Disaster Relief

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0:00:02 > 0:00:05We live in a world built on technology.

0:00:06 > 0:00:09But it's a world that can so easily be destroyed.

0:00:09 > 0:00:11An energy crisis,

0:00:11 > 0:00:14a pandemic,

0:00:14 > 0:00:15a natural disaster.

0:00:17 > 0:00:20Or as in the case of Syria, civil war.

0:00:26 > 0:00:29So what happens when the modern world falls apart?

0:00:29 > 0:00:33And how can science and technology come to the rescue?

0:00:33 > 0:00:36This is Zaatari refugee camp in Jordan,

0:00:36 > 0:00:39eight miles from the Syrian border.

0:00:39 > 0:00:41If I'd stood here 18 months ago,

0:00:41 > 0:00:45I'd have seen absolutely nothing - just barren desert.

0:00:46 > 0:00:49Now it's home to over 90,000 refugees

0:00:49 > 0:00:52who've fled their war-torn country.

0:00:53 > 0:00:57And yet these are just a fraction of the millions of people

0:00:57 > 0:01:00whose lives have been turned upside down

0:01:00 > 0:01:03by war and natural disasters.

0:01:05 > 0:01:06When disaster strikes,

0:01:06 > 0:01:10it triggers a massive global desire to help

0:01:10 > 0:01:14and a huge humanitarian effort swings into action.

0:01:14 > 0:01:17But to what extent is that effort shaped by science?

0:01:19 > 0:01:20Coming up, Liz finds out

0:01:20 > 0:01:24how volunteers are creating crucial maps of disaster zones

0:01:24 > 0:01:27without even leaving home.

0:01:27 > 0:01:30Anyone, wherever they're sitting, whatever age,

0:01:30 > 0:01:32can contribute to disaster relief.

0:01:32 > 0:01:36I discover how lessons learnt on the battlefields

0:01:36 > 0:01:38are saving lives in Britain.

0:01:38 > 0:01:41It doesn't matter whether it's an injury from an IED in Afghanistan

0:01:41 > 0:01:44or a road-traffic accident in the UK,

0:01:44 > 0:01:47you need to stop that bleeding as soon as possible.

0:01:47 > 0:01:51And we're joined by doctor and aid worker Chris van Tulleken

0:01:51 > 0:01:53to look at the radical advances being made

0:01:53 > 0:01:55in the fight against famine.

0:01:55 > 0:01:58How is this changing the way we treat malnutrition?

0:01:58 > 0:02:01This has changed the way malnutrition is treated

0:02:01 > 0:02:04at a global scale in a way that nothing before has ever done.

0:02:04 > 0:02:08Tonight on Bang, the science behind disaster relief.

0:02:12 > 0:02:17MUEZZIN'S CALL OVER PA

0:02:20 > 0:02:25Two and half million Syrians have now fled their country,

0:02:25 > 0:02:28giving up everything for the safety of places like Zaatari.

0:02:28 > 0:02:33What was the moment when you decided you absolutely had to leave Syria?

0:02:33 > 0:02:36My nephew, my cousin, my friend,

0:02:36 > 0:02:40some of them died, burned by regime army.

0:02:40 > 0:02:44Whenever I go outside my home, I have to say goodbye to my family,

0:02:44 > 0:02:47because I don't know if I will come back again or not.

0:02:49 > 0:02:53In less than two years, this camp has grown from nothing

0:02:53 > 0:02:56into the fourth largest city in Jordan.

0:02:56 > 0:02:58To run it takes over a thousand people

0:02:58 > 0:03:01and costs half a million US dollars a day.

0:03:01 > 0:03:03HORN BLARES

0:03:03 > 0:03:06As with any disaster, getting the priorities right

0:03:06 > 0:03:10can mean the difference between life and death.

0:03:10 > 0:03:12And at the top of the list

0:03:12 > 0:03:13is clean water.

0:03:21 > 0:03:253.6 million litres of water a day are needed to keep Zaatari running,

0:03:25 > 0:03:30and originally every single drop was trucked in from outside.

0:03:30 > 0:03:33Now there are boreholes, like this one,

0:03:33 > 0:03:36and that provides two thirds of the water needed.

0:03:36 > 0:03:39But it doesn't matter where the water comes from.

0:03:39 > 0:03:41Every single truckload is tested.

0:03:45 > 0:03:48We're testing the water samples from this truck

0:03:48 > 0:03:52- to help us know the chlorine levels. - And why do you use chlorine?

0:03:52 > 0:03:56We use chlorine because it kills the viruses, the pathogens,

0:03:56 > 0:03:58the bacteria in water system.

0:03:58 > 0:04:02It is the cheapest way of cleaning the water at this bulk level.

