectfully submitted

Michele Masellis

President

General Secretary’s Report 2004 – 2006

Since the last meeting in Nicosia, Cyprus, October 2004, during which a new Executive Committee was elected, progress in all areas of interest related to prevention and public education, disaster and emergency, cultural exchange, promotion, study and research, promotion of cooperation, and dissemination of MBC activities continued to be pursued. New projects have been implemented as well.

1) Cooperation with International Association for Humanitarian Medicine – Brock Chisholm – IAHM