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In case of an outbreak of Nankai Trough Mega-earthquake, it is predicted that a tsunami would invade Nagoya City within 100 minutes, hitting about one third of the City of Nagoya. If the administrative plan of the city and midwives’ expertise are coordinated, pregnant women’s chances of survival will increase. The authors carried out this simulation study in an attempt to improve consistency of the two efforts.
We estimated the number of pregnant women using a machine learning model. The evacuation distance of pregnant women was estimated on the basis of the data of road center line.
Through this simulation study, it became clear that preparation for approximately 2600 pregnant women escaping from tsunami predicted area and for about 1200 pregnant women possibly left in the area is needed.
Our study suggests that triage point planning is needed in areas where pregnant women are evacuated. The triage makes it possible to transport women to appropriate hospitals.
The Richter Scale measures the magnitude of the seismic activity for an earthquake; however, it does not quantify the humanitarian need at the point of impact. This poses a challenge for humanitarian stakeholders in decision and policy making, especially in risk reduction, response, recovery, and reconstruction. The new disaster metrics tool titled “The YEW Disaster Severity Index” (DSI) was developed and presented at the 2017 World Congress of Disaster and Emergency Medicine, May 2017, Toronto, Canada. It uses a median score of three for vulnerability and exposure indicators, a median score percentage of 100%, and medium YEW DSI scoring of four to five as baseline, indicating the ability to cope within local capacity. Therefore, scoring more than baseline coping capacity indicates that external assistance is needed. This special real-time report was presented at the 2nd National Pre-Hospital Care Conference and Championship, October 2018, Malaysia.
The aim of this analysis is to present the real-time humanitarian impact and response to the 2018 earthquake and tsunami at Donggala and Palu, Sulawesi in Indonesia using the new disaster metrics YEW DSI. Based on the earthquake (measuring 7.7 on the Richter Scale) and tsunami at Donggala, the humanitarian impact calculated on September 29, 2018 scored 7.4 High in the YEW DSI with 11 of the total 17 indicators scoring more than the baseline coping capacity. The same YEW DSI score of 7.4 was scored on the earthquake and tsunami at Palu, with 13 of the total 17 indicators scoring more than baseline ability to cope within local capacity. Impact analysis reports were sent to relevant authorities on September 30, 2018.
Discussion & Conclusion:
A State of Emergency was declared for a national response, which indicated an inability to cope within the local capacity, shown by the YEW DSI. The strong correlation between the earthquake magnitude, intensities, and the humanitarian impact at Donggala and Palu reported could be added into the science of knowledge in prehospital care and disaster medicine research and practice. As a conclusion, the real-time disaster response was found to be almost an exact fit with the YEW DSI indicators, demonstrating the inability to cope within the local capacity.
This chapter describes the role of prehospital teams deployed to large scale disaster events. It describes two categories of type I emergency medical teams (EMT), and provides an overview of their capabilities and expectations. It reviews competing models of prehospital care delivery that are prevalent worldwide, including the levels of service that can be expected within such systems. Finally, the chapter describes the role of the medical component of urban search and rescue (USAR) teams, and notes the differences that exist between type I EMTs and USAR teams. Future trends in the development of EMTs are explored, including the importance of national capacity building, the commitment to acute and long term community needs, and the continued promotion of EMT and USAR medical coordination.
This article sets out two case studies to examine the evolving reality of ‘boat migration’ and the intersecting legal frameworks at play. Our analysis takes a systemic integration approach to reflect on the complex dynamics underpinning responses to the phenomenon in Australia and the Central Mediterranean. The regime that governments purport to act under in any given instance reflects the way they choose to frame incidents and possibly exploit legal gaps in, or contested interpretations of, the relevant rules. The ‘closed ports’ strategy adopted by Italy and Malta against the MV Lifeline and the detention-at-sea policy pursued by Australia are investigated from the competing perspectives of what we call the ‘security lens’ and the ‘humanitarian lens’ to demonstrate how a good faith interpretation of the applicable (if apparently conflicting and overlapping) norms can (and should) be mobilized to save lives, and how that goal is unduly undercut when security concerns trump humanitarian interests.
