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Nurses in the fire and rescue service have been providing emergency care to people for more than twenty years. Their practice is regulated by national emergency nursing care protocols drawn up by the relevant learned societies. Numerous training programmes and more recently, the possible use of telemedicine, help to ensure the quality of the emergency care provided to patients or victims.

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An earthquake is a very common natural disaster. Numerous studies have focused on the acute phase, but studies concerning the subacute phase after an earthquake were very limited. This aroused more attention being paid to medical relief in the subacute phase, and this study elaborated on the division of the medical relief period and the definition of medical relief targets. More importantly, major types of disease were analyzed by reviewing the relevant published studies, which were identified by searching electronic databases. Findings suggested that the clear division of medical relief stage is vital for determining the priority of medical aid and allocating medical resources scientifically, and all concerned populations should be targeted for medical assistance. The focus of acute phase is injury (64.2%), and the subacute phase is disease (27.8% respiratory disease, 22.9% common disease, 12.5% wound/injury, 10.5% skin disease, 8.7% gynecological and pediatric disease, 8.5% digestive disease). However, due to the limited available studies, the included articles perhaps did not reflect the actual proportion of each type of disease. More studies are needed to better understand the proportion of different diseases in each phase of an earthquake.

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Non-profit organizations provide international medical relief trips to low/middle-income countries (LMIC) in order to provide healthcare to medically underserved areas. Short-term medical relief trips (STMRT) take a large amount of time and resources, and arouse concerns about their actual effectiveness. Here we develop a novel tool for consistently assessing how U.S. organizations provide primary care to Latin America through short-term medical relief trips. First, in Part 1, we create a "Best Practice" (BP) framework focused on the efficacy, sustainability, and long-term impact of the organizations based on a review of the last 27 years of available literature published in peer-reviewed journals. Second, in Part 2, out of 581 total medical relief organizations in the US, we identify the 19 organizations currently providing short-term primary care services to Spanish-speaking countries in Latin America. We use the BP framework to analyze the website content and secondary sources of these 19 organizations. We find that only three of the 19 organizations met 80% or more of the criteria defining BP according to the framework and four out of the 19 did not perform well in any of the framework's three aspects of efficacy, sustainability, and long-term impact. Because there exists no current standardized way of assessing the methods implemented and services offered by STMRT, we provide suggestions about using this novel framework as a self-assessment tool for STMRT organizations.

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Objective By measuring various medical relief standards and simulating the poverty reduction outcomes for compensation for self-paid expenses, to learn the outcomes of medical on poverty reduction in rural areas. Methods Using the detailed medical expenditure of those subject to medical relief in 2016 in Liandu district of Lishui city of Zhejiang province, we calculated their self-paid medical expenses and the proportion of medical relief. The data were analyzed by descriptive analysis. Results Thanks to the medical relief, the self-paid expenses of 458 people fell to under 22 000 yuan,i. e. the poverty line, and 30.25% of them overcame poverty. It was found that different medical relief schemes score different poverty reduction effects among various expense sections. Conclusions Rational choices of medical relief standards for such population call for reference of the distribution pattern of their specific self-paid medical expenses, a benchmark to identify those in need of assistance. Attempts are needed to explore partial assistance for self-paid medical expenses and introduce commercial insurance to make up for the assistance. It is recommended to select appropriate rescue means as required by the demand and supply of the rescue funds.

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OBJECTIVES: The primary health-care system in Syria has suffered a great deal of damage over the past 6 years. A large number of physicians and health-care providers have left the country. The objectives of this study are to describe our experience in establishing a primary health-care system in the opposition territories (OTs) in Syria and report the most common treated diseases. METHODS: The administrative databases of ten primary care centers in the OT from January 2014 to December 2015 were reviewed. All patients' encounters, including children and adults, in these centers were included in the study. RESULTS: Within the study period, the ten centers served 46,039 patients encounter per month (and average of 4600 patients encounters per center per month). A high number of communicable diseases were noted. Cutaneous leishmaniasis was the most common communicable disease (1170 cases a month). Tuberculosis was treated in 14 patients a month. Other infectious diseases that were almost eradicated before the crises were seen increasingly (29 mumps cases/month, 6 measles cases/month, and 34 cases of typhoid fever/month). CONCLUSION: The primary health-care system in Syria has been greatly damaged, and tremendous efforts are ongoing to provide access to various basic health-care services including primary care services. Despite these efforts, the current system is very vulnerable and not sustainable. This study summarizes basic health services provided by primary health-care centers in Syrian OTs.

