Mass casualty incident after the Taba terrorist attack: an organisational and medical challenge

Two suicide bombings in and around Taba, Egypt, on 7 October 2004 created a complex medical and organisational situation. Since most victims were Israeli tourists, the National Emergency and Disaster Management Division handled their evacuation and treatment. This paper describes the event chronologically, as well as the organisational and management challenges confronted and applied solutions. Forty-nine emergency personnel and physicians were flown early to the disaster area to reinforce scarce local medical resources. Two hundred casualties were recorded: 32 dead and 168 injured. Eilat hospital was transformed into a triage facility. Thirty-two seriously injured patients were flown to two remote trauma centres in central Israel. Management of mass casualty incidents is difficult when local resources are inadequate. An effective response should include: rapid transportation of experienced trauma teams to the disaster zone; conversion of local medical amenities into a triage centre; and rapid evacuation of the seriously injured to higher level medical facilities.     

Advanced rescue techniques: lessons learned from the collapse of a building in Nairobi, Kenya

This paper examines the collapse of a five-storey building in Nairobi, Kenya, on 23 January 2006. It draws on reports from local authorities and on debriefings by Israel's Home Front Command (HFC), including information on injury distribution, rescue techniques, and the mode of operation. Most of the 117 people found under the structure were evacuated on the first day to a public hospital, which was overwhelmed by the incident. HFC forces arrived 23 hours after the disaster. At that stage, two people were still buried under the building and special techniques (tunnelling and scalping) were required to secure their evacuation. The two people quickly recovered after a short stay in hospital. Local technology is the preferred option during such events because time is crucial. International cooperation is required when this technology is not available. All of the hospitals in the disaster area, including private facilities, should participate in treating casualties.     

Invisible institutions in emergencies: Evacuating the remote Indigenous community of Warruwi,Northern Territory Australia,from Cyclone Monica

Tropical Cyclone Monica is one of the most intense Australian cyclones in recorded history, and threatened several Indigenous communities in April 2006. It prompted the evacuation of the remote island community of Warruwi, and caused considerable damage to the mainland township of Maningrida. The evacuation of Warruwi went smoothly as emergency services personnel, the community and the airline cooperated to airlift some 350 people to designated safe areas on the mainland. We show that local institutions culturally embedded in Indigenous ways of understanding and responding to the world were important in providing essential but ‘unofficial’ services during the emergency. Recognizing and respecting the resilience of the local process involved in everyday Indigenous life is revealed as central to ensuring local cooperation and effective involvement of state and national institutions in delivering effective measures during emergencies. Ensuring that local, state and national authorities offer recognition and understanding of these Indigenous institutions, and develop strong relationships with them, should be a priority in developing approaches that limit conflict and trauma where emergency services risk overriding local protocol.     

An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces Field Hospital in Adapazari

On 17 August 1999 at 3:04 a.m., an earthquake of 7.4 magnitude (Richter scale) struck the Marmara region in Turkey. The city of Adapazari suffered 2,680 fatalities with approximately 5,300 injured. The Israeli Defence Forces (IDF) field hospital arrived at Adapazari, on day four after the quake. The team consisted of 102 personnel. The field hospital acted as a secondary referral centre. A total of 1,205 patients were treated in the field hospital between day four and day 14 of the earthquake. The frequency distribution of the medical problems seen in the field hospital was 32 per cent internal medicine, 13 per cent general surgery including plastic, 21 per cent orthopaedic surgery, 23 per cent paediatric disease, 10 per cent obstetrics and gynaecology and 1 per cent major psychiatric disorders. A mean number of 35 patients per day were hospitalised in the field hospital for between 24 hours to one week. The rapid establishment of the field hospital enabled the local medical facilities to 'buy time' in order to organise and restore surgical and hospitalisation abilities in this disastrous situation.     

A national system for disseminating information on victims during mass casualty incidents

Immediate provision of information to the public is vital during mass casualty incidents (MCIs). Failure to implement rapidly a communication response system may result in the public overwhelming hospitals. This paper shares Israel's experience in developing and maintaining a national system for supplying information on the location and identification of casualties. ADAM interfaces online with hospitals' patient registration systems, and allows for immediate electronic transfer of designated data. The system permits information centres to access information on which hospital has admitted identified and unidentified casualties. The latter are photographed at the entrance to the hospital and the picture is stored in ADAM. The system enables hospitals and municipalities to ensure immediate availability and accessibility of information and thus (in our belief) mitigate the concerns of family and friends. Use of such an interface system is recommended as an integral element of emergency preparedness.     

Household evacuation characteristics in American Samoa during the 2009 Samoa Islands tsunami

Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 M_w 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis.     

