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Field hospitals are a vital element in providing as many medical services as possible to a stricken population in times of disaster. Setting up a field hospital with advanced auxiliary medical services is possible as long as there is comprehensive and careful planning, training, and preparation done ahead of time. The main objective of the AMS department is to organize and assist in establishing the field hospital, ensure its smooth and efficient operation throughout the stay, and, at the close of a mission to disassemble the equipment for its return journey and then ensure it is in optimum working order for the next call up. The department is responsible for maintaining all medical devices in perfect working order with the focus being on safety compliance and patient welfare. The four core services provided by the department cover medical engineering, medical equipment and pharmacy, diagnostic imaging, and the clinical laboratory. All these services operate according to a predetermined workflow and clear working guidelines. In keeping with the goals of the humanitarian mission, the medical engineering service will handle the acquisition and maintenance of equipment capable of functioning in an electricity free environment. They will verify that all devices are robust and capable of operating under extreme weather conditions and comply with any specifications mandated by the different countries. The pharmacy service plays a vital role in ensuring medicine and its accompanying information is handled efficiently and safely. Data is accrued over the span of a mission to assist with ever more accurate future planning. The diagnostic imaging service must be able to provide both investigative and diagnostic examinations. This service is agile and can be provided in an imaging department tent, a dedicated container unit or bedside for patients who are not to be moved. The clinical laboratory service performs a full array of tests that facilitate in diagnosis and treatment of the patient. The services provided by the laboratory include biochemistry, hematology, and microbiology. The laboratory diagnoses the pathogens in infectious diseases and identifies the type of bacteria and its susceptibility to various antibiotics.
Typhoon Haiyan partially destroyed the Ormoc District Hospital in the Philippines. A field hospital was established to replace its outpatient department for 5 weeks. We investigated the reasons for medical consultation in the field hospital.
Methods:
We described the consultations by sex, age, week, and diagnosis according to the Surveillance in Post-Extreme Emergencies and Disasters system. We compared the number and proportion of upper respiratory tract infections (URTIs) with a control season in 2014.
Results:
We included 6785 consultations, 55.9% from women. The majority of consultations were communicable diseases (88.2%) followed by noncommunicable (7.1%) and injuries (5.6%). Males suffered more often from injuries than women (66.0% vs 34.0%). Consultations due to injuries decreased from 10.0% in the first to 2.9% in the last week. The most frequent diagnosis over the study period was acute respiratory infections (ARIs) (73.1%), of which 83.0% were children. The number of daily URTIs was higher than in a similar 2014 period.
Conclusions:
ARI was the most prevalent diagnosis. We recommend ARI treatments being fully accessible after such a disaster. During the first week, injury prevention should focus on adult men. Studies after natural disasters should include control periods to better understand disease distribution, ultimately improving the prioritization in disasters.
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