Good:”ž Firefighters and other emergency responders must remove their turnout gear or jackets and be sheltered from the environment. Optimally, both the turnout coat and pants of firefighters should be removed to aid in passive cooling. If this isn’t possible, the turnout pants should be pushed down below the knees while the firefighter is seated in the rehab sector. In many cases, the firefighter will continue to warm as metabolic heat is produced even if the turnout gear is reduced. If passive cooling is employed, expand the rehab time before returning to the incident to allow for core cooling. It’s important to remember that standard pulse oximeters cannot identify carboxyhemoglobin nor can they account for hydrogen cyanide in the cells. For patients poisoned with either of these gases, the SO will likely appear normal, even though the patient is displaying signs and symptoms of hypoxia. Although first responder rehab will most often be implemented on the fireground, it should also be considered essential in other types of incidents. For example, hazardous materials technicians will often employ splash- and vapor-resistant personal protective equipment that impairs thermoregulation, resulting in rising core temperatures. An organized rehab sector may also be required at an extended”žEMS incident if conditions require long periods of work outdoors without sufficient protection from the sun and weather. Although evaporation is impaired when a firefighter is wearing turnout gear, sweat is still produced when warm blood moves from the body core and travels to the skin surface. Production of sweat removes water from the plasma, thus reducing the effective blood volume. How should I monitor personnel in the rehab sector? In some sporting events, the rate of EHS is as high as 1 to 1,000. Once EHS has occurred, the severity is directly related to the time the core body temperature remains above the critical threshold. There’s a misconception in the medical community that treating EHS by immersion will result in further heating and heat stress from peripheral vessel constriction. However, cold water immersion (CWI) is the gold standard for treating EHS.(16) The conductive capacity of cold water placed directly against the skin far exceeds any impairment of skin blood flow from vasoconstriction. It’s likely that hydrogen cyanide poisoning has always been a problem on the fireground but has only recently been recognized. In March 2006, a series of routine structure fires in”žProvidence,”žR.I., sent 28 firefighters to the hospital with headaches, dizziness and incoherence. Eight were found to have elevated levels of cyanide in their blood. A new cyanide antidote kit has been approved by the FDA (Hydroxocobalamin, Cyanokit from Dey, L.P., Merck KGaA of”žDarmstadt,”žGermany) and should be available to hospitals that treat firefighters exposed to smoke. Hydrogen cyanide is formed from the incomplete combustion of many common materials, including paper, cotton, silk and plastic. Hydrogen cyanide binds to proteins in the cell mitochondria and disrupts the use of oxygen. Temporal thermometers have become more popular in health-care settings. These thermometers move across the skin of the forehead and behind the ear to measure the blood temperature in the temporal artery. However, although these devices appear accurate in pediatric patients, studies have found they’re not as reliable in adults. Finally, adhesive thermometers placed on the forehead have been shown to be accurate in exercising athletes. However, these items may not work correctly during cool weather conditions. Regardless of the thermometer you choose, it should be used only to augment the clinical picture. A large ambulance can also be used for rehab. However, don’t commit an ambulance that’s tasked with transporting patients. It’ll be difficult to evict four or five firefighters from the back of the rig if a medical emergency occurs. In cities with an established transit system, emergency agencies can often request a bus to be available on scene for rehab. The heat burden and loss of plasma volume from sweat forces the heart to work harder. This may cause heart rates to be persistently elevated, even after the firefighter leaves the scene and removes the protective clothing. For example, at one training fire, we measured a core body temperature of 103_ F (39.4_ C) in an asymptomatic instructor associated with a heart rate of 170 beats per minute. Exertional heat stroke (EHS) is the life-threatening endpoint of untreated hyperthermia resulting from exercise or work in hot environments. Victims of EHS are typically unconscious or have significantly altered levels of consciousness, but may have brief lucid intervals. Although sick and unable to thermoregulate in classic heatstroke cases, EHS victims will be extremely diaphoretic, having worked under conditions that make them appear Ë™wet.Ã“ This is a key feature to note in the rehab sector. Don’t confuse regular heat exhaustion with the more severe EHS because they’re not Ë™dry.Ã“ Observe all the monitoring parameters available, the temperature and the clinical picture in order to determine how severely affected the firefighter may be from the heat. For short-duration incidents, self-rehab may be all that’s required. However, for incidents extending beyond the second SCBA cylinder, a formal rehab sector must be established. It’s the incident commander’s (or safety officer’s) responsibility to ensure crews are rotated through the rehab sector. Exposure to smoke and particulate matter created from combustion at a fire are known environmental hazards that can stress the cardiovascular system. Although firefighters routinely wear self-contained breathing apparatus (SCBA) during fire suppression, overhaul operations are often conducted without respiratory protection. The byproducts of combustion, a complicated mixture of chemicals, are suspended in the air during overhaul, posing a hazard to the firefighters inside the structure. Two common chemicals associated with significant risks are carbon monoxide (CO) and hydrogen cyanide. Although constantly improving, the thermal protective clothing worn by firefighters impairs both evaporation and convection processes. Even if moving air were blown onto the firefighter, the thick layers of the garment hamper effective convection. Further, thick layers of turnout gear impede the evaporation of sweat, causing it to collect in the garment and gradually increase the weight of the gear during the incident. Impairing thermoregulation ultimately results in a rising core body temperature. Even if the heat stress doesn’t progress to exertional heat illness, a firefighter usually suffers some consequence from the additional heat burden. Where do I set up a rehab sector? The resulting”žhypohydration reduces the stroke volume of every cardiac contraction. To maintain the cardiac output, the heart must beat faster to ensure sufficient blood is delivered to working muscles and vital organs. Initially, all personnel who have been involved with strenuous activity, fire suppression or suppression support in a warm or hot environment will likely be tachycardic and have rapid respirations, due to the combined effects of exertion and mild hyperthermia. CO is present in high concentrations during the overhaul phase of fire suppression.(4) When inhaled, it binds tightly to hemoglobin, forming”žcarboxyhemoglobin and impairs oxygen delivery. Some level of carboxyhemoglobin is expected simply from living in an urban environment or from smoking cigarettes. However, when the level in the blood rises due to significant or prolonged exposure, the resulting hypoxia may induce myocardial infarction. Under these conditions, the modest amounts of salt in commercial sport drinks can off-set salt loss in sweat and minimize medical events associated with electrolyte imbalances (e.g., muscle cramps and hyponatremia). Better:”ž Sport drinks are often ignored by the emergency service organizations due to a misconception of rehydration. It’s a common belief that sport drinks cause gastric distress and lead to further dehydration by pulling water from the cells. On the contrary, a drink that includes glucose and sodium chloride should be considered for prolonged incidents or if there’s inadequate access to meals or during the initial days of hot weather.(8) The victim is ultimately located, unconscious but alive, and is extricated from the building. He’s placed in the only ambulance on scene and rushed to the hospital. After multiple entries and changes of SCBA cylinders, the crews bring the fire under control. During a prolonged incident, it’ll be necessary to provide some form of nutrition to working firefighters. In many cases, this nutritional support can be satisfied with small foods easily eaten cold and without utensils. It’s important to ensure nutritional support is balanced. Most sport nutritionists recommend snacks that are primarily complex carbohydrates to maintain blood glucose levels with some protein and a lesser amount of fat. Many of the individually wrapped sport snacks meet these requirements and have the advantage of a long shelf life. Be sure to check the labels and have crews try items before purchasing any for your rehab operation. Supplements won’t be useful if the taste prevents them from being eaten on the scene. Best:”ž The optimal rehab sector is established by a specialty vehicle designed for this task. A large ambulance or small bus can be fitted with rehab equipment and dispatched as needed. For departments with smaller run volumes, it may be possible to share this resource across multiple agencies. A designated rehab vehicle has the advantage of placing medical and rehab equipment in the same vehicle. Placing tents on the vehicle allows for rapid expansion of the rehab sector during larger incidents or on days with mild weather. One firefighter complains of being unusually tired. He looks pale and diaphoretic. When the crew picks up their gear to return to the scene, the firefighter loses consciousness and strikes his head on an SCBA cylinder when he falls to the ground. Other firefighters tend to the man while a second ambulance is called to the scene. Course Objectives Powered cooling vests use a cooling source similar to a portable air-conditioner to chill a fluid that’s then circulated through a vest worn by the firefighter while in the rehab sector. A variant on the theme are vests containing a material that feels cool after being immersed in water. These vests feel cool when first applied but can quickly become insulators once the initial cooling has been consumed. Heat Stress For truly prolonged incidents, it will be necessary to provide major nutritional support, usually in the form of a hot meal. In many cases, you will need to rely on outside agencies operating a mobile canteen to meet these needs. Preplan with these agencies to confirm the items being provided can be brought in sufficient quantity and meet the nutritional needs of the crews. What do baking, athletics and firefighting all have in common? All of these professions have had members die of heat-related illness. Exertional heat illness can be a deadly process by itself, but when additional stress is placed on the cardiovascular system, it can increase a person’s risk for myocardial infarction, stroke or sudden cardiac arrest. Although exertional heat illness can’t be entirely eliminated from firefighting, it should never be fatal when proper medical supervision and appropriate rehabilitation services are available. Understand the stresses experienced by emergency responders during fire suppression or other extended incidents.Describe the functions and operations of on-scene rehab.Understand the physiological response of the body to environmental stresses.Identify exertional heat illness and describe the treatments.Describe the available modalities for rehydration and core temperature cooling.”ž Immediate rehab is also called Ë™self-rehab.