Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti : Variability in Injuries Encountered and Collaboration with Local Available Resources Drive Optimal Response

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2016 Jun 4

PMID 27255939

Citations 5

Authors

Elhanan Bar-On

Nehemia Blumberg

Amit Joshi

Arnon Gam

Amos Peyser

Evgeny Lee

Shree Krishna Kashichawa

Alexander Morose

Ophir Schein

Amit Lehavi

Yitshak Kreiss

Tarif Bader

Affiliations

Soon will be listed here.

Abstract

Background: Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different-independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events. The purpose of this study was to analyze these differences and their implications for preparation and planning of future deployments.

Methods: Data were obtained from IDF records and analyzed using SPSS™ software.

Results: 1686 patients were treated in Nepal versus 1111 in Haiti. The caseload in Nepal included significantly less earthquake-related injuries (26 vs. 66 %) with 28 % of them sustaining fractures versus 47 % in Haiti. Femoral fractures accounted for 7.9 % of fractures in Nepal versus 26.4 % in Haiti with foot fractures accounting for 23.8 and 6.4 %, respectively. The rate of open fracture was similar at 29.4 % in Nepal and 27.5 % in Haiti. 18.1 % of injured patients in Nepal underwent surgery, and 32.9 % of which was skeletal compared to 32 % surgical cases (58.8 % skeletal) in Haiti. 74.2 % of patients in Nepal and 34.3 % in Haiti were treated for pathology unrelated to the earthquake.

Conclusions: The reasons for the variability in activities between the two hospitals include the magnitude of the disaster, the functionality of the local medical system which was relatively preserved in Nepal and destroyed in Haiti and the mode of operation which was independent in Haiti and collaborative with a functioning local hospital in Nepal. Emergency medical teams (EMTs) may encounter variable caseloads despite similar disaster scenarios. Advance knowledge of the magnitude of the disaster, the functionality of the local medical system, and the collaborative possibilities will help in planning and preparing EMTs to function optimally and appropriately. However, as this information will often be unavailable, EMTs should be capable to adapt to unexpected conditions.

Citing Articles

Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaraş earthquake; a section from Gaziantep Nurdağı district.

Tomak L, Demirel T, Demir I BMC Public Health. 2024; 24(1):937.

PMID: 38561730 PMC: 10986009. DOI: 10.1186/s12889-024-18444-7.

Medical care following earthquakes: Clinical, organizational, and logistic challenges.

Bar-On E Acta Orthop Traumatol Turc. 2024; 57(6):296-300.

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Medical disaster response: A critical analysis of the 2010 Haiti earthquake.

Arnaouti M, Cahill G, Baird M, Mangurat L, Harris R, Edme L Front Public Health. 2022; 10:995595.

PMID: 36388301 PMC: 9665839. DOI: 10.3389/fpubh.2022.995595.

Impact of 2015 earthquakes on a local hospital in Nepal: A prospective hospital-based study.

Giri S, Risnes K, Uleberg O, Rogne T, Shrestha S, Nygaard O PLoS One. 2018; 13(2):e0192076.

PMID: 29394265 PMC: 5796718. DOI: 10.1371/journal.pone.0192076.

A review of the epidemiology and treatment of orthopaedic injuries after earthquakes in developing countries.

MacKenzie J, Banskota B, Sirisreetreerux N, Shafiq B, Hasenboehler E World J Emerg Surg. 2017; 12:9.

PMID: 28203271 PMC: 5301447. DOI: 10.1186/s13017-017-0115-8.

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