Revelation of 5.12 Quake, Sichuan, China Part3 During the Quake

1. Revelation of 5.12 Quake, Sichuan, ChinaPart3 During the Quake Supercourse China http://www.SuperCourse.cn/ 2008-6-6

2. Outline • 3.1 Escape, self-help and mutual help for civilian For professional agencies • 3.2 Emergency response system • 3.3 Search and rescue • 3.4Medical assistance • 3.5Response of public health sector • 3.6Related work of state departments during Wenchuan Quake • 3.7 International Assistance

3. 3.1 Escape, self-help and mutual help

4. Importance of self-help and mutual help Civilians will play an important role in the rescue work if proper trained. For instance, in the 1980’s earthquake occurred in the south of Italy, 90% survivors were rescued by those untrained people only with their hands and simple tools such as scoops or axes. In 1967 Tangshan earthquake, about 200,000 to 300,000 civilians who were trapped in the ruin climbed out by themselves and then helped others out of danger. Thanks to those people, more than 80% people trapped were rescued.

5. Entrapment As might be expected, entrapment appears to be the single most significant factor associated with death or injury (81). In the 1988 Armenia earthquake, death rates were 67 times higher and injury rates more than 11 times higher for people who were trapped than for those who were not (33). In the 1980 southern Italian earthquake, entrapment requiring assistance to escape was the most important risk factor: the death rate was 35.0% for trapped people versus 0.3% for untrapped people (82). In the Philippine earthquake of 1990, people who died were 30 times more likely to have been trapped than were injured survivors (OR = 29.74; 95% CI, 12.35-74.96) (66).

6. Occupants' Behavior The behavior of people during an earthquake is an important predictor of their survival (85). In several recent earthquakes (e.g., 1990 Philippines and 1992 Egypt earthquakes), there were widespread reports of deaths and injuries due to stampedes, as panicked building occupants and students rushed for the nearest exits (76,86). On the other hand, a review of the first reaction of people following an initial earthquake shock revealed that those who immediately ran out of buildings had a lower incidence of injury than did those who stayed inside (65,66). Other reports, however, suggest that running outside may actually increase the risk of injury. For example, during the 1976 Tangshan earthquake, many were struck by the collapse of outer walls after running out of their houses.

7. Time Until Rescue Although the probability of finding live victims diminishes very rapidly with time, entrapped people have survived for many days. People have been rescued alive 5, 10, and even 14 days after an earthquake (91); these "miracle rescues" are often the result of exceptional circumstances--for example, someone with very light injuries is trapped in a void deep in the rubble with air and possibly water available.

8. 国家CDC

9. For professional agencies 3.2 Emergency response system 3.3 Search and rescue 3.4Medical assistance 3.5Response of public health sector 3.6Related work of state departments during Wenchuan Quake 3.7 International Assistance

10. 3.2 Emergency response system

11. The work of Seismological Bureau just immediately after earthquake occurred. China seismological emergency rescue center and CENC, along with professional information insuring institution of provincial seismological bureau, establish corresponding initiating preplan for their work. When the earthquake occurred, according to the junior judgment of seismological parameter, they will initiate corresponding level of responding preplan immediately after earthquake occurred and began to collect the data. Commonly, it will include:

12. The work of Seismological Bureau just immediately after earthquake occurred. 1） Collect and arrange the fundamental information such as geographic environment, geologic background, human society, infrastructure facilities, the ability of prevention and rescue, secondary disasters, historic disasters (earthquake, tsunami, and hurricane) etc 2） Collect and sum up the detailed measure dealt with disasters by all level of government, such as initiate of emergency preplan, army, epidemic prevention, ministers and commissions under state council, rescue team, physical distribution and public settlement etc. 3） Collect and arrange other rescue information includes: various denoting actions, NGO, opinions or suggestions of civilian.

13. The work of Seismological Bureau just immediately after earthquake occurred. 4） Collect dynamic information of international rescue groups and pay attention to the reaction of international society. 5） The form of information includes: character, satellite image, flight image, picture and video etc.

