MBC NEWS

Neuvième Congrès du MBC
Ninth Meeting of MBC

MBC EIGHTH ANNUAL MEETING
La Coruila, October 1994
President's report for 1993

It is my pleasant duty to report on the activities and developments of our association for the year 1993, since our last meeting in Perpignan, France. I shall briefly mention the highlights, leaving it to our able Secretary-General to expand on our programmes in greater detail.

If I were to summarize the achievements of the MBC during this period, I would say that it has been marked by our scientific expansion, by the growth of our international relations, and by our breakthroughs in training.

1. INTERNATIONAL RELATIONS

The MBC is now being increasingly solicited not only in the Mediterranean area but also worldwide as the acknowledged professional organization with particular expertise in the combined problems of burns and fire disasters.

1. 1. United Nations: For the third year the MBC awarded scholarship in the name of the UN International Decade for Natural Disaster Reduction, as a joint IDNDRIMBC Scholarship in management of burns and fire disasters. We shall continue our support of UN and IDNDR initiatives.

1.2. World Health Organization: In co-operation with the International Federation of Surgical Colleges, with which MBC is in official liaison, a project is being formulated to prepare a manual of basic and essential methodology,for the prevention of burns and control of fires in developing countries. We are also pleased that WHO is being officially represented at our 8th Annual Assembly.

1.3. International Federetion of Surgical Colleges: As mentioned above, a joint project with IFSC and WHO is now being studied. Attempts will also be made to modify and simplify the MBC computerized burns educational material for use in developing countries. The President of the MBC was elected Vice-President of the IFSC for the coming four years.

1.4. Giuseppe Whitaker Foundation: The Whitaker Foundation has close ties with MBC, but is a completely different institution. Our Secretary-General is its Scientific Secretary, and the Foundation plays a considerable role in the education and science of burns management.

1.5. European Union: The EEC, now the European Union, has vast plans (COMETT) for the scientific/educational standards of its comporent countries. Within this scheme, a consortium of burn centres, headed by the MBC, has prepared a computerized, multimedia interactive hypertext on burns management. This received great and unanimous acclaim at the recent ISBI Congress in Paris, and will be demonstrated to all our members at the La Corufla meeting. This is a unique international, educational and scientific achievement of which MBC can justly be proud.

1.6. International membership: Recent political and governmental changes among the states bordering the Mediterranean have an effect on the national membership composition of our organization. Thus, Slovenia has officially indicated that it desires to be a member and has nominated its National Representative. We welcome Slovenia, whose members have in any case long been active in the MBC. We shall deal with other changes as they present and are discussed by all of us.

1.7. Promotion of National Societies: Among its scientific objectives, the MBC promotes the establishment of National Societies in countries of the Mediterranean basin, for the study and management of burns and fires. In this respect the MBC is proud to have been instrumental in the founding of the Spanish Burn Association - which is holding its First Congress at the time of our Annual Meeting, and to whom we extend our best wishes. The MBC also played a significant role in the establishment of the Burn Society of Libya, to which we also extend a warm welcome.

1.8. World Association for Disaster and Emergency Medicine: The MBC is an affiliated Society in WADEM and our organization's concems in fire disasters are considered a valuable input in the field of major emergency management. The MBC, along with many other prestigious organizations, is collaborating in the World Congress on Emergency Medicine, to be held in Jerusalem in May 1995.

2. SCIENTIFIC ACTIVITIES

It will be evident that most of the international activities cited above concern primarily scientific and educational endeavours. Inter alia, the following deserve highlighting:

2. 1. Annals of the MBC: Our scientific publication is constantly improving in quality and is a worthwhile addition to the literature on burns management. Additionally, it is concerned with articles on fire disaster problems, issues that are not dealt with in other medical journals. The Annals are intentionally open to all members, thus providing a forum

for publications of regional interest.

2.2. Burns Multimedia Interactive Educational Hypertext: Reference is made to this under 1.5 above. This unique educational instrument breaks new ground in computer-assisted training, and has already received wide acclaim. Outside institutions are already interested in this, and members will see it in addition.

2.3 Simplified burns manuals: The World Health organization has a programme of providing manuals of medical and surgical techniques at a simplified level for use within primary health care in remote areas. As stated under 1.3 above, MBC, jointly with IFSC and WHO, is planning to produce such a simplified manual for burn prevention and therapy in developing countries.

