RESUMO
As a result of the 7.2 magnitude earthquake on August 14, 2021, according to Haiti's Civil Protection agency (DGPC), 2,207 people have died, 12,268 people were injured, and 320 are missing. In the most affected departments Sud, Grand'Anse and Nippes around 53,000 houses were destroyed and more than 77,000 damaged. Rapid assessments reported 59 health facilities affected in Grand'Anse, Nippes and Sud Departments: 27 severely damaged and 32 slightly damaged. In the affected departments, health sector evaluators are carrying out assessments to gather data on injured patients (hospitalizations, types of injuries and demographics) and the degree of damage to health facilities and needs. Logistics and security challenges continue limiting the delivery of supplies, deployment of personnel to affected areas and the transfer of patients to hospitals that are not overwhelmed. Health sector needs include: medical personnel, medicines, supplies and stock management, mental health and psychosocial support initiatives, implementation of preventive and control measures for communicable diseases, WASH operations in health facilities and shelters, rehabilitation of injured patients, among others
Assuntos
Humanos , Socorro em Desastres , Vítimas de Desastres , Terremotos/mortalidade , Desastres Naturais/mortalidade , HaitiRESUMO
BACKGROUND: Evidence on the indirect health impacts of disasters is limited. We assessed the excess mortality risk associated with the indirect health impacts of the 2011 triple disaster (earthquake, tsunami and nuclear disaster) in Fukushima, Japan. METHODS: The mortality rates in Soma and Minamisoma cities in Fukushima from 2006 to 2015 were calculated using vital statistics and resident registrations. We investigated the excess mortality risk, defined as the increased mortality risk between postdisaster and predisaster after excluding direct deaths attributed to the physical force of the disaster. Multivariate Poisson regression models were used to estimate the relative risk (RR) of mortality after adjusting for city, age and year. RESULTS: There were 6163 and 6125 predisaster and postdisaster deaths, respectively. The postdisaster mortality risk was significantly higher in the first month following the disaster (March 2011) than in the same month during the predisaster period (March 2006-2010). RRs among men and women were 2.64 (95% CI 2.16 to 3.24) and 2.46 (95% CI 1.99 to 3.03), respectively, demonstrating excess mortality risk due to the indirect health effects of the disaster. Age-specific subgroup analyses revealed a significantly higher mortality risk in women aged ≥85 years in the third month of the disaster compared with predisaster baseline, with an RR (95% CI) of 1.73 (1.23 to 2.44). CONCLUSIONS: Indirect health impacts are most severe in the first month of the disaster. Early public health support, especially for the elderly, can be an important factor for reducing the indirect health effects of a disaster.
Assuntos
Causas de Morte , Desastres/estatística & dados numéricos , Terremotos , Acidente Nuclear de Fukushima , Mortalidade/tendências , Tsunamis , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doença das Coronárias/mortalidade , Terremotos/mortalidade , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Pneumonia/mortalidade , Estudos Retrospectivos , Acidente Vascular Cerebral/mortalidade , Estatísticas Vitais , Adulto JovemAssuntos
Desastres/prevenção & controle , Terremotos/mortalidade , Monitoramento Ambiental/instrumentação , Previsões/métodos , Sedimentos Geológicos/análise , Movimento (Física) , Oceanos e Mares , California , Chile , Sistemas de Informação Geográfica , Humanos , Japão , Nova Zelândia , Oceanografia , Oceano Pacífico , Som , Tsunamis , WashingtonRESUMO
Orthopaedic surgeons have traditionally answered the call in times of disaster. Shortly after the devastating earthquake in January 2001, in Gujarat India, that call came from a buffer zone hospital. The Gandhi Lincoln Hospital in Deesa, Gujarat was struggling with an influx of injured survivors. Five days after the initial event, 2 of the traveling American authors met up with the Director of Surgery at the hospital. The clinical load was primarily extremity injuries and wounds. The authors present their assessment of the orthopaedic response highlighting factors of success, barriers, and lessons learned. Despite their published accounts, many of these lessons were not applied to the Haiti earthquake response.
Assuntos
Planejamento em Desastres/organização & administração , Terremotos/mortalidade , Serviços Médicos de Emergência/organização & administração , Ortopedia/organização & administração , Ferimentos e Lesões/terapia , Feminino , Humanos , Índia , Cooperação Internacional , Masculino , Avaliação das Necessidades , Socorro em Desastres/organização & administração , Análise de Sobrevida , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/mortalidadeRESUMO
BACKGROUND: Following the 2010 earthquake in Haiti, the Israel Defense Forces Medical Corps deployed a field hospital in Port au Prince. The purpose of this study was to characterize the injuries sustained by the pediatric population treated in the hospital and examine the implications for planning deployment in future similar disasters. METHODS: Medical records of children treated in the hospital were reviewed and compared with medical records of the adult population. RESULTS: A total of 1,111 patients were treated in the hospital. Thirty-seven percent were aged 0 to 18 years. Earthquake-related injuries were the cause of admission in 47% of children and 66% of adults. Forty-seven percent of children with traumatic injuries sustained fractures. Seventy-two percent were in the lower limbs, 19% were in the upper limbs, and 9% were in the axial skeleton, with the femur being the most common long bone fractured compared with the tibia in adults. There were four functional operating theaters, and treatment guidelines were adjusted to the rapidly changing situation. Soft tissue injuries were treated by aggressive debridement. Fractures were stabilized by external fixation or casting. Amputation was performed only for nonviable limbs or life-threatening sepsis. Children were more likely than adults to undergo surgery (44% vs. 29% of trauma patients). To maximize hospital surge capacity, minor procedures were performed in the wards under sedation, and patients were discharged after an average of 1.4 days, with subsequent follow-up in the clinic. CONCLUSION: Children constitute a high percentage of patients in a developing country. The epidemiology of pediatric injuries following an earthquake differs significantly from that encountered in everyday practice and compared with that in adults. Children sustain a significantly higher percentage of femoral fractures and are more likely to require surgery. The shift to nontraumatic reasons for admission occurred earlier in the pediatric population than in adults. Organizations providing post-earthquake relief are usually geared toward adult populations and will require supplementation of both manpower and equipment specifically suited for treatment of pediatric patients. Early deployment teams should be adequately staffed with adult and pediatric orthopedists.
Assuntos
Planejamento em Desastres/organização & administração , Terremotos/mortalidade , Unidades Móveis de Saúde/organização & administração , Ortopedia/estatística & dados numéricos , Ferimentos e Lesões/cirurgia , Adolescente , Criança , Pré-Escolar , Países em Desenvolvimento , Feminino , Haiti , Humanos , Lactente , Masculino , Pediatria , Análise de Sobrevida , Resultado do Tratamento , Ferimentos e Lesões/diagnósticoRESUMO
Population growth and the built environment are the primary root causes of morbidity and mortality associated with earthquakes. Earthquakes generally do not cause death and injury, but rather it is the buildings in which people are located and the contents therein that are directly responsible for human mortality and morbidity. Protective action messaging is intended to provide members of the public with information that can be recalled and acted on during earthquake shaking to reduce the chance of death and injury. In order to design appropriate guidance for developing protective action messages for earthquakes, it is important to understand their human impactthat is, how people are injured and killed during earthquake shaking. The purpose of this background paper is to describe the epidemiology of deaths and injuries during earthquakes. The paper will address the major causes of death and injury from earthquakes, including what the research indicates about injuries to building occupants who walk or run, the likelihood of death or injury from earthquakes, the likelihood of death or injury from earthquake-related building collapse, the likelihood of death or injury from substandard building evacuation routes during earthquakes, and other sudden onset threats, such as tsunami or fire. The health effects of earthquakes can be categorized in a variety of ways. Combs, Quenemoen, Parrish, and Davis (1999) developed a typology, which has been adopted by the U.S. Centers for Disease Control and Prevention (CDC), for categorizing the health effects attributable to earthquakes and other disasters based on two parameters: (1) the time the death or injury occurs relative to the event, and (2) whether the event is directly or indirectly related to the disaster. Deaths and injuries that are directly related are those that are caused by the physical forces of the event, whereas indirectly related deaths and injuries are, "those caused by unsafe or unhealthy conditions that occur because of the anticipation, or actual occurrence, of the disaster" (Combs et al., 1999, p. 1125). This paper will focus primarily on human deaths and injuries occurring during earthquakes that are directly related to the event.
