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Coping with the Challenges of Early Disaster Response: 24 Years of Field Hospital Experience After Earthquakes

Published online by Cambridge University Press:  18 October 2013

Elhanan Bar-On ,
Avi Abargel ,
Kobi Peleg  and
Yitshak Kreiss
Elhanan Bar-On*
Affiliation:
Schneider Children's Medical Center, Petah Tikva and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Avi Abargel
Affiliation:
Israel Defense Forces Medical Corps, Israel
Kobi Peleg
Affiliation:
Department of Disaster Management, School of Public Health, Sackler Medical School, Tel Aviv University, Tel Aviv, and Gertner Institute for Health Policy and Epidemiology, Israel
Yitshak Kreiss
Affiliation:
Israel Defense Forces Medical Corps and Hebrew University Faculty of Medicine, Department of Military Medicine, Israel
*
Address correspondence and reprint requests to Elhanan Bar-On, MD, MPH, Pediatric Orthopedic Unit, Schneider Children's Medical Center, 14 Kaplan St, Petah Tikva 49202, Israel (e-mail [email protected]).
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Abstract

Objective

To propose strategies and recommendations for future planning and deployment of field hospitals after earthquakes by comparing the experience of 4 field hospitals deployed by The Israel Defense Forces (IDF) Medical Corps in Armenia, Turkey, India and Haiti.

Methods

Quantitative data regarding the earthquakes were collected from published sources; data regarding hospital activity were collected from IDF records; and qualitative information was obtained from structured interviews with key figures involved in the missions.

Results

The hospitals started operating between 89 and 262 hours after the earthquakes. Their sizes ranged from 25 to 72 beds, and their personnel numbered between 34 and 100. The number of patients treated varied from 1111 to 2400. The proportion of earthquake-related diagnoses ranged from 28% to 67% (P < .001), with hospitalization rates between 3% and 66% (P < .001) and surgical rates from 1% to 24% (P < .001).

Conclusions

In spite of characteristic scenarios and injury patterns after earthquakes, patient caseload and treatment requirements varied widely. The variables affecting the patient profile most significantly were time until deployment, total number of injured, availability of adjacent medical facilities, and possibility of evacuation from the disaster area. When deploying a field hospital in the early phase after an earthquake, a wide variability in patient caseload should be anticipated. Customization is difficult due to the paucity of information. Therefore, early deployment necessitates full logistic self-sufficiency and operational versatility. Also, collaboration with local and international medical teams can greatly enhance treatment capabilities. (Disaster Med Public Health Preparedness. 2013;0:1–8)

Keywords

disasterearthquakefield hospital
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 5 , October 2013 , pp. 491 - 498
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

