The Gujarat earthquake (2001) experience in a seismically unprepared area: community hospital medical response.
BACKGROUND
At 08:53 hours on 26 January 2001, an earthquake measuring 6.9 on the Richter scale devastated a large, drought-affected area of northwestern India, the state of Gujarat. The known number killed by the earthquake is 20,005, with 166,000 injured, of whom 20,717 were "seriously" injured. About 370,000 houses were destroyed, and another 922,000 were damaged.


METHODS
A community health worker using the local language interviewed all of the patients admitted to the Gandhi-Lincoln hospital with an on-site, oral, real-time, Victim Specific Questionnaire (VSQ).


RESULTS
The census showed a predominance of women, children, and young adults, with the average age being 28 years. The majority of the patients had other family members who were also injured (84%), but most had not experienced deaths among family members (86%). Most of the patients (91%) had traveled more than 200 kilometers using their family cars, pick-ups, trucks, or buses to reach the buffer zone hospitals. The daily hospital admission rate returned to pre-event levels five days after the event, and all of the hospital services were restored by nine days after the quake. Most of the patients (83%) received definitive treatment in the buffer zone hospitals; 7% were referred to tertiary-care centers; and 9% took discharge against medical advice. The entrapped village folk with their traditional architecture had lesser injuries and a higher rescue rate than did the semi-urban townspeople, who were trapped in collapsed concrete masonry buildings and narrow alleys. However, at the time of crisis, aware townspeople were able to tap the available health resources better than were the poor. There was a low incidence of crush injuries. Volunteer doctors from various backgrounds teamed up to meet the medical crisis. International relief agencies working through local groups were more effective. Local relief groups needed to coordinate better. Disaster tourism by various well-meaning agencies took a toll on the providers. Many surgeries may have contributed to subsequent morbidity.


CONCLUSIONS
The injury profile was similar to that reported for most other daytime earthquakes. Buffer zone treatment outcomes were better than were the field and damaged hospital outcomes.
Roy
Nobhojit
N
BARC Hospital, Anushaktinagar, Mumbai, India. roy@archsfa.com
Shah
Hemant
H
Patel
Vikas
V
Coughlin
R Richard
RR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004190:Disasters; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005191:Family Characteristics; D006764:Hospitals, Community / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008875:Middle Aged; D012066:Relief Work; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality