The Canadian Forces' (CF) deployable hospital, 1 Canadian Field Hospital, was deployed to Haiti after an earthquake that caused massive devastation. Two surgical teams performed 167 operations over a 39-day period starting 17 days after the index event. Most operations were unrelated to the earthquake. Replacing or supplementing the destroyed local surgical capacity for a brief period after a disaster can be a valuable contribution to relief efforts. For future humanitarian operations/disaster response missions, the CF will study the feasibility of accelerating the deployment of surgical capabilities.
In a pandemic situation, resources in intensive care units may be stretched to the breaking point, and critical care triage may become necessary. In such a situation, I argue that a patient's combined vulnerability to illness and social disadvantage should be a justification for giving that patient some priority for critical care. In this article I present an example of a critical care triage protocol that recognizes the moral relevance of vulnerability to illness and social disadvantage, from the Canadian province of Newfoundland and Labrador.
There is a common interest in Swedish society in preparing nurses well for disasters. A special course in the basic nurse education programme is devoted to disaster nursing. The aim of this study is to investigate nursing students' knowledge and views of their own action at the disaster site, both in their professional role and as private persons. The present study is a descriptive one based on the students' written answers. The result shows that the students emphasize contacting the overall disaster officer, surveying the situation and carrying out basic life-saving measures in Sweden known as the ABCs. They also stress the importance of staying calm and, to a lesser extent, seeing to the needs of the mentally shocked. Thus the nursing students seem to regard treatment of physical injuries as most important in the disaster situation.
The 2004 terror attack on a school in Beslan, North Caucasus, with more than 1300 children and their families taken hostage and 334 people killed, ended after extreme violence. Following the disaster, many survivors with blast ear injuries developed complications because no microsurgery services were available in the region. Here, we present our strategies in North Ossetia to strengthen subspecialty surgical care in a region of instable security conditions. Disaster modifies disease burden in an environment of conflict-related health-care limitations. We built on available secondary care and partnered international with local stakeholders to reach and treat victims of a humanitarian disaster. A strategy of mutual commitment resulted in treatment of all consenting Beslan victims with blast trauma sequelae and of non disaster-related patients. Credible, sustained partnerships and needs assessments beyond the immediate phases after a disaster are essential to facilitate a meaningful transition from humanitarian aid to capacity building exceeding existing insufficient standards. Psychosocial impacts of disaster might constitute a barrier to care and need to be assessed when responding to the burden of surgical disease in conflict or post-conflict settings. Involving local citizen groups in the planning process can be useful to identify and access vulnerable populations. Integration of our strategy into broader efforts might strengthen the local health system through management and leadership.
Capital Health is the largest integrated academic health district in Atlantic Canada. It provides tertiary health services to Atlantic Canadians and to 40 per cent of Nova Scotia's population. Capital Health consists of nine facilities, one of which is the Queen Elizabeth II Health Sciences Centre. The QEII is the largest adult academic health centre in Atlantic Canada, occupying 10 buildings on two sites. It employs 8500 staff and has 1075 beds. The QEII was created in 1996 with the merger of the Victoria General (VG), Halifax Infirmary (HI), Abbie J. Lane Memorial, Camp Hill Veterans' Memorial, Nova Scotia Rehabilitation Centre and the Nova Scotia Cancer Centre. There are 33 operating rooms at the HI and VG sites; together about 29,000 operations are performed there each year. The two hospitals are located about five city blocks away from each other. This article discusses how the two facilities coped after the devastation of Hurricane Juan in September 2003.
This report is a summary of a study 1 conducted at the Royal Swedish Academy of War Sciences to evaluate collaboration during crisis management. The study includes relevant legal and regulatory dynamics, as well as conclusions and recommendations. Rules and regulations of international interest are presented in the Appendix. References are limited to those of international interest.