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PubMed1998

The use of simulation in planning the transportation of patients to hospitals following a disaster.

The characteristics of disaster management are outlined. Planning for the efficient management of a disaster is described. The level of preparedness for disasters can be increased using simulation models in conjunction with drills. With the simulation model, "what-if" analyses are performed to predict the consequences of conceivable scenarios. Emergency medical service personnel will find such computer simulation models a useful supplement to their standard training.

Adult↗
PubMed2006

Infectious diseases that pose specific challenges after natural disasters: a review.

In a time span of less than one year, December 2004 to October 2005, several natural disasters of extreme proportions struck different areas of the world, causing unparalleled destruction and loss of lives and property. In each of these instances, the potential existed for acquisition of infectious diseases caused by bacteria, viruses, mold, and mildew and demonstrated that such disasters represent a public health concern, which is exacerbated by the fact that many factors may work synergistically to increase the risk of morbidity and mortality caused by communicable diseases. This article reviews causes, symptoms, and treatments of various infectious diseases that pose a threat in the event of a natural disaster.

Child↗
PubMed2006

Mental health and psychosocial aspects of disaster preparedness in Bhutan.

Bhutan has taken the initiative in developing a comprehensive guideline on disaster risk preparedness and management in response to several minor disasters, namely earthquakes and flash floods in the country during the last couple of years. It is now widely accepted that the psychological symptoms of trauma resulting from devastation to lives and livelihood of affected people remain much longer and sometimes throughout their entire life span unless taken care of. Therefore, it is important to include psychosocial components of mental health protection and treatment of the affected persons in disaster risk preparedness and management to make it a comprehensive package. A four-tier system of mental health intervention and counselling has been proposed in line with the existing healthcare system and resources available in the country to make it sustainable. At the core of this programme is the mobilizing and training of volunteers from the community on psychosocial intervention, counselling and rehabilitation, backed up by three layers of trained health workers and mental health professionals.

Bhutan↗
PubMed2006

Mental health and psychosocial response after the worst natural disaster in the history of the Maldives.

The Maldives as a geographically diverse nation had to face tsunami with a number of key issues in hand. These included large geographical spread of islands, varied levels of communication across islands and internal displacement of people. One third of the total population was directly or indirectly affected. All except nine inhabited islands were partially or totally flooded. Although the total loss of life was limited the effect on the population was tremendous. The cost to the economy was 62% of the annual GDP. The government not only assigned high priority to mental health and psychosocial support activities after the tsunami but took charge of training and support measures. The community outreach programme provided psychosocial support to every affected person. This was provided by local Maldivians, who were appropriately trained, thus making it culturally and technically appropriate. Long-term plans for mental health and psychosocial aspects of disaster preparedness have been initiated. The experiences of the tsunami disaster has provided an opportunity to review the existing state of mental health services in the Maldives and to develop a plan to meet the mental health and psychosocial needs of the community. A rapid and appropriate response to a disaster depends on an existing policy structure and system, and an ability to mobilize these plans.

Disaster Planning↗
PubMedDate not supplied

Evidence of the effectiveness of health sector preparedness in disaster response: the example of four earthquakes.

In this article, evidence that health sector preparedness improves response performance in disasters was examined. Case fatality and survival data were compared for four earthquakes, in relation to health sector emergency preparedness levels. Vast differences in performance were found. The two California systems, with a high preparedness index, had low case fatality rates (about one death per 100 injuries). Kobe, Japan, with mixed levels of preparedness, had 31 deaths per 100 injuries, and Armenia (low preparedness index) had 167. Public health and health sector preparedness made a significant difference in the ability to respond effectively to meet patient needs in disasters, although it is only one of several factors that determine the health outcome of disaster victims.

Armenia↗
PubMed2004

The problems faced by three government disaster response teams of Ankara city during the Marmara earthquake - 1999 response.

OBJECTIVES: The objectives of this study were to determine the organization/system and personal problems faced by the personnel of Ankara greater municipality Firebrigade Department (firemen), Ankara Emergency Aid and Rescue Services (ambulance personnel), Civil Defence General Directorate's Ankara Search and Rescue Unit (rescuers), who participated in the 1999 Marmara earthquake. MATERIALS AND METHODS: A total of 1132 individuals were in the universe of the study; the total rate of participation was 95.1% (1076 individuals). This study was a cross-sectional survey, in which self-administered questionnaires were used. The study was conducted in May, June and July of 2001. RESULTS: Overall, 33.1% of the personnel of three government disaster response teams (356 individuals) said that they participated in the Marmara earthquake - 1999 response. The leading most important organization/system problem they faced during the Marmara earthquake was coordination (30.8%) according to the firemen, disaster management (31.4%) according to the rescuers, and coordination (41.6%) according to the ambulance personnel. The personal problems faced during the Marmara earthquake by the firemen were food problems (56.4%), accommodation problems (62.8%), safety problems (28.2%) and health problems (71.8%); according to the rescuers they were food problems (77.1%), accommodation problems (48.6%), safety problems (74.3%) and health problems (51.4%), and according to the ambulance personnel they were food problems (47.7%), accommodation problems (58.0%), safety problems (31.7%) and health problems (26.7%). CONCLUSION: Among the organization/system problems faced by the personnel of three government disaster response teams in the Marmara Earthquake of 1999, coordination problems were the major concern. The personnel also had some personal problems such as food, accommodation, safety and health.