14. For example In seismic area telephone communication can be likely suspended. But police, fire police and other emergency institution can still be able to keep wireless connection which is an efficient way available for public health institution. On the other hand, staffs of broadcasting and telecom often take high qualified commutation facilities with them in scene after disaster occurred.

15. For example • Tele news media can act as another effective method for providing sanitary suggestions or renewing of deaths. For instance, in emergency period, notice people in time the potential possibility of landslide to arouse highly vigilance, and clear people as soon as possible to prevent further injuries and deaths in the area where rock fall, landslide or mud rock flow could strike. When SOA and weather bureau initiate warning, people located in the low land on the bank must be first evacuated at once.

16. For example • After 1989 Loma Prieta earthquake, the investigation of Bourque, Goltz and their colleagues shows, despite there are many injuries and deaths in earthquake, as high as 40% of deaths occurred in the first 72hs after earthquake broke up. But we are able to avoid the situation if public warnings are available. The more ideal situation is public institution can direct the media to issue evacuating information to insure all people knows that they are facing to in an earthquake.

17. 3.3 Search and rescue

18. Insuring the free flow of rescue information Interview with Zijian Feng, Director of Emergency Office of State CDC, China The rescue team is packed with INMARSAT satellite telephone when sending out so that they can keep communication fluency before the restoration of mobile commutation. Because of the limit of facilities, they can only be supplied to the place most needed.

19. Basic insurance for rescue group Include basic food, water, tent, cloth etc. China seismological emergency rescue center has professional reserving insurance includes facilities insurance, logistic insurance, communication insurance and information insurance etc. When rescue groups were sent out, the headquarter will initiate the proper insuring measure according to the different emergency preplan to provide corresponding insurance. And succeeding insurance will be followed to ensure the rescue work of fronting rescue groups. Interview with Zijian Feng, Director of Emergency Office of State CDC, China

20. Search and Rescue People trapped in the rubble will die if they are not rescued and given medical treatment. To maximize trapped victims' chances of survival, search-and-rescue teams must respond rapidly after a building collapses.

21. Search and Rescue (cont.) With the exception of personnel from countries in close geographical proximity, foreign assistance usually arrives after the local community has already engaged in much of the rescue activity.

22. 3.4 Medical assistance

23. Different spectrum of disease caused by earthquake occurred in different time and places For instance, the earthquake magnitude of Sichuan earthquake is about the same to the Tangshan earthquake. But Tangshan earthquake happened in the night which killed more than 200,000 people. As for zone factors, the direct harm caused by collapse of building will increase if earthquake occurred in town. Time is also an important factor. The succeeding damage will be different in winter from autumn. For instance, raining and extremely hot may cause hinder dangers such as corps rot and epidemic. In winter the collapse of building will cause people homeless, so that corresponding frigidity may cause cold, pneumonia and frostbite etc. Interview with Zhong Wang, director of Emergency Room, Peking Union Medical College Hospital

24. China will insure blood safety provided for disaster area. Q: in such emergency situation with so many blood donor, will blood checking standard be dropped? A: the standard will not be dropped. China has specific law and rule for blood donation without repayment. Any manipulations over rules are disrespected for human lives. So, the blood quality is ensured in the period of earthquake. Don’t worry about that. Interview with Zhong Wang, director of Emergency Room, Peking Union Medical College Hospital

25. Medical Treatment Just as speed is required for effective search and extrication, it is also essential for effective emergency medical services: the greatest demand occurs within the first 24 hours (33). Ideally, "disaster medicine" (medical care for victims of disaster) would include immediate life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, field analgesia and anesthesia, resuscitative engineering (search and rescue technology), and intensive care (26).

26. Medical Treatment (cont.) The medical and public health impact of a severe earthquake may well be compounded by significant damage to medical facilities, hospitals, clinics and supply stores within the affected area (117). In the worst-case scenario, a hospital building may itself be damaged by the earthquake, and the hospital staff may have to continue emergency treatment without using the buildings (118).

