Level 1: Level 1 is considered the US normal, and as a standard of practice, should not apply to individuals and teams serving internationally.
Level 2: International normal readiness level. Standard overseas threat level. Level 2 situations are taken care of locally by the field team.
Level 3: Local Field Team manages the situation, but the team informs Reliant's International Crisis Manager by reporting the international incident so that Reliant can evaluate the situation. Typically at this level, the incident is localized and on a smaller scale. Reliant would not know of the incident without the field team informing us. Reliant would like to hear that "we are fine" and be available to help evaluate the situation and provide assistance if needed.
Level 4: Local Field Team still mostly manages the situation. As soon as possible, the team informs Reliant's International Crisis Manager by reporting the international incident and Reliant's ICMT is now actively involved in the decision-making and helping the field team directly.
Level 5: Management of the crisis is now beyond the capacity of the local field team to manage independently. Reliant's International Crisis Management Team or its pre-approved delegate is now managing the situation until the Local Field Team returns to a position to do so themselves. This is a major crisis resulting in ongoing disruption to field operations or the threat now inhibits the ability of the team to safely continue.
Specific Readiness Level To Determine Next Steps
| Level 5 | Level 4 | Level 3 | Level 2 |
|---|---|---|---|
Individuals with life-threatening injuries or illness (See also Contingency Planning: Accidental Death or Suicide) Needing ongoing permanent care or institutionalization. Examples: ICU See International Crisis Medical Evacuation Assistance | Injury or illness could result in permanent damage or ongoing effects even if treated properly Example: Pneumonia in a remote location without proper care available | Injury or illness will not likely cause permanent damage or ongoing effects if treated properly (See also Contingency Planning: Outbreak of Infectious Disease) A significant number of team members are ill or incapacitated and ministry operations are affected Injury or illness that is managed by Reliant insurance providers Example: Hospitalization | Standard bumps and bruises. Standard surgery with a high probability of good outcome and low risk. Appropriate medical care is present and available. |
Steps to Reduce Probability and Consequences
- Practice situational awareness (Color Codes for Situational Awareness) and follow safety regulations
- Keep a list of Reliant insurance providers and their services. Consult these quickly if an incident develops
- Have a prepared evaluation of local medical facilities with their strengths and weaknesses as well as a suggested list of possible transfer facilities including the nearest Level 1 Trauma Center and the best, most practical US-based facility depending on the general injury/illness
- Have an accessible record for all overseas personnel of relevant medical history or conditions, including current treatments
- Maintain emergency medical coverage for all staff ( See Insurance Overview and Rates for International Workers)
- Provide basic emergency medical response training to field staff
- Remember to contact Aetna early on in the process (See Claims for International Insurance with Aetna)
Applicable Corporate Policies
- Evacuations may be authorized and mandated at either the local, Self-Evacuation or Reliant level.
- Confidentiality During Crisis Events
- Medical Information Confidentiality
Crisis Resolution Protocol
- Provide immediate field medical triage as able to stabilize the patient for transport or to await emergency assistance
- Locate individual’s medical history data
- Call for local emergency assistance if needed and available (The Smart Traveler Enrollment Program (STEP) app has local "911" numbers you can call- See Helpful International Risk Management Resources)
- Call applicable Reliant insurance providers to report an incident and receive guidance about help that is available
- If emergency assistance is not available, transport the victim to the nearest medical facility following the team member's predetermined Evaluation of Local Hospitals and Health Facilities
- If you cannot or should not move the victim, seek out emergency assistance from the nearest location and insurance emergency call center
- As soon as you are able, begin documenting and gathering information
- Contact Reliant to report the incident: Crisis Reporting for International Incident
- Reliant will reach out to receive more details for their internal crisis report. Eventually, Reliant will share a communication tracking log that will serve as a way for team leaders and Shared Crisis Authority and Responsibility in Reliant Partnerships to all view communication updates between Reliant and the field team member
- Determine the location and status of all other personnel. Be alert to and able to advise them to Shelter in Place if needed unless the situation demands immediate Evacuation or Orderly Relocation
- Prepare affected individuals for potential medical evacuation if directed by insurance providers
- Contact other staff for emergency assistance if needed
- Determine the possibility of additional medical emergencies and act to limit the probability
- Identify escort for the evacuation. Make sure he/she has medical power of attorney and is able to assist the injured party in case of inability to make personal medical decisions.
- Determine the location and status of all personnel
- Reliant will work with local leaders to assign personnel to investigate the incident, establish a time frame for when the reported offense occurred, and confirm their activities leading up to the incident and locations they might have visited recently. This personnel should locate and contact any witnesses that might have observed the incident.
- The Team Leader should make contact with, notify, and provide continuing care for affected team members
- Follow all ICMT directions and recommendations
