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docs discuss SL tsunami study
By Thalif Deen in New York
NEW YORK - A six month study of the impact of the tsunami disaster
on patient care has revealed the strength and weaknesses of Sri
Lanka's fragile medical infrastructure.
The
findings of the study, which examined the extent of human and physical
destruction and the pattern of injuries and emergency management,
were presented to the 91st annual Clinical Congress of the American
College of Surgeons in San Francisco last week.
There
were only three tertiary care teaching hospitals — Galle,
Jaffna and Colombo — two general hospitals and 14 provincial/base
hospitals in the tsunami-affected areas, according to the study.
Besides
the 40,000 who died in the tsunami in late December, the hospitals
had to cope with 75,000 injured. The destruction also left about
1,000,000 people displaced and homeless.
"None
of the hospitals, except the tertiary care centre in Colombo, has
a disaster management plan," the study points out. "This
needs to be rectified and the authorities are working on it."
The
shortcomings included inability to reach disaster zones, lack of
trained personnel in affected areas and lack of health care facilities
to provide emergency services.
Still,
the dead outnumbered the injured in the tsunami aftemath and the
injuries of the survivors were relatively less severe. "Unlike
earthquakes or explosions, tsunami kills or spares. In the case
of the latter, the injured are relatively small and only a few needed
major surgeries."
The
team responsible for the study — the first of its kind —
was headed by Dr. A.H. Sheriffdeen of the Department of Surgery
at the University of Colombo, and included Dr T. Samarawickrama.
The findings were presented at the San Francisco meeting —
billed as one of the world's largest gathering of surgeons —
by Dr. G.A.P. Ganepola, Associate Professor of Clinical Surgery
at Columbia University in New York.
Dr
Ganepola told The Sunday Times the findings of the study and the
‘lessons learned’ from Sri Lanka's tsunami disaster
were considered relevant to most surgeons in the US which is still
struggling to cope with the recent hurricane disaster in the State
of New Orleans.
According
to the study, there were few medical officers to cope with the initial
sudden, massive influx of 26,000 people, while 8,200 were already
dead.
In some hospitals, there was only one surgeon on duty since the
tsunami hit on a holiday weekend.The workload in the hospitals immediately
following the tsunami included 15,024 admissions and 7,634 out patients.
The
majority of injuries needing surgical attention, over 2,300 constituting
86.7 percent of the workload, was highly contaminated lacerations
of the limbs. These are time-consuming procedures and subsequently
needed several visits to the operating rooms.
In
an exercise in ‘lessons learned’, the study calls for
an early warning system and an international registry of certified
healthcare professionals, including mental health. Additionally,
there is an urgent need to create a global network of emergency
transportation and global reserves of emergency medical supplies.
The study also calls for the regional availability of tent hospitals
with surgical capabilities.
In
the face of chaos and mayhem, Dr. Sheriffdeen cautioned, “even
the best thought out and best rehearsed disaster management plan
would be difficult to implement due to human factors, including
hysteria”.
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