title: Amputations of limbs during the 2005 earthquake in Pakistan: a firsthand experience of the author.
abstract: OBJECTIVE
  On 8 October 2005 a massive earthquake hit the northern mountainous areas of Pakistan and Kashmir causing 73,338 deaths and leaving over 125,000 severely injured. In a region which was less prepared for such an enormous disaster, mobilising rescue, relief and rehabilitation posed great challenges. The lead author (SMA) established two level 1 orthopaedic trauma and rehabilitation units in existing public hospitals through private philanthropy in the earthquake struck cities of Muzaffarabad in Kashmir and Mansehra in Khyber Pakhtun Khuwa (KPK) Province. The purpose was to combat the major catastrophe and later study the pattern of injuries especially amputations so as to improve the future strategies in similar scenarios.
  
  
  METHODS
  This is a retrospective descriptive study of patients suffering from injuries of the limbs due to the earthquake who were managed in these centres with special emphasis on the patients with amputated limbs. The patients were received, worked up, investigated and prepared for definitive surgical procedures, in this case amputations. All patients were provided assistance for the fitting of a prosthesis and rehabilitation by referring them to specialised centres.
  
  
  RESULTS
  Of 128,304 patients, 19,700 were managed in the centres established by the lead author over a period of seven months. Of these, 112 patients underwent amputations of upper and lower limbs.
  
  
  CONCLUSIONS
  In a massive calamity over a wide geographic area away from big university hospitals, such as the 2005 Pakistan earthquake, the level 1 operating theatre facilities must be established within the area to meet the needs of the patients nearest to their homes and families, and run forever so that patients can have excellent follow-up and can use the same facilities regularly. For example, in this study we managed 112 amputees and placed them in a rehabilitation programme, and transferred these centres to the hospital authorities after five years.
authors: Department of Orthopaedic Surgery and Traumatology, King Edward Medical University & Mayo Hospital, Lahore, Pakistan. drsmawais@kemu.pk
authors: Syed Muhammad
authors: SM
authors: Awais
authors: Usman Zafar
authors: UZ
authors: Dar
authors: Ayesha
authors: A
authors: Saeed
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery; D054597:Disaster Medicine / Q000458:organization & administration*; D004190:Disasters; D055866:Earthquakes; D004632:Emergency Medical Services / Q000458:organization & administration*; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D010154:Pakistan; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative