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Lessons Learned from the 2017 Kermanshah Earthquake Response

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Kosar Yousefi
Kosar Yousefi
Kosar Yousefi
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Davood Pirani
Davood Pirani
Davood Pirani
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Ali Sahebi at Medical University of Ilam
Ali Sahebi
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Iran Red Crescent Med J. In Press(In Press):e87109.
Published online 2018 December 29.
doi: 10.5812/ircmj.87109.
Letter
Lessons Learned from the 2017 Kermanshah Earthquake Response
Kosar Yousefi 1, Davood Pirani 2and Ali Sahebi2, *
1Department of Nursing, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
2Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*Corresponding author: Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Email: nurse.sahebi@yahoo.com
Received 2018 December 05; Accepted 2018 December 14.
Keywords: Disaster, Earthquake, Healthcare, Management, Non-Governmental Organizations, Rescue, Response
On November 12, 2017, at 21:48 local time, an earth-
quake struck Azgaleh in Kermanshah province, Iran, with
a magnitude of 7.3 on the Richter scale. In this event,
around 4700000 people were exposed and the number of
mortalities was 650. Around 8,000 people were injured,
and 70,000 were displaced. Furthermore, 12,000 build-
ings were damaged. The highest mortalities were reported
from Sar-e-Pol Zahab, Ghasr Shirin, and Salas Babajani (1).
Earthquake is a natural disaster with the least possibility
for being predicted. The immediate mortality following
an earthquake is high. In fact, 71% and 80% of deaths are
reported in a few minutes and the first six hours after an
earthquake, respectively.
Disaster Medical Assistance Team (DMAT) comprises
a group of medical and non-medical staff skilled in vari-
ous activities. Their primary function is to deliver clinical
care in the affected area. These individuals can perform
their functions for up to 72 hours and can treat as high as
250 injured daily without any external aids (2). Following
an earthquake, infrastructures and healthcare centers are
largely devastated, leading to a shortage in health provider
personnel. These events significantly hinder delivering
health services to a large number of injured. In these situa-
tions, relay teams are expected to treat the wounded in the
affected place. After the initial triage, the severely injured
individuals are translocated to outside areas to seek medi-
cal aids from DMAT established at the circumference of the
inflicted area. After being medically stable, the injured are
transferred to distant hospitals (3).
Following the earthquake in Kermanshah province,
the trustee rescue teams and non-governmental organiza-
tions (NGOs) were immediately deployed to the affected ar-
eas starting rescue operations as soon as possible. As the
disaster happened at night time and the health infrastruc-
tures and lifelines of the region were devastated, and be-
cause of the power outage and the disruption of commu-
nicative routes, the rescue operation encountered many
difficulties. Some of the injured were treated in outpa-
tient settings while others were transferred to hospitals
in Kermanshah and neighboring provinces by Emergency
Medical Services (EMS) and Helicopter Emergency Medi-
cal Services (HEMS). The transportation faced numerous
problems such as traffic, overcrowding, damaged roads,
mountainous regions, and unstable climate, delaying the
transportation process. As an experience, it was learned
that reaching rescue teams to the affected area and the
transportation of the injured to local hospitals to seek ad-
vanced medical care faced severe limitations due to de-
stroyed health infrastructures and lifeline routes follow-
ing the earthquake. The fast deployment of DMAT to the
disaster zone can have the following advantages:
- Immediate treating and discharging of the outpatient
injured in the affected area
- Delivering advanced medical services to the injured
who are in a dire situation in the affected area and trans-
porting them to regional hospitals after being stable
- Reducing the mortality rate following the earthquake
- Reducing the cost of search and rescue
- Avoiding overcrowding of the injured in hospitals
Footnotes
Conflict of Interests: The authors do not have any conflict
of interests to declare.
Funding/Support: None declared.
Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License
(http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly
cited
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Yousefi K et al.
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2Iran Red Crescent Med J. In Press(In Press):e87109.
... The quality of the studies was conducted by two researchers independently through the standard strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (11), which has 22 sections encompassing the minimum and maximum scores of 0 and 44 respectively. Based on the obtained scores, the studies were divided into either poor (<16), moderate (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) or good (31-44) quality categories (12). The studies that obtained at least the minimum score of 16, entered the meta-analysis process. ...