27. Surveillance of Injuries at Medical Treatment Sites Treatment sites, whether at hospitals or in temporary field clinics should designate someone to organize surveillance of injuries, collect data, and see that the data are tabulated and reported to disaster-response health officials.

28. 3.5 Response of public health sector

29. Disaster Response to Earthquakes Disaster response to earthquakes is more akin to medical treatment than to prevention, but some aspects of the response may be likened to tertiary prevention in that those responding seek to limit further injury and to control the secondary effects of the earthquake (92). Prompt rescue should improve the outcome of victims, and early medical treatment should lessen the sequelae of the primary injuries (e.g., wound complications, chronic neurological disabilities). Provision of adequate food, water, and shelter should especially help people in vulnerable age groups and those with pre-existing diseases. Effective environmental control measures should prevent secondary environmental health problems. Identification and control of long-term hazards (e.g., asbestos in rubble) should reduce chronic health effects.

30. Rapid Health Assessment after • the earthquake • Objectives: • To identify, define and prioritize potential impacts in disaster situations • To help mobilize resources and direct them to where they are most needed. 4

31. Rapid Health Assessment • The principles of methodology: • Simple consensus-based qualitative assessment process • Not replace the quantitative studies, but fills a gap until such studies are appropriate. • Can be used from the time disaster happens till some month later, or for any major stage-change in an extended crisis. 5

32. Rapid Health Assessment • Source of information: • Direct observation of the field • Reviewing of the pre-disaster records • Reviewing of community profiles in the news and on the Internet, and diverse reports. • Interviewing with local and national authorities • Interviewing with affected people 6

33. Rapid Health Assessment in the Bam Earthquake As part of a joint mission of the World Health organization (WHO) with the Iranian Ministry of Health (MoH), a rapid assessment was conducted on the health status of the affected population and health activities in Bam on Dec 27, 2003. 7

34. Surveillance of Search and Rescue Activities The conduct of future rescue operations can be enhanced by lessons learned from the position and circumstances of trapped victims and from specific details about the extrication process itself. Knowledge of collapse conditions helps set rescue priorities.

35. The public health staff facing to disaster should think about: Interview with Jianshi Huang, Dean of School of Public Health, Peking Union Medical College After the disaster, staff and work should be overall considered, along with other resource and material. After the disaster, quick investigation should be taken. However, quick investigation should have objective as well. With an objective, investigation should be taken immediately, and then evaluation and substantial measures will also be done. We should arouse civilian to report data. Then the civilian will all know the data should be reported and the assessment standard.

36. The public health staff facing to disaster should think about: Actually, we are very good designing questionnaire includes various kinds of detail records. The problem is how we can use it. Public health staff should filter the data reported which means they should not trust completely all the data reported, that is to say, they should have their own judgment. Concerned with long term research, we have many things to study. However, we should choose a small aspect when doing a specific research. We should also choose proper time and distinguish first and second assignment in order not to intervene rescue. Interview with Jianshi Huang, Dean of School of Public Health, Peking Union Medical College

37. 3.6Related work of state departments during Wenchuan Quake

38. Ministry of Civil Affairs Receive and issue domestic and foreign donations of money and materials. By June 1, the total contributions to the community include money and materials are worthy of 41.538 billion yuan. Transfer and resettle refugees to ensue their basic livelihood Responsible for the identification, claim and disposal of remains Responsible for the proper placement of orphans, the old, and the handicapped in the earthquake. To call for volunteers to involve in voluntary service, and to guide social workers, to train volunteers, to implement humanistic care to the victims, to provide psychological counseling and social support. 民政部

