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This year the focus is on trauma and disaster medicine and management under the theme new heights in emergency management. Dr. Pedro Ariaga from the medical and dental union told us why that is an important topic:…

Dr. Pedro Ariaga, Medical and Dental Union
"We are trying to move to have international recognition and try to bring people that have a tremendous amount of experience outside to help us to improve the quality of medical care that we provide to our community in Belize. We focus on emergency care. as a matter of fact the team for this year is 'new highlights in emergency medicine' so we try to focus in emergency medicine because it is extremely important for us for our physicians to teach our physicians and nurses how to deal with critical emergency situation. as a matter of fact you know we had 2 pre-congress workshops and one of them was focus on trauma. You know very well the situation in our country had been increasing dramatically. let's talk about trauma and crime and then we have a lot of people who are victims of traffic accidents, we have victims of crime; we got shots, stabbing etc."

Dr. Stephen Hargarten, Emergency Physician Winconsin
"From little disasters; a car crash with a family that's a big of a disaster as a potential disaster of Hurricane Richard inflicting damage to this country. Disasters that are measured by that low number but it's no less of a disaster for that family member in a car crash in a near drowning situation. Emergency physicians such as Dr. Bruce and I we think in systems, we think of systems of care for one patient of hundreds and hundreds of patients. In the case of preparing and managing an event that is the size of a potential hurricane it requires agencies across this country; the ministry of health; the minister of defense; transportation, all coming together to develop a plan with the healthcare professionals. so if this city is damage and its healthcare facilities and emergency workers are affected then there needs to be a plan and I suspect it's been discuss to bring in healthcare professionals from other parts of the country to help out in the area that's the hardest hit."

Dr. Mark Bruce, Medical College of Winconsin
"You have to have the ability to get help and you get that ability to get help by think about it ahead of time and arranging for those alliances and where you are going to look for that help before the disaster strikes."

Jules Vasquez
"The number of gunshot trauma cases, it's 11 a month right now for murders and many more who are just injured. Is a sort of ongoing trauma management required for that load, that cumulative load of gunshot related injuries?"

Dr. Stephen Hargarten, Emergency Physician Winconsin
"The vexing challenge in a City like Belize or City like Milwaukee where we are from is challenging its multi factorial it requires everyone to contribute and to do their part to reduce the burden. Law enforcement plays a critical role in addition to emergency care system that reduces its effects but also identifies prevention strategies. Prevention strategies that are evidence base that address child abuse, domestic violence and the issues around the environment that needs to be address, lighting in neighborhoods so that you can't do mischief."

Those two American doctors will revisit Belize to lecture on advanced trauma life support. This afternoon, a lecture was also offered on medical management of strokes and how to improve stroke care. The presentation was delivered by Belizean neurologist Dr. Randall Edgell. He lives and practices in St. Louis but told us how the advanced techniques being used there can also be effectively implemented in the Belizean setting.

Dr. Randall Edgell, Neurologist
"So today I'll be speaking about stroke and especially the emergency room management of stroke. There are very important steps to be followed in patients who have gotten a stroke to try and prevent the injury that may otherwise occur to try to open up a blood vessel or reduce the size of bleeding into the brain - if that's the type of stroke they are having - and so I am going to go over those steps with the group and hopefully give some practical points on how improve stroke care."

Jules Vasquez
"Are these strategies usable in an impoverished third world setting?"

Dr. Randall Edgell, Neurologist "Well I think certainly we have an impressive infrastructure already, we have a very nice cat scan available at the Karl Heusner Memorial Hospital, there are few areas which are still lacking and I think that they can be filled I think that certainly one of those is a drug call Tissue Plasminogen Activator which dissolves blood clots that cause stroke. I think that's something that can be made available and certainly I hope to work with the administration at Karl Heusner to try and do that in the future."

Jules Vasquez
"Is there real hope to sort of a mitigate the effects of a stroke?"

Dr. Randall Edgell, Neurologist
"They absolutely are excellent treatments for stroke; I think that both in the acute setting and in terms on rehabilitation there are many options out there available. I think that stroke is a common disorder is Belize, I think that Andy Palacio not long ago suffered a devastating stroke and I think that's very important for us to start to focus on that and to recognize that if caught early its possible to minimize the damage."

And even at this big conference, a poster competition was held - to see which medical center could generate the most interesting, thought provoking poster. The winner claimed one thousand dollars. The event continues tomorrow.