San José Declaration. Pan-American Health Organization. Done at San José, Costa Rica, 4 June 1999.
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LDS Hospital in Salt Lake City found that dealing with wounded and casualties from a natural disaster is just one problem; dealing with the natural disaster itself can be a whole other problem. A great success story in the midst of this summer's terrible tornado which hit Utah's capitol.
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On the night of October 29, 1998, a fire broke out in an old warehouse in Gothenburg, where nearly 400 teenagers had gathered for a disco party. More than 200 patients were brought to four different hospitals in the region. Sixty-one people died at the scene due to inhalation of toxic fumes caused by the fire. Another two died later in the hospital due to severe burns. Disaster management in Sweden is based on mobile medical teams consisting of hospital staff supporting ambulance crews in the event of major incidents. Only one team together with a GP was able to be mobilized during this incident. Thus, medical care at the scene was limited. The principle of OEload and go pi was used, placing the major burden of triage on the hospitals. The limited numbers of medical personnel and available supplies caused major stress for the physicians involved at the scene.
This article describes the experiences of six New Orleans healthcare facilities in preparing for and coping with one of the worst potential storms in years. Some of the problems they faced were foreseen. Others were unforeseen and required considerable ingenuity to solve.
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The article focuses on methodological approaches to the determination of sanitary losses among population in a catastrophic flood. An emergency is considered that can arise in the destruction of the water-development project assemblies. The following items were taken account of in working out of the above approaches: population density in the territories found to be in the zone of flood: notification and evacuation of the population from the zone of catastrophe in a timely fashion, the distance from the site of formation of the wave of breaking to the populated locality, the height and velocity of the wave of breaking, time of the year and day of the catastrophe. Scientific and methodological approaches and the mathematical model "Povin'" ("Flood") developed with the aid of such approaches permit analyzing the situation having presented itself, working out administrative decisions for the territorial public health services directing bodies to be taken in the current situation, instituting measures designed to eliminate medicosanitary effects of the catastrophic flood within the shortest time possible.
Deployable military hospitals are frequently requested to supplement surviving local health care capabilities after disasters. Although some authors have advocated their use after mass casualty events such as earthquakes, previous reports have questioned the appropriateness of deploying these hospitals after destructive storms. These hospitals are relatively slow moving, expensive, and may require the diversion of local resources to support. After Hurricane Marilyn in 1995, a military hospital was deployed to the U.S. Virgin Islands. For a variety of reasons, the local health care community declined to use the facility once it was operational. This report is based on interviews with disaster managers and local health officials involved in the Hurricane Marilyn response. Recommendations include improving communications while requesting resources, broadening the range of available health assets to increase flexibility, positioning resources regionally or in the civilian sector, and creating clear indications for full-scale deployable hospitals when they are required.
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This statement addresses the need for professional liability insurance coverage for pediatricians during disasters and suggests measures to ensure adequate coverage.
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