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Injury following exposure to toxic chemical agents has potential life–threatening effects, particularly on the respiratory system. Antidotes alone often are not sufficient to reverse this situation, and the need to provide early and effective advanced life support for chemical casualties increasingly has been accepted by emergency services around the world. Although the principles of life support are the same for toxic as for conventional casualties, the requirement for responders to wear personal protective equipment makes airway and ventilation management more difficult. Special training and familiarity with devices and equipment used are essential to ensure effectiveness. Recent studies have indicated both the limitations and the possibilities for resuscitation of casualties in a contaminated environment before decontamination. Ventilation of patients with respiratory failure or arrest requires the use of devices which are able to operate and be used by responders wearing protective equipment. The laryngeal mask airway has been shown to be an easier and viable alternative to intubation in this situation. Portable automatic ventilators have been developed which can be used to provide controlled ventilation in a contaminated zone. The ideal mode of ventilation for potentially damaged lungs, following exposure to agents such as chlorine and phosgene has yet to be established. There may be a case for early application of the protective lung ventilation strategies that are now common in intensive care units. This presentation will review recent human and animal studies related to resuscitation in a contaminated zone and provide illustrations of the practical approaches currently used by emergency medical services.
Liberia's 14 year civil war destroyed domestic agricultural production, veterinary and agricultural education, extension services and domestic food security. These losses severely limited domestic food production, and basic hygiene and sanitation: potable water, abattoirs, cold chain and food storage were greatly diminished. The average Liberian life expectancy fell from 45.8 in 1990 to 41.8 years presently. The population birth and death rate are two of the highest globally with a resulting population growth rate, of 2.7% per annum; this growth rate requires an immediate and concerted focus on domestic food production to alleviate nutritional inadequacy and hunger, trade imbalances and loss of foreign exchange credits. Food supply nationally is presumed adequate because of importation, though domestic production is inadequate. Unequal distribution precludes food security for all Liberians. Value chain augmentation, enhancing food availability across all sectors of Liberian society and ensuring distribution of a safe food supply needs critical development. Infant mortality remains one of the highest in the world (approximately 160/1000 births), much of which is attributed to food insecurity, food contamination and lack of uniformly available potable water. Recreation of Liberia's public health and food security requires redevelopment of disease monitoring and laboratory diagnostic capability to re-establish safe food production and handling practices across all sectors. This will allow determination of endemic disease burden for the principal livestock species: poultry, sheep, goats, cattle and swine. Creation of a national disease surveillance/monitoring system allows for targeted disease intervention, ensuring vaccination for correct serotypes and most critically prevalent diseases. Creation of community level training and support will target intervention of local diseases, but also allow for national prioritization of diseases. Targeting which are most prevalent or most likely to cause production limiting effects will require periodic surveillance, targeted vaccination, and chemotherapeutic intervention and evaluation of therapeutic success.
Why did we predict Y2K, but not 911? Why did we predict dirty bombs for much of the past decade, but failed to predict the Asian Tsunami, Hurricane Katrina, and the Haiti Earthquake? Rational disaster preparedness depends on rational risk assessment – but does this really occur? This presentation will explore why risk assessment in disaster medicine is broken, including (1) type I and type II errors in risk assessment; (2) limitations of human neurophysiology; (3) cognitive biases in risk assessment; (4) impact of the media; (5) lack of harmonization of the language of risk; (6) deference to so-called risk experts; (7) risk innumeracy; (8) flaws in risk assessment matrices; (9) black swan events; and (10) managing risk based on extreme events. Concomitantly, this presentation will explore how we can fix risk assessment in disaster medicine, proffering practical solutions to each of these common yet surmountable barriers.
The requirements of coping with emergencies on the national level include the necessity to modify the structure of disaster medicine centers that deal with major emergencies. Sharing the responsibility for the management of emergency response and preparedness also is important. The evolution of disaster medicine service is key for disaster risk activities. The goal of this presentation is to show the center subunits and their tasks based on strict management under the leading the Ministry of Health and Social Development of Russian Federation. The main units of the disaster medicine center are proposed in view of the relationship to the regional and municipal centers and local medical facilities. The participation of corresponding-level centers in emergency response is dictated by the emergency scale, characteristics of the event, number of injured, number and capacities of local (regional) medical facilities, and other needs in emergency response management. The system of supply management during emergencies comprises a network of warehousing conserving the federal, regional, and local reserves of medical products is revised regularly. The new, information-sharing, automatic, geo-informational system manages the distribution of supplies for any event and evaluates the presence of resources and personnel around any focal point where any natural or technological emergency occurs. Such an informational system is being discussed for the revision of supplies and management on the international scale. The issues of field practice are proposed and suggestions on the modern coordinating mechanisms will be discussed.
A sudden break-down of a heat-exchanger in vinyl chloride plant resulted in that 141 °C, 23% concentration of hydrochloric acid spouted out over the workers around it. Eight workers suffered and Ichihara City Fire Department was deployed in response to the call 3 minutes after the onset of the incident, 17 vehicles including 5 fire engines, 6 ambulances, and two helicopters. Finally three severely (> 80% of TBSA) burned, two moderately (20–80%) burned, and three slightly (< 20%) burned victims were identified and triaged. One severely burned was transferred at first to the closest tertiary care hospital (TUCMC) which existed within 2.5 km distance by an ambulance and other two and one moderately burned were transferred by helicopters to the neighboring tertiary care hospitals. Another moderately burned one was sent to TUCMC by an ambulance about 30 minutes later than the first one. Three slightly burned victims were sent to a local hospital and treated as an outpatient. This casualty mission was ended by 120 minutes after the call. Two among the three severely burned patients lost their lives but another severe one and two moderately burned were survived. Conclusions: With these considerations, the management of this multiple burn casualty was successful, partly because of small number of the victims and of that the incident occurred in a weekday morning.
The Australian Government first started to deploy civilian medical teams internationally in the aftermath of the 2004 Tsunami to Banda Aceh, the Maldives, and Sri Lanka. Historically, Australia had relied upon the Australian Defence Force (ADF) to provide overseas medical assistance, but, in this instance, the volunteers deployed were civilian staff, predominantly from tertiary hospital environments. Civilian Australian Medical Assistance Teams (AUSMATs), particularly in Banda Aceh, interacted closely with the ADF after the tsunami and have had a close liaison with the ADF in subsequent disasters, particularly where ADF assistance was required for aeromedical evacuation of patients. This has included assistance after the 2005 Bali bombing, the 2009 Ashmore Reef explosion, the 2009 Samoa tsunami, and the 2010 Pakistan floods. In the latter, Australia deployed a joint military-civilian medical taskforce to provide care to the affected people in Kot Addu in central Pakistan. Having had extensive experience in both military and civilian disaster responses, the authors in this presentation will look at the lessons that can be shared between civilian and military teams in the Australian context. The military brings particular proficiency in command and control, information gathering, security, communications, general logistics, aeromedical evacuation and living in the field. The civilian AUSMATs bring specialized medical expertise, experience in operating in small teams in a range of disaster conditions, health logistics, surveillance, and public health measures in a disaster setting. Learning how to blend these skill sets will be critical in ensuring effective and collaborative international deployments in the future.
Medical assistance for mass gathering can be classified based on the characteristics of mass gathering into primary or emergency health care for individual patient vs. medical assistance for public in case of disastrous mass gathering. It is necessary to prepare primary and emergency health care in case of routine mass gathering, but when an accident or event occurs, different medical approach will be necessary. One of the representative types of accident or event is crowd packing which can make high pressure among mass gathering participants usually from crowd rush or surge. This study was performed for identifying the characteristics of crowd packing in mass gathering.
Methods
The literature survey was performed on mass gathering and crowd packing. Human model simulation was done as a pilot study and 2-dimensional pedestrian pressure experiment was performed with volunteer students and pressure sensing device by video recording and analysis. Lateral shoulder loading and frontal chest loading were analyzed per load cell and per packed condition.
Results
As pushing pressure increased, the body was rotated to 90 degree after some threshold pressure point. The maximal and average pressures among volunteers were extracted. Pedestrian injury criteria(PIC) curve was generated.
Conclusions
When crowd packing occurs, the body will be rotated about 90 degree after some threshold pressure point. And then interpersonal pressure will be increased to crush injury as crowd packing proceed. For defining the interpersonal pressure to mortality and critical injury, further research will be needed reflecting real human physiology and anatomy.
Disaster and MCI events are occurrences that healthcare institutions must be prepared to respond to at all times. The events of September 11 2001 have rekindled our attention to this aspect of preparedness amongst our healthcare institutions. In Singapore, the SARS experience in 2003 and the recent H1N1 outbreak have thrust emergency preparedness further into the limelight. While priorities had been re-calibrated, we feel that we still lack far behind in our level of preparedness. This study is conducted to understand the perception of our healthcare workers towards their individual and the institution preparedness towards a disaster incident.
Method
A questionnaire survey was done for this study for the doctors, nurses and allied health workers in our hospital. Questions measuring perception of disaster preparedness for themselves, their colleagues and that of the institution were asked. This was done using a 5-point likert scale.
Results
The study was conducted over a 2-month period from 1st August 2010 till 30th September 2010. 1534 healthcare workers participated in the study. 75.3% felt that the institution is ready to respond to a disaster incident; but only 36.4% felt that they were ready. 12.6% had previous experience in disaster response. They were more likely to be ready to respond to future incidents (p = 0.00). Factors that influenced perception of readiness included leadership (p = 0.00), disaster drills (p = 0.02), access to disaster plans (p = 0.04), family support. 80.7% were willing to participate in future disaster incident response training. 74.5% felt that being able to respond to a disaster incident constitute part of their professional competency. However, only 31% of the respondents agreed that disaster response training was readily available and only 27.8% knew where to go to look for these training opportunities.
Conclusion
There is an urgent need to train the healthcare workers to enhance their capability to respond to a disaster incident. While they have confidence in the institutions capability they were not sure of their own capability. Training opportunities should be made more accessible. We should also do more to harvest the family support that these worker value in order for them to be able to perform their roles in a disaster incident.
Prehospital patients, irrespective of diseases or trauma, might experience discomfort due to a cold environment and are at risk for decreasing body temperature which can increase morbidity and mortality. Research concerning experiences of being injured in a cold environment is scarce.
Objective
The aim of this study was to explore the patients' descriptions of being injured in a cold environment.
Methods
Twenty persons who have been injured in a cold environment during wintertime in the north of Sweden were interviewed; 14 of them were treated with active heat supply. They waited on snow or ice for an ambulance between 8 minutes and 4 hours and 10 minutes. The interviews were performed face-to-face and telephone interviews were used when the participants lived far away. The interviews had a storytelling run-up and the participants were asked to narrate the injury event, from just before the event until arrival at the emergency department. The interviews were transcribed verbatim and analyzed by content.
Results
In the preliminary results three themes were formulated: (1) waiting for an ambulance; (2) being cared for; and (3) reflecting on changes in life after the traumatic event. The cold environment influenced the experience of being injured in a negative way. More suffering from the cold than from pain of the injury was described. Those who were treated with active heat experienced it in a positive way.
Conclusions
Discomfort from cold became the largest problem independent of their injury classification. Active heat should be used in prehospital care to reduce the negative experiences from cold.
Infirmier Pompier L'infirmier sapeur pompier est aujourd'hui en France un maillon fort de l'organisation des secours. Originaire d'exercices très variés, il dispose d'une culture commune aux sapeurs pompiers mais aussi á ses collègues infirmiers sur l'ensemble du territoire. Doté de moyens performants il arrive en renfort de ses collègues secouristes rapidement sur les lieux des détresses mais aussi prend une part active dans l'ensemble des missions qui leurs sont confiés comme la médecine d'aptitude, le soutien sanitaire, la médecine préventive. Il est au centre d'un réseau complexe, aidé par tous les outils des nouvelles technologies de communications disponibles et l'avancée de la télémédecine. Acteur incontesté des secours de proximité, il a néanmoins mis de longues années avant de trouver sa place et n'est á ce jour que difficilement accepté. Incompréhension, méconnaissance, absence d'explications, les ë képis noirs  / voient en cet officier un parvenu qui n'a pas mérité ses galons. Mais savent ils réellement ce qu'il en est ? Comme á l'hôpital, l'infirmier doit savoir tout faire, sans faire tout. Il doit se limiter á des règles professionnelles dictées par le bon sens médical mais aussi par le corporatisme important enclin chez nous. L'infirmier, un acteur aux multiples facettes mais au seul uniforme.
Associated with hospital evacuation is the need to track multiple patient evacuees from point of origination to final hospital reception. Patient tracking, a component of the hospital emergency operations plan, is vital to patient care; family association, resource management, financial reimbursement, risk management, and repatriation. Tracking strategies and plans can include a variety of vendors, hardware, software, and coordination issues. Hospital evacuee tracking plans and platforms exist at multiple jurisdictional levels but may not be interoperable.
