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Disaster Relief and Recovery after a Landslide at a Small, Rural Hospital in Guatemala

Published online by Cambridge University Press:  28 June 2012

Ithan D. Peltan*
Affiliation:
Harvard Medical School, Boston, Massachusetts USA
*
Cannon Society280 Longwood AvenueBoston, Massachusetts 02124 USA E-mail: [email protected]

Abstract

Introduction:

Though many reports have assessed hospital emergency responses during a disaster that affected the facility's operations, relatively little work has been dedicated to identifying factors that aid or impede the recovery of such hospitals.

Problem:

On 05 October 2005, Hurricane Stan triggered landslides that buried an impoverished Mayan community in Santiago Atitlán, Guatemala. The six-bed Hospitalito Atitlán also was in the landslide's path. Though opened just months earlier, the institution maintained 24-hour services until reopening in a new facility only 15 days after the landslides.

Methods:

This qualitative study examined the Hospitalito Atitlán's disaster recovery using unstructured interviews with key hospital personnel and community members. Participant observation provided information about institutional and cultural dynamics affecting the hospital's recovery. Data were collected retrospectively during June–September 2006 and June 2007.

Results:

The Hospitalito's emergency responses and recovery were distinct endeavors that nonetheless overlapped in time. The initial 12 hours of disorganized emergency relief work was quickly succeeded by an organized effort by the institution to provide inpatient and clinic-based care to the few severely injured and many worried-well patients. As international aid started arriving 2–3 days post-landslide, the Hospitalito's 24-hour clinical services made it an integral organization in the comprehensive health response. Meanwhile, a subset of the Hospitalito's non-clinical staff initiated rebuilding efforts by Day 2 after the event, joined later by medical staff as outside aid allowed them to handoff clinical duties. Effective use of the Internet and conventional media promoted donations of money and supplies, which provided the raw materials used by a group determined to reopen their hospital.

Conclusions:

Early work by a recovery-focused team coupled with a shared understanding of the Hospitalito as an institution that transcended its damaged building drove the hospital's rapid post-emergency revival. Encouraging a similar sense of mission, emulating the Hospitalito's handling of funding and material procurement, and conducting rebuilding and relief efforts in parallel may aid recovery at other health facilities.

Type
Case Study
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1. Censo nacional 2002. Instituto Nacional de Estadistica de Guatemala. 2002. Available at http://www.ine.gob.gt/index.php/demografia-y-poblacion/42-demografiaypoblacion/75-censo2002. Accessed 28 June 2008.Google Scholar
2. Schram, J, Etzel, N: Assessing community health in a Tz'tujil Maya village upon the reconstruction of Hospitalito Atitlán. University of Pennsylvania Guatemala Health Initiative. Available at http://www.med.upenn.edu/ghi/documents/community. pdf. Accessed 15 March 2008.Google Scholar
3. Encuesta nacional sobre condiciones de vida (ENCOVI) 2006.Instituto Nacional de Estadística de Guatemala.2006. Available at http://www.ine.gob.gt/index.php/sociedad/44-sociedad/127-encuesta-nacional-de-condiciones-de-vida-encovi-2006. Accessed 28 June 2008.Google Scholar
4. Carlsen, RS: The War for the Heart and Soul of a Highland Maya Town. Austin, Texas: University of Texas Press, 1997.Google Scholar
5. Southerland, D: When tourists and guerrillas share a town. Christian Science Monitor 12 December 1980:B1.Google Scholar
6. Christian, S: Santiago Atitlán journal: Routed by village's rage, a feared army retreates. New York Times 12 December 1991: A4.Google Scholar
7. Wind, AJA, Bickel, D, Rasmussen, B: Project Concern International mid-term evaluation of Child Survival VII project: Children of the Highlands, Sololà, Guatemala.USAID.2003.Report No.: PDC-O5OO-A-00-1042-00. Available at http://pdf.usaid.gov/pdf_docs/PDABR755.pdf. Accessed 15 March 2008.Google Scholar
8. Pasch, RJ, Roberts, DP: Tropical cyclone report: Hurricane Stan, 1–5 October 2005. National Weather Service, National Hurricane Center. 14 February 2006. Available at http://www.nhc.noaa.gov/pdf/TCR-AL202005_Stan.pdf. Accessed 15 March 2008.Google Scholar
9. Instituto Nacional de Sismología, Vulcanología, Meteorología e Hidrología: Resumado del impacto al Hurucan “Stan” en Guatemala. Instituto Nacional de Sismología, Vulcanología, Meteorología e Hidrología. 2005. Available at http://www.insivumeh.gob.gt/folletos/Informe_STAN.pdf. Accessed 15 March 2008.Google Scholar
10. Girón, GR, Matías, O: Evaluación del alud tipo lahar que soterró al cantón de Panabaj y afectación del canón de Tzanchag, municipio de Santiago Atitlàn, Sololà, Guatemala. Instituto Nacional de Sismología, Vulcanología, Meteorología e Hidrología.2006. Available at http://www.insivumeh.gob.gt/folletos/Alud%20de%20Panabaj%20y%20Tzanchag%20de%20Santiago%20de%20Atitlan.pdf. Accessed 23 March 2008.Google Scholar
11. Chavarría, MAM, Galicia, O: Caracterización de los flujos de lodo y escombros que afectaron la cabecera munipal de Santiago Atitlàn (Sololà) en octubre de 2005. CONRED. January, 2006. Available at http://www.conred.org/riesgo/evaluaciones/Flujos%20SAtitl%E1n.pdf. Accessed 12 March 2008.Google Scholar
12. Girón, GR, Matías, O: Pequeño tsunami (seiche) en la bahía de Santiago, Lago de Atitlàn, Sololà, Guatemala. Instituto Nacional de Sismología, Vulcanología, Meteorología e Hidrología.2006. Available at http://www.insivumeh.gob.gt/folletos/Pequeno_Tsunami_en_la_Bahia_de_Santiago_Atitlan.pdf. Accessed 12 June 2008.Google Scholar
13. Noji, EK: The Public Health Consequences of Disasters. New York: Oxford University Press, 1997.Google Scholar
14. Spiegel, PB: Differences in world responses to natural disasters and complex emergencies. JAMA 2005;293:19151918.CrossRefGoogle ScholarPubMed
15. Lautze, S, Leaning, J, Raven-Roberts, A, et al. : Assistance, protection, and governance networks in complex emergencies. Lancet 2004;364:21342141.CrossRefGoogle ScholarPubMed
16. Terry, F: Condemned to Repeat? The Paradox of Humanitarian Action. Ithaca: Cornell University Press, 2002.Google Scholar
17. De Waal, A: Famine Crimes: Politics and the Disaster Relief Industry in Africa. Indiana University Press, 1997.Google Scholar
18. Rieff, D: A Bed for the Night: Humanitarianism in Crisis. New York, NY: Simon & Schuster, 2002.Google Scholar
19. Kaji, AH, Koenig, KL, Lewis, RJ: Current hospital disaster preparedness. JAMA 2007;298:21882190.CrossRefGoogle ScholarPubMed
20. De Lorenzo, RA: Financing hospital disaster preparedness. Prehosp Disaster Med 2007;22:436439.CrossRefGoogle ScholarPubMed