Ã“ For self-rehab, firefighters consume liquids while changing their SCBA cylinder. This allows for initial rehydration before re-entering the incident. For self-rehab to be effective, the fluids must be readily available to all fire companies. One method to ensure firefighters have the opportunity to perform self-rehab is to place bottles of water or sports drink with spare SCBA cylinders. This guarantees they’re at hand when the firefighter returns to the apparatus for the second cylinder. Carbon monoxide is difficult to clinically identify in the prehospital setting. However, handheld devices (CO-oximeters and breath analyzers) capable of measuring CO bound to hemoglobin are now available and being deployed to monitor firefighters during rehabilitation. Best: The ultimate adjunct to a rehab protocol is measuring body weight. Normal body weight in a standard work uniform should be obtained monthly and entered into a rehab database, so emergency personnel can be weighed in the rehab sector wearing a work uniform to estimate how much fluid has been lost through sweating. Remember to correct for sweat soaked into the uniform. In our system, we estimate sweat-soaked clothing at 0.5 kg. If a firefighter is standing on the scale in sweat-soaked clothing and the scale displays a normal weight, we assume they’ve lost 0.5 kg of fluid and rehydrate them accordingly. This technique requires the purchase of accurate, reliable scales and continuous monitoring of normal body weight. Best:”ž IV rehydration with normal saline has produced mixed reviews in terms of athletic performance.(12,13) Although most studies have shown IV and oral rehydration to be the equivalent in rehydration techniques, the comparison hasn’t been applied to first responders working in PPE or thermal protective clothing. Introducing fluids directly into the plasma volume may be beneficial when the environment and protective equipment impair thermoregulation. Two clearly superior aspects of IV fluid administration are the ability to deliver larger volumes of fluid in a short period and the effect of mild cooling. When considering the heat index, any temperature over 90_ F should be treated as dangerous in terms of personnel working in thermal protective clothing. Under these conditions, it’s imperative that an effective rehab section be established at every major incident fire so crews can be regularly assessed for heat stress and receive appropriate preventative treatment. It’s widely believed that caffeine exerts a diuretic effect that will impair performance in the heat. Contrary to popular belief, there’s no evidence that caffeine consumption results in water-electrolyte imbalance or reduced exercise heat tolerance.(10) However, the stimulant effect will raise the heart rate, which isn’t helpful in the context of fireground rehab. Therefore, we recommend avoiding caffeine in the rehab sector. Oral and tympanic thermometers are most common. Tympanic thermometers are very sensitive to position in the aural canal. If the tip of the thermometer is not facing the middle ear, falsely low readings will be obtained. Oral thermometers are reliable in the lingual pocket but will read falsely low if used after fluids have been consumed or if the person is breathing rapidly. One study compared oral thermometers with tympanic in firefighters after exiting a training fire and found the readings poorly correlated.(9) Environmental conditions can also magnify heat stress during an incident. Thermal burden is increased with rising temperature and”žrelative humidity. Warm air can hold more moisture than cold air, intensifying the problem during warm weather. As the relative humidity rises, evaporation is inhibited and causes sweat to accumulate on the skin surface once thermal protective garments have been removed. Air temperature and relative humidity together create the heat index, the temperature Ë™experiencedÃ“ by the firefighter. In the desert, a temperature of 92_ F with a relative humidity of 10% feels like 87_. The same 92_ F day during a”žPittsburgh summer with 70% relative humidity feels like 155_ and can rapidly lead to exertional heat illness. Fire suppression is a physiologically stressful activity requiring the firefighter to work at near-maximal heart rates for extended periods. The firefighter is exposed to a combination of heat from the fire and environment, and the metabolic heat generated from the heavy exertion. When combined with heavy thermal protective clothing, thermoregulation is impaired and core body temperature begins to rise. Better:”ž Passive cooling is inefficient, especially in hypohydrated individuals. Place hyperthermic emergency personnel into air-conditioned vehicles to aid in cooling. Misting fans have also become popular devices in rehab units. Although moving air around a person in need of rehab will enhance convective heat loss, the application of water mist will be effective only if the relative humidity is low. Even under optimal conditions, the misting fan will reduce core body temperature less than 1.8_ F (1.0_ C) during a 30-minute exposure.(15) Better:”ž The easiest way to provide shelter is to use a vehicle equipped with heat and air conditioning. Many fire departments are now ordering apparatus with air-conditioned closed cabs. Some of these vehicles are sufficiently large enough to allow for four to six individuals to enter the vehicle to escape the environment. Additional hypohydration will result in a loss of cardiac output if the rising heart rate and falling stroke volume can’t maintain the body’s need. When combined with the additional heat load, this combination of stressors make the heart endure near-maximal heart rates for extended time intervals. Forearm immersion takes advantage of the many superficial arm veins by placing the forearms and hands into cold water, enhancing the convective transfer of heat from the blood to the water. Studies have shown this technique can result in 0.5Ã1.5_ C cooling in a 30-minute exposure. It’s a hot, humid day in August when Engine 219-1 arrives first on the scene at a commercial structure fire. The crew advances a 2.5″ hose into the warehouse to begin an interior attack. With the arrival of truck 219, a crew is sent to the roof to ventilate. When it’s learned that the warehouse foreman can’t be found, a second crew is sent into the structure to search for the missing man. How do I rehydrate in the rehab sector? Best:”ž Applying cooling modalities directly to the responder are the best regimens for cooling. Some level of evidence supports the effectiveness of powered cooling vests and forearm immersion, which take advantage of the great conductive capacity of water. These methods can be effective modalities for cooling mildly hyperthermic emergency personnel but require a significant investment to place these items on a rehab unit. Good:”ž At a minimum, all personnel in the rehab sector should be logged in (and out) and have vital signs monitored every ten minutes. Repeated vital signs demonstrate trends toward improvement or deterioration once the individual is cooled