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OBJECTIVE: The objective of this study was to explore a log of WhatsApp messages exchanged among members of the health care group Doctors For You (DFY) while they were providing medical relief in the aftermath of the Nepal earthquake in April 2015. Our motivation was to identify medical resource requirements during a disaster in order to help government agencies and other responding organizations to be better prepared in any upcoming disaster. METHODS: A large set of WhatsApp (WhatsApp Inc, Mountain View, CA) messages exchanged among DFY members during the Nepal earthquake was collected and analyzed to identify the medical resource requirements during different phases of relief operations. RESULTS: The study revealed detailed phase-wise requirements for various types of medical resources, including medicines, medical equipment, and medical personnel. The data also reflected some of the problems faced by the medical relief workers in the earthquake-affected region. CONCLUSIONS: The insights from this study may help not only the Nepalese government, but also authorities in other earthquake-prone regions of the world to better prepare for similar disasters in the future. Moreover, real-time analysis of such online data during a disaster would aid decision-makers in dynamically formulating resource-mapping strategies. (Disaster Med Public Health Preparedness. 2017;11:652-655).

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In April 2015 a 7.8-magnitude earthquake hit Nepal. As part of relief operations named Operation Maitri, the Indian Armed Forces deployed 3 field hospitals in the disaster zone. Rapid deployment of mobile surgical teams to far-flung, inaccessible areas was done by helicopters. In an operational deployment spanning 1 month, a total of 7532 patients were treated and 105 surgeries were carried out on 83 patients. One-fifth of the patients were less than 18 years of age. One-third of the patients had traumatic injuries directly attributable to the earthquake, whereas the remaining patients were treated for diseases of poor sanitation and hygiene as well as chronic illness that had been neglected owing to the collapse of the local health infrastructure. Cases of traumatic injuries directly related to the earthquake were seen maximally on the 5th day after the index event but tapered off rapidly by the 10th day. Nontraumatic illness required more attention thereafter and a need was felt for separate child health and reproductive health services later in the mission. Although immediate management of injuries and surgical intervention in selected cases was possible, ensuring long-term care and rehabilitation of cases proved problematic. This was especially so for spinal injury cases. Data capturing by a paper-based system was found to be inadequate. The lessons learned from this mission have led to a reimagining of the composition of future relief operations. Apart from mobile surgical teams, on which conventional field hospitals are generally centered, a separate section for preventive medicine and child and maternal services is needed. (Disaster Med Public Health Preparedness. 2017;11:394-398).

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Objective To select the best plan for establishing frontline surgical team (FST) for emergency medical relief based on the characteristics of health service for non-battle military missions, hoping to provide theoretical reference and evidence for establishing FST. Methods This study proposed 4 options to setup FST, including establishing a new one (PI), integration of professional operation teams (P2), selected group from field medical unit (P3), and modification of existing field medical team (P4). The analytic hierarchy process (AHP) was used to analyze the relevant factors influencing the establishment of FST, in an effort to build a hierarchical model diagram and to form a judgment matrix score of four scenarios; the four programs was evaluated by consulting experts and calculating the index weights and general weights. Results The consistency of matrix test results was judged as CR<0. 10, with the weights of the program scores being P1 =0. 213 8, P2 = 0. 242 0, P3 = 0.205 4, and P4 = 0. 338 8. Conclusion Application of AHP can achieve satisfactory result in selecting optimal plan for establishing FST; the optimal option to establish FST is to convert the existing field medical team (P4).

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The paper covered the implementation and social outcomes of the medical relief policy benefiting urban and rural residents in Anhui province. Based on analysis of problems identified, it proposed such recommendations: Enhance government financial support; improve the "safety net"mechanism of community hospitals; build a dynamic management system for those in need of medical relief; and tighten the linkage with social medical insurance.

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The massive 2008 Sichuan earthquake brought unprecedented international humanitarian aid to China. The monstrous damages and casualties aroused all human’s sympathy. I took the opportunity to join a Malaysian voluntary medical relief team to Sichuan in June 2008. This essay recounts the immediate events post-earthquake and reports on my experience during the mission.

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A major earthquake in Bam, Iran, which occurred on 26th of December,2003, claimed more than 26,000 deaths and most of the medical facilities were destroyed or left inoperative.<br>Although many relief organizations left Bam after the initial stage of the disaster, the necessity of medical support continued with the condition of many victims still desperate. Therefore, medical assistance was provided by HuMA in the recovery phase, and four prefabricated buildings were donated to an Urban Health Center (UHC) for use as a clinic. Essential medical equipment was provided to emergency centers in Bam. In addition, surveillance study was conducted to investigate how environmental health conditions could be improved and effective assistance be given during the recovery phase of the disaster. From monitoring of onsite disaster relief in Bam, it is concluded that the donor agencies should make efforts to continue their activities not only in the acute phase but also in sub-acute and recovery phase and if necessary to cooperate among different agencies according to their capability. Furthermore, it is suggested that close cooperation between NGOs and government agencies would lead to much faster and much more effective disaster relief for victims.