bluuebunny/crossref_metadata_2025 huggingface dataset:
(A287) Who Regional Office for Europe - Health Systems Crisis Preparedness Assessment Tool
Authors: Bayer C.P. , Rockenschaub G.
Published: May 2011

WHO Regional Office for Europe - Health Systems Crisis Preparedness Assessment Tool Bayer CP, Rockenschaub G.

Objectives

Health crises are often unpredictable and may occur at any place or time. Communities are particularly vulnerable when local and national systems, specifically health systems, are unable to cope with the consequences of a crisis, usually because they are overwhelmed by a sudden increase in demand or because the institutions that underpin them are fragile and cannot deliver what is required. The World Health Organization (WHO) Europe Health System Crisis Preparedness Assessment Tool aims to provide guidance to ministries of health and other relevant authorities on evaluation and strengthening of their health system's capacities for crisis management.

Methods

Based on an all hazard approach, an assessment tool was developed which comprises essential attributes considered vital for countries to meet the challenges of future health crises. The foundation of the tool derived from expert consultation workshops and pilot testing in eight countries in the WHO European Region.

Results

The tool lists essential attributes with respective indicators crucial for evaluating and identifying gaps in health system crisis preparedness. The assessment tool is structured according to the six building blocks of the WHO health system framework and is complemented by a user manual, allowing countries to apply a self–assessment approach. The tool is intended for use by ministries of health or other relevant institutions.

Conclusions

The tool may help determine the current status of health system crisis preparedness and facilitate the development of a prioritized plan of action that addresses any gaps identified. When used regularly the tool will help monitor progress.
(A289) Developing Damage Assessment Methodology with Community Participation — Case Study of the 2010 Leh Flash Flood
Authors: Kumar A. , Gupta S.
Published: May 2011

The frequency of catastrophic events has increased considerably in recent times. As a result, impacts of such catastrophes have multiplied exponentially. It is the responsibility of the government to revive and reconstruct the communities and economies affected by disasters. Domestic institutions should be resilient enough to absorb the shocks and mitigate the impacts. Too often, damage assessments rely on quantification in terms of monetary valuations of damage. This approach has created various distortions in valuation. Damage evaluation in developed countries is higher because of the monetary value of infrastructure and housing. On the contrary, in a poor, informal settlement, the value of the damage is less, but the impact is huge from a human development perspective. The government follows a standard procedure for items and means of assistance for initiating post-disaster recovery and response. All affected families are entitled to compensation based on the damage done to life and property, irrespective of socio-economic conditions. All items are listed beforehand, with their monetary values ascertained respectively. This paper examines Leh (Ladakh, India), which was struck by heavy flash flood in the month August 2010. It explores the methodology adopted for damage assessment in 42 affected villages of Leh. This case study demonstrates the inherent drawbacks of the standard procedure and methodology in assessing post-disaster damage and needs assessments, and analyzes the role of community participation in household and community damage assessment. The paper presents recommendations for a flexible and accommodating approach for conducting damage assessments on a contextual basis.
(A291) Medico-Physiological Support to Rescuers of Emercom of Russia at Accomplishing their Professional Activity
Authors: Aleksanin S. , Rybnikov V.
Published: May 2011

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.
(A295) Post Disaster Mental Health among Ethnic Minorities in Rural China: Results from Qualitative Studies
Authors: Cheung E.Y.L. , Chan E.Y.Y. , Lam H.P. , Lin C.L.Y. , Lee P.P.Y.
Published: May 2011

Background

China has one of the countries with highest occurrence of disasters and disasters are disproportionately affecting rural area of China where ethnic minorities are inhibiting. Limited studies have been conducted to examine how mental health of ethnic minorities in China might be affected by disasters. Through qualitative focus group study methods, this multi-site project examines the mental health impact of disasters in ethnic minority groups in rural China.

Methods

20 focus groups were conducted in rural Sichuan, Yunnan, Gansu and Hainan province of China to understand the mental health impact and coping of disasters during 2008–2010. Ethnic minority groups including Tai, Naxi, Li, Jiang and Hui affected by earthquake, flooding, mudslide, storm and snow storm were included for the focus group interviews. Guided questions were used and male and female participants participated separately in different groups. Focus groups were held at common area within the village and were all type recorded and transcribed for analyses. Saturation of data was reached and thematic analyses were conducted.

