“Recovering, not recovered” Hospital disaster resilience: a case-study from the 2015 earthquake in Nepal

Almeida, Maria Moitinho de

doi:10.1080/16549716.2021.2013597

Cited by 9 publications

(16 citation statements)

References 43 publications

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“…Due to being trapped under rubble, 48.9% of survivors suffered extremity crush injuries. 15 In the present study, 80.2% of the 662 victims were admitted as survivors to the emergency services (36.8% had been rescued under rubble, 40.1% had suffered injuries while trying to escape the earthquake, and 3.3% for nontraumatic reasons) while 19.8% had died under the rubble. The majority of the 131 deceased victims were women (52.7%), 20.6% were children, and 7.6% were elderly.…”

Section: Discussionmentioning

confidence: 53%

“…Health care demand increases suddenly after earthquakes and facilities face the highest admissions within 72 hours of the earthquake. 10 , 15 , 16 Sixty-eight percent (68.0%) of the 2,622 patients with earthquake-related injuries were admitted to the hospital within three days of the Yushu earthquake. 10 During the Taiwan earthquake in 2016, 123 entrapped victims under collapsed buildings were extricated and transported to hospitals within 72 hours after the events.…”

Section: Discussionmentioning

confidence: 99%

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First-Week Analysis after the Turkey Earthquakes: Demographic and Clinical Outcomes of Victims

Sarı

Özel

Akkoç

et al. 2023

Prehosp. Disaster med.

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Background: During a major earthquake, escape attempts or collapsed buildings can result in injury, disability, and even death for victims. The aim of this study is to examine the demographic characteristics, clinical outcomes, and injuries of victims admitted to the emergency department within the first week after an earthquake. Methods: This is a retrospective observational study conducted on earthquake victims who were admitted to the emergency services of a tertiary medical faculty and a training and research hospital in the city of Diyarbakir, located in the Southeastern Anatolia Region of Turkey, from February 6 through February 12, 2023. Results: Of the eligible 662 earthquake victims, the mean age was 10.66 (SD = 4.78 [min 0, max 17]) in children, 36.87 (SD = 4.78 [min 18, max 63]) in adults, and 72.85 (SD = 5.83 [min 65, max 84]) in the elderly. Women constituted 52.8% of the victims, 19.7% were children, and 8.0% were elderly. Sixty-one percent (61.0%) of earthquake victims were admitted to emergency services in the first three days following the disaster; 37.7% of all victims were transferred from other affected cities to Diyarbakır. In all, 80.2% of the victims were admitted as survivors to the emergency services (36.8% were rescued under rubble, 40.1% with injuries while attempting to escape the earthquake, and 3.3% with nontraumatic reasons) and 19.8% were deceased under rubble. The majority of the 131 deceased victims were women (52.7%), 20.6% were children, and 7.6% were elderly. An estimated 38.3% of victims were hospitalized (20.9% in the ward and 17.4% in the intensive care unit [ICU]). For all age groups that survived under the rubble, the extremities were most injured (53.6% for children, 53.1% for adults, and 55.5% for the elderly). Of adult survivors, 26.6% needed only fluid therapy, renal replacement treatment (hemodialysis) was required 20.7%, and 11.8% required amputation. Of children survivors under the rubble, renal replacement treatment (hemodialysis) was required for only four, seven required amputation, and 12 needed only fluid resuscitation for crush injury. Of elderly survivors, two needed only fluid therapy, renal replacement treatment (hemodialysis) was required for two, and no amputation was required. Six patients survived under the rubble and died in the ICU. Conclusion: The definition of the demographic characteristics and clinical outcomes of earthquake patients is critical to the development of preparedness, response, and recovery policies for future disasters.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

First-Week Analysis after the Turkey Earthquakes: Demographic and Clinical Outcomes of Victims

Sarı

Özel

Akkoç

et al. 2023

Prehosp. Disaster med.