0:04:05 > 0:04:08If the water system fails in any disaster zone,

0:04:08 > 0:04:11the biggest fear is that cholera could take hold.

0:04:11 > 0:04:14After the 2010 Haiti earthquake,

0:04:14 > 0:04:17over 6,000 people were killed by cholera,

0:04:17 > 0:04:20and nearly half a million more were hospitalised.

0:04:26 > 0:04:29Here in Britain, we take our clean water for granted,

0:04:29 > 0:04:32but just 150 years ago,

0:04:32 > 0:04:34we too were in the grips of a cholera outbreak.

0:04:36 > 0:04:37Over 10,000 people had died,

0:04:37 > 0:04:40and no-one seemed to be able to find the cause.

0:04:42 > 0:04:45Finally, a man named John Snow came up with the theory

0:04:45 > 0:04:49that cholera was being spread in the water supply.

0:04:49 > 0:04:52He traced the outbreak to a communal water pump in Soho in London,

0:04:52 > 0:04:55and he convinced the authorities to remove the handle from the pump

0:04:55 > 0:04:57so people couldn't drink from it,

0:04:57 > 0:04:59and cases of cholera reduced dramatically.

0:05:01 > 0:05:03The John Snow pump is now held here

0:05:03 > 0:05:06at the London School of Hygiene and Tropical Medicine,

0:05:06 > 0:05:10where scientists study the impact of infectious disease.

0:05:10 > 0:05:14- So this is live cholera bacteria. - It is, yeah.

0:05:14 > 0:05:16So this is a liquid culture of cholera.

0:05:18 > 0:05:20They look pretty innocuous, but believe me,

0:05:20 > 0:05:23this is the bacteria that's responsible for considerable misery

0:05:23 > 0:05:27and a huge amount of disease every year.

0:05:27 > 0:05:30- I just saw a long one zip across the screen up on the top.- Yeah.

0:05:30 > 0:05:35What is it that allows them to be so mobile?

0:05:35 > 0:05:37Yeah, they've evolved over a huge period of time.

0:05:37 > 0:05:39They have really exquisite mechanisms for movement,

0:05:39 > 0:05:42and one of those is they have a flagella.

0:05:42 > 0:05:44It's like a tail, it rotates,

0:05:44 > 0:05:48and basically it pushes the cholera bacteria through fluid.

0:05:49 > 0:05:51Our guts have a lot of mucus in,

0:05:51 > 0:05:54and that bacteria needs to swim through that mucus.

0:05:54 > 0:05:56OK, so it's very effective at boring through the mucus,

0:05:56 > 0:05:59and then once it gets to our intestinal wall,

0:05:59 > 0:06:02- what happens then? - It produces a toxin.

0:06:02 > 0:06:04The toxin actually goes into our cells,

0:06:04 > 0:06:07and it changes the functions of our own cells.

0:06:07 > 0:06:11It actually forces them to excrete huge amounts of water,

0:06:11 > 0:06:14leading to this massive and very rapid fluid loss.

0:06:16 > 0:06:20And it's this fluid loss that can be fatal.

0:06:20 > 0:06:25Our bodies are made up of 60-70% water,

0:06:25 > 0:06:29so for an average person that translates to 40 litres of fluid,

0:06:29 > 0:06:31represented in this tank.

0:06:31 > 0:06:34Now, a patient with severe cholera

0:06:34 > 0:06:38could lose up to one litre of fluids every hour.

0:06:38 > 0:06:43And it's not long before this sort of fluid loss causes problems.

0:06:43 > 0:06:47After losing just about one or two litres,

0:06:47 > 0:06:50the patient will begin to feel mild symptoms,

0:06:50 > 0:06:53so they'll have a dry mouth, they'll feel thirsty.

0:06:53 > 0:06:55And once they've lost four litres of fluids,

0:06:55 > 0:06:58the symptoms will have become moderately severe,

0:06:58 > 0:07:00so the patient could feel weak and dizzy

0:07:00 > 0:07:04and have neurological symptoms like confusion.

0:07:04 > 0:07:07Cellular functions in the body begin to be compromised.

0:07:07 > 0:07:10The immune system isn't working properly.

0:07:11 > 0:07:14And by the time they've lost eight litres of water,

0:07:14 > 0:07:16that's just 20% of body fluids,

0:07:16 > 0:07:21the organs will have shut down, quickly leading to death.

0:07:21 > 0:07:22So without treatment,

0:07:22 > 0:07:25a cholera patient could be dead in less than a day.

0:07:28 > 0:07:31The other reason why cholera can be so devastating

0:07:31 > 0:07:34is that for as long as the patient is infected,

0:07:34 > 0:07:38every drop of fluid that's passed is brimming with bacteria.

