 |
The Chinese
Medical Response in
|
| |
The Chinese
Medical Response in
|
The Chinese Medical Response in
Wenchuan Earthquake Relief :
Experience of Rescue Team Member
Wenchuan Earthquake was the worst earthquake in China during past 30 years which left 69185 dead. Chinese medical responses were prompt and considerable to provide rescue services. We found that This sudden disaster and subsequent rescue work may have some implications for future practice, while continuing help is still needed for the local residents despite the completion of the early rescue work.
The Chinese Medical Response in
Wenchuan Earthquake Relief :
Experience of Rescue Team Member
An 8.0 magnitude earthquake struck Wenchuan county of the South-Western province of Sichuan in China at 2:28 p.m. local time on May 12, 2008. It was the worst earthquake to hit China in the past 30 years. By June 26, 2008, the Wenchuan earthquake and aftershocks had left 69,185 dead, 374,174 injured, 18,457 missing, and nearly 15 million people displaced, of which five million are still homeless, according to the ministry of civil affairs of China. The national and international response was prompt and considerable: more than 100 national and international teams arrived and provided search and rescue services, together with local rescue efforts. All incoming personnel, including rescue groups, health servants, military troops and volunteers actively worked together, led either by government politics or by the need to help. At the same time, large numbers of injured people were transferred to hospitals throughout China because many local medical facilities in Sichuan had been destroyed and their personnel injured or killed.
Just hours after the earthquake, the Chinese government activated its national Medical Surgical Response Teams, of which we are members. We were notified late in the afternoon on May 12, 2008 to be prepared to head to the epicenter of the earthquake. We were deployed by car and plane to Beichuan by the next day’s afternoon. A total of 466 well trained and professional health care workers composed entirely of civil servants from our university and affiliated hospitals were divided into 26 teams and sent to the epicenter consecutively with fully equipped and deployable field hospitals. Almost all kinds of specialists in trauma surgery, orthopedics, cerebral surgery, anesthesiology, emergency medicine, primary care, cardiology, and pediatrics were selected to be in the teams.
After checking the local environment and considering the transition distance, geographical location and beneficiary allocation, we set up our field hospital on a playground of Anxian high school near the destroyed town of Beichuan, adjacent to two other national field hospitals from Shanghai and Beijing city. It took us only 3 hours at midnight to set up a simple field hospital despite the cold nighttime temperature and lack of running water. We started surgical operations for the refugees within 4 hours. Over the first 3 weeks of working day and night, our teams triaged and provided initial stabilization and definitive care to 5398 patients including 1094 seriously injured, carried out 2146 operations, and provided psychosocial counseling for 5531 disaster survivors. Meanwhile, we participated in the epidemic prevention after the initial rescuing work. We sprayed a total of 210 tons of disinfectant, covering an area of 2050 km2which is one-ninth of total epidemic preventive efforts in earthquake area.
To better fulfill our assignment, we set up a set of plan based on our well practiced battlefield medical care procedures. We arranged two surgical rooms for urgent patients, two big tents with 30 beds each for the people in need of less urgent care, two X-ray machines worked in order by three technicians. In order to promptly provide the best help for the seriously injured, we closely cooperated with disaster relief troops and professional relief groups to triage refugees and provide stabilization and definitive care for them. In addition to saving lives in the early phase, we provided professional treatment for non-life-threatening injuries caused by earthquake, such as trauma to the head and extremities, soft tissue infections, etc. Psychological support was also very important, especially for those who lost their family members and children who were saved from the debris. We have professional psychological consultation teams to help them live through this tough period.
The mountainous geographic characteristics of the earthquake area made the rescue work extremely difficult. Due to limits on transportation and communication, there were lots of rural patients who could not be transported to hospitals to receive dedicated care. The challenges of bad weather and threats from post earthquake landslides and lake flooding also made rescue efforts hard. Several of our members went out to the small towns with medicine to serve those patients who needed treatment but had no access to hospitals.
It is estimated that hundreds of thousands of people are likely to remain living in tents and makeshift shelters in the geographically flatter urban areas for months ahead. Living conditions in these tents and transitional settlements are harsh and will only worsen as summer temperatures continue to rise to the 40 degrees Celsius mark. Prevention of epidemic and psychological problems among the refugees will grow more urgent as an issue. As health professionals, we increased efforts to establish better methods of collecting epidemic data, training local health workers, teaching residents how to prevent diseases and mollify feelings of sadness and depression. As of yet there have not been major epidemic outbreaks after this huge disaster despite heavy rain, high temperature, and complete devastation of basic infrastructure including water supply and sewage treatment. Quick responses by the government and efforts by preventive care medical workers including our effort played a role, and this may have some implications for future practice. The psychological impact of this disaster, however, may be long-lasting. Though at present there have not been any reports of severe mental trauma, many cases are sure to arise in the future, especially when the situation calms down and affected children grow up. This aspect of the quake should be given sustained attention by professional mental health workers.
During the past 2 months, we also witnessed the precious and generous aids from all around the world. These countries selfless devotion embodied the spirit of humanitarianism. We would like to give our appreciations to all the international relief groups and donors. The Qingchuan field hospital equipped by AmeriCares will serve people in the area hardest hit by the earthquake for which we will also provide help with the staff training for the next 3 to 5 years.
In China, with the quickening process of urbanization and population intensification, the threats of natural disasters are increasing and the need for emergency medical response with specialized health care is more urgent than ever before. This sudden disaster and subsequent rescue work may have some implications for future practice. First, more detailed and better practiced preparation for emergency medical situations should be established. Second, patient transportation systems by air and on ground should be improved and dedicated. Third, the training of local relief groups and improvement of rural health infrastructure also need further improvement.
A consistent medical approach to disasters, called the mass-casualty-incident response, based on an understanding of common features and the response expertise required, is becoming the accepted practice throughout the world (Briggs & Brinsfield, 2003; Leaning et al., 1999). This strategy includes four critical medical components: search and rescue, triage and initial stabilization, definitive medical care, and evacuation (Schnitzer & Briggs, 2004). Epidemic prevention and mental health care are also inevitable components.
Continuing help is needed for the local residents despite the completion of the early rescue work. Rebuilding of local health infrastructure and health care facilities in may require more help from the government and health care professionals. As medical workers, we hope we can do more in this process.
Briggs S. M. & Brinsfield KH. (2003) (Eds). Advanced disaster medical response: manual for providers. Boston: Harvard Medical International.
Leaning J, Briggs SM, Chen LC. (1999) (Eds). Humanitarian crises: the medical and public health response. Cambridge, Mass.: Harvard University Press.
Schnitzer JJ. & Briggs SM. (2004) Earthquake Relief-The U.S. Medical Response in Bam, Iran. New England Journal of Medicine, 350, 1174-1176.
| Comments to Trauma.Webmaster@massey.ac.nz Massey University, New Zealand URL: http://trauma.massey.ac.nz/ |
Disclaimer
Last changed July 24, 2009 |