39. State General Administration of Quality Supervision, Inspection and Quarantine Implement quarantine inspection on the transport vehicles and entry-exit personnel. In 14 ports such as Beijing, Chengdu, Lanzhou, 402 granted international aid and 13 rescue teams have been given rapid identification and allowed to pass. To ensure the safety of food and drinking water, 8 technical teams have inspected 909 food enterprises. In addition, they have tested 151 water samples, 34 sources of drinking water sample testing, inspected 100 building materials enterprises, the measurement equipments of 352 enterprises Completed health and epidemic prevention work of the disaster areas. At 10:00 on June 1, a total number of 1817 mobilized personnel have completed disinfection of 28.94 million square meters, with the use of 45,046 kg of insecticidal drugs disinfection. Completed the inspection and maintenance of special equipments such as medical oxygen chambers and lifts 19 special equipment earthquake relief technical service teams have completed the reparation of all special equipments of Sichuan. Guarantee the stability of production of relevant enterprises. The affected enterprises and the implementation of relief materials supply business have been licensed "green channel" of production, declared admissible priority, review priority and certification priority, with no charge of license fees and testing fees. A qualified special technical service team are responsible for the technical support and inspection of the enterprises which produces simple tents and dwellings. 国家质检总局

40. Chinese military Soon after the earthquake the Chinese military took immediate action into the disaster area. On the morning of 13th a small number of radical vanguard force arrived in Wenchuan County City on foot. At 12:00 on the 14th Chinese military transport 30,000 officers and soldiers to the disaster areas.

41. Department of Transportation After the earthquake transport sector response rapidly, put forward four demands: Do a good job in disaster area’s road reparation Do a good job in disaster area’s road maintenance Step up the preparation of post-disaster reconstruction planning and elevate the planning to the national level Launch a number of constraints and thepilot of the transport projects soon

42. Ministry of Land and Resources Start serious geological disasters emergency response plan, organize geological experts to be dispatched to the disaster areas, to focus on the investigation of hidden dangers, provide guidance for emergency evacuation and prevention. Mobilize seven aircrafts on the implementation of aerial photographing of disaster areas, coordinate and make arrangements for six high-resolution radar remote sensing satellites to acquire remote sensing images of the earthquake disaster area. As of May 25, provided topographical maps 19,000 for the earthquake relief work, and provide production and processing of 22,000 relief dynamic thematic maps of the disaster area. Pay close attention to weather conditions, forecast timely reports of geological disasters; investigate disaster-stricken areas of water conservancy facilities, roads and railways, power lines, communications facilities and other areas of geological disasters. Large-scale potential disaster loci were found, up to 386 points. provide surveying and mapping support for post-disaster reconstruction. To carry out the investigation and disaster emergency response, recovery mining production, do a good job in land planning and post-disaster reconstruction and disaster prevention planning revision. To ensure post-disaster reconstruction sites, launch sites with “green channel”, to implement special policies for and increase the intensity of the reclamation of disaster-destroyed arable land. 国土资源部

43. The Ministry of Education According to the disaster and disaster prediction, the corresponding adjustment of their teaching arrangements, to take such measures as suspension of classes, emergency evacuation. Raise donations from the community through the China Education Development Foundation Open psychological counseling hotline and website to provide psychological assistance services. Organize expert group conducted in-depth disaster area college students psychological adjustment education backbone training Psychological assistance of 800,000 readers, 800,000 health prevention manuals, 300,000 textbooks and more than 4,200 school bags and learning amenities. According to disaster, postponed the college entrance examination 40 counties under serious suffering, provided the candidates with living conditions and examination review for free. Mobilize of all localities and institutions of higher learning to prepare them for the acceptance of the students from the disaster area. Do a good job in subsidizing the students in school from the affected families in the disaster area. 教育部

44. 3.7 International Assitance After the Wenchuan earthquake foreign friends and countries have given a good favor. China's Ministry of Foreign Affairs pays high attention to the requests of foreign countries to dispatch rescue teams. With their help, rescue teams have quickly rushed to the scene to accept the work. As of June 4 only, the total domestic and international community donations have reached a total amount of 43.681 billion yuan. The specific list of international assistance can be found on http://www.chinaelections.org/NewsInfo.asp?NewsID=128063

45. Supercourse China has already made more just-in-time PPT about the Sichuan Earthquake, which concerned with self-rescue and mutual-help in the earthquake, public health problems, as well as the first and secondary rescue( including psychological reconstruction ) after the disaster ect. Please visit: http://www.supercourse.cn/