重大危险源大规模人群疏散决策模型研究

为在重大危险源应急救灾中给决策人员提供最优的人群疏散方案,提高抢险救灾能力,将疏散过程分为两个阶段——先将灾民疏散至临时疏散救援点,再根据灾民受伤的严重程度有选择地将其疏散至定点医院进行救治。综合考虑灾害对人群疏散造成的影响,将道路危险系数等参数加入目标函数中,将灾区按灾害程度赋予不同的优先疏散系数并将之反映在时间满意度上,以总疏散时间最小为目标函数,建立疏散模型,并应用遗传算法进行求解。最后,通过MATLAB进行仿真计算。研究结果表明:模型和算法给出的疏散策略是有效的。     

A multilevel analysis of private-vehicle evacuation clearance times along the US Gulf Coast

This study uses multilevel regression analysis to examine the effect of social characteristics and the built environment on clearance time under an evacuation scenario. The primary unit of analysis is the US Census tract (N?=?1660), nested within 31 incorporated places spanning five US states. The dependent variable is an estimate of clearance time in hours derived using network analysis techniques within a geographic information system. We find that tracts with a more peripheral location, more female residents, a higher proportion of Hispanic residents, and higher median household incomes are associated with higher clearance times, on average. Our research suggests the relationship between suburbanization and clearance time is complex and evolving, mediated by past investments in the built environment and shifting social conditions. In addition to facilitating the evacuation of areas with low access to personal vehicles, urban planners and emergency management officials should also consider how the degree of connectivity in the street network impacts congestion and clearance time.     

Alternatives to evacuation during wildland fire: Exploring adaptive capacity in one Idaho community

The use of alternatives to evacuation during wildfire events continues to be an intensely debated strategy in the professional and policy circles of numerous fire-prone countries. The most recent chapter comes in response to the Black Saturday Fires in Australia, which has led to policy changes concerning alternatives to evacuation in both Australia and USA. This study explores the local context that influenced the development of alternatives to evacuation in one Idaho community through in-depth interviews with local residents and officials. It acknowledges alternatives as one ‘fire-adaptive behaviour’ of the local community, a key characteristic that US fire professionals identify as a means to better manage wildfire. We apply and extend a recently created adaptive capacity framework for wildfire to uncover specific community characteristics that both led to and reinforce the development of alternatives to evacuation that are tailored to the local population. Identification of these characteristics serves as one important step towards better local assessment of adaptive capacity for a broad classification of ‘fire-adaptive’ behaviours. We conclude that no one combination of local resources can guarantee the development of alternatives to evacuation. Rather, diverse local context will result in different approaches and applicability of the practice.     

Time needed to evacuate the Netherlands in the event of large-scale flooding: strategies and consequences

On 30 May 2008, the Government of the Netherlands informed the national parliament about the effectiveness of preventive evacuation of coastal and river areas in case of flooding. Analysis of a case study showed that it is impossible to evacuate coastal areas preventively within a 48-hour time span preceding a worst credible scenario flood caused by a storm surge. This fact illustrates the need for alternative evacuation strategies, such as vertical evacuation (evacuating to safe havens, inside the flood zone) or shelter-in-place (hiding), to reduce loss of life and the impact of the evacuation. This paper defines these strategies and demonstrates, by returning to the case study used by the Dutch government, that they require different measures, methods of approach, and crisis management processes. In addition, it addresses the need for flexible and scalable preparation so that after detecting and understanding the threat, authorities and citizens can make decisions about different evacuation strategies.     

Factors affecting the evacuation decisions of coastal households during Cyclone Aila in Bangladesh

Despite sincere efforts by concerned agencies and recent improvements in hazard warnings, thousands of at-risk people did not evacuate during Aila, a category-I tropical cyclone that struck southwestern coastal Bangladesh in 2009. This study investigated the responses of the people affected by Aila to cyclone warnings and associated evacuation orders, and unveiled behavioural aspects that explain why they did or did not comply with the evacuation orders. Utilising the primary data collected from 420 households living in the severely affected coastal sub-district Koyra, located in Khulna District, this study found that although more than 97% of the households had received cyclone warnings and evacuation orders before Aila's landfall, only around 26% had evacuated. We also examined this study's empirical findings for factors that had dissuaded people from complying with the evacuation orders. Relevant test statistics along with results from principal component analysis suggested that the significant and systematic absenteeism of households from disaster preparedness training appears to be one of the key determinants that affected their evacuation decisions, along with factors related to warning messages, the attributes of cyclone shelters, risk perception, and socioeconomic aspects. A number of recommendations are also presented in this study for people at risk to improve their evacuation rates in future emergencies, not only to save their own lives but also to save their livestock.     

Optimisation patterns for the process of a planned evacuation in the event of a flood

ABSTRACT

The main purpose of the article is to develop an optimisation pattern for the process of a preventive evacuation of people from flood-risk areas (at the first sign of a flood), aimed at mitigating the negative effects of the flood performed through the application of modern computer tools. It has been assumed that the use of both GIS tools and apps for vehicle traffic modelling (the research includes the use of a method developed by the authors) in emergency procedures implemented in response to a flood may increase the efficiency of the anti-flood campaign (here: the evacuation of residents from flooded areas), and thus, it may also minimise the negative effects of the flooding itself. The article distinguishes 14 stages of research, which were chiefly completed by means of the following methods: distance-based accessibility, cumulative accessibility, the Enhanced Two-Step Floating Catchment Area Method (E2SFCA) and the Two-Step Floating Catchment Area Method (2SFCA), the vehicle routing method, algorithms by Dinitz, Edmonds-Karp, and Ford-Fulkerson, and a comparative method applied to draw a comparison between the actual state of affairs and the optimum condition determined by the aforementioned methods.     

Protecting Tourists from Death and Injury in Coastal Storms

Hurricanes, typhoons, tsunamis and other storms force thousands to flee coastal regions every year. In many cases, resort areas have been severely damaged and tourists placed in jeopardy. This article examines ways tourist businesses can and already have protected holiday-makers from coastal storm hazards through emergency evacuation and other measures. Using data from a sample of large and small hotels in New Orleans, Louisiana, we find considerable variation in protective behaviour. To explain this variation, we look at how perceptions and preparedness differ by both managerial and organisational characteristics. We then suggest a variety of measures that can be taken by hotels in coastal resort areas to reduce risk.     

Civilians under fire: evacuation behaviour in north Israel during the Second Lebanon War

This paper seeks to understand evacuation behaviour in a case of spontaneous evacuation. During the Second Lebanon War of 2006, more than one‐third of residents in north Israel spontaneously evacuated—the remainder stayed in situ. Using a telephone survey of 665 respondents residing in north Israel, we were able to characterise the behaviour of evacuees and non‐evacuees. The main reasons cited for evacuating were fear of injury to self or family, the effect on children, inability to remain in a protective space, and family pressure. The main reasons cited for remaining at home were no suitable alternative, did not perceive a high level of danger, had to go to work, and there is no place like home. There were no significant differences with regard to most socio‐demographic characteristics of the population. These findings should aid emergency managers in preparing the population for a future emergency and in engaging in effective dialogue with the population during an emergency on the evacuation option.     

基于GIS的灾害疏散模拟及救援调度

台风是我国东南沿海各省夏秋季中经常遭遇的自然灾害。在台风登陆之前，根据气象部门对台风发生过程及发展趋势的分析，预测防御范围，进行必要的应急疏散与救援调度，可以有效地减少人员伤亡和财产损失。研究了城市在风灾情况下进行疏散的模拟方法。将微观离散模型和宏观交通流模型相结合，采用元胞自动机原理和LW宏观交通流理论，建立了城市区域不同类型的疏散模型和应急服务规划模型，进行了人员和车辆的疏散模拟与分析，并在此基础上研制了基于GIS的灾害疏散模拟及救援调度系统，该系统可对城市防灾减灾规划和灾时应急预案的制定提供决策支持。     

Variations in disaster evacuation behavior: public responses versus private sector executive decision-making processes

Data obtained from 65 executives working for tourism firms in three sample communities permitted comparison with the public warning response literature regarding three topics: disaster evacuation planning, initial warning responses, and disaster evacuation behavior. Disaster evacuation planning was reported by nearly all of these business executives, although it was highly variable in content, completeness, and formality. Managerial responses to post-disaster warnings paralleled the type of complex social processes that have been documented within the public response literature, except that warning sources and confirmation behavior were significantly affected by contact with authorities. Five key areas of difference were discovered in disaster evacuation behavior pertaining to: influence of planning, firm versus family priorities, shelter selection, looting concerns, and media contacts.     

火灾中人群疏散延迟时间的研究

火灾中人员的疏散时间主要包括疏散前的延迟时间和在通道上的疏散时间。对疏散延迟时间的分布及其对疏散时间的影响进行了研究,利用Building Exodus软件对实际工程进行了模拟,并得出了一些重要的结论。这些结论对于修正传统疏散时间的工程计算方法、制定合理的人群管理对策具有重要的指导作用。     

The World Trade Center Bombing: Injury Prevention Strategies for High-rise Building Fires

The WTC disaster provided an opportunity to look for ways to prevent morbidity among occupants of high-rise buildings during fires. This paper first describes the overall morbidity resulting from the explosion and fire, and second, presents the results of a case-control study carried out to identify risk factors for smoke-related morbidity. The main ones include: increased age, presence of a pre-existing cardio-pulmonary condition, entrapment in a lift and prolonged evacuation time. Study results point to the importance of the following safety systems during high-rise building fires: smoke-control systems with separate emergency power sources; lift-cars, lift-car position-monitoring systems, and lift-car communication systems with separate emergency power sources; two-way emergency communication systems on all floors and in stairwells; stairwells with emergency lighting and designed for the rapid egress of crowds; evacuation systems/equipment to assist in the evacuation of vulnerable people (elderly, infirm). Also important are evacuation plans that include regularly scheduled safety training and evacuation drills.     

荆江分洪区1998年洪水转移调查分析

对荆江分洪区１９９８年洪水期间安全转移的调查表明，叶然有分洪预案，但实际转移时仍出现了相当程度的拥挤与混乱。完善分洪转移的组织与管理，已成为分洪区居民１９９８年转移后关注的焦点，分洪区居民普遍表现出对分洪洪水情不甚了解，通过各种方式开展有关洪水的宣伟，提高区内居民的防洪意识，是荆江分洪区未来防洪减灾的重点工作之一，由于是国家为保护更重要的地区而主动分洪。对分洪区历分洪蒙受的损失给预某种形式的补偿已