Skip to main content
×
×
Home

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

  • Elhanan Bar-On (a1), Avi Abargel (a2), Kobi Peleg (a3) and Yitshak Kreiss (a4)
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)

Copyright
Corresponding author
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 elbar@013.net).
References
Hide All
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.
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.
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.
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/.
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/.
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.
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.
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.
9.Peleg, K, Reuveni, H, Stein, M. Earthquake disasters – lessons to be learned. Isr Med Assoc J. 2002;4:361-365.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
20.Drifmeyer, J, Llewellyn, C. Overview of overseas humanitarian, disaster, and civic aid programs. Mil Med. 2003;186(12):975-980.
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.
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.
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.
24.Alexander, D. Death and injury in earthquakes. Disasters. 1985;9(1):57-60.
25.Ramirez, M, Peek-Asa, C. Epidemiology of traumatic injuries from earthquakes. Epidemiol Rev. 2005;27:47-55.
26.Guha-Sapir, D, Carballo, M. Medical relief in earthquakes. J R Soc Med. 2000;93:59-61.
27.Lechat, MF. Disasters and public health. Bull World Health Organ. 1979;57(1):11-17.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
39.Peleg, K, Kellermann, AL. Medical relief after earthquakes: it's time for a new paradigm. Ann Emerg Med. 2012;59(3):188-190.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Disaster Medicine and Public Health Preparedness
  • ISSN: 1935-7893
  • EISSN: 1938-744X
  • URL: /core/journals/disaster-medicine-and-public-health-preparedness
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed