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.
An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general out-look, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES-score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an 'audience position' than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES > or = 19).
Disaster medicine, which is based primarily on military and emergency medicine, is a young branch on the old tree of medicine. It touches on various disciplines within and outside the medical field. The subject is being taught on the academic and postacademic levels at many universities throughout Europe. The first chair in disaster medicine was established in Linkoping, Sweden; the second is now in Amsterdam, The Netherlands. Some aspects of disaster medicine specifically oriented toward Europe are presented.
Of 31 soldiers caught by an avalanche in Northern Norway, one was not buried, 13 were partly buried and 17 were completely buried by the mass of snow. Only one of the completely buried soldiers survived. On admission to hospital after being buried by snow for three hours he had moderate hypothermia. The cause of death in the other 16 was most probably general compression of the body with acute respiratory and circulatory failure. Five of the 13 partly buried had physical traumas. None of the nine attempts at resuscitation succeeded. Self-rescue and rescue by friends were most important to the soldiers who survived. We discuss aspects of the organized rescue operation.
This report will explain the unique nature of the two avalanche accidents at Súthavík and Flateyri in the western part of Iceland. The report will describe the difficult conditions encountered by the rescuers, the medical personnel and all the other people involved. Finally, the implementation of Critical Incident Stress Management (CISM) will be described.