Posted in Issue 94 January 2004 News from PAHO/WHO
When a major earthquake struck Bam, Iran last December, killing at least 30,000 persons, more than 10 field hospitals (defined as mobile, self-contained, self-sufficient health care facilities capable of rapid deployment to meet immediate emergency requirements for a specific period of time) were sent.
These field hospitals were accompanied by a wide range of medical staff. Three hospitals arrived three days after the quake, two on the fourth day and the others after five or more days later. Some hospitals were set up and fully operational on the day of arrival, while others required up to two days to function. The length of time they were expected to remain in Bam varied widely: one week (four hospitals); two weeks (three hospitals); one month (one hospital); three/four months (one hospital); and up to one year (one hospital). The field hospitals that remained after the first weeks were consolidated into two hospitals to coordinate inpatient services while the destroyed hospitals are rebuilt.
A global consultation on the use of field hospitals prior to the Bam earthquake concluded:
- Field hospitals equipped to provide emergency medical care for trauma are useful only if they are available and on-site within the first 24 hours. No hospital arrived in Bam before the third day. Despite sending 25 surgeons, three field hospitals carried out only 15 operations, demonstrating that sending surgeons three to five days after impact is not cost effective.
- Once a field hospital is operational, it should remain on-site for a minimum of 15 days, allowing for follow up (secondary) care of trauma and routine medical attention. In Bam, the main purpose of one of the field hospitals was delivery of primary health care services, and because it remained in Bam for just one week, not many patients benefited.
- Field hospitals serving as temporary facilities pending reconstruction should be donated and not loaned. The Italian government has handed over the hospital they sent to Bam. The IFRC hospital, equipped with three outpatient care modules, is now managed by the Iranian Red Crescent Society, supported by the IFRC, and under the supervision of the Ministry of Health.