0:07:38 > 0:07:45Just one millilitre of fluid, just this amount here,

0:07:45 > 0:07:49contains a billion cholera bacteria.

0:07:49 > 0:07:53So it's easy to see how easily infection can spread

0:07:53 > 0:07:56and how one case can turn into 12

0:07:56 > 0:07:58and then 100 in a matter of hours.

0:08:02 > 0:08:04John Snow might get the accolade

0:08:04 > 0:08:07for identifying cholera as a waterborne disease,

0:08:07 > 0:08:10but the real heroes of our clean-water systems

0:08:10 > 0:08:14are the civil engineers who design our sanitation plants

0:08:14 > 0:08:16and use the element chlorine,

0:08:16 > 0:08:19injected into our water systems, just as in Zaatari,

0:08:19 > 0:08:22to destroy pathogens like cholera.

0:08:24 > 0:08:29So, Nick, the last outbreak of cholera in this country was in 1866.

0:08:29 > 0:08:32Is there any chance at all that it could happen again here?

0:08:32 > 0:08:35The tragedy of cholera is that it is very treatable,

0:08:35 > 0:08:37so if you have clean water and you have those systems in place,

0:08:37 > 0:08:39you can treat it, contain it.

0:08:39 > 0:08:42Of course, just like any other place, any warzone,

0:08:42 > 0:08:44any place where you have a natural disaster,

0:08:44 > 0:08:46if all of those systems broke down,

0:08:46 > 0:08:51then cholera could...can take hold, and in the UK like anywhere else.

0:08:51 > 0:08:54But of course the likelihood of that happening here is incredibly remote.

0:08:54 > 0:08:57I mean, we've had recent floodings and no cholera.

0:09:02 > 0:09:066:30 in the morning, and the daily routine at Zaatari begins.

0:09:06 > 0:09:10This is one of four bread distribution points in the camp.

0:09:10 > 0:09:14When a disaster hits any country and normal infrastructures break down,

0:09:14 > 0:09:19feeding the population becomes a massive and urgent problem.

0:09:29 > 0:09:33Although the nutritional health of the refugees is generally good,

0:09:33 > 0:09:36aid workers are concerned about some of the new arrivals from Syria

0:09:36 > 0:09:39where food supplies are becoming scarcer

0:09:39 > 0:09:41the longer the war continues.

0:09:41 > 0:09:44Yes, you're having your arm measured, aren't you?

0:09:46 > 0:09:48So just explain what's going on.

0:09:48 > 0:09:50She's taking MUAC.

0:09:50 > 0:09:52MUAC is the mid-upper arm circumference.

0:09:52 > 0:09:59It is an indicator that shows if a child is malnourished or not.

0:09:59 > 0:10:02And what was that? That was 11.5, so what does that mean?

0:10:02 > 0:10:05It means the child has moderate acute malnutrition.

0:10:05 > 0:10:12We provide high-energy food that will help boost the child's weight.

0:10:12 > 0:10:14Yeah, that's going to be much better for you.

0:10:19 > 0:10:22Sadly, malnutrition is all too common a problem

0:10:22 > 0:10:25faced by aid organisations.

0:10:25 > 0:10:29Famine still affects more than 840 million people worldwide,

0:10:29 > 0:10:33as Dr Chris van Tulleken knows first-hand.

0:10:33 > 0:10:35I've worked in parts of the world

0:10:35 > 0:10:37where malnutrition has been the single biggest problem,

0:10:37 > 0:10:40affecting almost every patient.

0:10:40 > 0:10:42Now, it has direct effects on the human body,

0:10:42 > 0:10:45particularly on development in children,

0:10:45 > 0:10:47but it also makes you intensely vulnerable

0:10:47 > 0:10:49to almost every other disease.

0:10:51 > 0:10:56Last year, more than three million children were killed by malnutrition.

0:10:56 > 0:11:00But an innovative treatment is changing that.

0:11:00 > 0:11:03This used to be the standard treatment for severe malnutrition.

0:11:03 > 0:11:05It's essentially turbo-boosted milk powder.

0:11:05 > 0:11:09It's got extra protein, extra fat, and extra vitamins and minerals.

0:11:09 > 0:11:12And to make it up seems pretty simple.

0:11:12 > 0:11:15Put it in a jug and add half a litre of water.

0:11:15 > 0:11:17But this is where the problems begin.

0:11:17 > 0:11:20In the kind of places we need to use this,

0:11:20 > 0:11:22clean water is very hard to find,

0:11:22 > 0:11:24and any bacteria that are in the water

0:11:24 > 0:11:26will start multiplying to dangerous levels

0:11:26 > 0:11:29the minute you add them to the milk powder.

