“Traslacion”, the Feast of Black Nazarene in Manila, Philippines; a Gathering of Medical Volunteers and Medical First Responders.

Summary: Traslacion is one of the biggest religious events in the Philippines. It involves a vigil and the procession of the carriage of the Black Nazarene in the streets of Manila, usually starting at the break of dawn and lasting for about 18 to 20 hours. This year, it is estimated that more than 10 million devotees flocked to the area during the event. Various risks and hazards are present. Compression asphyxia, heat exhaustion, and trauma cases are common. Traslacion is manned mainly by different rescue organizations that regularly volunteer to take care of medical services aside from the existing emergency medical services of the national and local government units. Thus, it is important to understand the preparation of medical volunteers and identify challenges and best practices during a mass gathering. Planning and meetings started six months ahead. It involved multiple government agencies, church officials, and civil society organizations. Online lectures were utilized by the volunteers, and a simulation exercise was done with uniformed personnel for harmonization. An Incident Management Team was organized, and a Multi-Agency Command Center was set up. Advanced medical posts were situated strategically with different rescue and medical volunteers along the whole route of the procession. Strike teams were formed by the volunteers to extract patients from the thick crowd and bring them to different medical stations. There were 1,484 patients reported, and most suffered minor injuries. No major injuries or deaths were seen during Traslacion 2024 despite the number of devotees. Now, the challenge for the organizers is to keep future Traslacion safe. The volunteers have been the backbone of the medical response to this event in providing an early response. Despite the risks and hazards present in this event, early planning and preparation can make a difference in the outcome of this anticipated annual event.