Cross-Sectional Studies↗
PubMed2004

Psychological impact of the animal-human bond in disaster preparedness and response.

The authors present an overview of the impact of the animal-human bond on disaster management and highlight the need to further examine the relationship of animals and humans in disaster response. The human connection to animals influences compliance with individual and community evacuation plans. Search and rescue teams with canine units confront physical and emotional demands that affect both handler and animal. The culling of animal populations on a scale such as occurred during the recent foot-and-mouth epidemic in the United Kingdom affects every member of rural society. Livestock farmers and their families endure enormous emotional losses, and veterinarians and government officials who must implement these programs suffer as well. A familiarity with and understanding of these issues is important for psychiatrists and other mental health professionals who are involved in disaster preparedness and response.

Animal Welfare↗
PubMed2003

Intensive care in a field hospital in an urban disaster area: lessons from the August 1999 earthquake in Turkey.

OBJECTIVE: To describe our experience with the implementation of intensive care in the setting of a field hospital, deployed to the site of a major urban disaster. DESIGN: Description of our experience during mission to Turkey; conclusions regarding implementation of intensive care at disaster sites. SETTING: Military Field Hospital at Adapazari in Turkey. PATIENTS: Civilian patients admitted for care at the field hospital. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: On August 17, 1999 a major earthquake occurred in western Turkey, causing approximately 16,000 fatalities and leaving >44,000 injured. Approximately 66,000 buildings were severely damaged or destroyed. A medical unit of the Israeli Defense Forces Medical Corps, consisting of 23 physicians, 13 nurses, nine paramedics, 13 medics, laboratory and roentgen technicians, pharmacists, and associated support personnel, were sent to Adapazari in Turkey. The field hospital treated approximately 1,200 patients over a period of 2 wks, 70 surgical operations were performed, 20 babies were delivered, and a variety of medical, surgical, orthopedic, and pediatric/neonatal care was provided. The 12-bed intensive care unit operated by the unit, was staffed by three physicians and eight nursing/paramedic personnel. Patient mix was: a total of 63 patients, among them five with major trauma, 20 with acute cardiac disease, 15 patients with various acute medical conditions, and 11 surgical and postoperative patients. Three patients were intubated and mechanically ventilated (one cardiogenic pulmonary edema and two major trauma). The intensive care unit provided the following functions to the field hospital: care of the critically ill and injured, preparation for and implementation of transportation of such patients, pre- and postoperative care for major surgical procedures, expertise, and equipment for the care of very ill patients throughout the field hospital. CONCLUSIONS: In suitable circumstances, an intensive care capability should be an integral part of medical expeditions to major disasters.

Disaster Planning↗
PubMed1997

The historical development of public health responses to disaster.

The first of a of series state-of-the-art reviews commissioned to mark Disasters' 21st anniversary, this paper considers key publications on public health aspects of natural disasters, refugee emergencies and complex humanitarian disasters over the past twenty-odd years. The literature is reviewed and important signposts highlighted showing how the field has developed. This expanding body of epidemiological research has provided a basis for increasingly effective prevention and intervention strategies.

Disaster Planning↗
PubMed1999

Race, ethnicity and disasters in the United States: a review of the literature.

In this paper we synthesise past disaster research that addresses issues of race and ethnicity in the United States. Using an eight-stage typology to organise the findings, this literature review presents the results from a wide range of studies. The synthesis shows how various racial and ethnic groups perceive natural hazard risks and respond to warnings, how groups may be differentially affected, both physically and psychologically, and how disaster effects vary by race and ethnicity during the periods of emergency response, recovery and reconstruction. We show that studies have important findings, many illustrating that racial and ethnic communities in the US are more vulnerable to natural disasters, due to factors such as language, housing patterns, building construction, community isolation and cultural insensitivities. By presenting these studies together, we are able to witness patterns of racial and ethnic inequalities that may be more difficult to see or interpret in individual studies that take place in one specific time and place. We conclude the review with policy and research recommendations.

Disaster Planning↗
PubMed2001

The changing emphasis of disasters in Bangladesh NGOs.

Bangladesh is one of the most disaster-prone countries in the world, affected by cyclones and floods, as well as chronic hazards such as arsenic poisoning. NGOs have played a major role in bringing concerns related to risk management on to the national agenda and promoting a shift of focus from mere relief response to disaster mitigation and preparedness. The government has, after earlier scepticism, now accepted NGOs as major partners in these tasks. Innovative approaches, such as the use of microfinance, have been applied; many of which are related to preserving the gains of development efforts as part of rehabilitation. NGOs have pressured for better coordination with government. Improved structures are now approved, but it is still too early to judge their impact. Despite progress, neither NGOs nor governmental agencies have clearly defined roles in the effort to link disaster management priorities. This will ensure that longer-term development efforts build on local capacities and reduce vulnerabilities.