0:11:29 > 0:11:33And this means that you can really only use it supervised in hospitals.

0:11:34 > 0:11:37But the milk formula is being replaced by this.

0:11:37 > 0:11:38This is Plumpy'nut,

0:11:38 > 0:11:41the first in a range of nutritional supplements

0:11:41 > 0:11:44that are revolutionising the way we treat severe malnutrition.

0:11:44 > 0:11:47This will keep for two years outside of a refrigerator,

0:11:47 > 0:11:50you don't need to add water in order to eat it,

0:11:50 > 0:11:53and in this 92g pack there are as many calories

0:11:53 > 0:11:56as there are in a triple-decker burger with cheese.

0:11:56 > 0:11:57Like many great inventions,

0:11:57 > 0:12:00the secret of these nutritional supplements

0:12:00 > 0:12:01lies in their simplicity.

0:12:01 > 0:12:03It can all be made

0:12:03 > 0:12:05from ingredients that are actually quite widely available

0:12:05 > 0:12:08in the regions where they're most needed.

0:12:08 > 0:12:11It's built on a foundation of peanut butter.

0:12:11 > 0:12:14Now peanut butter is actually a pretty good food

0:12:14 > 0:12:18containing fibre, protein, carbohydrate and fat,

0:12:18 > 0:12:20as well as vitamins and minerals.

0:12:20 > 0:12:23You could live a long time eating just peanut butter.

0:12:23 > 0:12:26And then we increase the calories by adding oil,

0:12:26 > 0:12:31and oil is the most densely calorific thing that you can eat.

0:12:31 > 0:12:33That also stops the growth of bacteria

0:12:33 > 0:12:35and increases the shelf life.

0:12:35 > 0:12:40Then sugar makes it tastier to eat and adds carbohydrate calories.

0:12:40 > 0:12:43Milk powder - more protein, fat, sugar -

0:12:43 > 0:12:47and also makes it quite palatable, adds a creaminess.

0:12:47 > 0:12:50Finally, because many of the people who will be eating this

0:12:50 > 0:12:52will be severely nutritionally deficient,

0:12:52 > 0:12:54we add extra vitamins and minerals.

0:12:59 > 0:13:00Let's see what it tastes like.

0:13:02 > 0:13:04It's not bad.

0:13:04 > 0:13:06It's like extremely sweet peanut butter, to be honest,

0:13:06 > 0:13:10and if you were hungry it would be really delicious.

0:13:10 > 0:13:14For such a simple idea, it's having a huge impact.

0:13:14 > 0:13:17How is this changing the way we treat malnutrition?

0:13:17 > 0:13:20This has changed everything, because we have a product

0:13:20 > 0:13:23that is safe to provide outside of a hospital environment.

0:13:23 > 0:13:25In enabling them to treat their children at home,

0:13:25 > 0:13:30we've been able to go from a couple of 100,000 cases treated globally

0:13:30 > 0:13:34to what is close to three million cases on an annual basis.

0:13:34 > 0:13:38It's hard to think of any other intervention in medicine

0:13:38 > 0:13:41that has had that dramatic an impact in the last ten years.

0:13:41 > 0:13:44Is this going to be the end of famine?

0:13:44 > 0:13:46I don't think it's going to be the end of famine.

0:13:46 > 0:13:48I think it's going to be the end of famine-related mortality.

0:13:48 > 0:13:50I think this is going to enable us

0:13:50 > 0:13:53to prevent children from dying from this condition,

0:13:53 > 0:13:54and that's a huge gain.

0:13:58 > 0:13:59Thankfully, here in Britain,

0:13:59 > 0:14:03we don't have the horror of severe famine to contend with.

0:14:03 > 0:14:06But the problems of malnutrition are still all too common,

0:14:06 > 0:14:08especially amongst the sick and the elderly.

0:14:10 > 0:14:12In the UK, we know that 15% of older people

0:14:12 > 0:14:15- who live in the community are malnourished.- Really?

0:14:15 > 0:14:18Cos as you get older, you eat less, your appetite goes down,

0:14:18 > 0:14:20and that's normal ageing.

0:14:20 > 0:14:23But it does make you vulnerable to malnutrition.

0:14:23 > 0:14:25- So how do you treat it? - We look at everything,

0:14:25 > 0:14:28and so Violet here, we've been working on her nutrition,

0:14:28 > 0:14:31but also she has been having some supplements in her diet.

0:14:31 > 0:14:35- How are you finding these supplements?- This is lovely.

0:14:35 > 0:14:38And the doctors here are trying to get you to gain a bit of muscle,

0:14:38 > 0:14:40- is that right?- Well, I gather so.