When a disaster exceeds the capacity of the affected country to cope with its own resources, the provision of external rescue and health services is required, and the deployment of relief units requested. Recently, the cost of international relief and the belief that such deployment is cost-effective has been questioned by the international community; unfortunately, there is still little informed debate and few detailed data are available. This paper presents the results of a comparative review on the cost-effectiveness analysis (CEA) of search and rescue (SAR) and Emergency Medical Team (EMT) deployment. The aim of this work is to provide an overview of the topic, highlight the criteria used to assess the effectiveness, and identify gaps in existing literature. The results show that both deployments are highly expensive, and their success is strongly related to the time they need to be operational; SAR deployments are characterized by limited outcomes in terms of lives saved, and EMTs by insufficient data and lack of detailed assessment. This research highlights that the criteria used to assess the effectiveness need to be explored further, considering different purposes, lengths of stay, and different activities performed, especially for any comparison. This study concludes that data reporting should be mandatory for humanitarian response agencies.
Mine rescue teams bear a high risk of injury. To improve medical emergency preparedness and injury prevention, this work analyzed the causes and severity of mine rescue teams’ casualty incidents, the primary injuries, and the link between the causes and the occurrences of the casualty incidents.
A total of 81 cases from 1953 to 2013 were used to analyze the casualty incidents of mine rescue teams based on the frequency of accidents. A panel with 4 rescue experts was set up to ensure the accuracy of the analysis.
The 81 casualty incidents occurred in 7 types of rescue work and were due to 6 causes. Organizational and personal factors were the leading cause, followed by rescue skill and equipment factors. Problems with decision-making and command have gradually become the primary inducement of casualty incidents in recent years, with an average death toll reaching up to 6 to 7 people. The main injuries causing death to team members were blast injury, burns, poisoning, suffocation, blunt trauma, and overwork injury. Some of the injured died because of medical emergency response failure.
The construction of emergency medical teams and the preparedness of disaster medicine need to be improved to reduce the mortality of the injured team members. Actions according to the causes of casualty incidents should be adopted for injury prevention. (Disaster Med Public Health Preparedness. 2019;13:695–699)
The development of unmanned systems (UMS) for naval combat poses a profound challenge to existing conventions regarding the treatment of the shipwrecked and wounded in war at sea. Article 18 of the 1949 Geneva Convention II states that warring parties are required to take “all possible measures” to search for and collect seamen left in the water after each engagement. The authors of the present paper analyze the ethical basis of this convention and argue that the international community should demand that UMS intended for roles in war at sea be provided with the capacity to make some contribution to search and rescue operations.
This article contributes to the international political theory of humanitarianism by unpicking the politics of humanitarian action’s simplest expression: saving human lives in the name of humanity. Both saving lives and defining notions of common humanity are closely interrelated acts of power. What saving a life means depends on a prior definition of humanity; humanitarians’ acts of rescue are the measure of their commitment to humanity. The politics of rescue and the politics of humanity are inextricably linked. The article explores four facets of this nexus. First, it considers the meanings of rescue, from saving bodies to saving lives, linked to contingent understandings of humanity. Second, it turns to the rescuers, for whom rescue performs particular functions, not least the need to preserve a sense of self. Third, it situates their often narcissistic motives in relation to the consequences of humanitarian action. Fourth, it addresses the power imbalance inherent in rescue and the problem of causing harm. It concludes that rescue is always an act of presumption, but one that can be tempered by humanitarian actors willing to embrace their role as ‘moral politicians’ (Walzer), aware of their power and their dirty hands, and open to contrasting understandings of humanity.
Community characteristics, such as perceived collective efficacy, a measure of community strength, can affect mental health outcomes following disasters. We examined the association of perceived collective efficacy with posttraumatic stress disorder (PTSD) and frequent mental distress (14 or more mentally unhealthy days in the past month) following exposure to the 2004 and 2005 hurricane seasons.
Participants were 1486 Florida Department of Health workers who completed anonymous questionnaires that were distributed electronically 9 months after the 2005 hurricane season. Participant ages ranged from 20 to 79 years (mean, 48; SD, 10.7), and the majority were female (79%), white (75%), and currently married (64%). Fifty percent had a BA/BS degree or higher.
In 2 separate logistic regression models, each adjusted for individual sociodemographics, community socioeconomic characteristics, individual injury/damage, and community storm damage, lower perceived collective efficacy was significantly associated with a greater likelihood of having PTSD (OR, 0.93; 95% CI, 0.90-0.96), and lower collective efficacy was significantly associated with frequent mental distress (OR, 0.94; 95% CI, 0.92-0.96).
