A scoping review of post-earthquake healthcare for vulnerable groups of the 2023 Turkey-Syria earthquakes.

BACKGROUND: Identifying healthcare services and also strengthening the healthcare systems to effectively deliver them in the aftermath of large-scale disasters like the 2023 Turkey-Syria earthquakes, especially for vulnerable groups cannot be emphasized enough. This study aimed at identifying the interventions undertaken or proposed for addressing the health needs or challenges of vulnerable groups immediately after the occurrence of the 2023 Turkey-Syria earthquakes, as well as for prioritizing their healthcare service delivery in the post-Turkey-Syria earthquake. METHODS: In this scoping review compiled with the five steps of the Arksey and O'Malley framework, five databases, including PubMed, Science Direct, Web of Science, OVID, and Google Scholar, were searched for studies published between March and April 2023 in line with the eligibility criteria. Interventions for enhancing post-earthquake healthcare services (PEHS) were grouped into seven (7) categories, adopted from previous guidelines and studies. Each one was assigned a default score of a value equal to one (1), which, in the end, was summed up. RESULTS: Of the 115 total records initially screened, 29 articles were eligible for review. Different interventions they reported either undertaken or proposed to address the healthcare needs and challenges, especially faced by the most vulnerable groups in the aftermath of the Turkey-Syria earthquakes, were categorized into 7 PEHS. They were ranked with their scores as follows: humanitarian health relief (25); medical care (17); mental health and psychosocial support (10); health promotion, education, and awareness (9); disease surveillance and prevention (7); disability rehabilitation (7); and sexual and reproductive health (5). CONCLUSION: Since there are no proper guidelines or recommendations about the specific or most significant PEHS to prioritize for vulnerable groups after the occurrence of large-scale earthquakes, this scoping review provides some insights that can help inform healthcare service delivery and prioritization for vulnerable groups in the post-2023 Turkey-Syria earthquakes and other similar disasters.

Impact of climate-induced floods and typhoons on geriatric disabling health among older Chinese and Filipinos: a cross-country systematic review.

BACKGROUND: Apart from both China and the Philippines continuing to be exposed to and affected by different climate-induced hazards, in particular floods and typhoons, they are also reported to be witnessing rapid ageing populations of 60 years and older. As such, this systematic review synthesized the existing evidence about the impacts aggravated by floods and typhoons on the geriatric disabling health of older Chinese and Filipinos, respectively. METHODS: Four (4) electronic databases were systematically searched to identify eligible studies published between 2000 and early 2023. This process had to confirm the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), as well as the standard protocol registered with PROSPERO (CRD42023420549). RESULTS: Out of 317 and 216 initial records retrieved for China and the Philippines, respectively, 27 (China) and 25 (Philippines) studies were eligible for final review. The disabling conditions they reported to affect the health of older adults were grouped into 4 categories: cognitive and intellectual, physical, chronic and terminal illnesses, and mental and psychological, with the latter identified as the most prevalent condition to affect older Chinese and Filipinos. On a sub-category level, posttraumatic stress disorder (PTSD) was the most common condition reported in 27 flood-related studies in China, while injuries and wounds prevailed in the Philippines, according to 25 typhoon-related studies. CONCLUSION: The increasing occurrence of extreme climate hazards, especially floods and typhoons in China and the Philippines, respectively, impacted the health of their older adults with various disabling effects or conditions. Therefore, this calls for appropriate geriatric-informed interventions in the context of climate change and rapidly ageing settings beyond China and the Philippines to others that are also prone to floods and typhoons.

Public health priorities for Sino-Africa cooperation in Eastern Africa in context of flooding and malaria burden in Children: a tridecadal retrospective analysis.

BACKGROUND: Malaria remains a major public health burden to children under five, especially in Eastern Africa (E.A), -a region that is also witnessing the increasing occurrence of floods and extreme climate change. The present study, therefore, explored the trends in floods, as well as the association of their occurrence and duration with the malaria incidence in children < 5 years in five E.A partner countries of Forum for China-Africa Cooperation (FOCAC), including Ethiopia, Kenya, Somalia, Sudan, and Tanzania between 1990 and 2019. METHODS: A retrospective analysis of data retrieved from two global sources was performed: the Emergency Events Database (EM-DAT) and the Global Burden of Diseases Study (GBD) between 1990 and 2019. Using SPSS 20.0, a correlation was determined based on ρ= -1 to + 1, as well as the statistical significance of P = < 0.05. Time plots of trends in flooding and malaria incidence were generated in 3 different decades using R version 4.0. RESULTS: Between 1990 and 2019, the occurrence and duration of floods among the five E.A partner countries of FOCAC increased and showed an upward trend. On the contrary, however, this had an inverse and negative, as well as a weak correlation on the malaria incidence in children under five years. Only Kenya, among the five countries, showed a perfect negative correction of malaria incidence in children under five with flood occurrence (ρ = -0.586**, P-value = 0.001) and duration (ρ = -0.657**, P-value = < 0.0001). CONCLUSIONS: This study highlights the need for further research to comprehensively explore how different climate extreme events, which oftentimes complement floods, might be influencing the risk of malaria in children under five in five E.A malaria-endemic partner countries of FOCAC. Similarly, it ought to consider investigating the influence of other attributes apart from flood occurrence and duration, which also compound floods like displacement, malnutrition, and water, sanitation and hygiene on the risk and distribution of malaria and other climate-sensitive diseases.

