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.
Most of the data on psychological outcome and the mental health treatment available following natural disasters originate from the indigenous population of the region destroyed. Examining tourists returning from the area affected by the 2004 tsunami presents an opportunity of studying the impact of natural disasters on psychological outcome and mental health treatment in their countries of origin. The aim of the present study was to extend the current knowledge on psychiatric morbidity and potential positive outcomes, as well as subsequent mental health treatment following a natural disaster, based on the results from a sample of home-coming Swiss tourists.
Tourists who had been potentially affected by the 2004 tsunami were assessed using the Post-traumatic Diagnostic Scale, the Hospital Anxiety and Depression Scale, and the Post-traumatic Growth Inventory. Outcome variables were related to the degree of tsunami exposure. In addition, mental health treatment before and after the tsunami was assessed.
Of the 342 respondents, 55 (16.8%) fulfilled the criteria of post-traumatic stress disorder (PTSD). Evidence of anxiety or depressive disorder was found in 17.8% and 8.0%, respectively. The tsunami victims who had been directly affected showed significantly more symptoms of anxiety, depression and PTSD, as well as post-traumatic personal growth, than tourists who were indirectly affected or unaffected. A total of 12.3% of untreated respondents fulfilled the criteria for PTSD and 38% of respondents who had received psychiatric treatment were still fulfilling PTSD criteria 2(1/2) years after the tsunami.
A marked percentage of respondents reported symptoms of PTSD but they remained untreated or were treated insufficiently. We recommend that tourists returning from regions affected by natural disasters be informed about PTSD and that careful screening be given to those found to be at risk of PTSD. An open-door policy of mental health services is particularly needed for tourists returning home who have been affected by large-scale disasters.
The information about foundation, development and main areas of activity of All-Russian Service for Disaster Medicine is given. Almost 20 years professional staff members help to save lives and health of people injured in emergency situations in Russia and other countries. There are 81 territorial centers for disaster medicine. The main center is All-Russian center for disaster medicine Zaschita. Its organizational structure, performance indexes including development of information and communication technology, telehealth, organization of firs-aid in a traffic collision are considered. The main ways of improvement of the whole service for disaster medicine including service for disaster medicine of Ministry of Defense are shown.
Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. christopher.kaposy@med.mun.ca
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.
In a previous study the knowledge and views of nursing students on how they thought nurses, both in their professional role and as private persons, should act at a disaster site were evaluated. In the present study the practical functional role and experiences of nurses (n = 16) in two major disaster situations (one 'load and go' and one 'stay and play' type of emergency situation) were assessed from personal interviews along a standardized questionnaire. Nurses more routinely involved in emergency care and nurses with no or limited previous practical experience of disaster nursing were included in the study. Leadership-type actions, i.e. a systematic way of attempting to survey and to comprehend the situation, what has happened, and how many injured there may be at the site of the accident, were reported by most of the experienced nurses, while inexperienced nurses were involved mainly in the immediate care of injured according to directions given by more experienced members of the emergency team. Readiness for action, reflected by having a feeling of being prepared for work at the disaster site, was experienced more often by nurses with considerable previous experience of disaster nursing than by nurses with limited experience. Negative experiences, such as feelings of being insufficient, of unreality, mental strain, and problems in understanding the organization, were commonly mentioned by the inexperienced nurses. The present study stresses the importance, for all types of nurses, of more systematic training in disaster nursing.
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.
Activity of the medical profession on the occasion of a disaster at sea. The tragedy of the sinking of the Andrea Doria witnessed by the ship's doctor.