... Therefore, identifying the risk factors of suicidal ideation is the first step to prevent and treat suicidal ideation and behaviors (27,28). In 2017, Iran experienced an earthquake with a magnitude of 7.3 Richter in Kermanshah Province (29,30). In a study (31), low and high-risk suicidal ideation were reported as 49.2% and 34.7% among widowed women in Kermanshah. ...
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... In Daliri et al. study, the prevalence of suicide in Iran was 8 per 100,000 population and despite the decreasing trend, the rate of suicide was reported high in the western provinces of Iran (7). Iran experienced a devastating earthquake in Kermanshah in 2017 (8,9). The survivors of the earthquake following the loss of livelihood, property, parents, and other family members can be exposed to psychological and social problems, which can lead to despair and suicidal ideation. ...
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Earthquake in Western Iran: Renovation Kills
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Introduction: Earthquake is the most important cause of death from natural disasters in Iran. This paper brings attention to the main causes of loss of life due to the Kermanshah province earthquake (Nov 12 2017), and provides a wakeup call about the unsafe nature of buildings there. Methods: This study is based on official reports review and a field assessment in the areas affected by the earthquake in western Iran. Results: Although buildings in this area are mainly old structures, strangely, more than 70% of the destroyed buildings in this earthquake were under 5 years of age, newly built or renovated buildings according to mandated building codes. Discussion: Mandated building codes and construction rules and regulations are not respected even for the newly constructed or reconstructed structures buildings.
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Disaster Medical Assistance Teams After Earthquakes in Iran: Propose a Localized Model
Article
Full-text available
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Background: In the past 10 years, 13 fatal earthquakes have occurred in Iran and led to death of 30,000 people whom most of them were killed in the earlier hours of the disaster. Disaster Medical Assistance Teams are groups of trained medical and non-medical personnel with various combinations that on the optimal conditions are deployed just within 8 hours of notification and are able to work self-sufficiently for at least 72 hours without any outside help and can treat up to 250 patients per day. Currently there are no such rapid-response teams in case of unexpected events in Iran, which causes the responses to such disasters, not to be organized or practiced. For instance, there were many rescue forces in 2003 Bam earthquake but not enough skilled ones to cope with; consequently they themselves became a problem in crisis management instead of solving the problem. Objectives: IN THIS STUDY, WE HAVE INVESTIGATED WHICH OF THE FOLLOWING IS MORE EFFICIENT: changing the size and combination of the team depending on the type of disaster and environmental conditions or, determine a fixed combination team. Materials and methods: Totally, several reasons for dynamic combination and size of the teams are presented. later, earthquake disaster is divided into 3 phases in terms of time including the acute phase (1(st) to 4(th) day after disaster), the sub-acute phase (5(th) to 14(th)day) and the recovery phase (after the 14(th) day), and finally the appropriate team combinations in every phases are offered. Results: Regarding to introduction and considering the existing statistics in different legal Iranian resources and by division of the earthquake disaster to three phases including acute phase (1st to the 4th day after disaster), sub-acute phase (5th to 14th day) and recovery phase (after the 14th day). Conclusions: The countries pioneer in disaster medical assistance teams, now are inclined to deploy different teams consistent with each kind of disasters or with other effective components on the combination of system. Every disaster has its own condition and would require different combination of relief and medical forces. For example, people's health needs in flood is different from the earthquake.
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Development of the Japanese National Disaster Medical System and Experiences during the Great East Japan Earthquake
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After the Great Hanshin-Awaji Earthquake in 1995, the Japanese national disaster medical system (NDMS) was developed. It mainly consists of four components, namely, a disaster base hospital, an emergency medical information system, a disaster medical assistance team (DMAT), and national aeromedical evacuation (AE). The NDMS was tested for the first time in a real disaster situation during the Great East Japan Earthquake in 2011. Two airports and one base were appointed as DMAT gathering places, and approximately 393 DMAT members divided into 78 teams were transported by Japan Air Self-Defense Force (JASDF) aircrafts to two AE staging bases the following day. Staging care units were installed at Hanamaki Airport, Fukushima Airport, and the Japan Ground Self-Defense Force Camp Kasuminome, and 69, 14 and 24 DMAT teams were placed at those locations, respectively. In total, 19 patients were evacuated using JASDF fixed-wing aircraft. Important issues requiring attention became clear through the experiences of the Great East Japan Earthquake and will be discussed in this paper.
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