Annals of the MBC - vol. 4 - n'2 - June 1991

THE MEDITERRANEAN BURNS CLUB: THREE YEARS OF ACTION

Masellis M., Gunn S.W.A.

MBC, c/o Divisione di Chirurgia Plastica e Terapia delle Ustioni, ospedale Civico,Palerivio, Italia

SUMMARY. The history of the Mediterranean Bums Club is described from the First Meeting of Burns Specialists of the Mediterranean area in Palermo in 1983 until the present day. The objectives of the Club are defined and its institutional activities described. An account is given of the Club's international relations, its participation in international scientific Meetings and its programme of activity with the International Civil Defence Organization, which has named it a <<Regional Training Centre)>. The 19 Member Countries are listed.

Inspired by the ideals of Professor Giovanni Dogo Founder, died in 1986, the first, Meeting of Burns Specialists of the Mediterranean area took place in 1983 in Palermo, Italy, during the 32 n' National Congress of the Italian Society of Plastic Surgery.
The object of th , e Meeting was to engage the intellectual forces of the Mediterranean countries in an open and extended confrontation in order to find, out more about the similarities, analogies and differences in the prevention, treatment and funetional recovery of such a dramatically frequent pathology as burns.
The specialists and experts of 1~ countries (Morocco, Tunisia, Libya, Algeria, Israel, Lebanon, Syria, Turkey, Greece, Yugoslavia, Spain and Italy) stressed the high frequency of accidental burns in their countries and lamented the serious problems of care and assistance as a result of the insufficient number of specifically equipped Centres and the very high management costs of the Centres actually existing.
The participants from Morocco, Algeria and Syria commented on the existence of even more anguishing conditions due to the total lack in their countries of appropriate structures for burns treatment and to the high rate of d , eaths and secondary pathologies, i.e. sequelae causing invalidity. All the participants remarked on the very serious risk of a paralysis of ca , re and assistance not only in any one particular country but in the entire Mediterranean area, in the event of Mass burns following grave natural disasters or war, as also on the need to draw up international assistance plans based on the principle of cooperation among the various countries.
At the end of the proceedings they prepared a common protocol, the object of which was to guarantee uniformity in trends of research, teaching and burns treatment; they also formulated the proposal to create an organism of continuous consultation among burns specialists from the participating countries.
This Organism was given the name "Mediterranean Burns Club" (MBQ; the official Statute of Constitution was approved and it was decided that its seat should be the Division of Plastic Surgery and Burns Therapy at the Civic Hospital, Palermo, Italy. The term "Club" was expressly chosen to underline the friendship and the informal fellowship of its,members, all inspired by the spirit of service. The official activity of the MBC began in 1988.
To attain the desired aims the Club proposes to develop the following activities:

• to encourage periodical meetings of specialists from the Mediterranean countries with the aim of verifying the similarities, analogies and differences and of studying the possible advantages of permanent reciprocal exchange of experiences;
• to promote studies, research, and programmes for young physicians, on the problem of burns, ranging from prevention to the psychological and functional recovery of the burn patient, with the aim of enriching scientific, , clinical and therapeutic knowledge in the field of burns; * Honorary Founder, died in 1986
• to encourage opportunities for young physicians and nurses to take part in continual exchanges between the various Centres in order to achieve greater integration of particular standards of care and assistance, with the aim of rel ' ieving human suffering and at the same time exalting the links of friendship and brotherhood between different peoples;
• to stimulate a continuous effort to unite intellectual and material resources in a sustained spirit of m~ernational cooperation in the field of ca ' re and assistance, 'particularly in the event of natural disasters or war.

The Club has prepared, produced and published in seven (!) languages (English, French, Spanish, Turkish, Greek, Slav and Italian) a didactic and preventive series of notices, posters, albums, brochures and sets of slides on accidental burns, for distribution in schools, hotels, hospitals and all public places.
The production of videotapes with commentaries in the various languages has provided a considerable amount of didactic material to be used also by the mass media. With immediate impact they reproduce or simulate dangerous situations which may occur during children's play, in the home environment or at work. The Club now has six videotapes with the following titles:

• The prevention of burns in children
• The prevention of industrial fire.disasters
• The prevention of electrical accidents in daily life
• The prevention of electrical accidents at work
• How to defend ourselves from forest fires.
• How to protect ourselves from fire.,

ACommission for the "Prevention of burns and fire I damage" coordinates the various aspects of prevention, which depend on the differq1it conditions prevailing in individual countries.

The preparation and production in various languages of model clinical files. to be used by general practitioners and physicians in decentralized hospitals are intended to guarantee that bum victims receive a m . ore aimed immediate treatment. In this way patients arrive at the Bums Centre accompanied by more uniform data regarding the aetiology, clinical course and therapeutic treatment during the first, phase of the bum disease. The Club is preparing a common clinical/therapeutic file for all Bums Centres in each country in order to facilitate the exchange, at international level, of ideas, studies, research and cooperation in teaching and assistance.

The Club intends to compile lists of volunteers (physicians and nurses) willing to offer.their sefvicps immediately in thl event of fire , disasters in any Mediterranean country. The study of Immediate Intervention plans drawn un in conjunction with the national Civil Defence organizations should make every type of cooperation more operational and more rational.

The First International Conference on Bums and fire , Disasters was organized by the MBC in September 1990. With this new way of approaching the management of bums as a clinical problem and of fire disasters as a social problem, the Club has entered the wider sector of disaster management. The name of the MBC's quarterly journal has thus become "Annals of the Mediterranean Burns Club, incorporating Fire Disasters".

