Telecommunications in Israeli field hospitals deployed to three crisis zones

A field hospital overseas requires various types of communication equipment. This study presents the communications equipment used by three Israeli field hospital delegations to earthquake sites at Adapazari, Turkey, in 1999, Port‐au‐Prince, Haiti, in 2010 and Minamisanriku, Japan, in 2011. The delegations to Turkey and Haiti were relatively large (105–230 personnel) and were on the site early (three to four days after each event). The 55‐person delegation to Japan arrived later and was established as an outpatient community hospital. Standard military VHF radios were the only effective tool up to 5 km, until cellular coverage was regained (1–2 weeks after each event). International communication was good. While short‐wave communication (telephone and Internet) was used in Turkey, a direct satellite channel was set up in Haiti. In Japan, BGAN Inmarsat provided efficient Wi‐Fi for all needs. Motorola walkie talkies were not efficient beyond the immediate vicinity. This paper recommends continued use of military‐specification equipment alongside newer modalities, particularly in situations where infrastructure is damaged.     

Needs assessment of the displaced population following the August 1999 earthquake in Turkey

In August 1999 a major earthquake struck north-western Turkey. An assessment followed to identify the immediate needs of the displaced population. A random cluster sample of displaced families living in temporary shelter outside of organised relief camps was designed. Representatives of 230 households from the four communities worse affected by the earthquake were interviewed. Most families lived in makeshift shelters (84 per cent), used bottled water (91 per cent), obtained food from relief organisations (61 per cent), had access to latrines (90 per cent), had a member on routine medication (53 per cent) and obtained information by word of mouth (81 per cent). Many respondents reported having family members who were over the age of 65 (32 per cent) or under age three (20 per cent), who were pregnant (6 per cent), or who had been ill since the earthquake (64 per cent). The greatest immediate need reported by most families was shelter requirements (37 per cent), followed by food (23 per cent) and hygiene requirements (19 per cent). Ten days after the earthquake, basic environmental health needs of food, shelter and hygiene still predominated in this displaced population. Significant portions may have special needs due to age or illness.     

Earthquake mortality in Pakistan

A strong earthquake, measuring 7.6 on the Richter scale, hit northern Pakistan on 8 October 2005, causing massive destruction, including an official death toll of 73,276. Four cross-sectional surveys were performed in late 2005 to assess mortality before the event, on the day, and subsequently. Two surveys were community-based and two were situated in camps for internally displaced persons. Crude mortality rates were low in the 3.5 months preceding the earthquake (less than 0.1 deaths per 10,000 per day) and slightly higher in the six-to-eight weeks after the earthquake (ranging from 0.10–0.43 per 10,000 per day). On 8 October 2005, approximately two per cent of the population in one community survey died and around five per cent in the other three surveys. Children less than five years and adults more than or equal to 50 years tended to have a higher risk of mortality on the day of the disaster. These results corroborate the high mortality caused by the earthquake.     

Psychological consequences among adults following the 1999 earthquake in Athens, Greece

One year after the 7 September 1999 earthquake in Athens, Greece, we investigated the psychological consequences among 305 individuals (71 per cent female) residing in the settlements of Ano Liosia Municipality. Adaptability was difficult (63 per cent) due to limited space (50 per cent). Insecurity feelings were predictive of difficult adaptability (chi2= 29.8, p<0.0001) and were common (63 per cent) among married subjects, independent of age (chi2= 5.0, odds ratio (OR): 0.49, 95 per cent confidence interval (CI): 0.26-0.90). Eighty per cent expressed stress feelings, mainly nervousness/tension (60 per cent). Adaptability (chi2= 5.3, OR: 0.5, 95 per cent CI: 0.27-0.9), age (chi2= 6.5, OR: 1.03, 95 per cent CI: 1.01-1.06), and female gender (chi2= 4.7, OR: 0.48, 95 per cent CI: 0.25-0.90) were independent predictors of stress feelings. The majority (55 percent) developed sleep disorders, chiefly insomnia (60 percent). Adaptability problems were the only predictor of sleep disorders (chi2= 6.4, OR: 0.5, 95 per cent CI: 0.33-0.87). Psychiatric medication use increased after the earthquake.     

Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey

This study examined the prevalence of post-traumatic stress disorder (PTSD) and comorbid depression some three years after the August 1999 earthquake in Turkey among a sample of 769 survivors relocated to a permanent housing site built for homeless survivors in the epicentre region. Time since trauma was 3.1 years for 81 per cent of the participants and 3.9 years for the remainder. Survivors were assessed using the Screening Instrument for Traumatic Stress in Earthquake Survivors, an easily administered self-rating scale with demonstrated validity. The estimated rates of PTSD and comorbid depression were 40 per cent and 18 per cent, respectively. Linear regression analyses showed that PTSD strongly related to fear during the earthquake, while depression related to loss of family members. These results suggest that catastrophic earthquakes have long-term psychological consequences and highlight the need for a cost-effective mental health care model for earthquake survivors.     

Profile of Mortality from the 1989 Loma Prieta Earthquake using Coroner and Medical Examiner Reports

Mortality patterns from earthquakes in the United States may differ from those observed in other parts of the world. We reviewed coroner and medical examiner records for all investigated deaths from seven California counties for 15 days following the Loma Prieta earthquake of October 17, 1989 (N = 327). Data on the circumstances surrounding death were used to classify each case as directly earthquakerelated, indirectly earthquake-related, or not earthquake-related. Fifty-seven deaths were judged as directly earthquake-related. Six other deaths were indirectly related. Ten circumstances accounted for all directly earthquake-related deaths, with the collapse of an elevated freeway accounting for 40 of these deaths. Forty-six (80.8 per cent) of the 57 directly earthquake-related deaths occurred in motor vehicles on public roadways. Fifty-three (93.0 per cent) of the directly earthquake-related deaths occurred within seconds or minutes of injury. Future earthquake deaths in the United States may best be prevented by identifying and modifying seismic hazards in earthquake-prone regions, particularly transportation structures.     

Reproductive health in Afghanistan: results of a knowledge, attitudes and practices survey among Afghan women in Kabul

A reproductive-health knowledge, attitudes and practices (KAP) survey was carried out among 468 Afghan women of reproductive age. A convenience sample of women was selected from attendees in the outpatient departments of four health facilities in Kabul. Seventy-nine per cent of respondents had attended at least one antenatal consultation during their last pregnancy. Two-thirds (67 per cent) delivered their first child between 13 and 19 years. The Caesarean-section rate was low (1.6 per cent). Two-thirds (67 per cent) of deliveries occurred in the home. The contraceptive prevalence rate was 23 per cent (16 per cent modern and 7 per cent natural methods). Twenty-four per cent had knowledge of any STIs, although most of these women did not know correctly how to prevent them. Most of the women (93 per cent) needed authorization from their husband or a male relative before seeking professional health-care. In multivariate analysis, women's schooling was significantly associated with antenatal-care attendance (AOR 4.78), institutional delivery (AOR 2.29), skilled attendance at birth (AOR 2.07) and use of family planning (AOR 4.59). Reproductive-health indicators were noted to be poor even among these women living in Kabul, a group often considered to be the most privileged. To meet the reproductive-health needs of Afghan women, the socio-cultural aspects of their situation--especially their decision-making abilities -- will need to be addressed. A long-standing commitment from agencies and donors is required, in which the education of women should be placed as a cornerstone of the reconstruction process of Afghanistan.     

Risk factors for long‐term post‐traumatic stress disorder among medical rescue workers appointed to the 2008 Wenchuan earthquake response in China

This study aims to determine the risk factors for clinically‐significant post‐traumatic stress disorder (PTSD) among Chinese medical rescue workers one year after the response to the Wenchuan earthquake on 12 May 2008. A sample of 337 medical workers who performed response work within the first three months of the event completed an online questionnaire, which included information on demographics, social support, the management and organisation of the disaster response, and an assessment of PTSD. Symptoms consistent with PTSD were prevalent in 17 per cent of the rescue workers. Those who developed PTSD symptoms were more likely to have been injured, experienced a water shortage, been disconnected from family and friends during the response, and have passive coping styles and neurotic personalities. Factors that cannot be changed easily, such as personality traits, should be evaluated prior to deployment to ensure that rescue workers at higher risk of PTSD are provided with adequate support before and during deployment.     

A determination of the prevalence of gender-based violence among conflict-affected populations in East Timor

The Reproductive Health Response in Conflict (RHRC) Consortium designed a standardised questionnaire to measure gender-based violence (GBV) prevalence in conflict-affected settings. A preliminary field test was undertaken July-August 2002 in one urban and one rural district in East Timor to assess the prevalence of GBV among women 18-49 years of age during and after conflict. The field test used a cross-sectional survey design with a two-stage random selection process. During the year preceding East Timor's 1999 crisis, 23.8 per cent of respondents reported physical assault by an intimate partner; this rate was not significantly different in the year preceding the survey (24.8 per cent). Assault by perpetrators outside the family declined significantly from 24.2 per cent during the crisis to 5.8 per cent post-crisis for physical assault (p<.001) and 22.7 per cent during the crisis to 9.7 per cent post-crisis for sexual assault (p=0.046). The field test stimulated and informed additional research in East Timor, and the complementary findings of these research initiatives continue to be used to develop local policies and programming to prevent and address GBV.     

Investigating the strategic antecedents of agility in humanitarian logistics

This study investigates the strategic antecedents of operational agility in humanitarian logistics. It began by identifying the particular actions to be taken at the strategic level of a humanitarian organisation to support field‐level agility. Next, quantitative data (n=59) were collected on four strategic‐level capabilities (being purposeful, action‐focused, collaborative, and learning‐oriented) and on operational agility (field responsiveness and flexibility). Using a quantitative analysis, the study tested the relationship between organisational capacity building and operational agility and found that the four strategic‐level capabilities are fundamental building blocks of agility. Collectively they account for 52 per cent of the ability of humanitarian logisticians to deal with ongoing changes and disruptions in the field. This study emphasises the need for researchers and practitioners to embrace a broader perspective of agility in humanitarian logistics. In addition, it highlights the inherently strategic nature of agility, the development of which involves focusing simultaneously on multiple drivers.     

Evaluation of Two Kurdish Refugee Camps in Iran, May 1991: The Value of Cluster Sampling in Producing Priorities and Policy

Following the end of the Gulf war in March 1991, Kurdish refugees from Iraq crossed the border into Western Iran. To plan public health interventions and to assist in priority setting for scarce resources, a rapid epidemiological assessment of two camps, Hafez and Kaliche, was conducted in May 1991. A 30 cluster sampling method was used to determine the demographics of the camp population, the morbidity and mortality from certain diseases, and the nutritional status of the children <5 years of age. The estimated population of the camps at the time of the survey was 28,500 and 22,500 for Hafez and Kaliche respectively; children < 5 years of age accounted for approximately 25 per cent of both camp populations. The mortality rate was highest in Hafez and estimated to be 2.5/10,000 per day (95%CI:0.3–5) for adults (> 14 years of age) and 4.9/10,000 per day (95%CI:2.4–7.4) for children. Diarrhoeal and respiratory diseases accounted for major morbidity in both camps with diarrhoea the commonest stated cause of death. Little malnutrition was found but it was greater in Hafez where 6 per cent (19/327) of the children between 1 and 5 years of age had a mid upper arm circumference (MUAC) <12 cm and eleven (5.2 per cent) of the 211 children measured for height and weight were below 80 per cent of the median (95%CI:2.6%;7.8%). The survey identified that morbidity and mortality were less severe than in the Kurdish camps on the Turkish border and provided information for camp authorities to plan appropriate relief interventions.     