Results

Whilst distress, including mood disturbance, sleep problems and heightened arousal after disaster occurrences, were reported among respondents, when compared with Han Chinese affected in disasters, ethnic minority respondents reported more resilience and coping capacity post disaster. Gender impact and gaps in mental health service were identified.

Conclusion

Study results disparities in resilience and coping behavior among different ethnic groups in China. More in-depth studies should be conducted to understand post disaster mental health needs and service utilization of ethnic minorities in China.
(A299) Comparison of Imbalance in Psyche as Sequel in Amputations and Salvage in Trauma of Extremities
Authors: Raju V.
Published: May 2011

Aim

Comparative analysis of under considered psychological implications in earning members of family who happen to be victims of trauma and end up in early or delayed amputations to those in whom salvage to acceptable or useful function was possible.

Material

Working and ably earning members who sustained traumatic wounds in industry, domestic, traffic, calamity, war, homicide, suicide, etc. Age groups from 1 to 75 years studied. Grade I,II,III A and III B compound wounds included. Psychological evaluation in early and delayed amputations compared with those salvaged to partial / useful function.

Methods

Periodic and frequent counseling as integral part of treatment regime to victims of trauma and their peers, family members, employers, police and lawyers.

Discussion

Classification, incidence and outcome of post traumatic psychosis. Need of effective counseling to reduce post traumatic psychological imbalance and improve quality of life.

Observations

Behavioral changes and suicidal tendency are profound and pronounced in traumatic and early amputees compared to subjects of delayed and revision amputations. Acceptance and adaptability with limb / extremity salvage is encouraging with minimal post traumatic psychosis.

Conclusion

Frequent and repetitive counseling aids reduce post traumatic psychosis. Depressive psychosis is much less prevalent even in partially functionally acceptable traumatic limb salvage than in early or delayed amputations, though salvage takes a long course in management, rehabilitation and changed occupation by relocation.
(A301) Le Centre De Crise Du Ministère Des Affaires Etrangères
Authors: Christophe S.
Published: May 2011

Les crises récentes montrent, si besoin en était, la complexité de leur traitement. Alors que la capacité de l'Etat à gérer les situations de crise est à la fois un élément essentiel de notre politique étrangère et une nécessité de résultat, il était essentiel de se doter d'un outil gouvernemental performant. Cet outil, apte à la prévention des risques (naturels, sanitaires et technologiques) et des menaces à l'étranger, comme en matière de gestion de crises est né en juillet 2008 et a été placé sous l'autorité du Ministre des affaires étrangères et européennes. Doté de plus de cinquante agents le Centre de Crise résulte de la fusion de deux services, initialement indépendants: la sous direction de la sécurité des français à l'étranger et la délégation à l'Action humanitaire. Aujourd'hui les moyens humains et matériels de ces deux entités travaillent dans un but commun: porter assistance aux populations françaises et étrangères partout dans le monde. Compte-tenu de sa vocation à mobiliser l'ensemble des moyens de l'Etat, le Centre de Crise a été placé sous l'autorité directe du Ministre. Il entretient des liens étroits et privilégiés avec ses homologues français de la Santé et de la Sécurité civile, ainsi qu'avec ses partenaires européens, les organismes internationaux (nations unies notamment) et ses partenaires européens (MIC, SitCen).
(A302) Le Feu Dans Un Hôpital, De L'incident ô La Catastrophe
Authors: Lévy F.
Published: May 2011