Assuntos
Humanos , Efeitos de Desastres nas Edificações , Terremotos/mortalidade , Colapso Estrutural/prevenção & controle , Promoção da Saúde , Desastres NaturaisRESUMO
OBJECTIVE: Physical disease patients are known to experience high levels of psychological distress. This study examined the association between the medical treatment of physical diseases and psychological distress in the coastal area affected by the Great East Japan Earthquake. METHODS: Using cross-sectional data, we studied 3032 individuals aged ≥40 years who lived in Shichigahama, Miyagi, Japan. We examined the associations between 8 medical treatments for physical diseases and psychological distress, defined as Kessler Psychological Distress scale score ≥13 of 24 points. To investigate the associations, we performed multiple logistic regression analyses. RESULTS: There were statistically significant associations between psychological distress and medical treatments for myocardial infarction/angina pectoris (odds ratio [OR]=1.8, 95% confidence interval [CI]=1.0-3.0) and liver disease (OR=3.1, 95% CI=1.0-7.7). The other 4 medical treatments for physical diseases had ORs of 1.3 or higher and were positively associated with psychological distress: cancer, hyperlipidemia, kidney disease, and diabetes mellitus. The degree of damage to homes did not affect the association between most of the medical treatments for physical diseases and psychological distress. CONCLUSIONS: In the disaster area, most of the medical treatments for physical diseases had positive associations with psychological distress, irrespective of the degree of damage to homes.
Assuntos
Comorbidade , Terremotos/mortalidade , Serviços de Saúde , Prevenção Primária/métodos , Saúde Pública/métodos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
This report emphasizes the belief that whatever the type and scale of disaster, the period of transition from relief to recovery is the most critical. Following the severe earthquake that struck Kachchh, Gurjarat, India on 26 January 2001, emotions spanned grief over the lives lost; anxiety over property and other economic losses; profound feelings of isolation, helplessness, and guilt; and panic in the face of problematic communications from authorities. In an attempt to manage this vast array of psychosocial problems, a large cadre of volunteers was rapidly trained and supervised by experts to work as grass-roots counselors for the community.
Assuntos
Terapias Complementares/métodos , Desastres/estatística & dados numéricos , Intervenção Médica Precoce/métodos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Voluntários , Adaptação Psicológica , Adulto , Criança , Serviços Comunitários de Saúde Mental/tendências , Aconselhamento/métodos , Terremotos/mortalidade , Terremotos/estatística & dados numéricos , Feminino , Saúde Holística , Humanos , Índia/epidemiologia , Agências Internacionais , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Avaliação de Programas e Projetos de Saúde , Psiquiatria , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Sobreviventes/estatística & dados numéricos , Fatores de TempoRESUMO
Following the Fukushima accident, the International Commission on Radiological Protection (ICRP) convened a task group to compile lessons learned from the nuclear reactor accident at the Fukushima Daiichi nuclear power plant in Japan, with respect to the ICRP system of radiological protection. In this memorandum the members of the task group express their personal views on issues arising during and after the accident, without explicit endorsement of or approval by the ICRP. While the affected people were largely protected against radiation exposure and no one incurred a lethal dose of radiation (or a dose sufficiently large to cause radiation sickness), many radiological protection questions were raised. The following issues were identified: inferring radiation risks (and the misunderstanding of nominal risk coefficients); attributing radiation effects from low dose exposures; quantifying radiation exposure; assessing the importance of internal exposures; managing emergency crises; protecting rescuers and volunteers; responding with medical aid; justifying necessary but disruptive protective actions; transiting from an emergency to an existing situation; rehabilitating evacuated areas; restricting individual doses of members of the public; caring for infants and children; categorising public exposures due to an accident; considering pregnant women and their foetuses and embryos; monitoring public protection; dealing with 'contamination' of territories, rubble and residues and consumer products; recognising the importance of psychological consequences; and fostering the sharing of information. Relevant ICRP Recommendations were scrutinised, lessons were collected and suggestions were compiled. It was concluded that the radiological protection community has an ethical duty to learn from the lessons of Fukushima and resolve any identified challenges. Before another large accident occurs, it should be ensured that inter alia: radiation risk coefficients of potential health effects are properly interpreted; the limitations of epidemiological studies for attributing radiation effects following low exposures are understood; any confusion on protection quantities and units is resolved; the potential hazard from the intake of radionuclides into the body is elucidated; rescuers and volunteers are protected with an ad hoc system; clear recommendations on crisis management and medical care and on recovery and rehabilitation are available; recommendations on public protection levels (including infant, children and pregnant women and their expected offspring) and associated issues are consistent and understandable; updated recommendations on public monitoring policy are available; acceptable (or tolerable) 'contamination' levels are clearly stated and defined; strategies for mitigating the serious psychological consequences arising from radiological accidents are sought; and, last but not least, failures in fostering information sharing on radiological protection policy after an accident need to be addressed with recommendations to minimise such lapses in communication.