A post‐earthquake psychopathological investigation in Armenia: methodology,summary of findings,and follow‐up

The post‐earthquake psychopathological investigation (PEPSI) was designed to probe the short‐and long‐term effects of the earthquake in northern Armenia on 7 December 1988 on survivors' mental and physical health. Four phases of this study have been conducted to date, and, overall, more than 80 per cent of a sub‐sample of 1,773 drawn from an initial cohort of 32,743 was successfully followed during 2012. This paper describes the methodology employed in the evaluation, summarises previous findings, details the current objectives, and examines the general characteristics of the sample based on the most recent follow‐up phase outcomes. Despite a significant decrease in psychopathology rates between 1990 and 2012, prevalence rates of post‐traumatic stress disorder and depression among study participants in 2012 were greater than 15 and 26 per cent, respectively. The paper also notes the strengths and limitations of the study vis‐à‐vis future research and highlights the importance and potential practical implications of similar assessments and their outcomes.     

Structural vs Non-structural Flood-alleviation Measures in the Yangtze Delta: A Pilot Survey of Floodplain Residents' Preferences

This study was initiated to test if structural flood-alleviation measures were more popular than non-structural measures among the floodplain residents of the Yangtze Delta, because of the long tradition of 'living with embankments and other flood control structures'. The results of a pilot questionnaire survey among 239 respondents from four sample villages of two typical floodplains of the delta indicated that, contrary to expectations, the non-structural measure of flood insurance attracted more favourable responses (97 per cent) than any one of the structural measures, although the latter were also frequently selected by the respondents (64 – 92 per cent). A number of multivariate logit regressions between each of the preferred flood-alleviation measures and the respondents' flood adaptations identified some of the determinants of these preferences. For a more complete explanation of the causes of popularity of various flood-alleviation measures, further research should incorporate a behavioural model with trade-offs for alternative measures.     

Mental health and media links based on five essential elements to promote psychosocial support for victims: the case of the earthquake in Chile in 2010

This paper reviews the role of news with respect to the mental health of a population exposed to a disaster. It is based on the five essential elements of psychosocial care presented by Stevan E. Hobfoll et al. (2007) that can be introduced after a potentially traumatic event: promoting a sense of safety, calming, self and collective efficacy, connectedness, and hope. This study developed a method to relate these elements to television coverage and applied it to the stories (n=1,169) aired by the main networks in Chile in the 72 hours after an 8.8 magnitude earthquake struck on 27 February 2010. Of the five elements, promoting a sense of safety occurred most often (82.72 per cent), whereas the others were barely present (less than 10 per cent). The study argues that these elements can increase the possibility of framing the news, given that the audience watching can also be affected by a disaster.     

Epidemiological assessment of food aid in the Bosnian conflict, 1994-97

Surveys in emergency settings are important for the accountability of food aid. Four household surveys conducted between 1994 and 1997 measured the performance of the Bosnia food aid programme, covering a random sample of clusters in Bosnia and Herzegovina and the Republica Srpska. The team calculated coverage, exclusion and inclusion errors, programme misses, and under-supply. Despite intended universal coverage from 1994-96, 15, 19, and 31 per cent, respectively, did not receive food across the three-year time frame. Households categorised as vulnerable were somewhat more likely to receive food. Programme misses were rare, whereas under-supply fell from 30 per cent in 1994 to four per cent in 1997, as the availability of other food increased. Extrapolation suggested that 61 per cent of the food distributed did not reach households. The programme introduced priority categories for targeting in 1997, yet nearly one-half of the highest priority households did not receive food. Incomplete coverage and weak targeting were related to political constraints.     

Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo

Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences.     

Multi-stakeholder collaboration in community post-disaster reconstruction: case study from the Longmen Shan Fault area in China

While multi-stakeholder collaboration is critical for effective community post-disaster reconstruction (CPDR), it is often very difficult in practice. The Longmen Shan Fault active seismic zone in China has experienced several recent earthquakes with the 2008 Wenchuan earthquake and 2013 Lushan earthquake, both of which caused extensive and widespread damage to many communities, presenting unprecedented challenges for post-disaster reconstruction. This paper develops a multi-cycle field research method that involves three interconnected cycles: internet research, field visits, and extensive surveys: to examine multi-stakeholder collaboration for the CPDR following the Wenchuan earthquake. It was found that there were 12 types of active stakeholders engaged across four main areas: infrastructure rebuilding, psychological recovery, socio-economic rehabilitation, and ecological restoration. Specifically, local community participation and effective collaboration between the community and the external stakeholders were found to be the most crucial elements for successful reconstruction. Multi-stage field research after the Lushan earthquake verified that CPDR was effective and that multi-stakeholder collaboration had improved from the lessons learnt from the Wenchuan earthquake reconstruction experience. Some advantages and limitations of this research are also given.     