Le feu dans un hôpital ou une maison de retraite présente des caractéristiques de risque particulier. A propos de la combustion d'un mètre cube de couches culottes pour adulte au Centre hospitalier de Pfastatt dans le Sud de l'Alsace, ces risques particuliers seront montrés. Ce feu globalement insignifiant en terme de quantité de comburant a cependant entraîné quatre morts par inhalation des fumées et plusieurs intoxiqués ainsi que l'évacuation de tout une aile de l'hôpital avec hospitalisation d'une cinquantaine de patients dans d'autres structures de soins sans compter les pertes matérielles et financières liées à la réparation des dégats. Les opérations d'extinction, de triage et d'évacuation des patients se sont déroulées simultanément nécessitant la mise en oeuvre du plan rouge pour nombreuses victimes, une opération de mise en sécurité des patients hospitalisés et l'évacuation vers les structures adaptées avec une coopération et une coordination entre les diférentes structures de secours intervenantes. Les investigations médico-légales secondaires ont permis de montrer chez tous les patients décédés une forte intoxication aux cyanures liée à la nature du comburant et responsables du décès rapide. Ceci pose le problème du stockage de ce type de produit et surtout de la disponibilité d'Hydroxocobalamine, antidote spécifique, en quantité suffisante pour des établissements à risque possédant beaucoup de produits synthétiques. Enfin il convient de signaler que le personnel hospitlier doit être entraîné à avoir les bonnes réactions devant un développement de fumées car c'est en premier de leurs attitudes que dépend la vie des patient en particulier s'ils sont alités.
(A319) Using a Computer Simulation (CS) to Improve Training and Event Management of Paramedics for Mass Casualty Incidents (MCI)
Authors: Jaffe E. , Dagan A. , Zahavi E.
Published: May 2011

Using a Computer Simulation (CS) to improve training and event management of paramedics for Mass Casualty Incidents (MCI). Eli Jaffe, Avi Dagan, Eyal Zahavi, Einat Aviel, Bruria Adini. The Department of Emergency Medicine, Ben-Gurion University of the Negev Magen David Adom (MDA) is the national emergency organization in Israel. Over the past few decades MDA personnel have been required to deal with MCIs involving large numbers of casualties. Recently, there have been fewer terrorist related MCIs, however, there is a continuing need for to maintain the knowledge and skills of paramedics to manage MCIs.

Objective

To examine performance of paramedics exposed to a CS compared to a control group exposed to a traditional lecture based learning experience.

Method

An interactive CS based on the MDA standard operating procedure for managing MCIs was developed. The participants were randomly divided into two groups. Group 1 received the lecture format, and Group 2 the CS. Both groups were given a pre-test (Group 1 average score 56.3, Group 2 average score 53.1), and two post-tests. One immediately following completion of the intervention, and a second a month after completion of the course.

Results

Average scores for the CS Group (n = 15) was significantly different on the first post-test (Group 1 average score 53.2, Group 2 average score 68.7), by 30% and on the second (Group 1 average score 71.9, Group 2 average score 80.8) by 12% compared to the Lecture Group (N = 17) (P = < 0.00).

Conclusion

CS allow for the use of multiple media formats based on real events, and are able to replicate reality using real media material. MDA has recommended that continuing education interventions for emergency medical personnel for maintaining knowledge and skills required for the management of MCIs utilize a CS based training methods.
(A322) Animals in Emergency Management: Veterinary Medical Triage and Treatment
Authors: Case H.
Published: May 2011

Veterinarians have been engaged in emergency preparedness and response activities for many years. The American Veterinary Medical Association (AVMA) founded in 1863 and representing approximately 83% of United States veterinarians, and the American Veterinary Medical Foundation, established by the AVMA in 1963, have been active in emergency preparedness and response, including the development of a world class veterinary disaster response program (VMAT) since 1993. Animals and humans share a special bond in the United States. According to the 2007 AVMA US Pet Ownership and Demographics Sourcebook, there are 72 million dogs, 81.7 million cats, 11.2 million birds and 7.3 million horses in US households. Approximately 60% of all US households own at least one pet, and 64% own more than one pet. Additionally, nearly 60% of pet owners consider their pets to be members of the family, and nearly 50% of pet owners consider their pets to be companions. Few US pet owners consider their pet to be property (approximately 2%). Following Hurricane Katrina, the Pets Evacuation and Transportation Standards Act of 2006 (PETS Act) became US law to ensure that state and local emergency preparedness plans address the needs of individuals with household pets and service animals following a major disaster or emergency. Recently a US effort to identify best practices in disaster veterinary care was sponsored by the US Department of Agriculture and the National Alliance of State Animal Agriculture Emergency Programs and chaired by members of the AVMA. Best practices were identified, including physical examination and triage, vaccination and parasite treatment and prophylaxis, decontamination, euthanasia, medical care of search and rescue dogs, field diagnostics, and components of a disaster veterinary medical equipment cache.
(A324) Emergency Management Preparedness and Response Planning in the US: Aphis Foreign Animal Disease Preparedness and Response Plan (FAD PREP)
Authors: Myers L.M. , Fromberg L.
Published: May 2011

Background

Preparing for and responding to foreign animal diseases are critical missions to safeguard any nation's animal health and food supply. A specific challenge of foreign animal disease preparedness and response is the ability to rapidly incorporate and scale-up veterinary functions and countermeasures into emergency management operations during a disease outbreak. The United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services has established a Foreign Animal Disease Preparedness and Response Plan (FAD PReP) which provides a framework for FAD preparedness and response. The FAD PReP goal is to integrate, synchronize, and de-conflict preparedness and response capabilities, as much as possible, before an outbreak by providing goals, guidelines, strategies, and procedures that are clear, comprehensive, easily readable, easily updated, and that comply with the National Incident Management System (NIMS). An overview of FAD PReP will be presented.

Body

The APHIS FAD PReP incorporates and synchronizes the principles of the National Response Framework (NRF), the National Incident Management System (NIMS), and the National Animal Health Emergency Management System (NAHEMS). The FAD PReP contains general plans and disease specific plans that include incident goals, guidelines, strategies, procedures and timelines for local, State, Tribal and Federal responders. The FAD PReP helps raise awareness of the required veterinary functions and countermeasures, helps identify gaps or shortcomings in current response preparedness and planning, and helps to provide a framework to the States, Tribes, and Industry sectors in developing their individual response plans for specific diseases such as HPAI and FMD. The FAD PReP will also identify resources and personnel for potential zoonotic disease outbreaks and large-scale outbreaks, define stakeholder expectations for successful and timely outcomes, identify and resolve issues that may become competing interests during an outbreak and provide a systems approach to preparedness issues that need additional time, attention and collaboration.
(A330) Training Agricultural Emergency Responders
Authors: Cowen P.L.
Published: May 2011

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.
(A332) Increasing Medical Situational Awareness and Interoperability via “Virtual USA”
Authors: Andress K.
Published: May 2011

Introduction

History is replete with interoperability and resource reporting deficits during disaster that impact medical response and planning. Situational awareness for disaster and emergency medical response includes communicating health hazards as well as infrastructure and resource status, capability and GIS location. The need for actionable, real-time data is crucial to response. Awareness facilitates medical resource placement, response and recovery. A number of internet, web-based disaster resource and situational status reporting applications exist but may be limited or restricted by functional, jurisdictional, proprietary and/or financial requirements. Restrictions prohibit interoperability and inhibit information sharing that could affect health care delivery. Today multiple United States jurisdictions are engaged in infrastructure and resource situation status reporting via “virtual” states and regional projects considered components of “Virtual USA”.

Methods

This report introduces the United States' Department of Homeland Security's “Virtual USA” initiative and demonstrates a health application and interoperability via “Virtual Louisiana's” oil spill related exposure reporting during the 2010, British Petroleum Gulf Horizon catastrophe. Five weekly Louisiana Department of Health and Hospital summary reports from the Louisiana Poison Center; Hospital Surveillance Systems; Public Health Hotline; and Physician Clinic Offices were posted on the Louisiana Office of Homeland Security and Emergency Preparedness's “Virtual Louisiana”.

Results

227 total spill-related, exposure cases from five reporting weeks were provided by five Louisiana source agencies and reported in Virtual Louisiana. Cases were reported weekly and classified as “workers” or “population”; associated with the parish exposure locations (8), offshore (1), or unknown (1); and shared with four other virtual states.

Conclusions

Real-time health and medical situation status, resource awareness, and incident impact could be facilitated through constructs demonstrated by “Virtual USA”.
(A335) Emergent use of Social Media: A New Age of Opportunity for Disaster Resilience
Authors: Keim M.
Published: May 2011

Background

Social media (SM) are forms of information and communication technology disseminated through social interaction. SM rely upon peer-to-peer (P2P) networks that are collaborative, decentralized, and community-driven transforming people from content consumers into content producers. The role of SM in disaster management galvanized during the world response to the 2010 Haiti earthquake. (Pew 2010) During the immediate aftermath, much of what people around the world were learning about the earthquake originated from SM sources. (Nielsenwire 2010) During the first 2 weeks following the earthquake, “texting” mobile phone users donated over $25 million to the American Red Cross. (Sysomos 2010) Both public and private response agencies used Google Maps™. Millions joined MySpace™ and Facebook ™discussion groups to share information, donate money, and offer support. SM has also been described as “remarkably well organized, self correcting, accurate and concentrated”, calling into question the ingrained view of unidirectional, official-to-public information broadcasts. (Sutton, et al 2008) SM may also offer potential psychological benefit for vulnerable populations gained through participation as stakeholders in the response. (Sutton, et al 2008) (Laor 2003)

