Egmann Gérald, Tattevin Pierre, Palancade Renaud, Nacher Matthieu
SAMU 97.3, Centre Hospitalier Andrée Rosemon, Cayenne, France (Dr Egmann).
Maladies Infectieuses et Réanimation Médicale, Centre Hospitalier Universitaire Pontchaillou, Rennes, France (Dr Palancade).
Wilderness Environ Med. 2018 Mar;29(1):72-77. doi: 10.1016/j.wem.2017.09.008. Epub 2018 Jan 12.
Illegal gold mining is flourishing in French Guiana, existing outside the law due to both the high cost of gold mining permits and the challenges of law enforcement within the Amazon forest. We report the characteristics of, and the medical responses to, medical emergencies in illegal gold mining sites.
We performed a retrospective study of all medical emergencies reported from illegal gold mining sites to the centralized call office of SAMU 973 from 1998 through 2000 and from 2008 through 2010. According to the national health care system, any medical emergency within the territory is handled by the prehospital emergency medical service (SAMU 973), irrespective of the patients' legal status. Data were extracted from the SAMU 973 notebook registry (1998-2000) or the SAMU 973 computerized database (2008-2010) and werre collected using a standardized questionnaire.
Of 71,932 calls for medical emergencies in French Guiana during the study periods, 340 (0.5%) originated from illegal gold mining sites. Of these, 196 (58%) led to medical evacuation by helicopter, whereas the overall rate of evacuation by helicopter after placing a call to SAMU 973 was only 4% (3020/71,932; P<0.0001 for comparison with illegal gold mining sites). Medical emergencies were classified as illness (48%, mostly infectious), trauma (44%, mostly weapon wounds), and miscellaneous (8%).
Medical emergencies at illegal gold mining sites in the Amazon forest mostly include infectious diseases, followed by trauma, and often require medical evacuation by helicopter. Our study suggests that implementation of preventive medicine within gold mining sites, irrespective of their legal status, could be cost-effective and reduce morbidity.
非法金矿开采在法属圭亚那十分猖獗，由于金矿开采许可证成本高昂以及在亚马逊森林地区执法面临挑战，其处于法律监管之外。我们报告了非法金矿开采点医疗紧急情况的特点以及医疗应对措施。
我们对1998年至2000年以及2008年至2010年期间从非法金矿开采点报告至SAMU 973集中呼叫办公室的所有医疗紧急情况进行了回顾性研究。根据国家医疗保健系统，境内任何医疗紧急情况均由院前紧急医疗服务机构（SAMU 973）处理，无论患者的法律身份如何。数据从SAMU 973笔记本登记册（1998 - 2000年）或SAMU 973计算机化数据库（2008 - 2010年）中提取，并使用标准化问卷进行收集。
在研究期间法属圭亚那的71,932次医疗紧急情况呼叫中，340次（0.5%）来自非法金矿开采点。其中，196次（58%）导致通过直升机进行医疗后送，而呼叫SAMU 973后通过直升机后送的总体比率仅为4%（3020/71,932；与非法金矿开采点相比，P<0.0001）。医疗紧急情况分为疾病（48%，主要为传染病）、创伤（44%，主要为武器伤）和其他（8%）。
亚马逊森林非法金矿开采点的医疗紧急情况大多包括传染病，其次是创伤，并且经常需要通过直升机进行医疗后送。我们的研究表明，无论金矿开采点的法律地位如何，在其中实施预防医学可能具有成本效益并降低发病率。