Analysis of hazardous material releases due to natural hazards in the United States

Natural hazards were the cause of approximately 16,600 hazardous material (hazmat) releases reported to the National Response Center (NRC) between 1990 and 2008-three per cent of all reported hazmat releases. Rain-induced releases were most numerous (26 per cent of the total), followed by those associated with hurricanes (20 per cent), many of which resulted from major episodes in 2005 and 2008. Winds, storms or other weather-related phenomena were responsible for another 25 per cent of hazmat releases. Large releases were most frequently due to major natural disasters. For instance, hurricane-induced releases of petroleum from storage tanks account for a large fraction of the total volume of petroleum released during 'natechs' (understood here as a natural hazard and the hazardous materials release that results). Among the most commonly released chemicals were nitrogen oxides, benzene, and polychlorinated biphenyls. Three deaths, 52 injuries, and the evacuation of at least 5,000 persons were recorded as a consequence of natech events. Overall, results suggest that the number of natechs increased over the study period (1990-2008) with potential for serious human and environmental impacts.     

Health Effects of the 1991 Bangladesh Cyclone: Report of a UNICEF Evaluation Team

To assess the impact on health of the cyclone and tidal wave that struck the southern coast of Bangladesh on the evening of 29 April 1991, a team of health professionals visited cyclone affected areas from 4–27 June, 1991. Team members met with health workers and officials of the Government of Bangladesh and with staff pom nongovernmental organizations, and conducted field surveys in two severely affected areas.
Mortality among the 135 households surveyed (pre-cyclone population 1,123) was 14 per cent. At highest risk of deaths were children of less than 10 years (26 per cent mortality) and women of more than 40 (31 per cent mortality). Almost all deaths occurred as a result of drowning from the tidal wave that accompanied the cyclone. Although 95 per cent of the population surveyed had received warning of the cyclone four or more hours before it struck, the 300 existing cyclone shelters had capacity for only 450,000 of the 5,000,000 people affected by the cyclone. Deaths following the cyclone were few. Diarrhea caused by Vibrio cholerae and Shigella dysenteria type 1, both of which are endemic in Bangladesh, occurred in the post-cyclone period. Reports by the national Diarrhea Surveillance System of large increases in diarrheal incidence following the cyclone were difficult to assess because of inconsistencies in pre-and post-cyclone reporting methods. No increase in other infectious diseases was identified.
Although water availability had been a major concern following the cyclone, the tubewell system was functioning well in the area that was surveyed. Distribution of relief assistance by the Government of Bangladesh and by non-governmental organizations was good, with 95 per cent of families surveyed receiving food aid within five days of the cyclone.
The major health effect of this cyclone was acute deaths due to drowning. Preventing deaths during future cyclones will require increasing accessible shelter.     

埋设管网系统地震危险性分析方法

埋设管网系统有如下三个特点,即:埋于地基中、在平面内延伸分布范围广、具有生命线工程的重要性,故其抗震设计与地震危险性分析方法也与一般房屋建筑不同。为此,本文提出了一种同时考虑给定地震下地震动场的空间相关性、局部场地条件及地震发生非确定性影响的地震危险性分析方法。本文建议的方法中给定地震下地震动场的确定包括四方面的工作:①确定地震动场的参数,用场内各点之间的相对运动(如相对变形)而不是单点的运动(如加速度);②在频域内确定场内单个点的地震动,以幅值谱与相位谱表示;③用若干个离散点的地震动来描述地震动场;④考虑局部场地的影响。地震动空间相关性与地震发生非确定性同时考虑之间的矛盾问题在本文方法中也得到了处理,采用这一方法的优点是在地震动场中同时考虑了震级、距离及场地的影响,本文提出的方法也可以用于在平面上分布范围较广的其它生命线网络工程。