Discussion

However, widespread use of SM also involves several important challenges for disaster management. Although SM is growing rapidly, it remains less widespread and accessible than traditional media. Also, public officials often view person to person communications as “backchannels” with potential to spread misinformation and rumor. (Akre 2010) In addition, in absence of the normal checks and balances that regulate traditional media, privacy rights violations can occur as people use SM to describe personal events and circumstances. (Palen 2007)
(A336) Sustaining Telecommunications Capability and Capacity during Acute Phase of Disasters and Disaster Responses
Authors: Gardner-Stephen P.
Published: May 2011

Background

Telecommunications plays a critical enabling role in disaster response, both for the local population and for responses of external origin. However, it is common for telecommunications capacity to be reduced or disabled by the disaster or emergency. Meanwhile, the disaster stimulates demand for any remaining capacity, often resulting in total loss of telecommunications capability during the acute phase of a disaster and its response.

Discussion and Observations

The Serval Project is addressing this through the implementation of a mesh mobile telephony system that is compatible with some existing mobile telephone handsets, and can be integrated into many more models without changing handset hardware designs or cost. This technology allows mobile telephones to directly communicate with one another, and allows telephone calls to be made without infrastructure beyond the telephones themselves. Our Distributed Numbering Architecture allows the telephones to use their existing telephone numbers, so that communications can continue immediately and without impediment when needed. The telephones self-organise, and relay calls for distant telephones, thus forming their own resilient telecommunications infrastructure that is able to remain operative during all phases of a disaster and its response, thus addressing an important vulnerability of the existing infrastructure-oriented approach to telecommunications. We see applications that include supporting communities in maintaining communication in order that medical and public health effects of emergencies can be responded to more effectively and potentially providing ready access to communications for distributed teams of emergency health and humanitarian workers in disasters. Our goal in creating this technology and removing all barriers to adoption is to facilitate its ubiquitous inclusion in new mobile telephones, so that we can leverage the mass production of consumer electronics to create a resilient telecommunications capacity that can be deployed anywhere without supporting infrastructure. This would enable the creation of, for example, networks consisting solely of used telephones.
(A343) Rebuilding Post Conflict Food Security in Liberia
Authors: Graham T.W.
Published: May 2011

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.
(A344) Integrating Post-Disaster Reconstruction with Pre-Existing Development Strategies — Experiences from the 2010 Leh Flashflood
Authors: Prakash A. , Kumar A. , Khan S.
Published: May 2011

Disasters cause destruction, but also bring opportunities for development. A lack of this perspective in disaster management leads to planning and managerial follies. The reconstruction and rehabilitation program from the Latur earthquake (Maharashtra, India) should be used as a starting point. Leh, the largest district of India, was hit by a cloudburst and subsequent flashfloods on 05–07 August 2010. The monetary value of the total damages is estimated to be approximately Rs 225 crores. A total of 87% of the affected infrastructure required complete reconstruction. The rest received partial damages. This paper uses field data collected on development needs in 112 villages over a span of five years (just preceding the disaster) and data for damage assessment from the 42 affected villages collected immediately after the disaster. The paper does a careful assessment of the damages in the flashflood, analyses the pre-existing developmental requirements of all the villages in the district, and explores the possibilities of integrating post-disaster reconstruction with the pre-existing developmental requirements. In India, post-disaster reconstruction quite often is an elaboration of short-term, makeshift arrangements, thereby giving rise to obvious developmental concerns. Merits and demerits of this strategy will be discussed. This research examines the financial implications of integrating reconstruction projects with development programs. It also looks into the sustainability of development, and how can this serve as a strategy in making communities more resilient to future disasters.
(A314) Role of Medical Rehabilitation in Acute Disaster Response
Authors: Rathore F.A.
Published: May 2011

Introduction

Natural Disasters result in a sudden onslaught of huge numbers of catastrophic and disabling injuries including spinal cord injuries, traumatic brain injuries, limb amputations, long bone fractures and peripheral nerve injuries. In addition to these there are persons with pre-existing disabilities in the affected disaster zones. Oftentimes disasters overwhelm the available resources and rehabilitation services are usually underdeveloped in most parts of the disaster affected zones. Both challenges are frequently neglected and not included in disaster response planning. As a consequence, Physical and Rehabilitation Medicine (PRM) has traditionally played no or little role in the post disaster phase and disaster planning.