Assuntos
Acidente Nuclear de Fukushima , Monitoramento de Radiação , Proteção Radiológica , Cinza Radioativa/estatística & dados numéricos , Criança , Terremotos/mortalidade , Exposição Ambiental/prevenção & controle , Feminino , Humanos , Incidência , Lactente , Japão/epidemiologia , Centrais Nucleares , Gravidez , Doses de Radiação , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Monitoramento de Radiação/legislação & jurisprudência , Monitoramento de Radiação/métodos , Monitoramento de Radiação/normas , Proteção Radiológica/legislação & jurisprudência , Proteção Radiológica/métodos , Proteção Radiológica/normas , Trabalho de Resgate , Medição de Risco , Fatores de RiscoRESUMO
Se busca identificar el significado de los conceptos 'terremoto' y 'maremoto' en dos grupos diferentemente expuestos al evento acaecido en Chile el 27/02/2010, en una muestra no probabilística intencional, compuesta por 240 personas provenientes de las ciudades de Constitución (n=104) - expuestas directamente al terremoto y maremoto -, y de Punta Arenas (n=136) expuestas vicariamente. Mediante redes semánticas naturales (R.S.) construidas ad-hoc, fue observado que terremoto y tsunami tienen significados semejantes, relacionados al miedo, muerte, destrucción, desesperación, desastre, pérdida, angustia, tristeza, pena, dolor y pánico. Adicionalmente, aquellos que vivieron directamente el fenómeno utilizan más definidoras de tipo emocional al definir terremoto que aquellos que fueron expuestos a él de modo vicario.
Procurou-se identificar o significado dos conceitos 'terremoto' e 'tsunami' em dois grupos diferentemente expostos ao evento acontecido no Chile em 27/02/2010, em uma amostra não-probabilística intencional, composta por 240 pessoas provenientes das cidades de Constitución (n=104), expostas diretamente ao terremoto e ao maremoto, e de Punta Arenas (n=136), expostas vicariamente. Pelas redes semânticas naturais (R.S.) construídas ad hoc, foi observado que terremoto e tsunami têm significados semelhantes, relacionadas a medo, morte, destruição, desespero, desastre, perda, angústia, tristeza, pena, dor e pânico. Além disso, aqueles que experimentaram diretamente o fenômeno tendem a usar mais palavras de cunho emocional para definir terremoto, do que aqueles que foram expostos a ele vicariamen.
The purpose of this research was to describe the meaning of "earthquake" and "tsunami" in two groups with different exposures to the Chilean natural disaster on February 27th, 2010. A non-probabilistic sample of two-hundred-forty subjects from Constitución (n=104) and Punta Arenas (n=136) was selected. The first group was directly exposed to the earthquake and tsunami and the second group was indirectly exposed. Natural semantic network analysis (SNA) evidenced that both groups have the same semantic representation of earthquake and tsunami, using emotional words such as fear, death, destruction, despair, disaster, loss, anxiety, sadness, pain and panic. Additionally, those who directly experienced the phenomenon use more emotional words to define earthquake than those exposed to it vicariously.