and rehydrated. Rehab operations can be divided into two phases: immediate and formal. Many fire departments operate on the Ë™two-cylinder rule,Ã“ in which two full SCBA cylinders can be consumed during fireground operations before the firefighter must enter the rehab sector. When following this rule, the firefighter is expected to perform immediate rehab during the first-cylinder change. In addition to monitoring vital signs, assessing the responder’s temperature adds to the clinical picture when assessing them in the rehab sector. There are many types of thermometers available. True core temperature is different than most commonly measured temperatures (i.e., oral, tympanic, etc). Although most high-quality thermometers read accurately on normothermic people at Ë™room temperature,Ã“ device limitations are revealed when monitoring hyperthermic individuals who are performing physical exertion in adverse environments. Good: At a minimum, the rehab area must provide shelter from the sun and heat or the cold depending on the time of year. Be sure to keep the sector away from running vehicles to prevent exposure to CO and diesel exhaust, and if possible, place the rehab sector out of sight of the incident. A rehab area can be created using a tent and folding chairs, allowing a firefighter to remove turnout gear and be seated. Add fans on hot days and portable heaters on cold days. If using gas-fired torpedo heaters, be sure to monitor the sector with a four-gas meter to avoid CO exposure. Rehab Operations How do I cool personnel in the rehab sector? Caffeinated beverages are perhaps the most misunderstood fluid in the context of rehydration and performance. Caffeine stimulates the sympathetic nervous system and is generally considered in sport to be an”žergogenic aid that improves continuous exercise time to exhaustion. Good:”ž The traditional fluid used for rehydration, bottled water, is cheap and easy to store for extended periods. For every kilogram of fluid lost, a kilogram must be replaced. That means the typical weight loss of one kilogram experienced by a working firefighter will require 34 oz. of water to ensure full rehydration. Many individuals may not voluntarily consume this quantity, so intake should be encouraged and documented for each individual on the rehab sector log. Cardiovascular Stress Ã Blood Cardiovascular Stress — & Tears (Smoke Exposure) Heat stress placed on responders is both intrinsic (metabolic heat produced by the individual) and extrinsic (heat from exposure to open flame or heated areas, and the environment). Under normal conditions, the body sheds additional heat by”žconduction, convection, evaporation, respiration and radiation. Of these, evaporation of sweat and convection to air or circulating water are most efficient. The role of the rehab sector is to provide: 1) medical evaluation and treatment; 2) rehydration and nutrition; 3) protection from the elements; 4) supervised rest and recovery; and 5) firefighter accountability.(2)”žAlthough this article focuses on fireground rehab at hot weather incidents, it’s important to remember rehab is required for every environmental condition. If carbohydrate concentrations are too high, delays in gastric emptying can be observed when mixing a sport drink from a powder; be sure to follow the directions and add sufficient water to avoid overly concentrated solutions.(9) Cooling for Exertional Heatstroke Heat stress also affects blood clotting and clot resolution.(3) With heat stress comes co-activation of coagulation (which makes blood thicker) and”žfibrinolysis (which makes blood thinner). As the body temperature returns to normal, fibrinolysis down-regulates to its normal level while coagulation remains activated for a period of time. This results in the blood being Ë™thickerÃ“ than normal under heat-stressed conditions. Combined with an increased endogenous epinephrine surge and the cardiovascular stress from the strenuous work associated with fire suppression, the addition of Ë™activatedÃ“ coagulation to these traditional cardiac stressors can accelerate the progression to myocardial infarction, resulting in a crippling heart attack or sudden death. In the case of a high-rise fire, the optimal place for rehab may be a few floors from the fire floor, a safe distance from fire suppression but close enough to allow reasonable access to the incident. 1. Karter M Jr, Molis J. Ë™Firefighter injuries for 2004.Ã“. NFPA Journal 2005;99:50-57.”ž2.”žDickinson E, Wieder M.”žEmergency Incident Rehabilitation,”žUpper”žSaddle”žRiver: Pearson Prentice Hall; 2004.”ž3. Bouchama A, Bridey F, Hammami M. Ë™Activation of coagulation and fibrinolysis in heatstroke.Ã“. Journal of Thrombosis and Haemostasis 1996;76:909-1015.”ž It’s not unusual for a firefighter to lose 1Ã2 kg of fluid in a prolonged incident or an exceedingly hot environment. Ideally, fluid replacement should equal fluid losses, requiring the firefighter to consume as much as 2 L of fluid before returning to the incident. More than a liter of fluid in the stomach will likely cause gastric distress. This can be overcome by providing a rapid bolus of normal saline through a peripheral arm vein. Additionally, a rapid bolus of normal saline will result in core cooling of as much as 1.0_ F.(14) Why Rehabilitation? Breathing and heart rates that remain elevated after providing fluids and cooling signal a worsening condition, and should be evaluated by a physician. Additionally, abnormal blood pressures should have the cause identified and treated; however, a normal blood pressure doesn’t rule out cardiovascular strain. In many instances, the resources for CWI won’t be readily available. The need for immediate cooling is still imperative. An effective mode of cooling used by field military units involves wrapping the victim in sheets soaked in ice-cold water, readily accomplished by placing two sheets into a cooler of ice water. Remove the clothing from the victim, and wrap one sheet on the anterior and lateral skin surface of the supine patient. After applying for 60Ã90 seconds, return the sheets to the cooler and apply the second sheet. Monitor the core temperature during this procedure and discontinue when a core temperature of 102_ F (39_ C) is achieved. Finally, the particulates found in fire smoke have both acute and chronic cardiovascular effects. Short-term exposure can trigger myocardial infarction, especially among those with pre-existing heart disease.(5) Long-term exposure may speed or change the process of atherosclerosis, creating a medical condition that increases the risk of myocardial infarction and stroke.(6,7) There are many possible solutions for incident rehab. We’ve attempted to answer the most common questions with”žgood, better and”žbest strategies. Conclusion CWI isn’t without risk. If the EHS victim is overcooled, there’s a risk of shivering or hypothermic afterdrop. Hypothermic afterdrop occurs if the body is overcooled and requires re-warming. This can be avoided with proper precautions. Any prehospital provider tasked with treating EHS should have the required equipment to measure rectal temperature. A flexible thermistor should be placed 10 cm into the rectum and remain in place during CWI.(17) This will allow the patient to be removed from the immersion when the core temperature reaches 102_ F (39_ C). In cases where a rigid rectal thermometer is used, the cooling rate of 0.2_ can be used to calculate when 39_ will be reached. This allows the victim to be removed before too much cooling is applied. Once initial cooling has been accomplished, the EHS victim can be transported to the emergency department. Fireground rehab is an essential component of any incident that may save lives and improve the health of responders. Preplanning for rehab is essential to ensure you have the means and protocols to monitor firefighters and to provide effective rehydration and cooling. It may also be necessary to provide nutritional support during extended incidents. Caring for the health and safety of firefighters during an incident will not only ensure their ability to work at the current incident but allows the crew to return to service, ready to answer the next alarm. Providing Nutrition during Rehab Firefighters suffer more than 80,000 injuries and nearly 100 line-of-duty deaths each year. Although the risk of morbidity and mortality rises dramatically when performing fire suppression at a non-residential structure, most firefighter injuries occur during fire suppression at single- and two-family homes. More than half of firefighter deaths are due to cardiovascular events, and nearly a quarter of the injuries are attributed to overexertion and strain.(1) The incident commander orders the first-arriving crews to report for rehabilitation while the second alarm crews begin the overhaul.”žEMS has left the scene with the extricated patient, so the crews remove their turnout coats and begin to drink bottled water on their own. The NFPA 1584: Recommended Practice on Rehabilitation for Members Operating at Incident Scene Operations and Training Exercises(2003) is a consensus document outlining recommendations for incident rehabilitation. This document will be beneficial to any organization developing rehab procedures but can be customized to meet the capabilities and needs of your organization and the environment (hot/cold) in which you customarily operate. We maintained the spirit of”žNFPA 1584 in this article, but we’ve supplemented that guideline with recommendations from the sports medicine and exercise physiology literature. Cardiovascular Stress Ã Sweat References Better: Baseline vital signs have been recorded for all emergency personnel and made available to rehab staff both during rest and after a fixed period of aerobic exercise (e.g., standardized one-mile run/walk). This data should be kept with rehab supplies or vehicles, and updated annually. Knowing the individual’s vital signs after exercise without the addition of heat stress allows the rehab officer to make rational decisions about returning a firefighter to the incident.
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A family solicitor is having to inform domestic violence victims that they must attend court on their own as a result of the latest glitches with the Legal Aid Agency’s online legal aid system.The agency had to take down its client and cost management system for 90 minutes yesterday to fix an issue. This morning it said it was ‘aware of issues continuing to impact on users which we are working to resolve urgently and apologise for any inconvenience caused’. Watkins: ‘error page’Solicitor Beverley Watkins, managing partner at Bristol firm Watkins Solicitors, told the Gazette that she has had to inform domestic violence victims that they must attend court on their own because of CCMS failures.She said the system has been ‘on and off’ for the past two weeks, and she is often met with an ‘error page’ message when she logs on.Watkins explains that her firm often has emergency legal aid for initial hearings, but is unable to attend future hearings because the necessary legal aid paperwork cannot be processed or the firm cannot submit the paperwork.On 9 November the agency announced that the system would be unavailable from 7pm to 11.59pm that day for ‘essential maintenance work’. Yesterday, the agency said: ‘We are aware of the issues around performance on our digital platforms. They are being investigated and worked on urgently and we will keep you updated.’ An hour later, it said: ‘Urgent, please note: CCMS will be unavailable for 90 minutes from 3.15pm.’Chris Minnoch, chief executive of the Legal Aid Practitioners Group, said: ‘Some of our members have emailed to tell us they are pulling their collective hair out as they haven’t been able to use the system for three days, and the only communications issued by the LAA seem to talk about issues affecting users and performance of their digital platforms.’Richard Miller, the Law Society’s head of justice, said CCMS has been beset with problems from the outset. ‘System outages mean legal aid solicitors are unable to submit legal aid applications for their clients, some of which require work to be done urgently. A system which too often makes it difficult or impossible for solicitors to undertake essential work for their clients is clearly not fit for purpose,’ he added.Update (Thursday 11.30am): A Legal Aid Agency spokesperson said: ‘We are working urgently to resolve the technical issues with the client and cost management system that some people are experiencing. We have apologised for the inconvenience and are urging anyone needing to progress emergency or urgent applications to contact us by telephone.’
