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Many organizations rally to areas to provide assistance to a population during a disaster. Little is known about the ability of the materials and services provided to meet the actual needs and demands of the affected population. This study sought to identify the perceptions of representatives of the international organizations providing this aid, the international workers involved with the delivery of this aid, the workers who were employed locally by the international organizations, the recipients, and the local authorities. This study sought to identify the perceptions of these personnel relative to the adequacies of the supplies in meeting the needs and demands of the population during and following the war in Bosnia-Herzegovina.
Structured interviews were conducted with representatives of international organizations and workers providing aid and with locally employed workers, recipients of the assistance, and the authorities of the areas involved. Descriptive and inferential statistics were used to assist in the analysis of the data.
Eighty-eight interviews were conducted. A total of 246 organizations were identified as providing assistance within the area, and 54% were involved with health-related activities including: 1) the provision of medications; 2) public health measures; and 3) medical equipment or parts for the same. Internationals believed that a higher proportion of the needs were being met by the assistance (73.4 ±16.4%) than did the nationals (52.1 ±23.3%; p <0.001). All groups believed that approximately 50% of the demands of the affected population were being addressed. However, 87% of the international interviewees believed that the affected population was requesting more than it actually needed.
While 27% of the international participants believed that ≥25% of what was provided was unusable, 80% of the recipients felt that ≥25% of the provisions were not usable. Whereas two-thirds of the international participants believed that ≥25% of the demands for assistance by the affected community could not be justified, only 20% of the recipients and authorities believed ≥25% of the demands were unjustified.
Many organizations are involved in the provision of medical assistance during a disaster. However, international organizations and workers believe their efforts are more effective than do the recipients.
To assess the volume of patients and the composition of their injuries and illnesses that presented to an emergency department (ED) close to the epicenter of an earthquake that occurred in a seismically prepared area.
A retrospective analysis of data abstracted from charts and ED logs for patient census and types of injuries and illnesses of the patients who presented in the ED of a community hospital before and after the earthquake (6.8 Richter scale) that occurred in 1994 in Los Angeles. Illnesses were classified as trauma- and non-trauma related. Data were compared with epidemiological profiles of earthquakes in seismically prepared and unprepared areas.
A statistically significant increase in ED patient census over baseline lasted 11 days. There was a large increase in the number of traumatic injuries such as lacerations and orthopedic injuries during the first 48 hours. Beginning on the third day after the event, primary care conditions predominated. When the effects of the LA quake were compared with those of similar Richter magnitude and disruptive capability, the ED epidemiology profile was similar to those in seismically unprepared areas, except for the total number of casualties.
The majority of patients with traumatic injuries presented within the first 48 hours. The increase relative to baseline lasted 11 days. Efforts to develop disaster response systems from resources outside the disaster-stricken area should focus on providing mostly primary care assistance. Communities in seismically prepared areas could require external medical assistance for their EDsfor up to two weeks following the event.
Because of great intervening distances, international medical relief activities in catastrophic, sudden-onset disasters often do not begin until days 5–7 after the precipitating event. The medical needs of those affected and what public health problems exist in the community in the week after the tsunami disaster in Papua New Guinea(PNG) were investigated.
The Japan Medical Team for Disaster Relief (JMTDR) conducted investigative hearings at the District Office responsible for the management of the disaster, the Care Center, and the Hospitals in Aitape, Vanimo, and Wewak in PNG.
The numbers of in-patients in the Aitate, Vanimo, and Wewak Hospitals, and in the Care Center in Aitape were 291, >300, 68, and 104, respectively. The exact number of people affected was unknown at the Aitape District Office. There ivas no lack of medical supplies and drugs in the hospital, but the Care Center in Aitape did not have sufficient quantities of antibiotics. No outbreak of communicable disease occurred, despite the presence of risk factors such as the dense concentration of affected people and the constant prevalence of malaria and diarrhea. The water at Wewak General Hospital contained chlorine and was suitable for drinking, but that elsewhere contained bacteria.
On about the 7th day after the event, the available information still was incomplete, and it was a time to shift from initial emergency activities to specialized medical care. Although no outbreak of communicable disease actually occurred, there was much anxiety about it because of the risk factors present. For effective medical care at this stage, it is essential to conduct a survey of actual medical needs that also include epidemiological factors.