The Response of the South Manchester Accident Rescue Team (SMART) to the Armenian Earthquake and Lockerbie Air Disaster: A Report to the Prime Minister's Office

The delay in receiving authorisation for the despatch of SMART significantly reduced our overall effectiveness. The majority of injured survivors were extracted during this time and our special expertise could have saved a significant number of lives. The episode has provided SMART with unique experience for a British medical team and this knowledge should not be wasted. In contrast to other major western countries the British response was fragmented. We have no central stockpile of equipment and no official response team. The British who responded were independent of each other even when from the same service. The quality of the individual British teams was as good as any and often better. However, the ability of other nations to coordinate their response centrally and draw from a pool of workers already used to working together, improved both their efficiency and effectiveness. There are great difficulties in communication during any disaster and these increase with the scale of the disaster. Incoming rescue workers were given false or misleading information and rumour was widespread. Even when few people were found alive rescue workers expressed a strong need for a medical presence in case they discovered an injured person or they them selves became ill or injured. We were told repeatedly by experienced rescuers that we were the first team of British senior doctors they had met at the front line of a disaster and they were extremely pleased to see us. Transport was a major problem both in terms of vehicles and local knowledge. It was not thought to be within the remit of a medical team to make provision for food and shelter and this was confirmed in Moscow prior to departure for Yerevan. In retrospect this was a mistake and reduced the time we could stay at the front line. If we had not equipped ourselves with special clothing we could not have gone to the front line. A medical team must be part of larger team of rescue workers. Within this unit there will be provision for food, shelter, transport and communication as well as medical and surgical equipment.