title: Earthquake disasters--lessons to be learned.
abstract: Human beings do not have the ability prevent earthquakes. However, we can take measures to minimize injuries and damage by using strict building codes and constructing infrastructures in areas of less risk. A great number of buildings in Israel, including some hospitals, will not withstand a major earthquake as they were built with inadequate standards. Data collected during earthquakes show a significant rise in cardiac-related disease and stress-related medical problems in addition to conventional injuries. Public health issues are of increasing importance due to the collapse of sanitation facilities. In addition to field clinics, field hospitals should be deployed in the vicinity of the stricken area. While planning the medical response for disasters such as earthquakes, one should take into account the availability of local medical personnel. Some or most of the local staff may be unable to function. A study from the Gulf War showed that even the threat of chemical attack resulted in less staff reporting to work [33]. During the 1999 earthquakes in Turkey, many of the hospital staff opted to care for their close families instead of reporting to work at the hospital. Regular training exercises in prehospital emergency medical services for the more common multiple casualty incidents should be bolstered with additional exercises in mass casualty incidents. The basic functions in these scenarios may be quite different. Although no exercise can mimic the real event, preplanning and drills are invaluable. When an earthquake does occur, medical management includes local search and rescue teams together with emergency medical service teams if these can still function. Early deployment of local medical centers can alleviate the burden from local hospitals. Evacuation to distant medical centers is probably a major key for success. Psychological problems are abundant in such incidences, affecting also rescue and medical teams. It becomes a major issue when there are large numbers of pediatric casualties and the operations continue for more than a few days.
authors.affiliation: Trauma and Emergency Medicine Research Unit, Gertner Institute for Health Policy Research, Tel Hashomer, Israel. kobip@gertner.health.gov.il
authors.forename: Kobi
authors.initials: K
authors.lastname: Peleg
authors.forename: Haim
authors.initials: H
authors.lastname: Reuveni
authors.forename: Michael
authors.initials: M
authors.lastname: Stein
mesh_terms: D004190:Disasters; D006801:Humans; D007858:Learning; D010346:Patient Care Management; D014947:Wounds and Injuries / Q000628:therapy*