Methodology

The data was derived from an English language literature search (1950–2010) using Pubmed, Google Scholar, Sciencedirect, Ovid, and Sagepub. Other sources of data included discussion with subject matter experts and the author's personal experience.

Results

PRM has not historically become actively engaged in medical rehabilitation of injuries until 24-48 hours post-event. The emergence of the discipline of disaster rehabilitation however, advances PMR into the emergency response phase. This paper describes the disability pattern after disasters, shortcomings in the traditional disaster response with reference to PMR interventions and disabled populations and its negative consequences. It then explores the rehabilitation interventions offered in different disaster scenarios during the last decade and its positive impact in achieving a better outcome for the new onset and pre-existing disabled population.

Conclusions

This is the first paper in biomedical literature exploring the possible role of PRM in the post disaster phase. The paper offers recommendations to include PRM in the disaster response phase and possible plans of action for organizations working in the fields of disability and disaster management. It is expected that this paper will guide future research and establishment of the field of Disaster Rehabilitation.
(A349) The Role of Poison Centers in the 2010 Gulf Oil Spill Response
Authors: Ryan M.
Published: May 2011

Introduction

There are 60 Poison Centers in the United States that manage over 2.5 million poison exposure calls each year. A poison center can be reached 24 hours a day by dialing a national 800 hotline. Poison Centers are staffed by Specialists in Poison Information who are highly trained in clinical toxicology and are very skilled in telephone triage.

Discussion

ATSDR and the Poison Centers in HHS/FEMA Region 6 developed draft guidance for incorporating Poison Centers into the National Response Plan. That framework was used to incorporate Poison Centers into the gulf oil spill response of 2010. The National Poison hotline was promoted to provide medical support for those with health effects or health questions related to the spill. During the response the surveillance capabilities of the National Poison Data System (NPDS) were highlighted. The Louisiana Poison Center (LPC) and the other gulf states Poison Centers provided information on health effects related to the spill. Information was provided by the LPC to the Louisiana Department of Health and Hospitals, Office of Public Health Section of Epidemiology and Environmental Toxicology, public information officer to assist in briefing the Governor, the Louisiana Governors Office of Homeland Security and Emergency Preparedness to post to the Virtual Louisiana website, as well as ATSDR, CDC, EPA, and other agencies participating in the gulf response unified command. Poison Centers, for the first time, participated in a response on a national level, providing medical support for those with symptoms or medical questions related to the spill. In addition to assisting in the medical care of those exposed to substances related to the oil spill and the response efforts, Poison Centers also responded to questions about air and water quality and seafood safety.

Conclusion

Poison Centers are a valuable resource to assist in emergency response plans.
(P1-4) Building Resilient Extended-Care Facilities during Natural Disasters – Lessons Learned From the 2007 Tulsa, Oklahoma Ice Storm
Authors: Stewart C.E. , Gulden J.
Published: May 2011

Building Resilient Extended-Care Facilities During Natural Disasters – Lessons Learned from the 2007 Tulsa, Oklahoma Ice Storm. In the last decade, increasing importance has been placed on building resiliency into critical healthcare systems. This has meant shifting the paradigm from focusing on response to one of preparedness. In 2007, an ice storm as part of a series of winter storms occurred in the south central United States causing extensive power outages, in Tulsa, Oklahoma, for a period of up to 3 weeks. Five of the six tertiary care hospitals in Tulsa suffered power outages, phone system failures or oxygen and/or suctioning system failures. Local water treatment plants were without power for 48 hours. During this time, multiple extended-care (nursing home) patients were discharged to homes or transferred to hospitals because the nursing homes were not prepared to cope with an extended power outage. This paper is a retrospective analysis and discussion of lessons learned with respect to the vulnerability of these extended-care healthcare systems and the public health response during natural disasters.
(P1-5) How Does Land use Pattern could Effect to Mitigate the Risk Flash Floods” a Success Story on a Model Project Implementing at the Upper Catchments Area of Badullu River in Sri Lanka
Authors: Attanayake K.J.
Published: May 2011

