Global & Disaster Medicine

Archive for August, 2016

On this date in 2005, Hurricane Katrina slams into Gulf Coast

History Channel



[Image of 5-day forecast and coastal areas under a warning or a watch]

Meanwhile….in the Atlantic

[Image of 5-day forecast and coastal areas under a warning or a watch]

Yemen: At least 60 have been killed in a suicide car bombing at a military training facility in the city of Aden


WHO: The Hazard to Humankind after an Earthquake


EARTHQUAKES – Technical Hazard Sheet – Natural Disaster Profile

The Hazard

Earthquake can be defined as the shaking of earth caused by waves moving on and below the earth’s surface and causing: surface faulting, tremors vibration, liquefaction, landslides, aftershocks and/or tsunamis.

Aggravating factors are the time of the event and the number and intensity of aftershocks.

Compound hazards are fire, landslide, and tsunami.

Factors of Vulnerability

  • Location of settlements in seismic areas and size of the population.
  • Inadequate building practices and regulations.
  • Dense concentration of building with high occupancy.
  • The absence of warning systems and lack of public awareness on earthquake risks.

Public health impact of earthquakes

The main public health threats vary according to the magnitude of the earthquake, the nature of the built environment and the secondary effects of the earthquake (eg. tsunamis, landslides and fires). The effects can be summarized in terms of how they relate to risk factors as follows:

Immediate health impact

  • Trauma-related deaths and injuries from building collapse.
  • Trauma-related deaths and injuries from the secondary effects of the earthquake (drowning and physical trauma from tsunamis, trauma from landslides, burns and smoke inhalation from fires).

Medium-term impact on health

  • Secondary infection of untreated wounds.
  • Increased morbidity and risk of complications related to pregnancy, deliveries and newborns due to interrupted obstetric and neonatal services.
  • Potential risk of communicable diseases, particularly in areas affected by overcrowding.
  • Increased morbidity and risk of complications of chronic diseases due to interruption of treatment.
  • Increased psychosocial needs.
  • Potential environmental contamination by chemical/radiological agents following destruction of industrial infrastructure.

Impact of earthquakes on the health system

  • Damage to health facilities and transport infrastructure, with subsequent disruption of service delivery, leading to reduced access to and functionality of all levels of health services.
  • Absence of health workers who may not be able to reach the health facilities that are still functional, or whose homes and families may have been directly affected by the earthquake.
  • Reduced ability to pay for health services as affected households lose assets and livelihoods.
  • Loss of medical supplies and interrupted procurement systems, with many stock-outs.

Mitigation and preparedness for earthquakes

  • Strengthen health emergency risk management systems.
  • Limit the risk of exposure to earthquakes by improving the quality of the built environment, with better land-use control, including regulating building.
  • Ensure that health facilities are resilient to hazards, and that they are able to remain functional and able to respond to increased and changed health needs after earthquakes, with staff trained appropriately.
  • Be prepared to mobilize medical response teams, including establishing temporary health structures and field hospitals.
  • Invest in community preparedness – communities are often the first responders.

WHO addresses the Earthquake Situation in Italy


Hundreds killed and health facilities seriously damaged in earthquake in central Italy


At least 247 people have lost their lives and hundreds more are injured in the 6.0-magnitude earthquake that hit central Italy in the night between 23 and 24 August 2016, according to the Italian Civil Protection Department. Power cuts and serious damages to infrastructure, including health facilities, were also reported.

“I want to express WHO’s solidarity with the victims in this tragedy”, commented Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “We are concerned that health facilities have been seriously damaged. It is important to ensure that hospitals are able to function continuously in such circumstances. WHO stands ready to help.”

Hundreds of aftershocks were registered after the initial earthquake, some reaching magnitudes of 4.0 to 5.3. At least one landslide was triggered. Many victims are still trapped under rubble, and death tolls are expected to rise.

