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To have or to be: ways of caregiving identified during recovery from the earthquake disaster in Taiwan.

The aim of this article is to report the results of therapy sessions conducted with survivors of an earthquake that struck Luku Township in Nantou County, central Taiwan, in September 1999. The sessions explored survivors' feelings, interactions, and interpretations of the crisis, as well as their roles in post-earthquake relief efforts. The participants were teachers and administrators from four primary schools. The results indicated three distinct forms of caring, namely: encumbered caring, connected caring, and reflected caring. The findings were used to construct a framework for caregiver self-monitoring. They also suggest that therapy groups provide an inner space that self-regulates the frustrations arising from this type of experience, for both caregivers and survivors. The intrasubjective and intersubjective dialogues within the groups are essentially reflective practices for improving services and generating new knowledge about medical ethics.

Caregivers↗

Operation Nightingale: the role of BMH Dharan following the 1988. Nepal earthquake, and some observations on Third World earthquake disaster relief missions.

Following a large earthquake in Nepal, the experience of a small hospital in dealing with the resulting mass casualties is described. The value of pre-planning and effective triage of the injured is stressed, and aspects of surgical and medical care specific to earthquake victims discussed. Clinical and administrative challenges encountered in mounting a major relief exercise in a Third World setting are also described. frequent exercising of military hospitals and personnel in handling mass casualties is an applicable to civilian natural catastrophies as to battlefield medical support.

Developing Countries↗

Hurricanes Katrina and Rita: role of individuals and collaborative networks in mobilizing/coordinating societal and professional resources for major disasters.

The medical support for the coordinated effort for Harris County Texas (Houston) to rescue evacuees from New Orleans following Hurricane Katrina was part of an integrated collaborative network. Both public health and operational health care was structured to custom meet the needs of the evacuees and to create an exit strategy for the clinic and shelter. Integrating local hospital and physician resources into the Joint Incident Command was essential. Outside assistance, including federal and national resources must be coordinated through the local incident command.

Cooperative Behavior↗