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“…Flexibility and creativity were frequently described as important features of adaptiveness during times of crisis, particularly for the health workforce. In FCAS, flexibility and creativity were linked to increases in demand linked to population displacement [ 51 , 56 , 57 ] or to the scarcity of resources and means due to disrupted supply chains [ 58 – 61 ]. These characteristics were also described as important within the informal health workforce.…”

Section: Resultsmentioning

confidence: 99%

Health systems resilience in fragile and conflict-affected settings: a systematic scoping review

Truppa,

Yaacoub,

Valente

et al. 2024

Confl Health

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Background Health systems resilience (HSR) research is a rapidly expanding field, in which key concepts are discussed and theoretical frameworks are emerging with vibrant debate. Fragile and conflict-affected settings (FCAS) are contexts exposed to compounding stressors, for which resilience is an important characteristic. However, only limited evidence has been generated in such settings. We conducted a scoping review to: (a) identify the conceptual frameworks of HSR used in the analysis of shocks and stressors in FCAS; (b) describe the representation of different actors involved in health care governance and service provision in these settings; and (c) identify health systems operations as they relate to absorption, adaptation, and transformation in FCAS. Methods We used standard, extensive search methods. The search captured studies published between 2006 and January 2022. We included all peer reviewed and grey literature that adopted a HSR lens in the analysis of health responses to crises. Thematic analysis using both inductive and deductive approaches was conducted, adopting frameworks related to resilience characteristics identified by Kruk et al., and the resilience capacities described by Blanchet et al. Results Thirty-seven studies met our inclusion criteria. The governance-centred, capacity-oriented framework for HSR emerged as the most frequently used lens of analysis to describe the health responses to conflict and chronic violence specifically. Most studies focused on public health systems’ resilience analysis, while the private health sector is only examined in complementarity with the former. Communities are minimally represented, despite their widely acknowledged role in supporting HSR. The documentation of operations enacting HSR in FCAS is focused on absorption and adaptation, while transformation is seldom described. Absorptive, adaptive, and transformative interventions are described across seven different domains: safety and security, society, health system governance, stocks and supplies, built environment, health care workforce, and health care services. Conclusions Our review findings suggest that the governance-centred framework can be useful to better understand HSR in FCAS. Future HSR research should document adaptive and transformative strategies that advance HSR, particularly in relation to actions intended to promote the safety and security of health systems, the built environment for health, and the adoption of a social justice lens.

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“…It is well-documented that the highest demand for hospital services occurs within the first 72 hours following a disaster. [ 6 , 7 ] However, in the affected areas, health services often face challenges due to damaged infrastructure, a lack of trained personnel in local response teams, shortages of necessary equipment, and issues with coordination and transportation. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

Anesthetic approach to trauma patients in the city hospital after the 2023 Maraş earthquake

Kılınçarslan

2024

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The February 6, 2023, Kahramanmaraş earthquake caused significant destruction across our country. More than 50,000 people lost their lives, thousands were injured, and health facilities were damaged. Victims were transferred to hospitals in other provinces for treatment. This study evaluates the anesthesia approach applied to the injured who were transferred to our tertiary hospital. METHODS: We retrospectively reviewed the data of patients who underwent surgery between February 6 and February 20, 2023. The study included earthquake victims who underwent emergency trauma surgery, aged 10 years and above. We recorded the date of admission to the hospital, demographic information, type of surgery, surgical site, anesthesia technique, preference for peripheral block, laboratory values, dialysis and intensive care needs, and survival rates. Data analysis was performed using the IBM ® Statistical Package for the Social Sciences (SPSS ® ) Version 26.0. RESULTS: A total of 375 cases were included in the study. Of these, 323 patients underwent surgery for extremity injuries, and 35 for vertebral injuries. Among the extremity injuries, 61.6% were to the lower extremities, and 17.1% to the upper extremities. Debridement was performed on 147 patients, fasciotomy on 49 patients, and amputation on 33 patients. General anesthesia was applied to 352 patients, spinal anesthesia to 19 patients, and sedoanalgesia to four patients. Peripheral nerve block was performed on 33 patients. Dialysis treatment was administered to 105 patients. Twenty-six patients were lost during the treatment process. There were no intraoperative patient deaths. CONCLUSION: The predominance of extremity injuries among earthquake victims increases the inclination towards regional anesthesia. Incorporating Plan A blocks into basic anesthesia skills could enhance the preference for regional anesthesia in disaster situations. Furthermore, transferring the injured to advanced centers may reduce morbidity.

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“Recovering, not recovered” Hospital disaster resilience: a case-study from the 2015 earthquake in Nepal

Cited by 9 publications

References 43 publications

First-Week Analysis after the Turkey Earthquakes: Demographic and Clinical Outcomes of Victims

First-Week Analysis after the Turkey Earthquakes: Demographic and Clinical Outcomes of Victims

Health systems resilience in fragile and conflict-affected settings: a systematic scoping review

Anesthetic approach to trauma patients in the city hospital after the 2023 Maraş earthquake

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