title: Armenia 1988 earthquake and telemedicine: lessons learned and forgotten.
abstract: OBJECTIVE
  To showcase the observations and lessons learned from the first large-scale international telemedicine program addressing the medical and health consequences of disasters.
  
  
  BACKGROUND
  Almost 24 years ago a major earthquake devastated the northwestern region of Soviet Armenia. The National Aeronautics and Space Administration deployed a telemedicine spacebridge, which operated uninterrupted for 3 months, extending its services to the remote region of Ufa to help the burn victims, mostly children, from a railroad explosion accident. Expert consultations were provided by four major medical center from the United States and several military and civilian medical services of the Soviet Union.
  
  
  CONCLUSIONS
  Disasters continue to contribute to increased morbidity and mortality with significant economic impacts worldwide. Psychological, physical, and social sequelae persist years after the events. Many pre-existing socioeconomic conditions are aggravated following disasters. Telemedicine is a useful medical and public health technology that continues to be underutilized due to the lack of inclusion in the preparedness planning, training, availability of networks, and connectivity costs.
  
  
  CONCLUSIONS
  Natural and human-made disasters require both near-term and long-term interventions to reduce morbidity and mortality among the surviving victims. Telemedicine, information technology, and modern portable communication devices should be incorporated in disaster preparedness and recovery training and operations.
authors.affiliation: Center for the Study of International Medical Policies and Practices, School of Public Policy, George Mason University, Arlington, Virginia 22201, USA. anicogos@gmu.edu
authors.forename: Arnauld E
authors.initials: AE
authors.lastname: Nicogossian
authors.forename: Charles R
authors.initials: CR
authors.lastname: Doarn
mesh_terms: D001136:Armenia; D002985:Clinical Protocols; D003195:Computer Communication Networks / Q000458:organization & administration*; D004189:Disaster Planning / Q000458:organization & administration*; D055866:Earthquakes; D004632:Emergency Medical Services / Q000458:organization & administration; D006801:Humans; D012066:Relief Work / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration; D017216:Telemedicine / Q000458:organization & administration*; D013997:Time Factors; D014586:USSR; D014481:United States; D018557:United States National Aeronautics and Space Administration