Programs that support local girls have earned the City of Farmington Hills a special award from Girl Scouts of Southeastern Michigan.Typically presented at an annual banquet, the organization mailed the “Friend of Girl Scouting Award” this year, due to the COVID-19 pandemic. The award honors businesses and community partners that help to further the Girl Scouts mission as the organization strives “to build girls of courage, confidence and character, who make the world a better place.”Nature Center Supervisor Ashlie Smith is pictured with the Girl Scout Award. (City of Farmington Hills)“We’ve enjoyed a strong partnership with local Scouting programs for many years,” said Nature Center Supervisor Ashlie Smith. “We’re happy to see so many Scouts having fun at the Nature Center and in our City parks.”The Farmington Hills Nature Center offers Scout Saturdays, where Brownies, Girl Scouts, and Boy Scouts can complete Badge Adventures and Journey Sessions with help from the city’s naturalist. Scout Saturdays offer activities such as hiking, geocaching, and bug studies, which help local Scouts meet nature-themed badge requirements.Scout leaders can also reserve space at the Nature Center for private programs.Groups have enjoyed many of the activities offered by the Special Services Department including snowshoeing, maple sugaring, archery, and stewardship.To learn more about Scout Saturdays or other Nature Center programs, call 248-477-1135 or write to [email protected] caption – Nature Center Supervisor Ashlie Smith accepted the Friend of Girl Scouting Award on behalf of the Special Services Department. Reported by jonihubred Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Pinterest (Opens in new window)
Bossier battled Woodlawn to the end Thursday night, but it wasn’t quite enough as the Knights pulled out a 24-20 District 1-4A victory at Independence Stadium.Bossier dropped to 2-3 overall and 0-2 in district. The Bearkats host Northwood next Friday. Woodlawn improved to 4-1 and 2-0. The Knights’ only loss was to Haughton in Week 3.“It was a heartbreaker,” Bossier coach Michael Concilio said. “We were in the the football game through the whole thing, all the way down to the last minute of the game. It was one of the toughest games I’ve seen our teams play in the last three years through these rough times.”For the second time this season, the Bearkats scored as many touchdowns as their opponent and wound up losing. Woodlawn made three two-point conversions to Bossier’s one.“We never got a lead. But we were score for score with them. We go in halftime 16-8 and had a lot of hope, come out with a lot of fire.“I tip my hat to the fact that my kids played hard and all the way to the very end and kept us in the game. Last year at this point, playing this team, by the time we reached the fourth quarter the game was out of hand.” Bossier tied the game early in the second quarter on a 1-yard run by Keimun Daniels and a Quinton Smith two-point conversion run.The Knights took the lead for good on Joshua Mosley’s 21-yard pass to Julian Johns with just 1:08 left in the first half.Isaiah Wallace-Blair’s 36-yard interception return for a touchdown got Bossier within 16-14 late in the third quarter.The Knights took a 24-14 lead in the fourth on an interception return for a touchdown. The Bearkats cut the lead to four on a 2-yard Keimun Daniels’ run with 5:29 to play. The TD was set up by a 40-yard halfback pass.Running back Corey Williams had a big game for Woodlawn with 153 yards rushing, according to The (Shreveport) Times, but both defenses played well.Woodlawn had 249 total yards to 210 for Bossier. Bossier had three turnovers to Woodlawn’s two.“(Woodlawn has) great athletes and they’re a good football team,” Concilio said. “They’re going to make plays when you’ve got people like that that are that fast, that athletic. We were able to minimize that, those big plays.”— Russell Hedges, [email protected] Expat InsuranceExpat Living in Hong Kong without Health Insurance?Top Expat Insurance|SponsoredSponsoredUndoTheTopFiveVPNThe Secret Netflix Doesn’t Want You To Know To Unblock RestrictionsTheTopFiveVPN|SponsoredSponsoredUndoCelebsland.com9 Celebrity Before-And-After Plastic Surgery DisastersCelebsland.com|SponsoredSponsoredUndoPerfect-Dating.comAre You Ready to Meet Cool Guys in Tung Chung?Perfect-Dating.com|SponsoredSponsoredUndoTheTopFiveVPNThe Trick Netflix Doesn’t Want You To Know To Unlock RestrictionsTheTopFiveVPN|SponsoredSponsoredUndoAspireAbove.comRemember Abby from NCIS? Take A Deep Breath Before You See How She Looks NowAspireAbove.com|SponsoredSponsoredUndo
Twenty-seven communities in Region 10 (Upper Demerara-Berbice) will benefit from works to be done by the National Drainage and Irrigation Authority (NDIA). This is the first time that the NDIA will be working in the area.Chief Executive Officer (CEO) Frederick Flatts stated that a large excavator and two smaller ones have been deployed to the Region to assist with drainage and irrigation works.“We are seeking to do enough works in Linden to make it possible for people to plant and so people can be more self-sufficient,” Flatts said.The NDIA CEO, however, noted that residential areas, including Block 22 and Coomacka, have drainage problems that require long-term solutions. He said the NDIA was prepared to assist with those long-term solutions.Work by the NDIA, in collaboration with Neighbourhood Democratic Councils (NDCs), started in the second half of 2015. Residential and farming communities had suffered from silted waterways, which led to persistent flooding.Flatts said this was the first time that the NDIA has executed drainage and irrigation works in the Region. He further noted that significant improvements in the drainage systems have been recorded. However, there is still more to be done, taking into consideration the important roles that other key farming and agricultural stakeholders play in the process.“In terms of persons being able to plant more in Linden, it takes more than just drainage and irrigation. There are other areas that have to be addressed, but we are seeking to do our part from the NDIA in terms of drainage and irrigation. If they need to do more works, we have the ability to hire equipment and to get those works done,” the CEO said.