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References

1.Schulz, CH, Deynes, S. Earthquakes. In: Koenig KL, Schultz CH, eds. Disaster Medicine: Comprehensive Treatment and Practices. New York, New York: Cambridge University Press; 2010:562-577.Google Scholar
2.Guha-Sapir, D, Vos, F. Earthquakes, an epidemiologic perspective on patterns and trends. In: Spence R, So E, Scawthorn C, eds. Human Casualties in Earthquakes. New York, New York: Springer; 2011:13-24.CrossRefGoogle Scholar
3. US Geological Survey. Historic earthquakes: notes about the Armenia earthquake, 7 December 1988. Washington, DC: US Geological Survey. http://earthquake.usgs.gov/earthquakes/world/events/1988_12_07_ev.php.Google Scholar
4. US Geological Survey. Historic earthquakes: magnitude 7.6 Turkey, August 17, 1999 00:01:39 UTC. Washington, DC: US Geological Survey. http://neic.usgs.gov/neis/eq_depot/1999/eq_990817/.Google Scholar
5. US Geological Survey. Historic earthquakes: magnitude 7.7 India, 2001 January 26 03:16:40 UTC. Washington, DC: US Geological Survey. http://neic.usgs.gov/neis/eq_depot/2001/eq_010126/.Google Scholar
6. US Geological Survey. Magnitude 7.0 Haiti region. 2010 January 12 21:53:10 UTC. Washington, DC: US Geological Survey. http://earthquake.usgs.gov/earthquakes/eqinthenews/2010/us2010rja6/#details.Google Scholar
7. Pan American Health Organization, World Health Organization. WHO-PAHO Guidelines for the Use of Foreign Field Hospitals in the Aftermath of Sudden-Impact Disasters. San Salvador, July 2003. Washington, DC: Pan American Health Organization; 2003.Google Scholar
8. WHO-PAHO: Proceedings of the WHO-PAHO Technical Consultation on Foreign Medical Teams (FMTs) Post Sudden Onset Disasters (SODs); December 7-9, 2010; Havana, Cuba.Google Scholar
9.Peleg, K, Reuveni, H, Stein, M. Earthquake disasters – lessons to be learned. Isr Med Assoc J. 2002;4:361-365.Google ScholarPubMed
10.Sommaruga, C. Strengthening the coordination of emergency humanitarian assistance: humanitarian policy and operational activities. Int Red Cross. Feb 28, 1995; No. 304. http://www.cicr.org/eng/resources/documents/misc/57jmc3.htm.CrossRefGoogle Scholar
11.Armenian, HK, Melkonian, A, Noji, EK, Hovanesian, AP. Deaths and injuries due to the earthquake in Armenia: a cohort approach. Int J Epidemiol. 1997;26(4):806-813.CrossRefGoogle Scholar
12. Marza VI. On the death toll of the 1999 Izmit (Turkey) major earthquake. Brasilia, Brazil: University of Brasilia; 2004. http://www.esc-web.org/papers/potsdam_2004/ss_1_marza.pdf.Google Scholar
13.Phalkey, R, Reinhardt, JD, Marx, M. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster. Glob Health Action. 2011;4:7196.CrossRefGoogle Scholar
14. Schwartz T. Haiti's questionable earthquake death toll. Open Salon website; May 30, 2011. http://open.salon.com/blog/timotuck/2011/05/29/haitis_questionable_earthquake_death_toll.Google Scholar
15.Noji, EK, Kelen, GD, Armenian, HK, Organessian, A, Jones, NP, Sivertson, KT. The 1988 earthquake in Soviet Armenia: a case study. Ann Emerg Med. 1990;19(8):891-897.CrossRefGoogle ScholarPubMed
16.Bar-Dayan, Y, Beard, P, Mankuta, D, etal. An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces field hospital in Adapazari. Disasters. 2000;24(3):262-270.CrossRefGoogle ScholarPubMed
17.Bremer, R. Policy development in disaster preparedness and management: lessons learned from the January 2001 earthquake in Gujarat, India. Prehosp Disaster Med. 2003;18(4):372-384.CrossRefGoogle ScholarPubMed
18.Kreiss, Y, Merin, O, Peleg, K, etal. Early disaster response in Haiti: the Israeli field hospital experience. Ann Intern Med. 2010;153(1):45-48.CrossRefGoogle ScholarPubMed
19.Peleg, K, Kreiss, Y, Ash, N, Lipsky, AM. Optimizing medical response to large-scale disasters: the ad hoc collaboration health care system. Ann Surg. 2011;253(2):421-423.CrossRefGoogle Scholar
