Emergency response and medical rescue in the worst hit Mianyang areas after the Wenchuan earthquake

Operational Health Pavilions in Mass Disasters: Lessons Learned from the 2023 Earthquake in Turkey and Syria

The massive earthquake that hit Turkey and Syria in February 2023 killed tens of thousands of people, and most of the deceased have not yet been identified. Many victims were pulled from the rubble hours or days later, injured and in need of assistance, treatment, and food, and many have not yet been connected with their families. Armed forces, volunteers, technicians, and health workers must cooperate in synergy in these situations to ensure effective interventions and to improve resilience. Based on the lessons learned from the response efforts to this recent natural catastrophe, this brief report proposes, for the first time, an organisational model structured around five functional pavilions that can be safely set up at the edge of a disaster area. Each pavilion should run its own activities to make a vital contribution to the overall coordinated emergency response. Looking to the future, it is extremely important to apply a technical approach that leads to maximum operational synergy at a disaster site and during the first phase of a sudden-onset emergency.

Resource-poor settings: response, recovery, and research: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement

BACKGROUND

Planning for mass critical care in resource-poor and constrained settings has been largely ignored, despite large, densely crowded populations who are prone to suffer disproportionately from natural disasters. As a result, disaster response has been suboptimal and in many instances hampered by lack of planning, education and training, information, and communication.

METHODS

The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of the disaster cycle (mitigation/preparedness/response/recovery). Literature searches were conducted to identify evidence to answer the key questions in these areas. Given a lack of data on which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process.

RESULTS

The five key questions were as follows: definition, capacity building and mitigation, what resources can we bring to bear to assist/surge, response, and reconstitution and recovery of host nation critical care capabilities. Addressing these led the panel to offer 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part I, Infrastructure/Capacity in the accompanying article, and part II, Response/Recovery/Research in this article.

CONCLUSIONS

A lack of rudimentary ICU resources and capacity to enhance services plagues resource-poor or constrained settings. Capacity building therefore entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is often needed to mount a surge response. Moreover, the disengagement of these responding groups and host country recovery require active planning. Future improvements in all phases require active research activities.

Health education and promotion at the site of an emergency: experience from the Chinese Wenchuan earthquake response

Theories and strategies of social mobilization, capacity building, mass and interpersonal communication, as well as risk communication and behavioral change were used to develop health education and promotion campaigns to decrease and prevent injuries and infectious diseases among the survivors of the Wenchuan earthquake in May 2008. We evaluated the effectiveness of the campaigns and short-term interventions using mixed-methods. The earthquake survivors' health knowledge, skills, and practice improved significantly with respect to injury protection, food and water safety, environmental and personal hygiene, and disease prevention. No infectious disease outbreaks were reported after the earthquake, and the epidemic level was lower than before the earthquake. After a short-term intervention among the students of Leigu Township Primary and Junior School, the proportion of those with personal hygiene increased from 59.7% to 98.3% (p< 0.01). Of the sampled survivors from Wenchuan County, 92.3% reported to have improved their health knowledge and 54.9% improved their health practice (p< 0.01). Thus, health education and promotion during public health emergencies such as earthquakes play an important role in preventing injuries and infectious diseases among survivors.

The Operating Room During a Severe Earthquake: Lessons From the 2011 Great East Japan Earthquake

OBJECTIVE

The Great East Japan Earthquake occurred at 14:46 on March 11, 2011, producing serious and widespread damage. To assess damages in hospital operating departments during and after the earthquake, we surveyed hospitals in this region.

METHODS

Questionnaires were sent to 415 acute care hospitals in Tohoku and east Kanto areas. The questionnaires elicited the number of perioperative patients when the earthquake hit, obstacles to continuing surgery, structural and nonstructural damage to the operating department, and the effect on routine surgery after the earthquake.

RESULTS

Of the 213 hospitals (51%) that completed questionnaires, 474 patients were undergoing operations during the earthquake, and 222 operations were canceled afterward. Risk factors for continuing operations, as reported by 102 hospitals, were tremors and electrical blackouts (odds ratio [OR]: 79.3 and 110.5; P < .01). In 154 hospitals, difficulties in performing operations after the earthquake were reported. Significant obstacles to the management of operations after the earthquake were characterized by infrastructure disorder scores, seismic intensity, disruption of electrical power and air conditioning, and damage to out-of-hospital telecommunications (OR, 0.46; P = .04).

CONCLUSIONS

Tremors and electrical blackouts were important risk factors for performing operations. Nonstructural damage, especially to out-of-hospital telecommunications, affected the management of the operating rooms. Hospital logistics are very important to achieve appropriate disaster management. (Disaster Med Public Health Preparedness. 2014;0:1-7).

Lessons learned from the Wenchuan earthquake

OBJECTIVES

To conclude experience and lessons from emergency medical rescue after Wenchuan Earthquake from national and overall review for consideration on worldwide catastrophe rescue in the future.

METHODS

To systematically collect huge amount of primary data, and to make analysis, draw conclusions and lessons in terms of five aspects respectively as quake-damage conditions, command system, emergency medical rescue, prevention and control over infectious diseases as well as pairing-assistance for medical system and service reconstruction.

RESULTS

1. Numbers as of the death, injured and migrants made Wenchuan Earthquake ranked one of the top 9 catastrophes around the world during the past two decades. 2. Countermeasures such as four-level linkage by nation-province-city-county model, mutual assistance between military force and local forces, frontline commanding did effectively ensure the dispatch and cooperation among rescue forces. 3. Three-leveled medical transfers, "four concentrations" prevention and treatment besides whole-course rehabilitation at early stage managed to lower mortality and disability rate to minimum levels respectively. 4. "Four-keynote infectious disease control" under whole coverage and "five measures and four reinforcement measures" in settlements made rates as for those infectious diseases under the average level as those in the 3 pre-quake years. 5. Pairing-assistance in terms of talents, finance, materials as well as capacity building between other 18 provinces/municipalities and those 18 extremely-stricken/severely-stricken areas in Sichuan Province guaranteed efficient post-quake reconstruction, system reconstruction and long-term mechanism construction.

CONCLUSIONS

Successful experience from Wenchuan Earthquake could be summarized as: one goal as people-oriented life-rescuing. Two tasks as medical rescue for diseases of those injured and healthcare & anti-epidemic for safe and sound of those lives. Three strategies respectively as medical transfers after on-site triage, treatment for severe diseases in quake-hit areas and rehabilitation in non quake-hit areas for medical rescue, and quick post-quake evaluation, quick promotion for whole coverage and scientific regulation in long term for healthcare & anti-epidemic. Four measures as concentration for patients, experts, resources and treatment respectively for medical rescue, and key regions, key groups, key infectious diseases and key steps for healthcare & anti-epidemic. Five links as overall commanding, medical rescue, healthcare and anti-epidemic, physical/mental rehabilitation and post-quake reconstruction. And whole course surveillance as information guidance, policy guarantee, data collection, evidence producing, effectiveness evaluation, and academic communication.