0:14:40 > 0:14:44So this has most of the stuff that Violet will need

0:14:44 > 0:14:45to gain some weight in it.

0:14:45 > 0:14:48So supplements are important,

0:14:48 > 0:14:51but they are a small part of the overall picture for a patient.

0:14:51 > 0:14:54It's mostly understanding their nutritional needs

0:14:54 > 0:14:56and then treating all the medical and social

0:14:56 > 0:14:58and psychological aspects as well.

0:15:01 > 0:15:07Malnutrition should always be seen as an indicator of much wider problems.

0:15:07 > 0:15:09Nutritional supplements like Plumpy'nut

0:15:09 > 0:15:11have saved many, many lives,

0:15:11 > 0:15:15but they mustn't distract us from addressing those wider problems,

0:15:15 > 0:15:18whether we're talking about an elderly person in the UK

0:15:18 > 0:15:19who can no longer do their own shopping

0:15:19 > 0:15:22or a child in the Horn of Africa

0:15:22 > 0:15:24affected by a failed crop cycle and war.

0:15:28 > 0:15:30When dealing with disasters,

0:15:30 > 0:15:34we all think about the absolute basics of life.

0:15:34 > 0:15:36But there's now another element

0:15:36 > 0:15:39that aid workers consider to be just as crucial,

0:15:39 > 0:15:42and that's information.

0:15:42 > 0:15:44Even in the most challenging environments,

0:15:44 > 0:15:46modern technology can create access

0:15:46 > 0:15:50to First World information systems really fast.

0:15:50 > 0:15:54So everyone here in Zaatari enjoys a really good mobile-phone signal.

0:15:54 > 0:15:56You've got access to internet,

0:15:56 > 0:15:58many of the refugees have got a satellite television.

0:15:58 > 0:16:01But there's one piece of information that's really basic

0:16:01 > 0:16:05that they haven't had up until now, and that's a map.

0:16:05 > 0:16:10By using a combination of satellite data and GPS technology,

0:16:10 > 0:16:13aid workers have created a detailed map of Zaatari

0:16:13 > 0:16:17that will eventually be given out to all the refugees.

0:16:17 > 0:16:19Zaatari is a big and complicated place,

0:16:19 > 0:16:21and I can see why, as a refugee,

0:16:21 > 0:16:24particularly when you first arrive, a map is essential.

0:16:24 > 0:16:27It's not only essential, it's life-saving.

0:16:27 > 0:16:32Say, for instance, if there is a fire in one district, in one home,

0:16:32 > 0:16:35how would the civil defence know where you live

0:16:35 > 0:16:37if you don't know your address?

0:16:37 > 0:16:41So that's why we're encouraging people to use these maps, learn them

0:16:41 > 0:16:45and, as such, learn their addresses and give it out when needed.

0:16:46 > 0:16:51The map has been created using crowd-sourcing software

0:16:51 > 0:16:53so that eventually the refugees themselves

0:16:53 > 0:16:58will be able to add information as things change on the ground.

0:16:58 > 0:17:02And the same technology is now allowing map makers around the world

0:17:02 > 0:17:06to map needs and resources in near real-time.

0:17:06 > 0:17:07Crowd-sourced mapping

0:17:07 > 0:17:11is transforming the way we respond to disasters.

0:17:11 > 0:17:13Across the world, communities of online volunteers

0:17:13 > 0:17:16are using the power of big data to save lives

0:17:16 > 0:17:19without ever having to leave their homes.

0:17:21 > 0:17:25When Typhoon Haiyan hit the Philippines last year,

0:17:25 > 0:17:27over 6,000 people were killed

0:17:27 > 0:17:32and 1.1 million homes damaged or destroyed in a matter of hours.

0:17:32 > 0:17:34But at the same time in Britain,

0:17:34 > 0:17:36Justine MacKinnon and a team of volunteers

0:17:36 > 0:17:40were creating a vital map of the damaged areas

0:17:40 > 0:17:44for aid workers using just social media.

0:17:44 > 0:17:48So talk me through what goes on within the social media

0:17:48 > 0:17:50and how you deal with that information.

0:17:50 > 0:17:52How does it all work?

0:17:52 > 0:17:55People seem to want to communicate what they're going through,

0:17:55 > 0:18:00so a lot of people take photographs of the incident they're in,

0:18:00 > 0:18:02they'll write messages,

0:18:02 > 0:18:06and they use hashtags, so #Haiyan.

0:18:06 > 0:18:08So with Haiyan, for example,

0:18:08 > 0:18:11how many messages, images, videos

0:18:11 > 0:18:16from all the social-networking sites were you receiving a day?

0:18:16 > 0:18:20- On average, a million a day. - A million a day?- One million a day.

0:18:22 > 0:18:24After filtering the millions of messages

0:18:24 > 0:18:26using artificial-intelligence software,

0:18:26 > 0:18:29picking out the ones that could be important,

0:18:29 > 0:18:32Justine's army of online volunteers got to work.

0:18:32 > 0:18:36Anyone, wherever they're sitting, whatever age,

0:18:36 > 0:18:38can contribute to disaster relief.

0:18:38 > 0:18:41So how do they go about doing that?

0:18:41 > 0:18:43They can sit there with their mobile phone, their laptop

0:18:43 > 0:18:45and click on buttons.

0:18:45 > 0:18:48You have at the top, "How much damage do you see in this picture?

0:18:48 > 0:18:51"None, mild, severe."

0:18:52 > 0:18:55- Well, obviously, severe. - It's severe.

0:18:55 > 0:18:59That picture will go through three to five different people

0:18:59 > 0:19:01to ensure you get the same answer.

0:19:01 > 0:19:06So when you have a text one, what does this tweet refer to?

0:19:06 > 0:19:10Not relevant, is it a retweet, is it a request for help,

0:19:10 > 0:19:12infrastructure damage?

0:19:12 > 0:19:15By pinpointing exactly where in the Philippines

0:19:15 > 0:19:17the tweets and pictures had been sent from,

0:19:17 > 0:19:20the volunteers created an online map,

0:19:20 > 0:19:24not just of the disaster zone but of the needs in each area.

0:19:25 > 0:19:27Exactly how much of an impact

0:19:27 > 0:19:32has this had on aid workers on the ground?

0:19:32 > 0:19:35This...saves...lives.

0:19:35 > 0:19:37Rather than them actually starting from scratch

0:19:37 > 0:19:39when they arrive in the country,

0:19:39 > 0:19:42we can have the information already for them -

0:19:42 > 0:19:47who needs water, who needs food, where there were dead bodies,

0:19:47 > 0:19:53displacement, damage, hospital damage, everything.

0:19:53 > 0:19:56How does it feel to be sitting in your kitchen on Hayling Island,

0:19:56 > 0:19:59knowing that you are, in a very real way,

0:19:59 > 0:20:02helping to save lives in the Philippines?

0:20:02 > 0:20:05It's a lot of pressure,

0:20:05 > 0:20:08but it has to be the most worthwhile thing

0:20:08 > 0:20:10I have ever done in my life.

0:20:10 > 0:20:14- And have you used the system here in the UK at all or...?- Oh, yes!

0:20:14 > 0:20:16We recently have had the bad weather,

0:20:16 > 0:20:20like everyone else in the country, with a lot of rain,

0:20:20 > 0:20:25so I actually produced our own flood map for Hayling Island.

0:20:25 > 0:20:28This is so...clever and so useful.

0:20:30 > 0:20:32This is really inspiring stuff

0:20:32 > 0:20:34and an example of the incredible things

0:20:34 > 0:20:37we humans can achieve when we work together.

0:20:37 > 0:20:41By getting involved in this invaluable sharing of information,

0:20:41 > 0:20:44we can all effectively play a part in humanitarian aid.

0:20:51 > 0:20:54Whether it's a hurricane in the Philippines

0:20:54 > 0:20:55or a bomb attack in London,

0:20:55 > 0:20:59getting the right resources to the right place fast is vital,

0:20:59 > 0:21:01especially when it comes to medical help.

0:21:03 > 0:21:05In the immediate aftermath of a disaster,

0:21:05 > 0:21:09there's a real need for experts in emergency medicine.

0:21:09 > 0:21:13Now, thankfully, here at Zaatari, most of the needs are less acute.

0:21:13 > 0:21:17However, nine miles north of here, over the border, there's a war on.

0:21:20 > 0:21:23Sadly, the casualty toll in Syria is still mounting.

0:21:25 > 0:21:29As in any war, the strange truth is that the carnage it creates

0:21:29 > 0:21:32leads to significant medical innovation.

0:21:33 > 0:21:36Our recent conflicts in Iraq and Afghanistan

0:21:36 > 0:21:40have led to advances in trauma care that mean many survive injuries

0:21:40 > 0:21:44that would have killed them just a few years ago.

0:21:44 > 0:21:48But traumatic injuries don't just happen in warzones.

0:21:48 > 0:21:49Here in the UK,

0:21:49 > 0:21:53they're the single biggest killer of people aged between one and 40.

0:21:53 > 0:21:56So can any of the lessons learnt on the battlefield

0:21:56 > 0:21:58be put into use here?

