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Session 1.2: national health perspectives of the Tsunami crisis.

This is a summary of the presentations and discussion of Session 1.2 of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related national health perspectives as pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) key questions; (2) discussion; (3) what was done well?; (4) what could have been done better?; and (5) what can be done to prepare for the future?.

Disasters↗
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Session 1.3: health protection and disease prevention: a critical review of experience.

This is a summary of the presentations and discussion of Health Protection and Disease Prevention of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related health protection and disease prevention as pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) key questions; (2) national perspectives; (3) an international perspective; (4) laboratory aspects in disease surveillance; and (5) partnership.

Disasters↗
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Session 1.5: health policy and coordination: a critical review of experiences.

This is a summary of the presentations and discussion of Session 1.5 on Health Policy and Coordination: A Critical Review of Experiences during the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to health policy and coordination as pertain to the responses to the damage created by the Tsunami. Key questions were answered in this session, and recommendations were made.

Disasters↗
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Panel 2.1: assessing impact and needs.

This is a summary of the presentations and discussion of Panel 2.1 of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to assessing needs and measuring impact as pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) key questions; (2) assessing needs; (3) measuring impact; and (4) lessons learned and recommendations.

Disasters↗
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Panel 2.3: gender dimensions and human rights aspects to responses and recovery.

This is a summary of the presentations and discussion of the Gender Dimensions and Human Rights Aspects to Responses and Recovery of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to gender dimensions and human rights pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) gaps encountered and major issues; (2) limitations of response; (3) what could have been done better?; and (4) recommendations.

Disasters↗
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Panel 2.6: mental and psychosocial effects of the Tsunami on the affected populations.

This is a summary of the presentations and discussion of Panel 2.6, Mental and Psychosocial Effects of the Tsunami on the Affected Populations of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to mental and psychological aspects as pertaining to the damage created by the Tsunami. It is presented in the following major sections: (1) responses; (2) needs assessment; (3) coordination; (4) gap filling; (5) capacity building; (6) stakeholder agreement; and (7) conclusions and recommendations. In the responses discussion, issues included: (1) psychosocial support services; (2) mental health services; and (3) the Thai response. Subsections in the stakeholder agreement section include: (1) public-private partnerships; and (2) preparedness.

Disasters↗
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Panel 2.7: first 30 days: organizing rapid responses.

This is a summary of the presentations and discussion of Panel 2.7, First 30 Days: Organizing Rapid Response of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to organizing rapid responses as pertain to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) issues; (2) key questions; and (3) recommendations.

Disasters↗
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Panel 2.12: the health sector contribution to disaster reduction.

This is a summary of the presentations and discussion of Panel 2.12, The Health Sector Contribution to Disaster Reduction, of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related the health sector's contribution to disaster reduction as pertain to the damage created by the Tsunami. It is presented in the following major sections: (1) issues; (2) lessons learned; and (3) recommendations.

Disasters↗
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What have we learned? Coordination.

This paper outlines each aspect of coordination as it relates to the responses made by various organizations in the disaster-affected areas. It is a synthesis of the presentations and discussions pertaining to coordination during the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO), in Phuket, Thailand, 04-06 May 2005. Coordination is defined, and two important questions are answered: (1) What coordination was done well?; and (2) What coordination could have been done better?

Disasters↗
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What have we learned? Filling gaps in available services.

This is a synthesis of the presentations and discussions of the Conference in Phuket, Thailand relative to filling the gaps in available services. The topics discussed in this section include: (1) gaps in the early phases of relief, including food, water and sanitation, shelter, health services, field hospitals, mental health, and women's health; (2) what can be done better including the armed forces, the private commercial sector, and coordination; (4) the development of standards; and (5) conclusions and recommendations.

Cooperative Behavior↗
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What have we learned? Capacity building for health responses in disasters.

This is a synthesis of the presentations and discussions pertaining to Capacity Building for Health Responses in Disasters of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO), in Phuket, Thailand, 04-06 May 2005. The topics discussed included: (1) Specific goals; (2) Main focal areas, including available training programs, country-specific training programs, targeted technical assistance for training programs, certified training programs, and ensuring that funding is available for training; (3) What has been achieved in building capacity; (4) Challenges; (5) Where capacity building is needed; and (6) Conclusions and recommendations.

Disasters↗
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International medical response to a natural disaster: lessons learned from the Bam earthquake experience.

An earthquake measuring 6.5 on the Richter scale devastated Bam, Iran on the morning of 26 December 2003. Due to the great health demands and collapse of health facilities, international aid could have been a great resource in the area. Despite sufficient amounts and types of resources provided by international teams, the efficacy of international assistance was not supported in Bam, as has been experienced in similar events in other countries. Based on the observations in the region and collecting and analyzing documents about the disaster, this manuscript provides an overview of the medical needs during the disaster and describes the international medical response. The lessons learned include: (1) necessity of developing a national search and rescue strategy; (2) designing an alarm system; (3) establishing an international incident command system; (4) increasing the efficacy of the arrival and implementation of a foreign field hospital; and (5) developing a flowchart for deploying international assistance.

Delivery of Health Care↗
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In the path of disasters: psychosocial issues for preparedness, response, and recovery.

