Disaster Epidemiology Lessons From Bam Earthquake Dec 26, 2003 Iran Part 4: Rescue and relief operation in Bam earthquake A. Ardalan MD, MPH, PhD student in Epidemiology 1

To view the rescue and relief operation in Learning objectives: To view the rescue and relief operation in Bam earthquake To understand the importance of public training and education in basic first aid and rescue methods. To understand the major concern and barrier for effective services delivery in Bam To understand the importance of health status and basic needs of rescue teams and relief workers in disasters. 2

Immediate National Response Immediate International Response Initial Response Immediate National Response Immediate International Response Despite the enormous devastation caused by the disaster, the response of and cooperation between the Iranian authorities, Iranian Red Crescent Society (IRCS) and the international community was swift and exemplary. 3

Massive rescue and relief operation Various government agencies including the Ministry of Interior, Ministry of Health, the Army, the IRCS and NGOs launched a massive rescue and relief operation. 4

Massive rescue and relief operation More than 1600 Search and Rescue, Health and Relief personnel from 44 countries arrived in the affected areas within a couple of days to help with the rescue and relief operations. 5

About 70 % of the families needed rescue efforts for pulling out their family members from under the rubble. 6

On the 20th day of post-disaster, about 10 % were hopeful to find their relatives alive under the rubble and asked for rescue efforts. You see here the picture of a 6 year old beautiful girl, who had been rescued on the 13th day after the quake. She and her 12 year old sister had been entrapped in the kitchen and fed by some of available food. 7

Time after the disaster Percents of families in need of rescue efforts who were helped by trained rescue groups, by time of help Time after the disaster % Never 46 First 12 hours 18 Second 12 hours 14 2nd day 13 After 2nd day 9 As you see, about half of families in Bam had pulled out their members from under the rubble, themselves or with the help of neighbors or other volunteers. During the first 24 hours, as the most critical phase in search and rescue efforts, just about one third of people were helped by trained rescue groups such as Iranian Red Crescent or International Red Cross. 8

Special training for action during an earthquake in Bam Only in 11% of families, at least one person had been trained in special action during an earthquake or first aid and rescue methods. 9

Cumulative percent of the first time basic services delivery to the earthquake-stricken households in Bam till 20th days of post-disaster period In this slide, you can see the cumulative percent of the first time basic services delivery including food, clothes, tent and safe water to the earthquake-stricken households in Bam till 20th days of post-disaster period, which are classified to first day, second day, third to fifth days and after fifth day from the time of earthquake. 10

The overall satisfaction of the earthquake-stricken people from basic services delivery Herein is the overall satisfaction rate of people from the basic services in the time of study. The most important reasons of their dissatisfaction were the poor quality of delivered services and inappropriate way of delivery that is eminent about the clothes and considerable about food and tents. 11

Population movement after the earthquake Earthquake-stricken area   Zones After the earthquake there are some inward and outward movements in the population and also some internal movements in the affected area.   Earthquake-stricken area 12

Major concern and barrier for effective services delivery in Bam Population Movement Major concern and barrier for effective services delivery in Bam Invasion of poor people from neighboring areas to Bam: 10,000-15,000 people Changing living places inside Bam: 10 % 13

17% were injured during their activities, but not sever Injuries and illnesses in relief workers who were studied on 21st day of post-disaster period in Bam 17% were injured during their activities, but not sever So, 67% did not need to medical care & 23% were received medical care Injuries of Relief workers in Bam 10 % did not referred in spite of need 14

49.3 % experienced at least one episode of illnesses Illnesses in relief workers who were studied on 21st day of post-disaster period in Bam 49.3 % experienced at least one episode of illnesses 67.2 % received medial care 15

80 % of relief workers in Bam expressed their need to psychological consultations. 16

Qualified accommodation status 8 % The demands of rescue team on the 21th days of post-disaster period in Bam Bath room 34 % Hot / qualified Food 10 % Qualified accommodation status 8 % Clothes 7 % The rescue teams' demands are presented in this slide. As in decreasing order are: bathroom, food, clothes, security, latrine, money and etc. Most of needs to these items are related to asking for higher quality of available services. While, 35 % had not been trained for action in crises before leaving for Bam, and 20 % had not received a scheduled program for their activities. It reminds me of Maslow hierarchy. The basic initial needs were prior to management and training. Training & management 6% Others 17

In disaster-prone areas like Iran, Conclusion 1: In disaster-prone areas like Iran, training and education in basic first aid and rescue methods should be an integral part of any community preparedness program. 18

Research-based information is necessary for estimation of needed Conclusion 2: Research-based information is necessary for estimation of needed relief supplies, equipment, and personnel to deliver services efficiently to earthquake-stricken people. 19

Do not forget the health status and basic needs of rescue teams and Conclusion 3: Do not forget the health status and basic needs of rescue teams and relief workers, otherwise they will not be efficient and will be waiting for replacements. 20