Philadelphia, Nov 15, 2000 — The R2K Medical Team was an overall success, especially compared to previous efforts at providing medical care, such as N30 and A16. In this brief report, I intend to outline the strengths and weaknesses of our Medical Team, as well as offer a few basic suggestions for the future.
Before I say anything more, I want to be clear about my own role. I was asked by my organization (SLAM!) to provide care for our affinity group a few days prior to Aug. 1. This turned into a request that I help coordinate the larger medical effort in Philly, which eventually turned in to me being a "bottom-liner." However, all said and done, I had a very specific and limited point of view as one of the roaming streetmedics during Aug. 1, and as a staff member at the clinic site. I would encourage folks to talk to the Philly Direct Action Medical Team (DAMiT) for a more broad-based review.
The medical team was perhaps the most coordinated team at R2K. The experiences of the last year provided us with a few key lessons that we were able to implement effectively. Each section below focuses on one of those lessons.
Training
We ran many trainings in the days leading up to Aug. 1, and were able to have a coordinated team of over 50 medics as a result. This does not include the approximately 50 other people who participated in the trainings but who were tied to specific affinity groups. I've heard very few criticisms of these trainings, and from what I saw they were a major improvement over the already excellent workshops offered at A16.
However, we still fell into the trap of cramming trainings in the day before the major actions. This lowered the quality of those trainings, and ended up reducing their length as well. I also found that trainings could differ in significant ways, sometimes to the point of contradicting each other. This created a bit of confusion, especially around the chemical weapons protocols.
In the future, we need to ensure that trainings are set up earlier and have extra time built into them. We should also strive to improve communication between trainers, and attempt to formulate a standardized set of trainings. This suggestion has been put out on the nationwide action-medical listserv, and is being discussed.
Communication
The DAMiT folks put in a lot of effort to setup and maintain our communications network. Each sector had a radio link with the central office, which allowed for rudimentary dispatching. Each team could be notified of events happening in their area, and the central office was able to keep track of where all our people were and where our efforts were most needed. In addition, we had two teams of roaming medics who were responsible for "watching the watchers" and making sure that our medics took care of their own health. These roaming teams also had highly trained individuals who were available in case of a more serious problem.
One major criticism of the radio network focused on our tendency to "play army." We tended to use obscure radio codes (such as "10-9") and the like for no other reason than they sound "cool." These codes differ from region to region, and there is no accepted standard. This did not increase our security in any significant way, and at times created confusion. Associated with this was the lack of sufficient radio training.
In the future, we need to use radio language that is clear, concise, and easy to learn. This can be aided by developing short but efficient radio-use trainings, perhaps offered by the Comm. team in association with the medics. It would also be beneficial for local medic teams to purchase their own programmable radios, which would allow more teams to be in contact with the central office.
Structure
The Medical Team was very structured, with both a centralist setup and a framework that allowed for group autonomy. In terms of centralization we had the coordinator (A.) who assigned teams to areas, provided central dispatching, acted as a liaison to the police, and helped to maintain order at the medic space. As for group autonomy, each team was able to choose (within reason, and the needs of the larger group) the area they wanted to cover. They also were responsible for their own organization and structure, without any serious requirements from the center. At the same time, medic teams still had a tendency to "clump," rather than maintaining a good distribution over the entire sector. Furthermore, because of the decentralization we didn't always know where we had which skills, or if people were teamed up in the best way possible.
In the future, we may avoid the "clumping" by having more radios per sector (as I've already suggested). We might also consider asking folks to register individually rather than just the team leader, which might help us to make suggestions concerning team composition, etc.
Visibility
One of the most significant improvements in terms of visibility was the use of standard T-shirts. These shirts were highly visible, and made obvious the presence of medical personnel. All reports I've heard suggest that this improved morale and confidence, and increased the number of people we were able to treat. The shirts also gave us an air of professionalism and respectability, which plays well in the media and to semi-neutral bystanders.
The biggest criticism of the shirts was that they contradicted the suggestion that people wear long sleeves. There was also an underproduction of shirts, as well as a tendency for some medics to take two or three to turn into patches. Finally, although the medical team asked for donations, the total fell significantly short of what the number should have been ($5/shirt).
In the future, we should definitely continue to use an easy and obvious form of identification like a shirt. The Syracuse medical team has adopted a uniform of navy blue with "star of life" insignias, and reds hats to improve visibility. Any effort towards standardization will be an immense improvement. Furthermore, shirts should be long-sleeve and should as clean as possible from the start. Lastly, shirts should be distributed to medics when they register, and a fee should be required except in the most extreme cases of hardship.
Mobility
One of the greatest strengths of our movement is its ability to be mobile. The medical team adopted this notion with its use of bicycles. We had available to us over 40 bicycles that were "disposable," which enabled us to cover larger sectors with little problem. They also helped us to run messages, transport supplies, etc.
The only criticism of this effort is that some of the bicycles could have been screened out early on. By eliminating known "problem bikes" we would have had fewer mechanical obstacles to deal with. In the future, we should definitely continue to integrate bicycles into our teams.
Clinic
The most impressive development seen during R2K was the setup and operation of a half-scale medical clinic. Thanks to the beneficence of the Philadelphia Society of Friends (Quakers), were able to have a safe, air-conditioned space in which to provide medical care. In addition, this space functioned as a supplies depot, a training site, a medic safe-space, a central office, and a bike storage. Having a space dedicated to medical made us much more efficient, which benefited every aspect of our operation.
The clinic itself was well-stocked with both naturopathic and allopathic remedies, and had an incredibly well-trained staff on hand including paramedics, senior herbalists, psychologists/therapists, MD's and nurses. We provided medical and psychological care, conflict resolution, and a temporary safe space.
However, some serious criticisms surfaced within days of Aug. 1 concerning the changing tone of the clinic space. Whereas it had been a fairly efficient and safe space on Aug. 1 and the day following, it soon turned into a clique-ish, alienating place. A few major stories have rattled those of us who sank serious energies into the clinic, including one about a woman, abused in jail, who was forced to wait in the basement for over an hour while the staff had a meeting in the first-floor clinic space. These allegations have been too numerous to disregard, and have been the darkest spot on the record of the R2K medical efforts.
While this is not the best forum for a thorough critique, it should be stated that the events mentioned above have been strongly condemned by many of the Aug. 1 clinic staff. There has yet to be an open explanation of what occurred, but the subject will not be allowed to disappear.
In the future, we must attempt to setup and maintain these clinical spaces. They are an essential part of good medical support. We must also ensure that the most solid and experienced medics take responsibility for the space, and that a "clinic operations" training is developed. Finally, we must perform a thorough review of the problems mentioned above, attempt to draw out what occurred, and come up with a plan to prevent such events in the future.
Conclusion
The R2K medical effort drew many lessons from the previous year, and attempted to incorporate them into itself. We must continue that same process in the coming months. Some individuals are working on new trainings, others on building medic conferences, and still others on the idea of a medic network. We look forward to hearing the suggestions and criticisms of the movement at large, and encourage other to share their ideas.
The development of a serious and skilled medical support system is essential to the development of a direct-action/community-based movement that can achieve its goals. I hope that each of you will consider in assisting our efforts.
Respectfully submitted September 15, 2000.