This is a story about numbers: 10 shillings, US$15-million, 70 years, over 160 covers and three centuries of continuous radio air play. It’s the story of a song we all know, the impoverished Zulu migrant worker who wrote it, the musicians and record companies who raked in millions for it, and the almost 70 years it has taken for his family to see justice done.full story: southafrica.info
The South Africa where foreigners fear for their lives is not the South Africa envisioned by Nelson Mandela and the Freedom Charter, writes Thebe Ikalafeng.Leaders from faith-based organisations, trade unions, NGOs and corporate South Africa joined ordinary citizens to protest against xenophobia during a people’s march in Newtown, Johannesburg, on 23 April 2015. (Image: GCIS) Thebe IkalafengReflecting on the moment on 11 February 1990 when his 27 years of incarceration ended and he walked toward the promise of a new South Africa, Nelson Mandela once recalled: “I knew if I didn’t leave my bitterness and hatred behind, I’d still be in prison.” His freedom heralded the opportunity of a new start for the pariah nation.Unsurprisingly, after being issued with his first South African passport eight days after his release, he began a global thanks-giving tour of countries that had supported the anti-apartheid struggle, starting with African states, including Zambia, Tanzania, Zimbabwe, Nigeria and Ethiopia.Many of these nations’ leaders, such as Kenneth Kaunda of Zambia and Mwalimu Julius Nyerere of Tanzania, sacrificed the welfare of their states to invest in the struggle for South Africa’s freedom.As President Jacob Zuma reminded us at a briefing at the ANC headquarters, Luthuli House, these nations paid more than lip service to the struggle, providing anti-apartheid cadres with weapons, transporting them across borders at great risk to themselves and accommodating exiles in their homes and communities.Mandela’s remarks at his inauguration as the first democratically elected president of the new Republic of South Africa summed up the mood of the new nation: “Few of us could suppress the welling of emotion as we were reminded of the terrible past from which we come as a nation; the great possibilities that we now have and the bright future that beckons us.”Over the next decade or so the hopeful republic, “alive with possibility”, as Brand South Africa defined it, became an example of how to reimagine a nation.The Truth and Reconciliation Commission, established in 1996 “to enable South Africans to come to terms with their past on a morally accepted basis and to advance the cause of reconciliation”, as the late Dullah Omar, former minister of justice described it, became a universal inspiration and foundation for a forgiving post-apartheid South Africa and for other nations dealing with conflict and reconciliation.On 8 May 1996, when then-deputy president Thabo Mbeki launched the new constitution, a document drafted by an assembly representing all political parties and liberation organisations, he put it in the broader African context, saying: “I am an African.”This symbolised not merely the constitutional foundations of a new South Africa but its identification with all of Africa.The fall of the last colonial outpost was the realisation of the hope expressed by Kwame Nkrumah of Ghana when his country gained independence: “Our independence is meaningless unless it is linked up with the total liberation of the African continent.”Therefore the xenophobic – or rather, Afrophobic – attacks on the eve of the 21st anniversary of the new republic, in which at least seven fellow Africans have died, 5 000 people have been left homeless and foreign-owned shops have been looted, are unexpected of a nation that owes so much to the rest of the continent.They were a brutal attack on the foundation of a nation built on “unity through diversity” and Ubuntu – the universal African principle of mutual humanity: “I am because you are.”As Anglican Archbishop Emeritus Desmond Tutu put it: “Our rainbow nation that so filled the world with hope is being reduced to a grubby shadow of itself. The fabric of the nation is splitting.”While much has been done to deliver a promised better life for all, with unprecedented access to basic services, many “reasons” have been postulated for this shocking turn of events: an unacceptably high unemployment rate, estimated to be more than 30%, and the widening gulf between the haves and have-nots that has given South Africa a Gini coefficient of 65.0, placing it among the most unequal nations in the world.About 20% of the population live below the food poverty line – a figure that has decreased from 45.5% in 2011, according to Statistics South Africa – and a staggering 14.6-million (compared with 2.4-million in 1996) depend on state social welfare. Sluggish economic growth threatens the state’s ability to deliver on its 2030 National Development Plan (NDP) to create jobs and reduce poverty and inequality.The most prominent of the arguments in the debate on xenophobia is that the impressive progress South Africa has achieved since the dawn of democracy has made it a beacon of hope for a better Africa, and a refuge for many across sub-Sahara searching for a better life.The perpetrators of xenophobic violence argue that the foreigners are the reason for South Africa’s inability to overcome the challenges of unemployment, poverty and inequality.However “rational” these arguments may sound, this is certainly not the way to deal with them. Perhaps, as Zuma said at the briefing, there has been a failure by the leadership to explain to the broader majority that while the armed struggle was a necessary but last resort to force the end of apartheid, it was not the way to resolve problems.Xenophobia and violence against foreigners are not consistent with the South Africa envisioned in the Freedom Charter at the Congress of the People, Kliptown, on 26 June 1955.They are not consistent with Mandela’s dream, which he expressed on 20 April 1964 at the Rivonia Trial, of “a democratic and free society in which all persons live together in harmony and with equal opportunities”.The potential damage to the country is incalculable. It has the real effect of affecting the country in four critical areas: trade, tourism, international relations and citizenship, and its ability to deliver the NDP vision to create jobs and reduce poverty and inequality.As Africa’s leading beneficiary of foreign direct investment, according to Economic Development Minister Ebrahim Patel, South Africa sells R260-billion in goods to other African countries, supporting more than 160 000 jobs.Leading South African businesses such as MTN and Shoprite have invested widely in Africa. MTN has more than 215-million subscribers across its 22 markets in Africa and the Middle East, and international operations account for 74% of its turnover.Shoprite has about 1 400 corporate and franchise outlets in 16 countries across Africa and the Indian Ocean Islands.It is reported that Sasol has had to repatriate more than 300 employees from Mozambique in fear of retaliation for the violence against foreigners.Of the 9.6-million tourists last year, 70% were from the rest of Africa. According to Statistics South Africa, direct tourism contributes about 3% of gross domestic product and more than 600 000 direct jobs, amounting to about 4.6% of direct employment in the country.Post-apartheid