Assuntos
Humanos , Masculino , Feminino , Medo , Tsunamis , Terremotos/mortalidadeRESUMO
BACKGROUND: On 23 October 2011, an earthquake occurred in the city of Van, Turkey. This earthquake was an enormous devastating disaster and caused mass casualties. The descriptive analysis presented here serves as a reference not only for the present injury profile but also for future disaster response. METHODS: This is a retrospective study based on the medical records of earthquake victims admitted to Van Training and Research Hospital. The results were compared with the current literature. RESULTS: 1582 earthquake victims (806 male, 776 female, mean age 36.9 years) were admitted to emergency service. 301 of the patients were treated with hospital care in different departments: 84 (27.9%) in orthopedics surgery, 40 (13.2%) in general and pediatric surgery, 26 (9%) in thorax surgery, 34 (11%) in neurosurgery, 56 (19%) in internal medicine, 39 (13%) in the intensive care unit, and 22 (7%) in other departments. The total number of deceased was 60. CONCLUSION: To minimize mortality and morbidity after earthquake disaster, immediate and effective triage should be done, and after the patients are transported to the hospital, individualized treatment should be planned according to the patients' respective clinical features. Coherent collaboration between many departments is vital.
Assuntos
Desastres/estatística & dados numéricos , Terremotos/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adulto , Terremotos/mortalidade , Feminino , Humanos , Masculino , Estudos Retrospectivos , Turquia/epidemiologia , Ferimentos e Lesões/classificação , Ferimentos e Lesões/mortalidadeRESUMO
Background: On February 27, 2010 a powerful earthquake followed by a tsunami stroke Chile. The study of mortality during this emergency can provide important public health information. Aim: To describe the main characteristics of people who died during the earthquake and the following three months. Material and Methods: Cross sectional analysis of death records databases obtained from Department of Health Statistics and Information of the Ministry of Health and the Coroner office. Results: Until May 25,2010, 505 corpses were completely identified. Seventy two of these corresponded to people aged 80 years or more. The higher age adjusted death rates per 100,000 inhabitants were observed among subjects aged more than 80 years and those aged 70 to 79 years (22.6 and 7.7 respectively). The higher rates of deaths were observed in regions where the earthquake had a higher intensity and coastal regions affected by the tsunami. The causes of death were trauma in 75% of cases and drowning in 25%. There was no association between the Mercalli scale of earthquake intensity and rates of death. Among deceased subjects, there was a concentration of unemployed, under educated and low socioeconomic status subjects. Conclusions: After the earthquake, the higher rates of deaths occurred among older people and in the region of the epicenter of the earthquake. Most deaths were due to trauma.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Atestado de Óbito , Desastres/estatística & dados numéricos , Terremotos/mortalidade , Tsunamis/estatística & dados numéricos , Distribuição por Idade , Chile/epidemiologia , Estudos Epidemiológicos , Distribuição por Sexo , Ferimentos e Lesões/classificação , Ferimentos e Lesões/mortalidadeAssuntos
Planejamento em Desastres , Terremotos , Liberação Nociva de Radioativos , Tsunamis , Planejamento em Desastres/tendências , Terremotos/mortalidade , Terremotos/estatística & dados numéricos , Previsões/métodos , Humanos , Japão , Incidentes com Feridos em Massa/prevenção & controle , Energia Nuclear , Liberação Nociva de Radioativos/prevenção & controle , Liberação Nociva de Radioativos/estatística & dados numéricos , Socorro em Desastres , Tsunamis/estatística & dados numéricosRESUMO
OBJECTIVES: There exists no standard hospital emergency department (ED) triage procedure model for earthquake victims. This study provides an overview of the hospital triage procedure used for patients evaluated and treated at the West China Hospital of Sichuan University, Chengdu in the Sichuan province of China, following the May 12, 2008 Wenchuan earthquake. METHODS: Emergency triage and treatment teams were comprised of senior emergency medicine (EM) attending physician, junior EM attending physician, EM residents, and specialty surgeons. Retrospective analysis of the hospital medical records of 2283 earthquake victims was performed. Victims' demographic data, triage process and group assignments, diagnoses and dispositions were reviewed. RESULTS: In the 2 weeks following the Wenchuan earthquake, 2283 total patients with earthquake-related injuries were admitted to our hospital. 54 victims (2.4%) were lost to follow up. Patients were triaged into four main groups: resuscitation (n=6), urgent treatment (n=369), delayed treatment (n=1502), and minor injuries (n=406). 68.9% (1572/2283) of the patients were admitted to the hospital during the 15 days after the earthquake. The overall hospital mortality rate was 1.0% (15/1572). 1304 victims were transferred to nearby hospitals after initial treatment, stabilization, or surgery. CONCLUSIONS: Proper triage strategy should be established prior to the onset of a mass casualty event and should be appropriate to both the severity of the disaster and the accepting facility resource availability. Triage methods utilizing multi-specialty treatment teams and dynamic hospital-wide coordination are critical for efficient, efficacious patient management. Hopefully, sharing with the emergency medicine community the arduous challenges we faced in the wake of the Wenchuan earthquake will be useful for planning the response to future disasters.
