BackgroundIn the summer of 2015, the exodus of Syrian war refugees and saturation of refugee camps in neighbouring countries led to the influx of asylum-seekers in European countries, including Belgium. This study aims to describe the demographic and clinical characteristics of asylum seekers who arrived in a huddled refugee camp, in the centre of a well-developed country with all medical facilities.MethodsUsing a descriptive cross-sectional study design, physicians of Médecins du Monde prospectively registered age, gender, origin, medical symptoms and diagnoses of all patients presenting to an erected field hospital in Brussels in September 2015. Diagnoses were post hoc categorised according to the International Classification of Diseases.ResultsOf 4037 patients examined in the field hospital, 3907 were included and analysed for this study. Over 11% of patients suffered from injuries, but these were outnumbered by the proportion of patients with respiratory (36%), dental (9%), skin (9%) and digestive (8%) diagnoses. More than 49% had features of infections at the time of the consultation.ConclusionsAsylum seekers arriving in a refugee camp in Brussels after a long and hazardous journey suffer mostly from respiratory, dental, skin and digestive diseases. Still, one in seven suffers from injury. These findings, consistent with other reports, should be anticipated when composing emergency medical teams and interagency emergency health or similar kits to be used in a field hospital, even in a Western European country.Trial registration numberISRCTN13523620, Results.

Background: In 2003, the Task Force on Quality Control of Disaster Management (WADEM) published guidelines for evaluation and research on health disaster management and recommended the development of a uniform data reporting tool. Standardized and complete reporting of data related to disaster medical response activities will facilitate the interpretation of results, comparisons between medical response systems and quality improvement in the management of disaster victims. Methods: Over a two-year period, a group of 16 experts in the fields of research, education, ethics and operational aspects of disaster medical management from 8 countries carried out a consensus process based on a modified Delphi method and Utstein-style technique. Results: The EMDM Academy Consensus Group produced an Utstein-style template for uniform data reporting of acute disaster medical response, including 15 data elements with indicators, that can be used for both research and quality improvement. Conclusion: It is anticipated that the Utstein-style template will enable better and more accurate completion of reports on disaster medical response and contribute to further scientific evidence and knowledge related to disaster medical management in order to optimize medical response system interventions and to improve outcomes of disaster victims.

Objective: The Syrian civil war since 2011 has led to one of the most complex humanitarian emergencies in history. The objective of this study was to document the impact of the conflict on the familial, educational, and public health state of Syrian children. Methods: A cross-sectional observational study was conducted in May 2015. Health care workers visited families with a prospectively designed data sheet in 4 Northern Syrian governorates. Results: The 1001 children included in this study originated from Aleppo (41%), Idleb (36%), Hamah (15%), and Lattakia (8%). The children's median age was 6 years (range, 0-15 years; interquartile range, 3-11 years), and 61% were boys. Almost 20% of the children were internally displaced, and 5% had deceased or missing parents. Children lacked access to safe drinking water (15%), appropriate sanitation (23%), healthy nutrition (16%), and pediatric health care providers (64%). Vaccination was inadequate in 72%. More than half of school-aged children had no access to education. Children in Idleb and Lattakia were at greater risk of having unmet public health needs. Younger children were at greater risk of having an incomplete vaccination state. Conclusions: After 4 years of civil war in Syria, children have lost parents, live in substandard life quality circumstances, and are at risk for outbreaks because of worsening vaccination states and insufficient availability of health care providers. (Disaster Med Public Health Preparedness. 2016;10:874-882)

It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS). Computer modelling and simulation enable to study and test operational assumptions in a virtual but controlled experimental environment. The SIMEDIS (Simulation for the assessment and optimization of medical disaster management) simulation model consists of 3 interacting components: the victim creation model, the victim monitoring model where the health state of each victim is monitored and adapted to the evolving clinical conditions of the victims, and the medical response model, where the victims interact with the environment and the resources at the disposal of the healthcare responders. Since the main aim of the DMR is to minimize as much as possible the mortality and morbidity of the survivors, we designed a victim-centred model in which the casualties pass through the different components and processes of a DMRS. The specificity of the SIMEDIS simulation model is the fact that the victim entities evolve in parallel through both the victim monitoring model and the medical response model. The interaction between both models is ensured through a time or medical intervention trigger. At each service point, a triage is performed together with a decision on the disposition of the victims regarding treatment and/or evacuation based on a priority code assigned to the victim and on the availability of resources at the service point. The aim of the case study is to implement the SIMEDIS model to the DMRS of an international airport and to test the medical response plan to an airplane crash simulation at the airport. In order to identify good response options, the model then was used to study the effect of a number of interventional factors on the performance of the DMRS. Our study reflects the potential of SIMEDIS to model complex systems, to test different aspects of DMR, and to be used as a tool in experimental research that might make a substantial contribution to provide the evidence base for the effectiveness and efficiency of disaster medical management.Electronic supplementary materialThe online version of this article (doi:10.1007/s10916-016-0633-z) contains supplementary material, which is available to authorized users.

The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it.In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters.We propose the following universal medical and public definition of terrorism: The intentional use of violence — real or threatened — against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.

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As in any other medical discipline, developments in disaster medicine have occurred. A model for medical disaster management is briefly discussed and then applied retrospectively to the Enschede fireworks disaster (2000). Differences between the theoretical model and the actual situation are shown with respect to the number of casualties, the average severity of injury sustained, the medical rescue capacity, the medical transport capacity and hospital treatment capacity. It was concluded that the proposed model for the management of disasters with traumatically injured victims worked adequately.

Introduction During disaster relief, personnel’s safety is very important. Mental well being is a part of this safety issue. There is however a lack of objective mental well being monitoring tools, usable on scene, during disaster relief. This study covers the use of validated tools towards detection of psychological distress and monitoring of mental well being of disaster relief workers, during the Belgian First Aid and Support Team deployment after the Haiti earthquake in 2010. Methodology The study was conducted using a demographic questionnaire combined with validated measuring instruments: Belbin Team Role, Compassion Fatigue and Satisfaction Self-Test for Helpers, DMAT PsySTART, K6+ Self Report. A baseline measurement was performed before departure on mission, and measurements were repeated at day 1 and day 7 of the mission, at the end of mission, and 7 days, 30 days and 90 days post mission. Results 23 out of the 27 team members were included in the study. Using the Compassion Fatigue and Satisfaction Self-Test for Helpers as a monitoring tool, a stable condition was monitored in 7 participants, a dip in 5 participants, an arousal in 10 participants and a double pattern in 1 participant. Conclusions The study proved the ability to monitor mental well being and detect psychological distress, by self administered validated tools, during a real disaster relief mission. However for practical reasons some tools should be adapted to the specific use in the field. This study opens a whole new research area within the mental well being and monitoring field. Citation: Van der Auwera M, Debacker M, Hubloue I. Monitoring the mental well-being of caregivers during the Haiti-earthquake.. PLoS Currents Disasters. 2012 Jul 18