The psychosocial impacts of disasters are profound. In recent years, there have been too many reminders of these impacts and the dire needs of the people involved. The purpose of this article is to present the following themes from the psychosocial literature on disasters and emergency management: (1) differential impacts of disasters according to gender and age; (2) prevention efforts to reduce racial discrimination, rape, and other forms of abuse; (3) readiness for cultural change toward prevention and preparedness; and (4) the need to involve aid beneficiaries as active partners in relief strategies, particularly during reconstruction of communities and critical systems. Psychosocial needs change throughout the disaster cycle, particularly as social support deteriorates over time. It is important to anticipate what psychosocial needs of the public, emergency responders, support staff, and volunteers might emerge, before advancing to the next stage of the disaster. Particular consideration needs to be directed toward differential impacts of disasters based on gender, age, and other vulnerabilities.

Disaster Planning↗
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Frequency of post-traumatic stress disorder among relief force workers after the tsunami in Asia: do rescuers become victims?

OBJECTIVE: The objective of this study was to evaluate the frequency of posttraumatic stress disorder (PTSD) among the participants of the Turkish Red Crescent Disaster Relief Team after the Tsunami in Asia. METHODS: The Clinician Administered PTSD Scale-1 (CAPS-1) was administered to 33 of 36 team members one month after their Disaster Relief Team duty. Along with the CAPS-1 interview, demographic features, profession, previous professional experience, previous experience with traumatic events and disasters also were recorded. To be classified as present, a symptom must have a frequency score of "1" and an intensity score of "2" at the CAPS-1 interview. For a diagnosis of PTSD, at least one re-experiencing, three avoidance and numbing, and two increased arousal symptoms should be present. RESULTS: The PTSD was diagnosed in eight of the 33 (24.2%) participants. No significant difference was detected in the distribution of PTSD diagnosis according to gender, age, profession, professional experience, previous disaster experience, and/or previous experience of traumatic events. However, the severity of PTSD symptoms as measured by the CAPS-1 score was significantly higher in women, nurses, and participants with <3 previous disaster duty experiences. CONCLUSION: Post-traumatic stress disorder is prevalent within disaster teams and healthcare workers, and measures should be taken to prevent PTSD within this group.

Adult↗
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Medical support for emergency relief workers after typhoon Sudal in Yap, Micronesia.

INTRODUCTION: On 09 April 2004, Typhoon Sudal struck the Island of Yap in the Federated States of Micronesia (FSM). Over 90% of homes, public utilities, and public property were damaged or destroyed. Nearly 10% of the population was displaced to shelters, and the majority of the population was without drinking water or power. United States disaster workers were deployed to Yap for three months to assist in the recovery and relief efforts. OBJECTIVE: The objective of this study was to evaluate the acute healthcare needs of the US disaster relief population serving in a remote setting with limited medical resources. METHODS: A retrospective chart review of all disaster relief workers presenting to an emergency clinic in Yap during the disaster relief effort from April 2004-July 2004 was performed. Investigators extracted demographic data, chief complaints, medical histories, medical management, disposition, and outcome data from the clinic charts. RESULTS: Together, the 60 disaster workers present on Yap during the relief effort made 163 patient contacts in the disaster emergency clinic. A total of 92% of patient contacts were for minor medical complaints or minor trauma, 13% were for upper-respiratory infections, 9% were for gastrointestinal illness, and 9% were for dermatological problems. Eight percent of visits were for serious medical problems or trauma. Life-threatening illnesses or injuries did not occur. CONCLUSIONS: Disaster relief workers on Yap frequently utilized the disaster relief clinic. In general, disaster workers remained healthy during the relief effort in Yap, and most injuries and illnesses were minor. On-site medical providers resulted in rapid care and stabilization, and after treatment, disaster workers were able to return to duty.

Disasters↗
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Analysis of medical needs on day 7 after the tsunami disaster in Papua New Guinea.

INTRODUCTION: Because of great intervening distances, international medical relief activities in catastrophic, sudden-onset disasters often do not begin until days 5-7 after the precipitating event. The medical needs of those affected and what public health problems exist in the community in the week after the tsunami disaster in Papua New Guinea(PNG) were investigated. METHODS: The Japan Medical Team for Disaster Relief (JMTDR) conducted investigative hearings at the District Office responsible for the management of the disaster, the Care Center, and the Hospitals in Aitape, Vanimo, and Wewak in PNG. RESULTS: The numbers of in-patients in the Aitape, Vanimo, and Wewak Hospitals, and in the Care Center in Aitape were 291, > 300, 68, and 104, respectively. The exact number of people affected was unknown at the Aitape District Office. There was no lack of medical supplies and drugs in the hospital, but the Care Center in Aitape did not have sufficient quantities of antibiotics. No outbreak of communicable disease occurred, despite the presence of risk factors such as the dense concentration of affected people and the constant prevalence of malaria and diarrhea. The water at Wewak General Hospital contained chlorine and was suitable for drinking, but that elsewhere contained bacteria. CONCLUSIONS: On about the 7th day after the event, the available information still was incomplete, and it was a time to shift from initial emergency activities to specialized medical care. Although no outbreak of communicable disease actually occurred, there was much anxiety about it because of the risk factors present. For effective medical care at this stage, it is essential to conduct a survey of actual medical needs that also include epidemiological factors.

Anti-Bacterial Agents↗