Programs enhancing community collective efficacy may be a significant part of prevention practices and possibly lead to a reduction in the rate of PTSD and persistent distress postdisaster. (Disaster Med Public Health Preparedness. 2019;13:44–52).
In a recent Antiquity article, Ammerman et al. (2017) suggest that three radiocarbon dates on seventh- or eighth-century AD samples obtained by coring beneath St Mark's Basilica—including two peach stones—illuminate the earliest settlement of the historic centre of Venice. Excavations at several other locations, however, have yielded in situ settlement remains at least as old as the peach stones, some of which are securely dated by a floating tree-ring chronology and radiocarbon dates from stratified structural samples. Here, the authors summarise this evidence, and propose that a large area of the historic centre may have been settled by, or during, the mid seventh century AD.
This article presents an analysis of how activists, politicians, and the media framed youth involvement in the sex trade during the 1970s, the 1990s, and the 2000s in the United States. Across these periods of public concern about the issue, similar framing has recurred that has drawn upon gendered and racialized notions of victimization and perpetration. This frame has successfully brought attention to this issue by exploiting public anxieties at historical moments when social change was threatening white male dominance. Using intersectional feminist theory, I argue that mainstream rhetoric opposing the youth sex trade worked largely within neoliberal logics, ignoring histories of dispossession and structural violence and reinforcing individualistic notions of personhood and normative ideas about subjectivity and agency. As part of the ongoing project of racial and gender formation in US society, this discourse has shored up neoliberal governance, particularly the build-up of the prison industrial complex, and it has obscured the state's failure to address the myriad social problems that make youth vulnerable to the sex trade.
The rare and threatened fern Christensenia aesculifolia of South-east Asia is listed in China as a second-ranked plant for national protection and is also categorized as one of 62 plant species with extremely small populations by the Yunnan provincial government. Field investigations during 2014–2017 failed to relocate one previously known population, and revealed that the single known extant population of C. aesculifolia contains only 10 individual plants. The most urgent conservation requirement for this species is to conserve the threatened habitat of the remnant population. Further field surveys and research are also required for an improved understanding of the species’ status.
We examined the impact of demographic confounding factors on responses to the Impact of Event Scale–Revised.
Participants were rescue workers aged 20 to 65 years who had responded during the Great East Japan Earthquake in 2011. A multiple indicators, multiple causes model was used to examine associations between covariates and latent factors or items in the Impact of Event Scale–Revised.
Participants were recruited from April to August 2015. The model fit indices in the confirmatory factor analysis and the multiple indicators, multiple causes model suggested an acceptable model fit. Higher education and the Connor-Davidson Resilience Scale score were significantly associated with a decrease in intrusion, avoidance, and hyperarousal. Counseling was significantly associated with increased avoidance. In the direct path model using modification indices, counseling and early arrival were identified as significant covariates.
This study found that higher education and resilience reduced all 3 factors in the Impact of Event Scale–Revised and improved the symptoms of intrusion, avoidance, and hyperarousal. Counseling and early arrival were also associated with improvement in certain items. However, counseling was also linked to increased avoidance and worsening psychophysiological reactions. Further research is recommended to clarify these relationships. (Disaster Med Public Health Preparedness. 2019;13:309–318)
The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people’s lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2019;13:203–210).
Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.
This paper examines the intervention of the law, and the role of the court, in debt restructuring, both in terms of imposing constraints on creditors and in seeking to ameliorate the potential abuses that can arise from such constraints. Three potential forms of abuse are examined: the imposition of a restructuring on dissenting creditors, which introduces the potential for wealth transfers between creditors; the imposition of a moratorium while a restructuring is negotiated, which might lead to misuse of the process by managers wishing to prop up companies which are not viable, or may allow managers of a viable business to “shake off” liabilities that it is capable of servicing; and the facilitation of rescue finance, which raises the potential for new creditors to be preferred at the expense of existing creditors. It is argued that the court's role in protecting creditors from these three forms of potential abuse is vital, although the nature of that role differs according to the form of abuse. Recent debt restructuring reform proposals in both the UK and the EU, which adopt distinct approaches to the role of the court in this process, are examined in the light of this discussion.