2.4 Collaboration with the Vishnewsky Institute: The headquarters of our organization is proudly housed in Professor Masellis's ultramodern Burn Centre. Through this and the MBC, agreement has been signed with the Vishnewsky Institute of the Russian Academy of Medical Sciences, Moscow, for scientific collaboration. Two researchers were Resident Scientists at the Burn Centre for several weeks.

2.5 Participation in Congresses: MBC members are very often invited to scientific bum conferences not only in member countries but also farther afield. Also, burn specialists from non-Mediterranean countries are increasingly requesting to become Associate Members, a sign of their recognition of MBC's worth.

2.6 Third International Conference on Burns and Fire Disasters: Following the success of the 1990 and 1992 Conferences on this broadened theme, the American Burn Association expressed the wish to cosponsor the forthcoming Conference, and we appreciate this recognition. ITACCS (the International Trauma Anesthesia and Critical Care Society) and WADEM (the World Association for Disaster and Emergency Medicine) are also collaborating. Plans are in progress to hold this as a Mediterranean cruise-conference.

3. CONSTITUTIONAL MODIFICATIONS

The Mediterranean Burns Club has been constituted with the aim of promoting the highest scientific and professional standards in the man-agernent of thermal injury. Increasingly it has become evident that the prevention of fires and the treatment of burns are intirnately interlinked, and it is to the credit of the MBC that this organization has been the pioneer in dealing with the conjoint problems of burns as a clinical, surgical issue, and fires as a societal, disaster management issue. We have been praised and acknowledged for this vision, and our approaches have opened new vistas in prevention, response and rehabilitation. In this light I shall make a proposal to the General Assembly that the name of our Organization be modified, to better express this progression. It is moved that the Mediterranean Burns Club be named Mediterranean Club for Burns and Fire Disasters.

4. FINANCIAL SITUATION

The MBC is in the fortunate situation of having a healthy financial balance. We are particularly grateful for this to the Italian and Regional Authorities for assuring our finances by legal statute. We are indebted to our indefatigable Secretary-General, Michele Masellis, for having suc-ceeded in obtaining such governmental backing, and indeed for all his work in ensuring such a lively and productive organization as your MBC.

Prof. William Gunn, MD, MS, FRCS
President

The 1994 General Assembly is being held in La Cortifla on the occasion of the Eighth Meeting of the MBC and the Joint First Meeting with the Spanish Burns Association.
The objective of the Assembly is to examine, discuss and approve the Club's activities in 1993.
The Order of the Day is as follows: Approval of the Agenda President's Report Secretary-General's Report Treasurer's Report Reports of Representative Members Approval of 1995 Budget Future activities of the MBC Proposals to modify the MBC Statute Admission of new Members Election of National Representatives Admission of Associated Society Any other business
The MBC's activity has been distributed as discussed in the General Assembly held in Perpignan in 1993 in the following sectors:

• Sector of prevention and public education
• Sector of disasters and emergencies
• Sector of cultural exchanges between Member Countries
• Sector of cooperation
• Sector of the management of the coordination of MBC activities

1. SECTOR OF PREVENTION AND PUBLIC EDUCATION

All the material produced by MBC in the sector of prevention continues to arouse keen interest among organizations, voluntary groups, schools andjournals that are interested in this problem.
The requests to the Club for folders, brochures, posters and videotapes are increasingly numerous. These are sent free of charge to Club Members on presentation of a written application in which they formally undertake to use the material in a prevention campaign.
Non-Members at present receive the material on payment of postal charges. It is thought that if these expenses increase it will be necessary to ask for the cost price of the material in addition to postage.
This year the Club has produced a new booklet entitled "Burn Prevention Campaign - Immediate Care of burn victims - 10 Guidelines for rescue workers". This has been published in English, French, Spanish and Italian.
It is the Club's intention also to produce versions in Arabic, Turkish and Greek.
Next year a second booklet will be published entitled "10 Guidelines for first aid to burn victims by trained teams".
In the context of the MBC's activities in education and training it has finally become possible to realize the project already announced entitled:
"A multimedia computerized teaching system in the field of burns -the COMETT project of the European Union". This project, requested and managed in collaboration with the European Union by the MBC, saw the participation, on the level of scientific content, of five Burns Cerutres in the Mediterranean area: Athens, directed by Prof. J. Joannovich; Madrid, directed by Prof. V. Garcia Torres; Palermo, directed by Prof. M. Masellis; Turin, directed by Prof. G. Magliacani; and Toulouse, directed by Prof. M. Costagliola.
The project was presented during the Ninth ISBI Congress in Paris and viewed in detail by numerous colleagues at the MBC stand in the Congress display area. The opinions expressed were very positive, and many national Burns Societies, some from beyond the Mediterranean area, asked for the programme to be presented during their Meetings. Official invitations have been received from the Burns Societies of Russia, the Czech Republic, Italy, Saudi Arabia, the Slovak Republic and China, as well as from the American Burn Association.
It is the Club's intention to produce versions of the programme in the languages of the Member Countries of the Club and to propose an agreement with INFORMED, the technical producer of the project, to supply copies at a special price to Members or organizations requesting them.
We would like to emphasize that this project - which is considered to be without any doubt the most up-to-date instrument in training and teaching in this specific field that exists today on the market - bestows genuine prestige on our Club, both from the scientific and technical point of view and in the light of the purposes it was intended to achieve.
The purpose of the project is facilitate greater knowledge in the field of burns and fire disasters among the Mediterranean countries in order to consolidate common experiences in the subject.
These experiences will be used to improve the training of medical and paramedical personnel in burns treatment and in the psychological and functional recovery of the burn patient, as also in the prevention and management of fire disasters.

