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[Panic anxious-depressive states in children and adolescents who have experienced natural disasters and catastrophes].

744 children and adolescents at the age of 1-17 years who underwent disasters (earthquakes) and catastrophes were observed. In 216 cases anxious-depressive conditions of different duration were revealed. These disorders were divided into 3 groups: the neurosis of fear (42.1%), phobia-like states of the type "panic disorders" (31.0%) and mixed somatogenic and psychogenic disorders of "panic type" (26.9%). The least favorable prognosis was noted in the 3d group. The questions of drug therapy and psychotherapy of every type of these disorders are discussed.

Accidents↗

[PTSD as a result of a natural disaster].

A review of modern conceptions that may help in diagnosing of PTSD in the victims of flood in Poland in July 1997 was made. Diagnostic, epidemiological and prognostic problems in the development of the disorder were discussed.

Disasters↗

Guidelines for the use of foreign field hospitals in the aftermath of sudden-impact disaster.

Natural and complex disasters can cause a dramatic increase in the demand for emergency medical care. Local health services can be overwhelmed, and damage to clinics and hospitals can render them useless. Many countries maintain mobile field hospitals for defense or humanitarian purposes. Dispatching these facilities to disaster-affected countries would seem an ideal response to emergency medical needs. Unfortunately, experience has shown that in the case of natural disasters, field hospitals often have not met the expectations of recipients and donor institutions. In July 2003, the World Health Organization and Pan American Health Organization sponsored a workshop in El Salvador to discuss the pros and cons of using foreign field hospitals in the aftermath of natural disasters. These guidelines are the result of that workshop. The workshop participants identified different phases when foreign field hospitals and specialized medical personnel are most useful. They can provide advanced trauma care and life support if at the disaster site within 48 hours of the impact of an event; they would provide follow-up care for trauma victims and resumption of routine medical care in the two weeks following the event; during rehabilitation and reconstruction phases (from two months to two or more years), a field hospital might serve as a temporary replacement for damaged health facilities. These guidelines propose conditions that field hospitals and their staff should meet for each of these phases. The guidelines also outline issues that authorities in donor countries and disaster-affected countries should discuss before mobilizing a field hospital.

Disaster Planning↗

Global assessment of El Niño's disaster burden.

BACKGROUND: Natural disasters have profound effects on health and require medical intervention as part of relief operations. The world's populations are becoming increasingly vulnerable to extreme weather events, which are responsible for most natural disasters. The El Niño Southern Oscillation (ENSO) is the most prominent global climate system associated with year-to-year weather variability and extreme events. We have estimated the burden on human health of natural disasters associated with ENSO. METHODS: We used time-series regression analysis of the relation between El Niño years and the annual rates of persons affected by natural disasters per 1000 population during 1964-93, globally and also by region and disaster type. Correlations between sea-surface temperature (SST) anomalies (index of ENSO) and the rates of persons affected by natural disasters per 1000 population were determined globally, by region and by disaster type. FINDINGS: The rate of persons affected by natural disasters worldwide is strongly associated with ENSO; rates are greater during the first El Niño year (p = 0.05) and the following year (p = 0.01) than in the pre-Niño year. The correlation between rates of persons affected by natural disasters and SST anomalies in the Eastern Pacific (a key ENSO indicator) is highest in the last quarter of the previous year (r = 0.53, p < 0.01). These associations are strongest in South Asia, the region where more than 50% of all disaster victims live. Worldwide, rates of persons affected by drought/famine (half of all disaster victims) and by volcanic eruptions show significant associations with the ENSO cycle, being highest in the post-Niño year and El Niño year, respectively, and being significantly associated with SST anomalies. INTERPRETATION: The strong relation between ENSO and populations affected by natural disasters can be described as a "natural disaster cycle". Determining the phase in this cycle, using SST from the Eastern Equatorial Pacific, could benefit disaster preparedness on a global scale, for South Asia in particular, and for all populations affected by drought/famine and volcanic disasters.

Disaster Planning↗

Accident and disaster epidemiology.

Natural disasters such as floods, earthquakes, and cyclones are responsible each year for a large number of deaths and injuries. Over recent years, the emphasis in disaster management has shifted from post-disaster improvisation to pre-disaster planning. There is a strong feeling that one should be able to prevent or mitigate the human consequences through improved preparedness. The decade 1990-99 has been proclaimed by the United Nations the International Decade for Natural Disaster Reduction (IDNDR). Epidemiology is proving an essential tool to study the health effects of disasters and to suggest appropriate control measures at each of the phases of the disaster process, from prevention to long-term rehabilitation. Case-studies have shown that rescue by the disaster-struck community is the most effective way to reduce the death toll due to earthquakes. Disaster preparedness should be part and parcel of primary health care in disaster-prone areas. Appropriate information to evaluate needs should be preferred to precipitate relief. Epidemiological surveillance should replace indiscriminate vaccination. In the long term, disaster preparedness can provide a stimulus for setting up more efficient health services.

Accident Prevention↗