triage policy

“Death is an extremely grave non-emergency; its only treatment is mourning”. That is how doctor Miguel Martinez Almoyna introduces his concept of emergency. The retired 92-year-old anaesthesiologist played an active role in creating France’s SMUR, and later SAMU, emergency medical systems. Still quite active overseas (in Brazil and Mexico), where he has exported the French pre-hospital model, he explains his approach to régulation médicale, whose purpose is to guide patients to the medical services their condition requires while offering a range of responses corresponding to different degrees of severity and urgency.

In exceptional circumstances where the demand for care exceeds the supply, how do you decide who to start with? Triage is necessary where there is exceptional demand, leading to the use of a specific procedure to establish priorities. Interview of Jean-Hervé Bradol conducted by Elba Rahmouni based on the article “In a disaster situation: get your bearings, triage and act” published in the book La médecine du tri. Histoire, éthique, anthropologie edited by Céline Lefève, Guillaume Lachenal and Vinh-Kim Nguyen.  

On 12 January 2010, a high-magnitude earthquake caused numerous buildings in the city of Port au Prince in Haiti to collapse. Tens of thousands of people were killed or injured by falling blocks of concrete. The aftershocks from the earthquake, the predictions made by some seismologists and public rumours prompted fears of a repeat of the disaster. Houses, schools, churches, hospitals and business premises – all the places that had housed the capital’s residents and their main activities – had become lethal traps and a permanent threat. 

Michaël Neuman's review of "Medical Humanitarianism: Ethnographies of practice" edited by Sharon Abramowitz and Catherine Panter-Brick (Philadelphia: University of Pennsylvania Press, 2015)