Bangladesh↗
PubMed1995

Towards a redefinition of security in Central America: the case of natural disasters.

Over the past 25 years Central America has suffered a number of major disasters: the Managua Earthquake (1972), Hurricane Fifi (1974), the Guatemalan Earthquake (1976), the San Salvador Earthquake (1986) and Hurricane Joan (1988). These events are briefly described, with special reference to their political aspects and implications. Recognition of the political importance of disasters in Central America leads to a questioning of the traditional notion that security is essentially a matter of defending the state from outside aggression. It is suggested that the analysis of disasters should be part of the debate that is currently underway in international relations about redefining the concept of security in the post-Cold War world.

Central America↗
PubMed2003

Strategies of disaster response in the health care system for tropical cyclones: experience following Typhoon Nari in Taipei City.

Natural disasters present significant potential for injuries and death. Unlike the experience of Hurricane Andrew that destroyed a vast surface area in the rural countryside, Typhoon Nari in Taipei proved that significant damages from natural disasters also can happen to modern health care systems in urban areas. To ameliorate such damages, specific structural, nonstructural, and administrative issues must be taken into account. Such issues include the location of the health facility, design of the infrastructure, storage of equipment and machines, maintenance, medical, and nonmedical operations. Specific considerations, such as early evacuation and securing the safety of the patients before a disaster, should be emphasized. Recovery plans that determine how soon medical service can be restored to the community should also be established. Emphasis on emergency-response preparedness, mitigation procedures, and recovery efforts should all be included in a comprehensive emergency plan against the destruction caused by natural hazards.

Disaster Planning↗
PubMed1989

A research method for the study of psychological and psychiatric aspects of disaster.

This paper attempts to draw together some of the current questions related to the methodology of exploring the psychological and psychiatric aspects of human response to disaster. It sets out some of the key areas in which research questions might be mounted. A range of relevant instruments are suggested. The value of a structured interview which can explore issues of relevance to disaster victims is demonstrated. Early screening measures and proposals regarding these, as well as the particular instruments for longer term follow-up and assessment of outcome, are discussed in considerable detail. The article concludes with an overview of the principal issues to be addressed in methodology research, and emphasises the need for a collaborative approach using core items so that studies embracing different disasters and different countries can have some comparative basis.

Adaptation, Psychological↗
PubMedDate not supplied

Earthquake in Pakistan--The Renal Disaster Relief Task Force in action.

Following an earthquake, an International stream of help is launched. Teams of nephrologists, renal nurses and technicians from many European countries are ready as volunteers to come into action when needed. Basic help is necessary but what is the benefit of nephrologists and renal nurses, as the Renal Disaster Relief Task Force comes into action? The scouting team assesses the situation in the disaster area. Treatment of acute renal failure, hyperkalemia and Crush Syndrome can be life saving. The ability to accommodate dialysis treatment is investigated, in collaboration with local nephrologists. Belgian, French, Irish and Turkish colleagues who made up two teams, with Médecins sans Frontières (MsF) left for Pakistan following the devastating earthquake in October 2005. This is a report from one of the volunteers from the first team explaining the individual contribution that his mission made to the disaster.

Acute Kidney Injury↗
PubMed2005

Social-ecological resilience to coastal disasters.

Social and ecological vulnerability to disasters and outcomes of any particular extreme event are influenced by buildup or erosion of resilience both before and after disasters occur. Resilient social-ecological systems incorporate diverse mechanisms for living with, and learning from, change and unexpected shocks. Disaster management requires multilevel governance systems that can enhance the capacity to cope with uncertainty and surprise by mobilizing diverse sources of resilience.

Adaptation, Psychological↗
PubMed2006

Disaster and emergency communications prior to computers/Internet: a review.

When communications are needed the most desperately and most urgently, the difficulty of effecting the desired communications increases exponentially. Recent natural disasters in different parts of the world have provided eloquent testament to this. The history of disaster or emergency communications can provide us with a foundation for understanding the problems encountered today, and can offer us insight into how we might improve the systems and processes for communications. The first applications of communication technology that allowed messages to be sent more rapidly than the fastest form of transportation were mainly military in origin. This review takes us from the days of optical or visual telegraphy, through the early development of mobile and radio communications, and up to the current sophisticated technologies. We pay particular attention to the use of amateur radio operators in times of emergency, and relate their activities to those of the most effective military communications. The germane assumption made in this discussion is that any emergency or disaster communications would necessarily be involved in response and resolution of medical aspects of those emergencies.

Communication↗
PubMedDate not supplied

Disaster preparedness and response: more than major incident initiation.

To ensure an efficient and effective response to disaster situations, communities must be prepared at all levels. A disaster presents problems that go beyond the scope of major incident preparedness and requires a response that utilizes all of the available resources that a community may posses, as well as assistance from outside the affected community. In order that the optimum response to a disaster situation is forthcoming, planning must take place that ensures the appropriate response across the service spectrum, including voluntary organizations. The lessons that can be learned from non-governmental organizations in developing world contexts must also be acknowledged and incorporated into the planning process.

Disaster Planning↗