2. SECTOR OF DISASTERS AND EMERGENCIES

The second volume on The Management of Mass Bums Casualties and Fire Disasters is in the press (again Kluwer Academic Publishers of Dordrecht). This will contain the papers presented at the Second International Conference on Burns and Fire Disasters - Perspectives 2000.

3. SECTOR OF CULTURAL EXCHANGES BETWEEN MEMBER COUNTRIES

The MBC scholarships were again awarded in 1994. This year the total number was ten. The scholarship winners were:

Physicians

Dr H. Boukind (Morocco)
Dr A. Liri-Pema (Albania)
Dr A. Rizzo (Italy)
Dr K. Schembri (Malta)
Dr Farid Zeidam (Syria)
Dr Elmad Diab (Egypt)

Paramedicals

Mr L. Buttigic G. (Malta)
Mr M. Abderrazak (Algeria)
Mr V. Greco (Italy)
Mr Nafissa-Mouchtar (Morocco)

For the realization of the training purposes of the project an interactive multimedia application on CD-ROM was developed which can be used by anyone with access to a personal computer.
The programme, in its various contents, is intended for the following categories:

• medical students
• physicians specializing in bums
• paramedical personnel
• students, voluntary workers and the general public, as regards prevention, initial response and management of disasters

MBC intends to publish the contents of the project in a treatise to which the CD-ROM will be attached. This initiative is being discussed with various publishers who have viewed the contents of the programme and shown their keen interest.

4. SECTOR OF COOPERATION

The participation of the MBC in various Meetings either as a Collaborating Institution or by official invitation was at a good level.
In particular, the MBC was present, in the person of the Secretary General, at the following meetings:

First Pan-Arab Conference of Plastic Reconstructive Surgery, Tripoli (Libya), 1-4 May 1994, on which occasion the Pan-Arab Association of Burns and Plastic Surgery (PAAS) was constituted. The MBC greets with pleasure this new Association and accepts with pleasure the request to include it among the Associate Societies.
Another important presence of the MBC was at the Ninth ISBI Congress in Paris, where the Club set up a display stand, thanks to the friendly goodwill of our French colleagues. It was thus possible to present all the Club's production in the field of prevention (videos, folders, posters, etc.), Club publications, and the Multimedia Computerized Teaching System in the Field of Burns.

Future MBC Activities

As we all know, organization is in progress for the Third International Conference on Bums and Fire Disasters, which will be held in the form of a Joint Meeting with the American Burn Association, WADEM and ITACCS from 3rd to 6th June 1995 during a Mediterranean cruise on board the turboship Ausonia.
In view of the fact that many participants have sent in their application forms late or have complained about the earliness of the date by which they are obliged to commit themselves, the shipping company has agreed to postpone the deadline for applications to 15th December 1994.
Ourcolleague M. Dargouth has advanced a request to hold the Ninth MBC Meeting in Tunisia, and our colleague L. Rosemberg has advanced a request for the 1998 Meeting in Israel.

Publication of Annals of the Mediterranean Burns Club

Publication of the journal has continued regularly with a circulation of some three thousand copies. Starting from Volume VII, the-lay-out and paging have been modified, making it more compact and more in line with the printing style of other scientific journals. We believe that the quality of the scientific content is growing, and this is confirmed by the considerable number of articles that are sent to the Editors' office - even from authors outside the Mediterranean area - and by the numerous notifications of change of address, which lead us to suppose that interest remains high.