Methods
Three patient tracking platforms representing a local, state and federal application were used during a multi-hospital evacuation exercise, initiated in New Orleans, Louisiana, May 2010. Simulated patients were flown and tracked to multiple patient reception centers in the southern United States, including the Federal Coordinating Center in Shreveport, Louisiana, and receiving National Disaster Medical System hospitals. This review summarizes tracking operations, patient data characteristics captured and interoperability at the Shreveport reception location.
Results
7 New Orleans hospitals entered 51 patients for evacuation into Louisiana's web-based, At-Risk-Registry (ARR) database including 8 patient identifiers each. ARR data was shared with federal and Louisiana Region 7 patient evacuee receivers for flight manifest construction and reception planning. 34 ARR evacuee patients were indicated for the Shreveport, Louisiana, reception site. 34 patients with 6 identifying characteristics were entered from ARR into EMTrack, the local patient tracking system. A C130 arrived with a TRAC2ES manifest of 20 simulated patients with 6 patient data characteristics. The local tracking system was reconfigured for the hardcopy manifest; simulated patients were received at the airport; transported and received at local hospitals.
Conclusions
Tracking system interoperability may be challenged by tracking technologies, jurisdictional requirements and degree of implementation at the local, state and federal level. Tracking should be standardized based on national recommendations with local systems remaining flexible for just-in-time requirements.
In Southern California in 2010, there were 76 declared disasters of which the majority were in Southern California, for this reason and at the request of our clinical partners, when West Coast University (WCU) started its nursing program in 2008, it recognized the need to have a course in disaster management. With nursing being the largest of the health professions, the American Association of Colleges of Nursing (AACN) recognized the need to incorporate disaster nursing in its new Baccalaureate Nursing standards. The Disaster Management course was developed in concert with other parts of the curriculum such as Leadership, Physical Assessment, Critical Care courses to help students focus their assessment and intervention skills to prepare them to be future responders. The disaster management course is delivered in both didactic and hands on format including online Federal Emergency Management Agency (FEMA) modules, disaster drills, guest lecturers and field trips. Students are also introduced to many volunteer opportunities and are trained to be disaster ready once they are needed. Students are excited and ready to volunteer at various organizations before graduation such as the American Red Cross, the Medical Volunteer Program and the Disaster Medical Assistance Teams. Since WCU has new campuses, the students have been instrumental in implementing a new disaster plan for our facilities, including developing flyers, videos and conducting disaster drills. We have received feedback from our clinical partners that our students are better prepared than their current emergency staff in regards to disaster management and to that end we plan to work with our clinical partners to translate our class into an online course so their staff can be trained on disaster management.
An earthquake struck Haiti on 12 January 2010. More than 200,000 people were killed and more than 300,000 people were injured in this earthquake. The Japanese government dispatched the Japan Disaster Relief Medical Team (JDR-MT) to Haiti on 16 January. This is the report of the medical activities of JDR-MT in Haiti. The JDR-MT consisted of 27 members, including four medical doctors, seven nurses, one pharmacist, one radiologist, one medical technologist, two emergency medical technicians, and 11 logisticians. The JDR-MT was equipped with medicines for 1,000 patients, a portable x-ray system, and ultrasound diagnostic equipment. The JDR-MT performed relief activities at Leogane City, which was 40km west of the capital of Port-au-Prince, and was the first medical team that entered the Leogane area after the earthquake. The JDR-MT treated 534 patients for eight days. The male-female ratio of total patients was 180/354, and the male-female ratio of 242 injured cases treated by the JDR-MT was 80/162. Among the patients treated by the JDR-MT, 100 were diagnosed as bone fractures with the portable x-ray system. There were 17 cases of open bone fractures and 15 cases of pelvic fractures. The male-female ratios were 28/72, 4/13, and 1/14 respectively. The total number of female patients was approximately double compared with the number of male patients in this experience. The proportion of female patients was much higher in the cases of severe injury, such as open bone fractures and pelvic fractures.
There remains a lack of comprehensive pediatric emergency preparedness planning worldwide. A disaster or mass-casualty incident (MCI) involving pediatric patients could overwhelm existing pediatric resources within the New York City (NYC) metropolitan region. The NYC Department of Health and Mental Hygiene (DOHMH) recognizing the importance to plan for a MCI with a large number of pediatric victims, implemented a project (the Pediatric Disaster Coalition; PDC), to address gaps in the healthcare system to provide effective and timely pediatric care during a MCI.