21. Johannigman, JA: Disaster preparedness: It's all about me. Crit Care Med 2005;33:s22–s28.CrossRefGoogle ScholarPubMed
22. Toole, MJ, Waldman, RJ: Prevention of excess mortality in refugee and displaced populations in developing countries. JAMA 1990;263:32963302.CrossRefGoogle ScholarPubMed
23. Salama, P, Spiegel, P, Talley, L, et al. : Lessons learned from complex emergencies over past decade. Lancet 2004;364:18011813.CrossRefGoogle ScholarPubMed
24. Wattanawaitunechai, C, Peacock, SJ, Jitpratoom, P: Tsunami in Thailand—Disaster management in a district hospital. N Engl J Med 2005;352:962–964.CrossRefGoogle ScholarPubMed
25. Abolghasemi, H, Radfar, MH, Khatami, M, et al. : International medical response to a natural disaster: Lessons learned from the Bam earthquake experience. Prehosp Disaster Med 2006;21:141147.CrossRefGoogle ScholarPubMed
26. Sariego, J: A year after Hurricane Katrina: Lessons learned at one coastal trauma center. Arch Surg 2007;142:203205.CrossRefGoogle ScholarPubMed
27. Berggren, RE, Curiel, TJ: After the storm—Health care infrastructure in post-Katrina New Orleans. N Engl J Med 2006;354:15491552.CrossRefGoogle ScholarPubMed
28. Akbari, ME, Farshad, AA, Asadi-Lari, M: The devastation of Bam: An overview of health issues 1 month after the earthquake. Public Health 2004;118:403408.CrossRefGoogle ScholarPubMed
29. Lis, J, Eliades, MJ, Benishi, D, et al. : Post-war Kosovo part 3: Development and rehabilitation of emergency services. Prehosp Disaster Med 2001;16:275280.CrossRefGoogle ScholarPubMed
30. Médecins sans Frontières:Work to treat polluted waters after Hurricane Stan. Available at http://www.msf.org/msfinternational/invoke.cfm?objectid=26A3CF63-E018-0C72-094D870A5A112287&component=toolkit.article&method=full_html. Accessed 02 February 2008.Google Scholar
31. Hospitalito Atitlàn: In Pueblo a Pueblo. Available at http://www.puebloapueblo. org/ha.html. Accessed 15 October 2005.Google Scholar
32. Smith-Spark, L: Hospital hope for mudslide town. 23 October 2005. In BBC. Available at http://news.bbc.co.uk/go/pr/fr/-/2/hi/americas/4351674.stm. Accessed 23 February 2008.Google Scholar
33. Enriquez, S: Newly resurrected Guatemalan hospital a victim of deadly storms. Los Angeles Times 13 October 2005: A3.Google Scholar
34. Stephenson, RS, DuFrane, C: Disasters and development (Part 1): Relationships between disasters and development. Prehosp Disaster Med 2002;17:110115.CrossRefGoogle Scholar
35. Stephenson, RS, DuFrane, C: Disasters and development (Part 2): Understanding and exploiting disaster-development linkages. Prehosp Disaster Med 2002;17:170174; quiz 174–175.CrossRefGoogle ScholarPubMed
36. Stephenson, RS, DuFrane, C: Disasters and development (Part 1): Understanding and exploiting disaster-development linkages. Prehosp Disaster Med 2005;20:6164; quiz 64–65.CrossRefGoogle ScholarPubMed
37. Sternberg, E, Lee, GC, Huard, D: Counting crises: US hospital evacuations, 1971–1999. Prehosp Disaster Med 2004;19:150157.CrossRefGoogle ScholarPubMed
38. Sternberg, E: Planning for resilience in hospital internal disaster. Prehosp Disaster Med 2003;18:291299.CrossRefGoogle ScholarPubMed
39. Hospitals Safe from Disasters: Reduce risk, protect health facilities, save lives. In Pan American Health Organization. Available at http://safehospitals.info. Accessed 22 June 2008.Google Scholar
40. Qureshi, K, Gershon, RR, Sherman, MF, et al. : Health care workers' ability and willingness to report to duty during catastrophic disasters. J Urban Health 2005;82:378388.CrossRefGoogle ScholarPubMed
41. Iserson, KV, Heine, CE, Larkin, GL, et al. : Fight or flight: The ethics of emergency physician disaster response. Ann Emerg Med 2008;51:345353.CrossRefGoogle ScholarPubMed
42. Berckmans, P, Dawans, V, Schmets, G, et al. : Inappropriate drug-donation practices in Bosnia and Herzegovina, 1992 to 1996. N Engl J Med 1997;337:18421845.CrossRefGoogle ScholarPubMed
43. Berggren, RE: Adaptations. N Engl J Med 2006;354:1, 550–1, 551.CrossRefGoogle ScholarPubMed
44. Eaton, L: Hospitals mirror New Orleans's devastation. International Herald Tribune 24 July 2007:A4.Google Scholar
45. Pan American Health Organization: Reestablishing normal health programs. Natural disasters: Protecting the public's health. Washington, DC: PAHO, 2000, pp 9192.Google Scholar