The watersheds are the home for our key natural resources and have been one of the basic elements in land use management systems throughout the hydraulic civilization of our country. “Badulla River” is one of the main watersheds in Sri Lanka extend about 1400sq.km consisting five sub catchments high steep lands. It mainly represents tea estates and agricultural lands with a weak land use pattern due to poor maintenance and unsuitable human involvements. This has contributed to reduce the rain water infiltration in to the soil increasing a huge amount of runoff water drainage. Situation has resulted frequent floods even in a small precipitation causing widespread damages to community. Hence, an initial project was started on surface water management, soil conservation and livelihoods development to control the frequent floods highlighting the urgent actions for an optimal land use management with support of field experts. Improved surface water drainage and soil conservation are the main options that might lead to mitigate the flash floods. Efforts were sharpened by integrating GIS Mapping for such initiation to enhance the effectiveness of the design. Results achieved could address many issues in relation to flood protection, habitat management, water protection and water quality management. Food risk generally related to the specific characters in a particular catchments and this model project proved that such issues can effectively be addressed through a joint program properly designed.
(P1-15) Russian Mobile Hospital Response to the Earthquake in Sumatra, Indonesia, October 2009
Authors: Petlakh V.I. , Bojko N.V. , Demenko V.V. , Popov A.S.
Published: May 2011

Introduction

A destructive 7.9 magnitude earthquake struck the Sumatra Island of Indonesia on 30 September 2009. A Russian mobile hospital was implemented on 04 October in the village of Lupu-Alu, 20 km from the city of Padang.

Method

The mobile hospital consisted of 20 pneumo modules equipped with technical systems. Personnel included 9 engineers and 25 medical specialists comprised of surgeons, therapists, traumatologists, children's surgeons, a pediatrician, and anesthesiologists. An air-mobile hospital was equipped with modern medical equipment (X-ray, ultrasonic diagnostics, etc.). Work at the hospital was complicated by almost daily tropical rains. The language barrier was addressed by using local translators who spoke Russian or English languages.

Results

Medical aid was rendered to 479 patients. The intensive care department experienced the heaviest patient load (n = 11). Trauma (n = 54, 2%) and proinflammatory complications prevailed among surgical patients (n = 131). Treatment of bone fractures represented significant difficulties due to the late delivery of care. Of the 479 patients, 207 (43.2%) were children; among them, 49 (7%) had diseases of the upper airways, and 30 (4%) experienced trauma. Psychologists consulted with 52 children with post-traumatic stress syndrome. Telemedical consultations were conducted by the following specialists: (1) orthopedist (n = 2); (2) dermatologist (n = 2); (3) neurosurgeon (n = 1); and (4) plastic surgeon (n = 1).

Conclusions

Following the earthquake, medical personnel at the Russian mobile hospital in Indonesia experienced: (1) a large number of outpatients with various diseases who lacked medical care as a result of the non-functioning network of local public health services; (2) the admission of the patients with complications of trauma; (3) a significant number of children with inflammatory diseases of the upper airways; and (4) an opportunity of use telemedical consultations.
(P1-16) Local Health-Related Capacities in the Northern Haiti Post-Earthquake Response
Authors: King R.A. , Thomas D.S.K. , Montas S. , Minn P. , Varda D. , Sasson C. , Ansari S.
Published: May 2011

Background

The January 2010 earthquake affected many services in Haiti, including health care. After the disaster, top-down response from international sources seemed like the only solution. While the existing health system was fragile, opportunities likely existed for incorporating bottom-up approaches in the capital and other cities, such as Cap Haitien in the North.

Objective

The study aims to: (1) identify available local health-related resources; (2) examine how these were, or were not, utilized in response efforts; and (3) evaluate the level of coordination among health delivery groups, particularly preparedness and recovery.

Methods

This case study included 11 key informant interviews at two hospitals (six at Justinian and five at Milot) and an organizational analysis of cooperation among 16 health-related organizations operating in northern Haiti. Disaster preparedness and recovery data for the health-sector organizations were obtained using a validated survey instrument and the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) tool that uses the principles of Social Network Analysis (SNA) to elucidate the makeup of collaborative relationships.