Methods
The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from the NYC pediatric/children's hospitals, DOHMH, Office of Emergency Management, and Fire Department (FDNY). Two committees addressed pediatric prehospital triage, transport, and pediatric critical care (PCC) surge capacities. They developed guidelines and recommendations for pediatric field triage and transport, matching patients' needs to resources, and increasing PCC Surge Capacities.
Results
Surge recommendations were formulated. The algorithm developed provides specific pediatric triage criteria that identify severity of illness using the traditional Red, Yellow, and Green categories plus an Orange designation for continual reassessments that has been adopted by FDNY that has trained > 3,000 FDNY EMS personnel in its use. Triaged patients can be transported to appropriate resources based on a tiered system that defines pediatric hospital capabilities. The Surge Committee has created PCC Surge Capacity Guideline that can be used by hospitals to create their individual PCC surge plans. 15 of 25 NYC hospitals with PCC capabilities are participating with PDC planning; 5 have completed surge plans, 3 are nea completion, and 7 are in development. The completed plans add 92 surge beds to 244 regularly available PICU beds. The goal is to increase the PCC surge bed capacity by 200 + beds.
Conclusions
The project is an effective, multidisciplinary group approach to planning for a regional, large-scale pediatric MCI. Regional lead agencies must emphasize pediatric emergency preparedness in their disaster plans.
Training Agricultural Emergency Responders by Paula L. Cowen, D.V.M., Director, Professional Development Staff, Veterinary Services, Animal Plant Health Inspection Service, United States Department of Agriculture
Background Emergency Response is a critical component of our Animal Agriculture infrastructure. The ability to deploy trained personnel to handle any kind of emergency is key to quickly containing any disaster and mitigating the effects. This training is provided by a number of federal agencies, universities as well as at the state and local level. Body Several training strategies are employed by a number of different entities. Training is available on-line, in the classroom, with wet labs using live animals, through exercises and case studies. An overview of training and education of Agricultural Emergency Response personnel across the United States will be covered with a more in depth look at the training provided by the Animal Plant Health Inspection Service.
Conclusion
The Professional Development Staff provides technical training in disease identification and control, emergency response, import/export, and other topics as needed. Protecting and promoting American Animal Agriculture is our core mission. Veterinary Services provides leadership at the intersection of Animal and Public Health concerns.
There is a paucity of reliable data on the healthcare needs over time after sudden onset disasters (SOD). There also are no widely acknowledged definitions and data on deployment, use, staffing, and management of foreign field hospitals (FFH) after such disasters. Further, the efficiency, relevance, timing and cost-effectiveness of FFHs in the aftermath of SODs have been questioned. This was again highlighted after the 2010 Haiti earthquake, when the situation, to a large extent, was chaotic, uncoordinated, and care was not adapted to needs. These shortcomings create severe difficulties with respect to studying the real impact of medical aid after a SOD and optimizing the international medical relief efforts to be applied afterward. This article aims to present a health system approach to the deployment of FFHs after a SOD, here applied to an earthquake. By reviewing the literature and drawing on field experiences from SODs, a conceptual framework was developed that capture the essential dimensions in such a model, including: (1) classification standardization of levels of care in FFH (1–4); (2) time-phases after the event (1–5); and (3) the need for health care based on the assumed burden of disease and, hence, need for medical care in relation to the socio-economic context. The model currently is being tested on a number of international experts in the field. By using this framework, the authors hope to create: (1) a common platform for research within this area; and (2) a tool for international actors that will facilitate a development toward an international coordination body in the future. As such, the framework hopefully will offer an opening to a structural approach to the above mentioned difficulties, support international actors in their SOD preparations and deployments, and put them in a better position to optimize the resources available to the targeted population.
India is one of the most flood prone countries in the world, flooding annually about 9 million hectares and accounting for one-fifth of global flood deaths. Approximately 56.5 % of flood-affected Indians live in Bihar. Out of 38 districts in Bihar, 22 are flood prone, including Begusarai. The life line to the community is the Primary Health Center (PHC) which is at stake during a disaster such as floods.
Methods
To study the status of primary health care in rural parts of Begusarai during recurring floods, a survey was undertaken to analyze the preparedness and response mechanism at various hospital levels. The status of rural hospitals during a flood was represented by a case study on the PHC of Bakhri block of Begusarai district. To determine the prevailing situation during floods, the chief medical officers of each level of health care centers were interviewed.
Results
The PHC of Bakhri caters to a population of about 408,896, which is four times the normal load for a PHC. In 2007, it was affected severely by flooding from the Baghmati River. The PHCs that were studied perennially face a shortage of human resource and infrastructural support. This is compounded by unsafe locations and structural hazards associated with the hospital building, rendering the working conditions unsafe for the medical team during disasters.
