(A219) Development of a Hospital Disaster Plan for Countries with Limited Resources

Abstract

The Chris Hani Baragwanath Hospital (CHBH) in South Africa is the largest in the world, with 2,900 beds. Its trauma unit boasts 15 resuscitation bays, while the triage area has space for 40 stretchers. There are 5,000 trauma resuscitations performed yearly, out of 50,000 patients seen in the Trauma Emergency Department. There is an eight-bed Trauma Intensive Care Unit (ICU) and a 56-bed Trauma Ward. There also are 25 stepdown beds, 70 outlying beds, a six-bed Burn ICU, 20-bed ward, and a 24-bed shortstay ward. There are about 80 resuscitations and 70 trauma emergency operations weekly. However, the hospital is severely limited in financial and human resources, with only 2–3 interns, two registrars, and one trauma consultant on-call. The hospital is at > 130% bed occupancy. The CHBH was designated as the main disaster hospital for the 2010 FIFA World Cup, due to its proximity to the 96,000-seat Soccer City. Nominal disaster plans existed, but there were no resources, preparations, or knowledge, as was the case with most other government hospitals. The Trauma Directorate developed a new plan for the World Cup, future mass-casualty incidents at CHBH, and for other resource limited hospitals. The plans are centered on four critical issues: (1) preparedness of hospital structure and staff; (2) dissemination of the plan; (3) disaster training; and (4) the development of “Disaster Bags” for 350 casualties A free disaster course trained > 400 staff members on in-hospital triage and trauma management. All hospital staff were allocated specific functions in case of disasters. This is the first time the CHBH has had an integrated disaster plan, with separate equipment allocation, through private funding, and involving all disciplines.