Results

During the response phase, command-and-control approaches from international healthcare organizations had a roll given the numbers of people affected and the overwhelmed local response capabilities. Pre-disaster vulnerabilities limited response capacity. Even during response, opportunities existed for integrating established groups. Generally, this was not a model utilized by international organizations, although some examples were present.

Conclusions

The external infusion of money, priorities, and forces potentially may harm the current system, rather than build upon it. International aid provides free health services beyond treatment of earthquake-related injuries, taking the place of some service functions of the Haitian system. Eventually, this could erode aspects of the Haitian health system. Alternative models of aid may better incorporate and integrate existing structures. Disaster planning is linked intrinsically to strengthening the health system as a whole.
(P1-19) Disaster Medical System in APEC Japan 2010
Authors: Kondo H.
Published: May 2011

Background and Method

The preparedness for mass casualty is needed in political event. We have the experience to build up the disaster medical system in G8 summit in Okinawa and Hokkaido. But these two areas were resort area which had little population. This time Japan hosted APEC JAPAN 2010 which held in Yokohama City. We reported disaster medical system for this event in big city.

Result

We mobilized DMAT from 21 hospitals whole Japan. We set 11 teams in Yokohama city, 10 teams in 2 Airports. DMAT inspected rerated disaster base hospitals. These hospitals made the plan for receive mass casualty included the victims by CBRNE event and had the exercise. They set up the decontamination system during APEC leader's week. We also have the contingency plan to coordinate with fire department. This contingency plan included transportation plan for hospitals and coordination plan in site. In transportation plan, sever casualty transported dispersal for hospital in Yokohama within 25. For over 25, sever casualty transported intensive for 4 hospitals in Yokohama. After stabilization treatment in these hospitals, the casualty transported dispersal from these hospitals to outside of Yokohama. In coordinate plan in site included job description in command and control, decontamination and medical relief post.

Discussion

We established disaster medical system for APEC JAPAN 2010. This event hold in Yokohama City had the big population. Compare with former G8 summit, medical system put importance in mass casualty event. As a result, non mass casualty event happened. But this preparedness will contribute not only future same kind events but also accidental mass casualty event such as train accident.
(P1-20) Disasters and Women's Health: The 2010 Earthquake in Haiti
Authors: Bloem C. , Miller A.
Published: May 2011

Background

Recent reports have highlighted the health disparities that women and other vulnerable populations experience following disasters. Humanitarian groups have struggled to implement effective measures to mitigate such disparities during subsequent disasters.

Objectives

To analyze and provide practical solutions to mitigate barrier's to women's health encountered in Haiti following the 7.0 magnitude earthquake in January 2010.

Methods

In February 2010, a New York based team of emergency and international medicine specialists staffed the mobile emergency department in Port au Prince at L'Hôpital de l'Université d'Etat d'Haïti.

Results

Common presentations included infectious diseases, traumatic injuries, chronic disease exacerbations, and follow-up for earthquake-associated conditions. Female gender-specific problems included vaginal infections, breast pain or masses, pregnancy-related concerns, and the effects of gender-based violence. Identified barriers to effective gender-specific care included communication, camp geography, supply availability, and poor inter-organization communication.

Discussion

Recent disasters in Haiti, Pakistan, and elsewhere have challenged the international health community to provide gender-balanced healthcare in sub-optimal environments. Much room for improvement remains. Although our assessment team was gender-balanced, improved incorporation of Haitian personnel may have enhanced patient trust, and improved cultural sensitivity and communication. Camp geography should foster both patient privacy and security during sensitive examinations. This could have been improved upon by geographically separating men's and women's treatment areas and using a barrier screen to generate a more private examination environment. Women's health supplies must include an appropriate exam table, emergency obstetrical and midwifery supplies, urine dipsticks, and sanitary and reproductive health supplies. A referral system must be established for patients requiring a higher level-of-care. Lastly, improved inter-organization communication and promotion of resource pooling may improve treatment access and quality for select gender-based interventions.

Conclusion

Simple inexpensive modifications to organized post-disaster medical relief settings may dramatically reduce gender-based healthcare disparities.