Conclusion
This paper envisages the functionality and challenges of healthcare providers during floods despite their limited available resources. The prevailing case scenario demonstrates the challenges in rural India, and the best practices for safe rural hospitals in coping with disasters in a resource-poor setting will be discussed.
To identify attitudes and understanding of Chinese undergraduate nursing students towards disaster, therefore providing information for the development of a disaster nursing curriculum in the Chinese context.
Methods
A total 214 undergraduate nursing students (Year 1 to 4) in one medical university in China were surveyed in 2010.
Results
The majority of undergraduate nursing students (94.9%) were concerned about disaster, 46.7% of them thought they were very knowledgeable about disaster, while 39.3% of them stated they were moderately knowledgeable about disaster. The most popular way for the students to get information about disaster was television (88.3%), followed by internet (67.8%) and newspaper (45.8%). Only 33.6% of them said they gained information from the university. Earthquake (93.7% of students) and flood (36.1% of students) were mentioned by the students as examples of disasters that have occurred in China. The majority of students said the Wenchuan earthquake (2008) was the disaster that had the greatest impression on them. Five aspects were identified from their description of disaster, which included the cause, category, characteristic, impact and type of disaster. 36.4% of students were certain that disaster would happen again in China. A further 50.9% felt disaster was likely. Flood and earthquake were considered the most likely future disasters. 71% of nursing students strongly agreed that being prepared for disaster was important. The main reasons were better preparedness could decrease the damage to property and the incidence of death and injury. However, the level of understanding of the effects of disaster and the exposure of students to education about disaster health response was limited.
Conclusion
Knowledge and skills for disaster preparedness of nursing students should be strengthened in the medical university.
Extreme professional working conditions of EMERCOM rescuers have a harmful effect to their health leading to high rate of digestive, respiratory, musculoskeletal and cardiovascular diseases. The morbidity frequency of these diseases at rescuers is higher, beyond all doubts, than at male population of the corresponding age, and it is connected with total years of occupational work and its intensity. This fact shows the necessity of establishing the system of medico-physiological support to rescuers of EMERCOM of Russia which must be seen as a significant part of their social protection and rehabilitation and must include six main components, i.e. consideration of conditions and character of activity in everyday and emergency situations; complex evaluation and monitoring of their health state; medical support during rescue work in emergency situations; psychological support; information and analytical maintenance of longstanding monitoring; development of hospital base and specialized medical assistance. An important component of the system of medico-physiological support to rescuers of EMERCOM of Russia is information and analytical maintenance of longstanding monitoring of professional load, health state and medico-social protection of the rescuers of EMERCOM of Russia. It was implemented by creating a Medical register of EMERCOM of Russia. We developed concepts, principals and organization methodical ground of multilevel system of medico-physiological support to rescuers of EMERCOM of Russia regarding their work in conditions of emergency situations. On the basis of professional work load studies, hygienic evaluation of work hardness and intensity, analysis of rescue work of State fire fighting services divisions of EMERCOM of Russia there were detected main stress factors, physiological and hygienic distinctive features of work.
Immediately following a major public health emergency or complex humanitarian emergency such as the South East Asian Tsunami in 2004, the Haitian Earthquake in 2010 or Hurricane Katrina in 2005, there is a critical need to rapidly and as accurately as possible gather information not limited to morbidity and mortality, but necessary to assess the stability and existence of a public health or medical infrastructure, logistic supply chain, condition of food, water and shelter for victims and rescue workers, and particularly the security and stability of the region following the incident. With this information, only then can an effective humanitarian response be planned and executed that meets the actual versus perceived needs of an affected population.
Methods
Specific disaster risk assessment and medical intelligence techniques will be presented that are currently used by a variety of relief organizations. Specific topics of discussion include: Disaster epidemiology; Indicators of health in populations; Systems of surveillance; Impact of weather and climate; Displaced populations and refugee health; Tactical and combat medical intelligence; Zoonotic diseases; Agricultural trends and food security; Public health and health system infrastructure assessment; and Personal and physical security concerns.
Conclusions
Utilizing case reports, best-practices and lessons learned from numerous international humanitarian responses, this session will guide participants though the performance of a rapid disaster assessment and the gathering of critical medical intelligence to determine the kinds and types of resources needed in an affected area. And the process of utilizing limited information to plan humanitarian relief efforts.