Nobody likes to see injured players writhing in pain on the pitch, but life threatening incidents are what the physicians fear most. The key is to treat them as soon as possible, and that is why FIFA and the FIFA Medical Assessment and Research Centre (F-MARC) held a course on medical emergencies and mass disasters in football in the Nigerian city of Abuja between 20 and 21 October.
With an emphasis on practical procedures, the course was held for the medical officers at each of the FIFA U-17 World Cup Nigeria 2009 host cities, as well as physios, team doctors and all the medical personnel of the first and second leagues. Run by Dr. Demitri Constantinou, Director of the FIFA Medical Centre of Excellence in Johannesburg, Dr. Efraim Kramer from the Division of Emergency Medicine at the University of the Witwatersrand in Johannesburg and Dr. Sello Motaung of the FIFA Medical Centre of Excellence of Johannesburg, the objective of the course was to teach techniques that can save lives in the event of serious injuries on the pitch and around, in the stands and in VIP lounges - and all in the space of two days.
"We were able to teach them a lot about how to act and react if emergency situations arise on a football pitch," said Dr. Constantinou. "From now on, they'll know what to do about injuries linked to blows to the head, the neck and the spine and what to do about cardiac arrests, as well as knee and foot injuries etc."
What, in more concrete terms, were the attendees able to learn in the space of just two days, with a few hours reserved for exercises? "We taught them the principles: specifically, how to move or immobilise someone in the event of whiplash and also how to perform cardiac resuscitation," explained Dr. Constantinou.
The two doctors were nonetheless keen to make the course pleasurable. "OK, you're there in the stadium," joked Dr. Kramer at one point. "Now, imagine 300 million people are sitting in front of their TV screens and you have to make the correct move. Don't forget to smile at the camera on your way off the pitch." The 30 or so doctors present laughed in unison, but all of them took the lessons being taught extremely seriously. "I learned how to deal with injured players, especially those suffering with spine problems," commented Dr. Babatunde Olayinka. "I now know how to at least limit the impact of the injury on a player. What's important is to protect mobility and avoid mortality."
"These doctors showed us techniques adapted to the football stadium and the circumstances in which they are required," added Dr. Isa Abubakar Sadeeq, who will be the chief medical officer at Kano. "It was innovative. We crossed paths with people from different cultures, different countries and it was very enriching. As hosts of a tournament like this, we benefit from its legacy. Lots of doctors are present here and they'll leave with more knowledge and more equipment."
"They're doctors, so obviously they know the theory; we show them how to act in practical terms on a pitch and in case of mass disasters," explained Dr. Constantinou. "We also provided them with a manual which goes into more detail. These principles are useful for the players, but also for everyone present in the stadium."
The principal message Drs. Kramer and Constantinou hope to have passed on is a simple one: "Prevention is primordial. If it's not possible, then you need to be prepared and proactive to protect the players and everyone else in the stadium."
They can count their mission a success because every doctor in attendance spoke afterwards of having grown in confidence and being ready to deal with any eventuality, whether with players or other injured parties. "These principles are not only useful for the players, but also for the spectators, staff or whoever else in the stadium," said Dr. Olayinka. "In something like eight hours, we got to grips with enough subjects for a whole year," added Dr. Sam Opara. "But it was worth the effort. I learned some extremely useful practical procedures."
Set to serve as FIFA's doctor in Kano, Dr. Rachid Boukhalfa also found the course highly effective. "What we were taught was quite simply to care about the health of the players," he said. "These intelligent exercises let us know how to react as a team in the event of breathing failures, either with massages or a defibrillator, and also how to pick up and move someone who could be suffering from whiplash. The most important thing, ultimately, is to take the injured player to hospital alive."
All the techniques passed on will of course remain part of the knowledge pool in Nigeria and be passed on to other doctors in time. "This is also a heritage for Africa," explained Dr. Constantinou. "We'll be leaving, but they'll keep hold of this knowledge and will then be able to transmit it to others themselves." Dr. Boukhalfa echoed those thoughts, but he believes a sustained effort should be made to share the lessons learned. "We should popularise these techniques so that as many people as possible get to know them," he said. "I know that club doctors want to learn them, for example. These are useful procedures that can save lives and should be spread far and wide. That's precisely the point of having this kind of seminar before competitions."