The main effects are currently being reported from the towns of Amatrice and Accumoli in the Rieti area of the Lazio region. The regions of Marche (in particular the municipality of Arquata del Tronto) and Umbria have also been affected.

The immediate response

In the relief phase, the priority of the Civil Protection Department is to save lives through search-and-rescue operations and emergency medical assistance. Support to those who have lost their homes and assessment of the damages will follow soon after. Telephone lines for the public are activated and social media are being used to provide advice and ask for blood donation.

The Government of Italy has not requested international assistance at this time. WHO is following the situation closely and offering assistance to the Italian Ministry of Health.

Earthquake impacts

Earthquakes have both direct and indirect impacts.

  • Direct impacts include high mortality, especially from trauma, but also from asphyxia, dust inhalation and hypothermia. Medical needs are high in the first weeks after an earthquake, and range from cuts, bruises and simple fractures to serious multiple fractures, internal injuries and crush syndrome requiring surgery and other intensive treatment.
  • Indirect impacts involve damages to health facilities, which can lead to interruptions in basic health care services, and to lifelines such as water and sewer systems, energy lines, roads, telecommunications systems and airports.

Health services in earthquakes

Health services must be fully responsive in the first 48 hours after an earthquake, as up to 95% of people rescued alive from collapsed buildings are saved within this time.

The resilience of health facilities, and particularly hospitals, during and after earthquakes is a critical component of saving lives and reducing diseases in the affected population. Using a new tool, WHO is currently assessing hospital safety in several European countries and recommending strategies for keeping hospitals operational during earthquakes and other health emergencies.

Italy: The First Responders

Protezione Civile

Terremoto Italia centrale: le forze in campo

August 28, 2016

Prosegue, nei territori colpiti dal terremoto, l’impegno del Servizio Nazionale della Protezione Civile: sono 6012 le forze dispiegate sul territorio tra gli appartenenti alle diverse strutture operative, ai centri di competenza tecnica scientifica e alle aziende erogatrici di servizi essenziali. A questi si aggiunge tutto il personale delle amministrazioni statali e di quelle delle aree colpite dal sisma, nonché quello delle colonne mobili attivate dalle altre regioni per portare aiuto.

In particolare,

1174 sono le unità dei Vigili del Fuoco,

794 gli appartenenti alle Forze Armate e

980 alle Forze di Polizia, a cui si aggiungono

197 unità di personale della Croce Rossa Italiana,

5 del Corpo Nazionale Soccorso Alpino e Speleologico e

339 uomini e donne delle organizzazioni di volontariato nazionale, nonché

817 del volontariato locale di Lazio, Marche e Umbria e

654 delle colonne mobili proventi da fuori dalle regioni colpite.

Ammonta a un totale di 41 il personale dei diversi centri di competenza tecnica e scientifica; circa 445 unità di personale in campo per le aziende erogatrici dei servizi di luce e gas; 303 per gli operatori di telefonia; circa 120 per la viabilità, 30 per le Ferrovie dello Stato; 15 per il Ministero delle Infrastrutture e Trasporti e 98 per il Dipartimento della Protezione civile. I mezzi di soccorso complessivamente impegnati sul territorio sono circa mille.


9/11 & disaster-related adverse birth outcomes.


Carey B. Maslow, Kimberly Caramanica, Jiehui Li, Steven D. Stellman, and Robert M. Brackbill.  (2016). Reproductive Outcomes Following Maternal Exposure to the Events of September 11, 2001, at the World Trade Center, in New York City. American Journal of Public Health. e-View Ahead of Print.

Krakatoa, a small, uninhabited volcanic island located west of Sumatra in Indonesia, erupted on this day in 1883. The explosion was heard 3,000 miles away. The explosions threw five cubic miles of earth 50 miles into the air, created 120-foot tsunamis and killed 36,000 people.

History Channel


A blaze, due to a faulty lamp, swept through a printing plant in Moscow Saturday, killing at least 17 Kyrgyz workers.




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