Risk factors associated with road traffic injuries at the prone-areas in Kampala city: a retrospective cross-sectional study.

BACKGROUND: Road traffic injuries (RTIs) pose a disproportionate public health burden in the low and middle-income countries (LMICs) like Uganda, with 85% of all the fatalities and 90% of all disability-adjusted life years lost reported worldwide. Of all RTIs which are recorded in Uganda, 50% of cases happen in Kampala -the capital city of Uganda and the nearby cities. Identifying the RTI prone-areas and their associated risk factors can help to inform road safety and prevention measures aimed at reducing RTIs, particularly in emerging cities such as Kampala. METHODS: This study was based on a retrospective cross-sectional design to analyze a five year (2011 - 2015) traffic crash data of the Uganda Police Force. RESULTS: Accordingly, 60 RTI prone-areas were identified to exist across the Kampala. They were ranked as low and high risk areas; 41 and 19, respectively and with the majority of the latter based in the main city center. The bivariate analysis showed a significant association between identified prone-areas and population flow (OR: 4.89, P-value: 0.01) and traffic flow time (OR: 9.06, P-value: 0.01). On the other hand, the multivariate regression analysis only showed traffic flow time as the significant predictor (OR: 6.27, P-value: 0.02) at identified RTI prone-areas. CONCLUSIONS: The measures devised to mitigate RTI in an emerging city like Kampala should study thoroughly the patterns of traffic and population flow to help to optimize the use of available resources for effective road safety planning, injury prevention and sustainable transport systems.

Can Digitization of Health Care Help Low-Resourced Countries Provide Better Community-Based Rehabilitation Services?

In the wake of globalization, proliferation of digital technologies (DTs) is rapidly changing many activities across sectors, including influencing health to "go digital." Harnessing opportunities of DTs can be a pathway for delivery of health services, such as community-based rehabilitation (CBR) to the vulnerable groups of populations, particularly those in countries with low resources where health systems are weak and experiencing a deficit of trained health workers necessary to effectively deliver a full spectrum of health services. This perspective explored how some DTs can be leveraged in delivery of CBR services in rural and remote areas of countries with low resources. This is described based on information access and exchange, social satisfaction, shortages of rehabilitation workforce, professional development, and capacity building. However, since seizing advantages of DTs can inevitably be associated with spillovers and limitations, including needs prioritization, skills and language limitations, internet addiction and censorship issues, professionalism and ethical dilemmas, and sustainability, if proper measures are not taken, a caution is made. Moreover, as DTs are revolutionizing various activities across sectors, including health, this is not meant as a substitute for traditional health care activities, including those delivered through CBR, but rather to augment their delivery in settings with low resources and elsewhere.

Uganda at Glance of 5.7 Magnitude Earthquake: Lessons for Earthquake Risk Reduction.

INTRODUCTION: Uganda remains seismically vulnerable to earthquakes, which constitute one of the most deadly naturally triggered disasters in the world. This is not surprising given the country's location in the East African Rift Valley System. METHOD: This paper draws mainly on the authors' live event experience and some media reports to narratively outline the nature of a sizable earthquake, which measured a magnitude of 5.7 on the Richter scale that struck Uganda and other countries within the Lake Victoria Basin region on 10th September 2016 in the afternoon. RESULTS: Rakai - a district in central region was the worst affected in Uganda. It witnessed the death of four people; 20 people were admitted to the hospital with injuries; a total of 590 people were affected; and serious structural damages mainly in buildings were reported, leaving many either razed to the ground or left with cracks. DISCUSSIONS: Although this earthquake was less devastating in terms of injuries and fatalities compared to two previous earthquakes in Uganda, based on the Modified Mercalli Intensity Scale it was still considered to be severe. Therefore, this paper identified some proactive lessons as far as earthquake risk reduction in Uganda is concerned, which among others include: encouraging earthquake-resistant buildings; the safety of essential infrastructure; earthquake early warning systems supported by free global technologies; and the safety of rescue workers along with prioritizing the psychosocial needs of rescue teams. With all this in mind, the September 2016 earthquake should serve as a timely reminder that there is a real need for the proactive ex-ante earthquake preparedness rather than risking an expensive post-ante approach to responding to any future devastating earthquakes in Uganda.

Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study.

BACKGROUND: Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). METHODS: A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims' pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions respectively. Data was descriptively analyzed, and after the principal component analysis was employed to identify the most influential weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTI in the GKMA. RESULTS: From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the GKMA. Although some strengths exist like ambulance facilitation, EMS structuring, coordination and others), the key weaknesses affecting the pre-hospital care for victims were noted to relate to absence of predefined EMS systems particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment; insufficient skills/training of the first responders; inadequate EMS resources; and avoidable delays to respond and transport RTI victims to medical facilities. CONCLUSIONS: Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study.

BACKGROUND: The Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in motorized vehicles which, predisposes the region to a high risk of road traffic incidents (RTIs). A number of concerted road safety and post-crash management measures to respond to RTIs in the KMA in particular and Uganda as a whole have been undertaken. However, there is a need to greatly improve the measures by better identifying the factors influencing the exposure, vulnerability and emergency medical service (EMS) capacity for RTI victims. The present study seeks to investigate and reveal these factors. METHODS: A Delphi technique employing a questionnaire and involving a multidisciplinary panel of experts was used in three rounds. RESULTS: The ten (10) most important factors affecting the exposure, vulnerability and EMS capacity for victims of RTIs in the KMA were identified. Socio-cultural, infrastructure and road safety aspects were the factors most identified as affecting the exposure and vulnerability. The absence of a national EMS policy and post-crash care system, as well as the fact that many victims lack health insurance, were noted to be the factors adversely affecting the EMS capacity. CONCLUSIONS: There exists is a real need to substantially reduce the burden of RTIs in KMA, with ultimate goal of saving lives that are being lost needlessly and reducing the impact of injuries and trauma and the economic losses associated with it. This study offers insights into the causes of RTIs and the most appropriate ways of responding to them especially with the establishment and empowerment of predefined and structured EMS systems.

Road traffic incidents in Uganda: a systematic review study of a five-year trend.

BACKGROUND: Over the years, Uganda has been one of the low and middle-income countries bearing the heaviest burden of road traffic incidents (RTI). Since the proclamation of the United Nations Decade of Action for Road Safety 2011 - 2020, a number of measures have been taken to reduce the burden. However, they ought to be premised on existing evidence-based research; therefore, the present review ventures to report the most recent five-year trend of RTI in Uganda. METHODS: Based on Preferred Reporting Items for Systematic Reviews and Meta-Data Analysis (PRISMA) guidelines, a systematic review was employed. Using a thematic analysis, the articles were grouped into: trauma etiology, trauma care, mortality, cost, trauma registry and communication, intervention and treatment for final analysis. RESULTS: Of the nineteen articles that were identified to be relevant to the study, the etiology of RTI was inevitably observed to be an important cause of injuries in Uganda. The risk factors cut across: the crash type, injury physiology, cause, victims, setting, age, economic status, and gender. All studies that were reviewed have advanced varying recommendations aimed at responding to the trend of RTIs in Uganda, of which some are in tandem with the five pillars of the United Nations Decade of Action for Road Safety 2011 - 2020. CONCLUSIONS: Peripheral measures of the burden of RTIs in Uganda were undertaken within afive-year timeframe (2011-2015) of implementing the United Nations Decade of Action for Road Safety. The measures however, ought to be scaled-up on robust evidence based research available from all the concerned stakeholders beyond Kampala or central region to other parts of Uganda.

Virtual Disaster Simulation: Lesson Learned from an International Collaboration That Can Be Leveraged for Disaster Education in Iran.

Disaster education needs innovative educational methods to be more effective compared to traditional approaches. This can be done by using virtual simulation method. This article presents an experience about using virtual simulation methods to teach health professional on disaster medicine in Iran. The workshop on the "Application of New Technologies in Disaster Management Simulation" was held in Tehran in January 2015. It was co-organized by the Disaster and Emergency Health Academy of Tehran University of Medical Sciences and Emergency and the Research Center in Disaster Medicine and Computer Science applied to Medicine (CRIMEDIM), Università del Piemonte Orientale. Different simulators were used by the participants, who were from the health system and other relevant fields, both inside and outside Iran. As a result of the workshop, all the concerned stakeholders are called on to support this new initiative of incorporating virtual training and exercise simulation in the field of disaster medicine, so that its professionals are endowed with field-based and practical skills in Iran and elsewhere. Virtual simulation technology is recommended to be used in education of disaster management. This requires capacity building of instructors, and provision of technologies. International collaboration can facilitate this process.