0:22:00 > 0:22:03A lot of the trauma innovations that we've brought in

0:22:03 > 0:22:06in the military over the last ten years

0:22:06 > 0:22:09are now appearing in the NHS.

0:22:09 > 0:22:12Because of the volume of trauma that we see,

0:22:12 > 0:22:17and the sheer severity of trauma that we see,

0:22:17 > 0:22:19we've been able to come back to the NHS

0:22:19 > 0:22:24and say, "Actually, these are the things that you really need to do

0:22:24 > 0:22:25"to improve your trauma care."

0:22:28 > 0:22:30Many of the innovations

0:22:30 > 0:22:32relate to the treatment of massive blood loss,

0:22:32 > 0:22:37something Lieutenant Colonel Matt Boylan knows all too well.

0:22:37 > 0:22:39As an emergency doctor in the military,

0:22:39 > 0:22:42he's served in Iraq and Afghanistan.

0:22:42 > 0:22:45But he's also part of the Midlands Air Ambulance Service

0:22:45 > 0:22:47here in Britain, so he's seen first-hand

0:22:47 > 0:22:52just how we're benefiting from the lessons learnt in war.

0:22:52 > 0:22:56So, as a consultant in an urban inner-city emergency department,

0:22:56 > 0:22:59we see a large amount of penetrating trauma,

0:22:59 > 0:23:01particularly stab wounds and gunshot wounds.

0:23:01 > 0:23:04Over the last few years, there've been a number of cases

0:23:04 > 0:23:07where patients have bled out and died as a result.

0:23:07 > 0:23:11We've got various techniques that we've adopted within the military

0:23:11 > 0:23:13that we can now employ in our civilian trauma patients

0:23:13 > 0:23:15to try and combat this bleeding.

0:23:19 > 0:23:22It doesn't matter whether it's an injury from an IED in Afghanistan

0:23:22 > 0:23:25or a road-traffic accident in the UK,

0:23:25 > 0:23:27the principle is exactly the same.

0:23:27 > 0:23:29You need to stop that bleeding as soon as possible,

0:23:29 > 0:23:32because it really is life-or-death time.

0:23:32 > 0:23:35So this version of a tourniquet

0:23:35 > 0:23:40is standard issue to all military personnel in Afghanistan.

0:23:40 > 0:23:43And as I tighten it, what I'm doing

0:23:43 > 0:23:48is to apply really strong pressure on the arteries in the leg,

0:23:48 > 0:23:51and that will stem the flow of blood.

0:23:52 > 0:23:55The success of this tourniquet in the military

0:23:55 > 0:23:58has led to it becoming an essential part of the kit

0:23:58 > 0:24:00on ambulances across the UK.

0:24:00 > 0:24:03But it's not always appropriate to apply a tourniquet.

0:24:03 > 0:24:06And that's where a really clever substance,

0:24:06 > 0:24:10granules made from the ground shells of shrimps, comes in.

0:24:10 > 0:24:14Now, if I just drop this into here,

0:24:14 > 0:24:18you can see that the really unique thing

0:24:18 > 0:24:20is that this can absorb

0:24:20 > 0:24:23over ten times its own weight in liquid.

0:24:25 > 0:24:26Once poured into wounds,

0:24:26 > 0:24:30it can take as little as 30 seconds to form a solid gel.

0:24:31 > 0:24:33And you can see how useful that would be

0:24:33 > 0:24:35at stemming the flow of blood.

0:24:37 > 0:24:39For the patients treated with these techniques,

0:24:39 > 0:24:42it can mean the difference between life and death.

0:24:42 > 0:24:44One of the cases I've been to recently

0:24:44 > 0:24:47involved a young lady who'd lost a lower limb.

0:24:47 > 0:24:48We had to apply a tourniquet

0:24:48 > 0:24:52and give her resuscitation en route to hospital

0:24:52 > 0:24:55and ultimately saved her life.

0:24:55 > 0:24:58With battlefield medicine, it's adapt or die.

0:24:58 > 0:25:00So it's often at times of war

0:25:00 > 0:25:04that our knowledge and understanding around how best to treat casualties

0:25:04 > 0:25:06moves faster than at any other.

0:25:06 > 0:25:11But it's a sad truth that long after those wars have been won or lost,

0:25:11 > 0:25:13it's civilians all over the world

0:25:13 > 0:25:17who'll benefit from the lessons learnt on the battlefield.

0:25:20 > 0:25:24Whether it's from the spread of disease, injuries or famine,

0:25:24 > 0:25:28one thing that's inevitable in most emergency aid situations

0:25:28 > 0:25:30is death.