This article compares the law and practice of the European Union and Australia in respect to the search and rescue (SAR) of boat migrants, concluding that the response to individuals in peril at sea in both jurisdictions is becoming increasingly securitized. This has led to the humanitarian purpose of SAR being compromised in the name of border security. Part I contrasts the unique challenge posed by SAR operations involving migrants and asylum seekers, as opposed to other people in distress at sea. Part II analyses the relevant international legal regime governing SAR activities and its operation among European States and in offshore Australia. Part III introduces the securitization framework as the explanatory paradigm for shifting State practice and its impact in Europe and Australia. It then examines the consequences of increasing securitization of SAR in both jurisdictions and identifies common trends, including an increase in militarization and criminalization, a lack of transparency and accountability, developments relating to disembarkation and non-refoulement, and challenges relating to cooperation and commodification.
a. Event Type: Earthquake measuring 6.2 (SD=0.016) on the moment magnitude;
b. Event Onset: August 24, 2016 - 03:36:32 CEST (01:36 UTC);
c. Location of Event: Central Italy, in the town of Amatrice;
d. Geographic Coordinates: latitude (DMS): 42°37′45.77″N; longitude (DMS): 13°17′18.14″E; elevation: 955 meters above sea-level;
e. Dates: August 24, 2016 at 4:48 AM;
f. Response Type: Medical Relief.
On August 24, 2016, an earthquake hit the town of Amatrice (Italy). This study aims to document the first medical aid provided to earthquake victims in Amatrice immediately following the earthquake.
Patient data were collected and recorded during the first clinical evaluation and before definitive hospitalization. Blood gas tests were performed on survivors extricated from the rubble using the iSTAT (Abbott Point of Care Inc.; Princeton, New Jersey USA) handheld blood analyzer.
Performing “victim-side” blood gas tests could provide concrete information to facilitate clinical evaluation and decision making when treating buried victims. After a natural disaster, it is essential to provide effective analgo-sedation to victims.
BlasettiAG, PetrucciE, CofiniV, PizziB, ScimiaP, PozoneT, NecozioneS, FuscoP, MarinangeliF. First Rescue Under the Rubble: The Medical Aid in the First Hours After the Earthquake in Amatrice (Italy) on August 24, 2016. Prehosp Disaster Med. 2018;33(1):109–113.
Firefighting is an important profession during disasters. Firefighters are on duty for many vital functions, including fire extinguishing, search and rescue work, and evacuation of disaster victims to a safe zone. In case of a disaster situation, it is vital to have willing personnel to work in disasters. In the literature, type of disaster, individual demographic factors, family factors, and workplace factors have been identified as factors that influence health care personnel’s willingness to work during a disaster. However, little is known about firefighters and firefighter candidates’ willingness to work in a disaster.
This study was aimed to identify the willingness of civil defense and firefighting program students to work in different disasters after graduation and the factors associated with their willingness.
The universe of this descriptive, epidemiological study was 1,116 students of civil defense and firefighting programs in Turkey. They were from 11 different universities. In the research study, a sample was not chosen as it was aimed at reaching the whole universe. A standardized survey form of 58 questions, prepared by researchers, was used to gather data.
The rate of participation was 65.5%. Of the students, 82.8% said that after graduation they would like to work in disasters, whereas 16.2% were indecisive. The students were less willing to work in nuclear accidents (42.4%) and epidemic disasters (32.1%). In chi-square analysis, “willingness of students to work in disasters after graduation” (dependent variable) and the independent variables: “university of student,” “exercising regularly,” “having a hobby related to disaster,” “having been educated about disaster,” and “being satisfied from the received education” were found statistically significant. When students’ willingness to work in disasters after graduation (ref=unwilling) was analyzed with multi-variate analysis, only “university of students” and “having a hobby related to disasters” were found statistically significant.
Overall, 16.2% of the students stated that they were indecisive to work in disasters in the future, and 1.0% of them stated that they did not want to work in disasters. Moreover, willingness of students to work in nuclear accident and contagious disease disasters has been found to be lower compared to other disaster types.
KayaE, AltintasH. Willingness of Firefighting Program Students to Work in Disasters—Turkey. Prehosp Disaster Med. 2018;33(1):13–22.