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 Post subject: Top docs discuss SL tsunami study
 Post Posted: Sun Oct 23, 2005 11:40 am 
Top docs discuss SL tsunami study

By Thalif Deen in New York
@ Sunday Times /Sunday, October 23, 2005

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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