Military medical assistance following natural disasters: refining the rapid response.

The opinions or assertions are those of the author and do not necessarily reflect those of the Army Medical Department or the Department of Defense. All countries came into Egypt, to Joseph, to buy grain, because the famine was severe in all the earth Genesis 41:57 Since the beginning of recorded history, governments have provided humanitarian assistance during disasters due to natural hazards. The eruption of Mount Vesuvius on 24 August AD 79 destroyed the cities of Pompeii and Herculaneum. In response, the emperor of Rome established a relief fund to assist the displaced and widowed. 1 Today, disasters due to natural hazards are attended by an outpouring of humanitarian aid from both governmental and non-governmental agencies. The military, in particular, often is tasked with the initial governmental response, owing to its state of readiness. In this issue of Prehospital and Disaster Medicine, Malish et al analyze the response of an Army Mobile Surgical Team (MST) following the 2007 Peruvian earthquake. 2 Even though the MST was deployed and operational in less than 48 hours (one of the best-documented response times in the literature), they were unable to provide a single earthquake-related life-saving surgery. They did claim, however, to make a significant contribution to the evacuation effort and provided acute care augmentation to the overwhelmed local health services. The conclusions made in this article support the findings of other emergency humanitarian relief agencies—that is, responding medical assets seldom respond rapidly enough to substantially contribute life-saving surgical needs. Either these needs will have been met through the intervention of local health services or the opportunity to intervene already will have expired. 3 Following the 2001 earthquake in Gujarat, India, Bremer reported that most surgical teams arrived too late to provide life-saving care. 4 In his review of 43 foreign field hospitals deployed following four recent disasters, von Schreeb et al found that none of the foreign field hospitals arrived early enough to provide emergency trauma care. 5 Even when surgical assets are available, they are utilized infrequently relative to non-surgical assets. In describing the aftermath of the 1999 earthquake in Turkey, Bar-Dayan et al noted that of the 2,230 patients treated at the Israeli Defense Forces field hospital over a nine-day period, 90% had non-traumatic illnesses. 6 Another Israeli Defense Force medical unit performed surgery <6% of the 1,200 patients they treated following the same earthquake. 7 During a sudden-onset disaster, …