5. SECTOR OF ORGANIZATION AND COORDINATION OF MBC ACTIVITIES

In the framework of the purposes laid down in the Club Statute, the Directive Council has always pursued the idea of extending the field of' action of the Secretariat's activities.
For years we have spoken about creating a data bank for burns and fire disasters, and about setting up a communications network between the various Burns Centres in Member Countries in order to promote better cooperation on the epidemiological, informative, didactic and collaborative level. We have encountered not a few difficulties in devising a project that would be limited in cost and could be completed only in the course of several years, bearing in mind the Club's financial resources.
The programme, in its general lines, can be subdivided as follows:

A. Creation of a Data Bank: epidemiological (organization of the "Mediterranean Burns Register"), bibliographical and iconographic

The first point derives from the urgent need for collaboration between the Mediterranean countries in order to gain wider knowledge of burns pathology by means of the exchange of clinical experiences and information.
The practical realization of the project requires:

1. Creation of a host station
2. Creation of an image processing and filing post
3. Production of a modem communications network
4. Development of software applications

The creation of a communications network between the various Mediterranean countries will have a dual purpose.

1. Link-up with the host station for consultation of data contained in the data bank

1. Bibliographical data. By means of a special search module, users will be enabled to request a bibliographical report on the selected subject, using key words. Besides the bibliographical references related to the subject, a summary of the article will be provided, plus the whole article, if this is in MBC's possession. The management software has already been created and is now being tested.
2. Iconographic data. The MBC possesses an image data bank which all Members can use for didactic and informative purposes. The management base module contains personal details, the reference data of the photograph, its Centre of origin, the clinical diagnosis, key words for research and a notes field where any useful reference information can be inserted. The management program has already been realized and it is now being finalized.
3. Epidemiological data. The awareness that burns are not a pathology of regional or national interest but rather of world interest has led us to develop a plan concerning all the Mediterranean countries in order to devise a prevention strategy based on data that interest various populations.

Hence the utility of the "Mediterranean Burns Registe?': this will comprise a series of data of epidemiological, clinical and therapeutic interest, originating from all the Burns Centres in the Mediterranean area, to which all partners will have access for the inclusion of new clinical cases and for consultation purposes. All clinical cases will be furnished with images.

2. Link-up between the various peripheral units for:

1. Creation of a bed availability plan (indispensable in nre disasters).
2. Use of a common computerized clinical file in order to facilitate long-distance consultation between Burns Centres and between Burns Centres and decentralized Emergency and Casualty Departments. This clinical file is already in use at the Palermo Burns Centre and could be proposed to other Centres.
3. Transmission of scientific material intended for publication in Annals of the Mediterranean Burns Club.

B. Creation of a multimedia classroom at the seat of the MBC to be used in refresher and training courses for medical and paramedical personnel.
The courses will use the most up-to-date multimedia technology including the multimedia CD-ROM on burns produced by the Club (i.e. the COMETT project).

A future prospect is the link-up of the multimedia station in a communications system permitting the simultaneous use of the multimedia teaching software applications by the peripheral posts connected to it. It will thus be possible to hold training courses simultaneously in different countries, using the multimedia post in the MBC scat.
On the basis of this programme of enlargement, organization and coordination of the Club's activities, we have requested INFORMED, a company working in information science in this specific field which has already collaborated with MBC, to provide strictly technical information in order to support the realization of the project with the most appropriate technology available, with relative indications of cost.
INFORMED has supplied us with the information in the form of a Draft Project which is attached to this report.
In the light of the estimated costs, which we believe we can contain, at least in the first part regarding the units employed for management of the program, it is our opinion that the project can be realized in three years.

Prof. Michele Masellis, M.D.
Secretary-General

REVENUE consisted of the Sicilian Region contribution of 300 million lire.

EXPENDITURE was limited within the limits of allocation as established in the budget with a distribution of expenses as follows: 15% for Prevention and Health Education 50% for Cultural Co-operation and Promotion 12% for Functioning of the Secretariat 23% for Functioning of Infotelematic Services

INSTITUTIONAL EXPENDITURE used up 65% of Revenue, with an increase compared to 1993 of 10%; this concerned: production and distribution of illustrative material for the different Mediterranean Countries; award of ten scholarships which in 1994 were distributed as follows: European countries: 5; African countries: 5. production and publication of the Journal, which absorbs 33% of the expenses in the sector; contribution for the organization of the annual Meeting.

EXPENDITURE for functioning of the Secretariat diminished by 23%, involving only 12% of revenue; this saving enabled us to stipulate a pluriennial contract for infotelematic collaboration.

G. Sferrazza Papa, M.D.

EXPENDITURE