Global & Disaster Medicine

Archive for March, 2018

The highest concentration of the agent used against Sergei and Yulia Skripal was found on their front door.



  • The pair were found collapsed on a bench in Salisbury on 4 March.
  • They remain in a critical condition.
  • Traces of Novichuk had been found at other sites in the city, but they were at lower concentrations.
  • About 250 counter terrorism officers continue to work on the case
  • 5,000 hours of CCTV footage and 1,350 items have been seized and examined.
  • Timeline of events
  • 3 March:  Yulia Skripal flew into London’s Heathrow Airport on a flight from Russia at about 14:40 GMT
  • 4 March, 09:15 GMT:  Mr Skripal’s car was seen in Salisbury in the area of London Road, Churchill Way North and Wilton Road
  • 4 March, 13:30 GMT:  His car was seen driving down Devizes Road, towards the town centre
  • 4 March, 13:40 GMT:  Mr Skripal and his daughter arrived at the Sainsbury’s upper level car park at the Maltings shopping precinct.
  • 4 March, between 41:20 GMT and 15:35 GMT:  Police said the pair went to The Mill pub before going to Zizzi restaurant
  • 4 March, 16:15 GMT:  Emergency services received the first report of an incident
  • 4 March:  Police found the pair on a bench outside Zizzi in an “extremely serious condition”
  • 4 March:  Det Sgt Nick Bailey fell ill after attending the incident – – was treated in hospital but discharged on 22 March
  • 48 people were assessed in hospital in relation to the incident
  • Only Mr Skripal and his daughter Yulia remain in hospital
  • Investigators have identified 131 people who have potentially been in contact with the nerve agent.
  • None has shown symptoms


Emergency responses to Manchester Arena attack (5/22/2017)

The Guardian

Manchester Arena bombing report: the key points

• The Greater Manchester fire and rescue service did not arrive at the scene and therefore played “no meaningful role” in the response to the attack for nearly two hours.

•  A “catastrophic failure” by Vodafone seriously hampered the set-up of a casualty bureau to collate information on the missing and injured, causing significant distress to families as they searched for loved ones and overwhelming call handlers at Greater Manchester police.

•  Complaints about the media include photographers who took pictures of bereaved relatives through a window as the death of their loved ones was being confirmed, and a reporter who passed biscuit tin up to a hospital ward containing a note offering £2,000 for information about the injured.

•  A shortage of stretchers and first aid kits led to casualties being carried out of the Arena on advertising boards and railings.

•  Armed police patrolling the building dropped off their own first aid kits as they secured the area.

•  Children affected by the attack had to wait eight months for mental health support.

3/27/1977: Two 747 jumbo jets crash into each other on the runway at an airport in the Canary Islands, killing 582 passengers and crew members.


A reporter in the Kabul bureau of The New York Times: When she hears bombs explode

NY Times

“….[C]all my little brother…..”

“….I was a civilian, not a journalist, at the first suicide bombing I witnessed…… It was a hot July day and I took refuge from the afternoon heat in the shade of a wall.

That wall saved my life. I have no words to describe the horrible sound of that blast, a sound I had never heard before. Dust filled the air and I was lying on the ground, too shocked to move. Which was fortunate because a few minutes later came another blast — a vicious trick of terrorists to get first responders as well. Flying glass cut my nose, but I had no other injury.

Far worse was what I saw: the dead and dying, the dismembered victims and distraught survivors, the terrible screams of agony and suffering, and the howls of despair and rage. The blast killed 84 and wounded more than 400…..”


Impact of Armed Conflict on Healthcare in Afghanistan: UN Report

Afghanistan and the Protection of Civilians :  Document

“…..In 2017, UNAMA documented 75 incidents targeting and/or impacting healthcare and healthcare workers that caused 65 civilian casualties (31 deaths and 34 injured) compared to 120 incidents in 2016 that resulted in 23 civilian casualties (10 deaths and 13 injured).

Most of the civilian casualties (26 deaths and 22 injured) in 2017 occurred in the context of a complex attack by Anti-Government Elements on the Mohammad Sardar Daud Khan Hospital in Kabul city on 8 March.

Threats, intimidation, harassment and abduction of medical personnel comprised the majority of incidents in 2017.

UNAMA recorded the targeted killing or attempted targeted killing of five healthcare professionals (three deaths and two injured) by Anti-Government Elements in 2017. In one case, on 10 October, in Tera Zayi district, Khost province, Anti-Government Elements stopped a healthcare professional from a mobile team while he was riding a motorcycle, opened fire and killed him.

Throughout 2017, Anti-Government Elements abducted 22 healthcare workers in 11 incidents, killing one of them. The other healthcare workers were released unharmed, mostly without ransom, often following the intervention of local elders. In 2017, Anti-Government Elements continued to target ambulances – UNAMA recorded five such attacks, all during the first half of the year.  For example, on 26 April, in Bagram district, Parwan province, Anti-Government Elements detonated a remote-controlled IED against an ambulance driving to the site of a murder, injuring five civilians, including a forensic doctor, two investigators, and two child bystanders.

UNAMA also recorded five incidents of intentional damage to medical facilities by AntiGovernment Elements, including one case in Badghis province, on 20 September, where AntiGovernment Elements fired rocket-propelled grenades at a clinic under construction, which resulted in its destruction and caused three civilian casualties (one death and two injured) in a nearby private house.

UNAMA documented the temporary closure of at least 147 health facilities in 2017, following threats issued by Anti-Government Elements, compared to 20 such closures in 2016. These closures ranged from several hours, with partial continuation of services, to several months of complete interruption of services, and negatively affected access to healthcare for numerous people in these areas…..”


Stray dog situation in Thailand out of control & thus, the risk of rabies grows


“…..According to the last nationwide survey in 2014 there are around eight and a half million dogs in Thailand. Seven hundred thousand of those are considered to be strays with a round half of that number being females who produce up to ten puppies a year. This figure means that the stray canine population could increase by up to 3.4 million dogs a year.

Stray dogs as well as being unclean and causing noise pollution can also spread diseases such as rabies. 90% of the animals found with rabies in Thailand are dogs and 60% of rabid dogs are strays…..”

CDC:  This patient presented with early, though progressive symptoms due to what was confirmed as rabies virus.

Doctors in a Russian town treated dozens of children complaining of dizziness and nausea on Wednesday because of noxious fumes (hydrogen sulfide & nitric oxide) coming from a local dump


Image result for hydrogen sulfide

See the source image


Medical security plan set during Egyptian presidential elections (3/26-28)


“…..Ministry of Health and Population declared that as a part of the comprehensive medical plan, 2887 equipped ambulances will be distributed across polling stations, centers for the final announcement of election results, as well as along main roads in each governorate …….the Egyptian Ambulance Authority has coordinated with the Critical and Emergency Care Department to provide emergency doctors for each ambulance. ….. three fully- equipped medical convoys, with different medical specialties, will be stationed in each governorate during the election. Enough emergency blood supplies and medicine for six months will be provided to all hospitals during the election…..”

Kemerovo: At least 64 people, many of whom are believed to be children, perished on Sunday as a massive fire swept through a crowded shopping center.

Washington Post


At least 37 people are confirmed to have died and dozens more are missing in a fire that tore through a shopping centre in the Siberian city of Kemerovo.




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