Assuntos
Planejamento em Desastres/organização & administração , Terremotos/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Hospitalização/estatística & dados numéricos , Triagem/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Planejamento em Desastres/normas , Terremotos/mortalidade , Serviço Hospitalar de Emergência/normas , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Incidentes com Feridos em Massa , Pessoa de Meia-Idade , Estudos Retrospectivos , Triagem/normas , Adulto JovemRESUMO
The objective of this publication is to draw the lessons to be learned for improving the health response in future sudden-onset disasters. We know that massive earthquakes will occur again and some will devastate metropolitan areas or even the capital city, as was the case in Haiti. Haiti is the subject of this study, hopefully not the object, as Haiti has had her share of catastrophes.The scope of the book is limited to the health response, health being defined in its broad sense, not merely medical care or disease control. The review is confined to the immediate and early response in the first three months, the period during which most of the international assistance was mobilized and influences, for better or worse, rehabilitation and reconstruction. The publication focuses specially but not exclusively on those lessons that are of general interest, i.e., not specific to the special case of Haiti. The international community has much to learn from the response in Haiti where it has shown an ability to repeat its errors and shortcomings from past disasters. The methodology used for this study is common to most evaluations: in-depth review of reports, evaluations, studies, and peer-reviewed scientific publications; over 150 interviews, half of them carried out exclusively for this study and others for similar evaluations carried out by one of the three authors; circulation of the draft to all interviewees for factual validation and comments on the authors interpretation of the findings; and, finally, discussion with a review board convened by PAHO/WHO.
Assuntos
Atenção à Saúde , Planejamento em Desastres/organização & administração , Terremotos , Educação em Desastres , /métodos , Zona de Desastre , Emergências em Desastres , Terremotos/mortalidade , Haiti , Gestão da Informação em Saúde , Recursos Humanos em Desastres , Organização Pan-Americana da Saúde , Gestão de Riscos , Análise de VulnerabilidadeRESUMO
BACKGROUND: A massive earthquake struck North Pakistan on 8 October 2005. The objective of this study was to evaluate the types of injuries and the procedures carried out on the admitted casualties, and to present recommendations based on these experiences for improvement in disaster preparedness and management. This is a descriptive study conducted at the Military Hospital, Rawalpindi. METHODS: Inclusion criteria included all patients who required admission for treatment. Patients who had minor injuries not requiring indoor treatment and those who were dead on arrival were excluded from this study. The files of admitted patients were analyzed for type of injuries, procedures performed, complications, and causes of death. RESULTS: The total number of patients received was 1698, of which 862 (50.8%) were admitted. A total of 2289 operations were performed including 1046 (45.7%) major interventions. Sixteen (1.5%) amputations were necessary. Seventeen deaths (1.9%) occurred in hospital, while 76 dead bodies were received. CONCLUSION: After the initial days of life- and limb saving, it is important to quickly divide the manpower into teams with a major emphasis on plastic, orthopedics and spinal surgery, to start shifts and to utilize the volunteer manpower early and judiciously. Prevention of tetanus is essential.