South Africa is the most welcome and represented nation internationally, with representation in 282 states, including 47 of the 54 African countries, second only to the US. Reciprocally, there are 309 foreign representations in South Africa.Threats against South African businesses and people and the temporary closure of South Africa’s foreign missions in such leading African countries as Nigeria and Ghana have compromised South Africa’s relations with her fellow African states.What is of particular concern is that while, broadly, these attacks have been portrayed as xenophobic, the most visible victims have been fellow Africans, with countries such as Malawi and Zimbabwe repatriating displaced and traumatised citizens.The reaction to foreign individuals who have taken their “better life” has cast a negative light on South Africans’ identification with their fellow Africans. There is now a perceived lack of gratitude for the selfless sacrifice made during the apartheid years.The universal condemnation of these attacks by the majority of South Africans, their call for peaceful coexistence and harmony with foreigners, and the comprehensive response by the government underline that xenophobia is not a South African value.The attacks were a callous and criminal act by a few that has reinforced an unfortunate perception of South Africa as a crime capital. The eventual deployment of the army in the affected areas affirms that this is a war against the ideal of the new South Africa that should be met with the greatest and most decisive force.This is a defining moment. It is the new struggle, not just for South Africa – but for Africa.How South Africa responds will signal how other African nations relate to South Africa in the future, and how they relate with one another should they encounter similar actions.It is a struggle, similar to those against Boko Haram in Nigeria and al-Shabaab in Kenya, that requires that the affected countries and all of Africa stand together for a better continent.The world is looking to South Africa once again to lead and re-establish its moral authority.South Africa can emerge stronger – inspired by its triumph over apartheid, empowered by the universally admired principles and ideals of a constitution that values diversity, human rights and humanity, and guided by the gratitude for and of all of Africa and the world.This is a defining moment for all of South Africa to take up a new struggle, echoing the spirit of the 16 December 1961 Manifesto of Umkhonto we Sizwe “not (to) submit … hit back by all means in our power in defence of our people, our future, and our freedom”.This is a defining moment to defend Mandela’s 1994 commitment to “never, never and never again … suffer the indignity of being the skunk of the world”.This is a defining moment to stand up and proclaim: Not in our name. Not on our watch. Not in our Africa.As we look beyond this inexcusable episode and rebuild the fractured rainbow nation, it is time to reaffirm our identity with Africa because our African bonds are stronger than the borders that divide us.It is time to adopt formally and celebrate Africa Day on 25 May in the same spirit as we celebrate our founding on 27 April.It is time to incorporate the African and South African liberation struggle in school curricula so that we never forget – and never repeat – the mistakes of history. It is time to fly the flag and sing the anthem of the AU along with those of South Africa.It is time, as the celebrated late Nigerian Afrobeat pioneer Fela Kuti once said, to “identify with Africa, then (we’ll) have an identity”.The least we can do is to fly all South African flags at half-mast to honour the innocent men and women who lost their lives in the country, where they had hoped to share in the fruits of the freedom that their nations had helped South Africa attain.Thebe Ikalafeng is a global African branding and reputation architect, adviser and author, founder and chairman of Brand Africa and Brand Leadership, and a director of Brand South Africa and South African Tourism. @ThebeIkalafeng
To read more from Steve Browne on Everyday People Blog, please click here. This past week I had a very cool experience !! I was one of the judges for the SHRM Student Case Study competition. I sat with two other great HR pros from the area as we heard graduate students from various schools give their take on an HR scenario. It was very cool to hear their approaches which ranged from a traditional HR viewpoint to some that were extremely creative.I was so geeked to see so many students come in and share. It helped to continue to dispel the stereotype that the most recent generation is so “different” and just doesn’t “get it” like other generations. I wasn’t surprised because this isn’t new. There have always been generations in the workplace. The stigma that has been assigned to younger people is from older generations. We have fallen into the same trap that we said we would never fall into when older generations made broad generalizations about us. We hated it, but it hasn’t stopped us from doing the same thing.I think we need to have a serious change of heart and be the generation that encourages and lifts up the newest folks. Let me ask you a question . . .Do you remember when you got into HR?Most people don’t start in HR, they fall into it. I’m one of those outliers who has been in HR for my entire career (on purpose). When I started though, I was pretty much on my own. I taught myself what I thought was correct, but to be honest, my efforts had to be limited because I didn’t look outside of what was within my reach. I must have missed areas. I did what I had to, but I could have done better.I didn’t know having someone who was also in HR as a mentor was needed. The truth is, I didn’t think someone like that even existed. I was wrong on this account as well. When I finally reached out and connected with other HR pros, I found some great people who are still mentoring me to this day several years later.Now, back to these students.We can be the ones who reach out to them now to be their connections and mentors. They don’t have to “earn their stripes” in order to struggle as they enter HR. We can be the ones to share our experiences with them and make sure that they are not left to try and figure out this industry on their own.We have the chance to help shape not only the future of these great young people, but we can help shape the future of our profession !!Wouldn’t it be great to help these kids who are interested in joining our field have a great experience coming into HR? How would they see our generation, and how would we see theirs, if we did more to build each other up instead of trying to focus on generational differences?The future of HR is bright !! I was able to see this first hand. I plan to reach out to these students and connect with them now and going forward. I’d love to see them succeed now and become the leaders of HR to come. I want to break the cycle and not be the stereotype of my generation. Will you be willing to join me? I hope you will !!
On March 27, @shrmnextchat chatted with Speaker and Co-Host of The Chad and Cheese podcast, @Chad_Sowash about the ever-changing field of recruitment platforms in “The Recruitment Platform to Rule Them All.” If you missed this amazing chat filled with great tips and advice, you can read all the tweets here or below: