Point-of-care testing, spatial care paths, and enhanced standards of care - preparing island communities for global warming and rising oceans
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Municipality of Bantayan, Cebu, Philippines
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A152
Background and Objective: The goal of this research is to create point-of-care (POC) strategies that accelerate decision making, increase efficiency, improve outcomes, and enhance standards of care in small-world networks (SWNs) of island communities faced with global warming, rising oceans, population migration, and public health crises. The Philippines lies in the “typhoon alley” of the Pacific and needs assessment was done in the Bantayan Archipelago to map POC testing (POCT), rescue times, and spatial care paths (SCP). Global warming is intensifying the severity of major storms, increasing their frequency, and magnifying the scope of damage. Archipelagos will be increasingly vulnerable and perpetually at risk to rising ocean levels. Every centimeter increase in ocean levels magnifies storm surges and flooding, and poor planning can adversely impact medical outcomes.  Methods:  Needs assessment was done in the Bantayan Archipelago and other locales on mainland Cebu. Well-established investigational methodsconducted in other limited-resource countries were adapted and there was focus on POCT, ambulance rescue, emergency medicine, critical care testing, and the organization of resources in the healthcare SWN. Results: Significant deficiencies included lack of cardiac marker testing for rapid diagnosis of acute myocardial infarction, absence of blood gas testing for support of critically ill patients, and geographic gaps prolonging patient transfers and delaying treatment. Strengths comprised primary care that can be facilitated by POCT, logical inter-island transfers for which decision making could be accelerated with onboard diagnostic testing, and healthcare SWNs amenable to POC advances that avoid overloading emergency rooms. Healthcare resources must be distributed to archipelago islands, not concentrated in large metropolitan areas inaccessible for emergency interventions. Conclusions: A point-of-need focus will help improve public health, decrease disparities in mortality among rural islanders, and pave the way for heightened resilience in anticipation of the adverse impact of global warming on vulnerable coastal areas.
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