20.Drifmeyer, J, Llewellyn, C. Overview of overseas humanitarian, disaster, and civic aid programs. Mil Med. 2003;186(12):975-980.CrossRefGoogle Scholar
21.Morton, MJ, Burnham, GM. Dilemmas and controversies within civilian and military organizations in the execution of humanitarian aid in Iraq: a review. Am J Disaster Med. 2010;5(6):385-391.CrossRefGoogle ScholarPubMed
22.Lhowe, DW, Briggs, SM. Planning for mass civilian casualties overseas: IMSuRT—International Medical/Surgical Response Teams. Clin Orthop Relat Res. 2004;(422):109-113.CrossRefGoogle ScholarPubMed
23.Macintyre, AG, Barbera, JA, Smith, ER. Surviving collapsed structure entrapment after earthquakes: a “time-to-rescue” analysis. Prehosp Disast Med. 2006;21(1):4-19.CrossRefGoogle ScholarPubMed
24.Alexander, D. Death and injury in earthquakes. Disasters. 1985;9(1):57-60.CrossRefGoogle ScholarPubMed
25.Ramirez, M, Peek-Asa, C. Epidemiology of traumatic injuries from earthquakes. Epidemiol Rev. 2005;27:47-55.CrossRefGoogle ScholarPubMed
26.Guha-Sapir, D, Carballo, M. Medical relief in earthquakes. J R Soc Med. 2000;93:59-61.CrossRefGoogle ScholarPubMed
27.Lechat, MF. Disasters and public health. Bull World Health Organ. 1979;57(1):11-17.Google ScholarPubMed
28.Gutiérrez, E, Taucer, F, De Groeve, T, Al-Khudhairy, DH, Zaldivar, JM. Analysis of worldwide earthquake mortality using multivariate demographic and seismic data. Am J Epidemiol. 2005;161(12):1151-1158.CrossRefGoogle ScholarPubMed
29.De Ville de Goyet, C. Earthquake in Guatemala: epidemiological evaluation of the relief effort. Bull Pan Am Health Organ. 1976;10(2):95-109.Google ScholarPubMed
30.Chu, K, Stokes, C, Trelles, M, Ford, N. Improving effective surgical delivery in humanitarian disasters: lessons from Haiti. PLoS Med. 2011;8(4):e1001025.Google ScholarPubMed
31.Abolghasemi, H, Radfar, MH, Khatami, M, Nia, MS, Amid, A, Briggs, SM. International medical response to a natural disaster: lessons learned from the Bam earthquake experience. Prehosp Disaster Med. 2006;21(3):141-147.CrossRefGoogle ScholarPubMed
32.von Schreeb, J, Riddez, L, Samnegard, H, Rosling, H. Foreign field hospitals in the recent sudden-onset disasters in Iran, Haiti, Indonesia and Pakistan. Prehosp Disaster Med. 2008;23(2):144-153.CrossRefGoogle ScholarPubMed
33.Bar-On, E, Lebel, E, Kreiss, Y, etal. Orthopedic management in a mega mass casualty situation: the Israel Defense Forces field hospital in Haiti following the January 2010 earthquake. Injury. 2011;42(10):1053-1059.CrossRefGoogle Scholar
34.Mulvey, JM, Awan, SU, Qadri, AA, Maqsood, MA. Profile of injuries arising from the 2005 Kashmir earthquake: the first 72 h. Injury. 2008;39:554-560.CrossRefGoogle ScholarPubMed
35.Sami, F, Ali, F, Zaidi, SH, Rehman, H, Ahmad, T, Siddiqui, MI. The October 2005 earthquake in Northern Pakistan: pattern of injuries in victims brought to the Emergency Relief Hospital, Doraha, Manshera. Prehosp Disaster Med. 2009;24(6):535-539.CrossRefGoogle Scholar
36.Yang, C, Wang, H, Zhong, H, etal. The epidemiologic analyses of trauma patients in Chongqing teaching hospitals following the Wenchuan earthquake. Injury. 2009;40:488-492.CrossRefGoogle ScholarPubMed
37.Helminen, M, Saarela, E, Salmela, J. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the first three weeks of operation. Emerg Med J. 2006;23:654-656.CrossRefGoogle ScholarPubMed
38.Roy, N, Shah, H, Patel, V, Coughlin, RR. The Gujarat earthquake (2001) experience in a seismically unprepared area: community hospital medical response. Prehosp Disaster Med. 2002;17(4):186-195.CrossRefGoogle Scholar
39.Peleg, K, Kellermann, AL. Medical relief after earthquakes: it's time for a new paradigm. Ann Emerg Med. 2012;59(3):188-190.CrossRefGoogle ScholarPubMed