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Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti

Variability in Injuries Encountered and Collaboration with Local Available Resources Drive Optimal Response

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Abstract

Background

Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different—independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events. The purpose of this study was to analyze these differences and their implications for preparation and planning of future deployments.

Methods

Data were obtained from IDF records and analyzed using SPSS™ software.

Results

1686 patients were treated in Nepal versus 1111 in Haiti. The caseload in Nepal included significantly less earthquake-related injuries (26 vs. 66 %) with 28 % of them sustaining fractures versus 47 % in Haiti. Femoral fractures accounted for 7.9 % of fractures in Nepal versus 26.4 % in Haiti with foot fractures accounting for 23.8 and 6.4 %, respectively. The rate of open fracture was similar at 29.4 % in Nepal and 27.5 % in Haiti. 18.1 % of injured patients in Nepal underwent surgery, and 32.9 % of which was skeletal compared to 32 % surgical cases (58.8 % skeletal) in Haiti. 74.2 % of patients in Nepal and 34.3 % in Haiti were treated for pathology unrelated to the earthquake.

Conclusions

The reasons for the variability in activities between the two hospitals include the magnitude of the disaster, the functionality of the local medical system which was relatively preserved in Nepal and destroyed in Haiti and the mode of operation which was independent in Haiti and collaborative with a functioning local hospital in Nepal. Emergency medical teams (EMTs) may encounter variable caseloads despite similar disaster scenarios. Advance knowledge of the magnitude of the disaster, the functionality of the local medical system, and the collaborative possibilities will help in planning and preparing EMTs to function optimally and appropriately. However, as this information will often be unavailable, EMTs should be capable to adapt to unexpected conditions.

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Author information

Authors and Affiliations

  1. Schneider Children’s Medical Center, Petah Tikva, Israel

    Elhanan Bar-On

  2. Israel Defense Forces Medical Corps, Jerusalem, Israel

    Elhanan Bar-On, Nehemia Blumberg, Arnon Gam, Amos Peyser, Evgeny Lee, Shree Krishna Kashichawa, Alexander Morose, Ophir Schein, Amit Lehavi, Yitshak Kreiss & Tarif Bader

  3. Sackler Medical School, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel

    Elhanan Bar-On & Nehemia Blumberg

  4. Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel

    Nehemia Blumberg

  5. Nepalese Army Institute of Health Sciences, Shree Birendra Hospital, Kathmandu, Nepal

    Amit Joshi

  6. Shaare Zedek Medical Center, Jerusalem, Israel

    Amos Peyser

  7. Barzilai Medical Center, Ashkelon, Israel

    Evgeny Lee & Alexander Morose

  8. Hadassah Medical Center, Jerusalem, Israel

    Shree Krishna Kashichawa

  9. Dov Klein Medical Center, Tel Aviv, Israel

    Ophir Schein

  10. Rambam Healthcare Campus, Haifa, Israel

    Amit Lehavi

  11. Sheba Medical Center, Tel Hashomer, Israel

    Yitshak Kreiss

  12. The Department of Military Medicine, The Hebrew University, Jerusalem, Israel

    Yitshak Kreiss & Tarif Bader

Authors
  1. Elhanan Bar-On
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  2. Nehemia Blumberg
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  3. Amit Joshi
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  4. Arnon Gam
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  5. Amos Peyser
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  6. Evgeny Lee
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  7. Shree Krishna Kashichawa
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  8. Alexander Morose
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  9. Ophir Schein
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  10. Amit Lehavi
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  11. Yitshak Kreiss
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  12. Tarif Bader
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Corresponding author

Correspondence to Elhanan Bar-On.

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Bar-On, E., Blumberg, N., Joshi, A. et al. Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti. World J Surg 40, 2117–2122 (2016). https://doi.org/10.1007/s00268-016-3581-3

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  • DOI: https://doi.org/10.1007/s00268-016-3581-3

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