The MBC offers '' annually ten scholarships, worth 4 million lire each, to be shared equally between physicians and nurses who can attend a Burns Centre or Division of Plastic Surgery in a country in the Mediterranean area, for a period of one month. One of these scholarships is reserved for . the United Nations (IDNDR). The objective of th , e scholarships is to offer an opportunity to Young people at the beginning of their career to enter the field of these specialities and to those who are already well stablished to perfect , their skills and keep up to date with latest developments. A Commission on the "Problems of nursing activities and technical assistance" analyses, studies and coordinates the conditions of ca re and assistance in the various countries with a view to achieving standard levels.

The Club organizes annually in rotation in the various countries (Palermo, 1988; Cairo, 1989; Rabat, 1990) meetings, congresses and training courses with the intention of promoting the integration of the different types of culture in the sector of burns and fire.disasters. The Club accordingly proposes to favour and stimulate the formulation of programmes of research and continuous comparison between the various scientific and health care realities.

The 'MBC, in the person of the President, the Secretary-General or a delegate, is present at the cultural or scientific events taking place in the various countries that are Members of the Club. This is a way of ex , tending the study of th , e particular realities in each country and of developing a more incisive programme of cooperation. The creation within the Club of a. Commission for ."The promotion of structures for burns treatment" has provided us with a working means of international contact with governments, universities, hospitals, etc. in every country.

The MBC publishes a quarterly jour , nal, "Annals of the Mediterranean Burns Club, incorporating Fire Disasters", which is the Club's offici?!l organ. This journal is already well established. It publishes scientific papers by Members and others, proceedings of the meetings, results of research and studies promoted by the Club, reports on seminars and all other information that may be useful jn the management of burns and fire disasters.

The Club has acquired and installed in its officipl seat, i.e. the Division of Plastic Surgery and Bums Therapy in the Civic Hospital, Palermo, equipment for the storing of clinical, bibliographic, didactic and image data. An electronic Editing Centre has been set up, as also a Computer Graphics Centre and a Computer Animation Centre.

This has made it possible for the Club to:

1. create a bibliographic databank covering burns, reconstructive surgery and fire.disasters;
2. create a clinical, therapeutic and assistance databank on the basis of information from the various Centres in the Mediterranean area;
3. collect and manage all graphic and printed material for the promotion of prevention campaigns;
4. produce and store images to be used in teaching, scientific activity and text-editing;
5. create a Centre for ~he electronic distribution of all, data collected;
6. create a Centre for , the management of the different activities of the Club.

The MBC's specific activity is encountering considerable appreciation at international level. Many requests for . scientific . collaboration have been fulfilleO. The UNO's International Decade for Natural Disaster Reduction (IDNDR 1990-2000) has identified , the MBC as the principal promoting Centre for the promotion of th.e burn prevention campaign and for the management of fire disasters. One of the MBC scholarships is reserved for . an IDNDR candidate. The European Economic Community (Common Market) relies upon the MBC for liaison in its vast programme of Civil Defence.
The World Association of Emergency and Disaster Medicine (WAEDM) has established close links with the MBC as a Counsellor in the sector of thermic agent damage. In view of the presence in the Club of various fire , disaster experts it is expected that this field of consultation will also expand. The courses on burns in the CEMEC (European Centre of Disaster Medicine) programme are coordinated on the scientific I , evel by the MBC, through the Division of Plastic Surgery and Bums Therapy in Palermo. The MBC is part of UNDRO's United Nations International Emergency Network (UNIENET). The MBC is a Liaison Member of the prestigious International Federation of Surgical Colleges (IFSQ. An MBC/IFSC Travelling rofessorship has been created.

By invitation the MBC has participated, presenting papers, in various international scientific meetings:

• Emergency 1988 (London, 1988)
• Burns Course (Rabat, 1988)
• The International Medical Care Development
• Congress (Washington, August 1989)
• Training Course on Bums in Greece (January, 1989)
• 6" World Conference on emergency and Disaster Medicine (Hong Kong, September 1989
• French Bums Society (September 1989)
• Spanish International Bums Symposium (October 1989)
• Session for the foundation of the Spanish Bums Society (1990)
• Italian Army Medical Corps Symposium (1990)
• Conference on biological and chemical weapons organized by the International Commission for Human Rights (1990).

The MBC has been officially named an International Civil Deferic , e Organization "Regional Training Centre". On behalf of IQDO and on the invitation of the national government of Pakistan, the MBC held a training course in Lahore, from 12 th to 18' November 1989, at the Department of Civil Defenc , e (Ministry of the Interior) and another course in March 1990 in Aleppo and Damascus for the Universities of the two'cities, on the request of the Syrian Ministry of Civil Defence. The following 19 -countries are now Members of the MBC: Albania, Algeria, Cyprus, Egypt, France, Greece, Israel, Italy, Lebanon, Libya, Matta, Morocco, Portugal, Republic of San Marino, Syria, Spain, Tunisia, Turkey and Yugoslavia, with a total number of 54,5 paid-up Members.

RESUME. Les Auteurs décrivent I'histoire du Club Moditerranéen des'BrOlures depuis la Premiere Réunion des Spécialistes des Brélures de I'aire méditerranéenne a Palerme en 1983 jusq.'au présent. Ils définissent les objectifS du Club et ses activités institutionelles. lls décrivent en outre les relations internationales du Club, sa participation aux Congrés scientifiqu.es intemationaux et son programme d'activité avec l'Organisation Internationale de Protection Civile, qui I'a nomm& "Centre Régional de Formation". Enfin il y a la liste complete des 19 Pays Membres.