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In the 1960s and 1970s, revolutionary guerrilla groups rose as the epitome of anti-imperialist resistance across the globe. Feeling the heat of this global movement, Iranian activists left the country to undergo guerrilla training and participate in irregular battles in the Middle East and beyond. After the 1979 revolution, a few of these trained guerrillas became involved in the formation of a revolutionary state militia, soon to be known as the Islamic Revolutionary Guards Corps (IRGC). This did not make the IRGC a professional guerrilla force, despite IRGC leaders’ retrospective claims. Nevertheless, the IRGC can be seen as a participant in and a contributor to the global network of guerrilla organizations, although not in terms of structure and practice. This chapter follows Iranian activists’ extraterritorial networks and trajectories of key individuals within them. It demonstrates that as a state-sponsored militia, the Revolutionary Guards translated the common global guerrilla agenda – that of a systematic fight against a given imperialist state – into defying state-mandated rigid and centralized organization. With the help of previously tested patterns of informal order within Islamist circles, the IRGC emerged as a revolutionary organization for postrevolutionary times, leaving its mark on a new era of state-sponsored yet insurgent militias.
On 26 December 2003, an earthquake measuring 6.5 on the Richter scale occurred in the city of Bam in southeastern Iran. Bam was destroyed completely, >43,000 people were killed, and 30,000 were injured. The national and international responses were quick and considerable. Many field hospitals werecreated and large numbers of patients were evacuated from their homes and transported to hospitals throughoutIran. Nearly 700 patients were transferred to Chamran hospital in Shiraz within the first 48 hours after the earthquake.
Methods:
This is a retrospective study based on the medical records of earthquake casualties dispatched to Chamran Hospital. A screening tunnel composed of multiple stations was prepared before patients entered to facilitate the large influx of patients. Each of the victims was passed through this screening tunnel and assigned into one of three groups: (1) those needing emergency surgical intervention; (2) those needing less urgent surgery; and (3) those needing elective operations, supportive care, observation, and/or rehabilitation.
Results:
Among the 708 patients, 392 were male (male/female ratio: 1.24) with a mean value of their ages of 30.5 years. (range: 1.5 months–70 years). Extremity fractures (136, 19%) were more common than were axial skeleton fractures (28, 4%). Out of the total 708 patients, 152 (21.5%) patients needed emergency operations, 26 (4%) needed less urgent surgery, and 530 (74.5%) required wound care or antibiotic therapy and other forms of supportive care. Some complications occurred, such as two patients with compartment syndromes of theleg, three required below-the-knee amputation, eight suffered acute renal failure, two developed fat emboli syndrome, and one had a brain injury that resulted in death.
Conclusion:
A comprehensive disaster plan is required to ensure a prompt disaster response and coordinated management of a multi-casualty incident. This can influence the outcomes of patients directly. A patient screening tunnel has advantages in rapid and effective evaluation and management of victims in any multi-casualty incident.
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