0:25:30 > 0:25:31For the families of those killed,

0:25:31 > 0:25:34knowing what's happened to their loved ones

0:25:34 > 0:25:37and giving them a proper burial is crucial.

0:25:37 > 0:25:39But in the chaos of disaster zones,

0:25:39 > 0:25:44the needs of the living are often eclipsed by the fear of the dead.

0:25:44 > 0:25:47One of the biggest misconceptions during a disaster

0:25:47 > 0:25:49is that dead bodies spread disease.

0:25:49 > 0:25:52It's an idea that's often circulated by the media,

0:25:52 > 0:25:55by aid workers, and even by local authorities.

0:25:55 > 0:25:58But the reality is that, even on a mass scale,

0:25:58 > 0:26:01the bodies themselves don't pose an immediate threat.

0:26:01 > 0:26:03So why does this myth prevail?

0:26:06 > 0:26:08Dead bodies don't spread disease.

0:26:08 > 0:26:11The living people spread disease, the lack of sanitation,

0:26:11 > 0:26:14the breakdown of infrastructure in a disaster zone spread disease.

0:26:14 > 0:26:17Bacteria, like most things, needs life.

0:26:17 > 0:26:19A dead body, by definition, is dead.

0:26:19 > 0:26:20A lot of the infections,

0:26:20 > 0:26:24a lot of the disease needs the hosts to be alive to survive.

0:26:24 > 0:26:28So what does this persisting myth lead to on the ground

0:26:28 > 0:26:30- when a disaster has just happened? - Let me give you an example.

0:26:30 > 0:26:33I went to Haiti right after the earthquake.

0:26:33 > 0:26:38Now, roughly 200...250,000 human beings died in that earthquake.

0:26:38 > 0:26:42The Haitian response was to take an area and dig huge pits.

0:26:42 > 0:26:45The human remains were loaded into trucks and pushed into the pits.

0:26:45 > 0:26:49Taking the dead and burying them to get them out of sight

0:26:49 > 0:26:50doesn't stop disease.

0:26:50 > 0:26:52It only causes injury to families later on.

0:26:52 > 0:26:57So what is the correct way to deal with dead bodies in a disaster zone?

0:26:57 > 0:27:01I can really probably show you easier than I can explain to you.

0:27:01 > 0:27:02The right to have an identity,

0:27:02 > 0:27:04the right to have a name is a human right.

0:27:04 > 0:27:06Anyone can bury a body,

0:27:06 > 0:27:09but we need to collect information before they're buried.

0:27:09 > 0:27:12So what are the main methods used to identify a body?

0:27:12 > 0:27:14Simple tools like this.

0:27:14 > 0:27:16This is what we use to take a dental X-ray,

0:27:16 > 0:27:18and there's a lot that we learn from the teeth.

0:27:18 > 0:27:22We can tell age, we can use it to identify

0:27:22 > 0:27:25if there's dental work that was done when the person was alive.

0:27:25 > 0:27:27- Fingerprints.- Fingerprints.

0:27:27 > 0:27:29A lot of countries still fingerprint people

0:27:29 > 0:27:32for driver's license, passports, databases.

0:27:32 > 0:27:35And then DNA. Now, DNA is really difficult.

0:27:35 > 0:27:38We actually have to cut in and remove a bone sample or two,

0:27:38 > 0:27:41and the DNA will survive in the bone and the tooth

0:27:41 > 0:27:44much longer than it will survive in tissue.

0:27:44 > 0:27:46That's a sobering thought, isn't it?

0:27:46 > 0:27:48And this is why all of these different aspects

0:27:48 > 0:27:51of the identification process are so hugely valuable.

0:27:51 > 0:27:54Absolutely, cos the questions you're going to answer are two things -

0:27:54 > 0:27:56did we take care of the dead?

0:27:56 > 0:28:01And can we identify them to return an answer to the families?

0:28:05 > 0:28:09None of us ever imagine that a war or a natural disaster

0:28:09 > 0:28:12could cut the ties to everything that matters most.

0:28:12 > 0:28:14But what I've learned here at Zaatari

0:28:14 > 0:28:16is that if that were to happen,

0:28:16 > 0:28:18there are innovations in humanitarian aid

0:28:18 > 0:28:21creating an ever-stronger safety net

0:28:21 > 0:28:25to give us the best possible chance of rebuilding our lives.

0:28:25 > 0:28:28And that could be any one of us at any time.

0:28:32 > 0:28:35Sadly, that's it from Bang for now,

0:28:35 > 0:28:37but the website is still up-and-running

0:28:37 > 0:28:39with clips and stories from across the series.

0:28:39 > 0:28:42And you can follow the links to the Open University

0:28:42 > 0:28:46for more information on aid and international development.