Schwartz Dagan, Goldberg Avishay, Ashkenasi Issac, Nakash Guy, Pelts Rami, Leiba Adi, Levi Yeheskel, Bar-Dayan Yaron
Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel.
Prehosp Disaster Med. 2006 May-Jun;21(3):204-10. doi: 10.1017/s1049023x0000368x.
On 26 December 2004 at 09:00 h, an earthquake of 9.0 magnitude (Richter scale) struck the area off of the western coast of northern Sumatra, Indonesia, triggering a Tsunami. As of 25 January 2005, 5,388 fatalities were confirmed, 3,120 people were reported missing, and 8,457 people were wounded in Thailand alone. Little information is available in the medical literature regarding the response and restructuring of the prehospital healthcare system in dealing with major natural disasters.
The objective of the study was to analyze the prehospital medical response to the Tsunami in Thailand, and to identify possible ways of improving future preparedness and response.
The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research delegation to study the response of the Thai medical system to the 2004 earthquake and Tsunami disaster. The delegation met with Thai healthcare and military personnel, who provided medical care for and evacuated the Tsunami victims. The research instruments included questionnaires (open and closed questions), interviews, and a review of debriefing session reports held in the days following the Tsunami.
Beginning the day after the event, primary health care in the affected provinces was expanded and extended. This included: (1) strengthening existing primary care facilities with personnel and equipment; (2) enhancing communication and transportation capabilities; (3) erecting healthcare facilities in newly constructed evacuation centers; (4) deploying mobile, medical teams to make house calls to flood refugees in affected areas; and (5) deploying ambulance crews to the affected areas to search for survivors and provide primary care triage and transportation.
The restructuring of the prehospital healthcare system was crucial for optimal management of the healthcare needs of Tsunami victims and for the reduction of the patient loads on secondary medical facilities. The disaster plan of a national healthcare system should include special consideration for the restructuring and reinforcement prehospital system.
2004年12月26日09:00时，印度尼西亚苏门答腊岛北部西海岸外海域发生了里氏9.0级地震，引发了海啸。截至2005年1月25日，仅在泰国就有5388人确认死亡，3120人报告失踪，8457人受伤。医学文献中关于院前医疗系统在应对重大自然灾害时的反应和重构的信息很少。
本研究的目的是分析泰国对海啸的院前医疗反应，并确定改善未来准备和应对措施的可能方法。
以色列国防军后方司令部医疗部门派出一个研究代表团，研究泰国医疗系统对2004年地震和海啸灾难的反应。该代表团会见了为海啸受害者提供医疗护理和疏散的泰国医护人员及军事人员。研究工具包括问卷（开放式和封闭式问题）、访谈以及对海啸发生后几天举行的汇报会报告的审查。
在事件发生后的第二天，受灾省份的初级卫生保健得到了扩展和延伸。这包括：（1）用人员和设备加强现有的初级保健设施；（2）增强通信和运输能力；（3）在新建的疏散中心设立医疗设施；（4）派遣流动医疗队到受灾地区为洪水难民上门看病；（5）派遣救护人员到受灾地区搜寻幸存者，并提供初级护理分诊和运输服务。
院前医疗系统的重构对于优化海啸受害者的医疗需求管理以及减轻二级医疗设施的患者负担至关重要。国家医疗系统的灾难计划应特别考虑院前系统的重构和强化。
