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医学灾害应对:对 2010 年海地地震的批判性分析。

Medical disaster response: A critical analysis of the 2010 Haiti earthquake.

机构信息

Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States.

Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States.

出版信息

Front Public Health. 2022 Nov 1;10:995595. doi: 10.3389/fpubh.2022.995595. eCollection 2022.

Abstract

INTRODUCTION

On January 12, 2010, a 7.0 magnitude earthquake struck the Republic of Haiti. The human cost was enormous-an estimated 316,000 people were killed, and a further 300,000 were injured. The scope of the disaster was matched by the scope of the response, which remains the largest multinational humanitarian response to date. An extensive scoping review of the relevant literature was undertaken, to identify studies that discussed the civilian and military disaster relief efforts. The aim was to highlight the key-lessons learned, that can be applied to future disaster response practise.

METHODS

Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidance was followed. Seven scientific databases were searched, using consistent search terms-followed by an analysis of the existent Haitian literature. This process was supplemented by reviewing available grey literature. A total of 2,671 articles were reviewed, 106 of which were included in the study. In-depth analysis was structured, by aligning data to 12 key-domains, whilst also considering cross-sector interaction (Civilian-Civilian, Military-Military, and Civilian-Military). Dominant themes and lessons learned were identified and recorded in an online spreadsheet by an international research team. This study focuses on explicitly analysing the medical aspects of the humanitarian response.

RESULTS

An unpreceded collaborative effort between non-governmental organisations, international militaries, and local stakeholders, led to a substantial number of disaster victims receiving life and limb-saving care. However, the response was not faultless. Relief efforts were complicated by large influxes of inexperienced actors, inadequate preliminary needs assessments, a lack of pre-existing policy regarding conduct and inter-agency collaboration, and limited consideration of post-disaster redevelopment during initial planning. Furthermore, one critical theme that bridged all aspects of the disaster response, was the failure of the international community to ensure Haitian involvement.

CONCLUSIONS

No modern disaster has yet been as devastating as the 2010 Haiti earthquake. Given the ongoing climate crisis, as well as the risks posed by armed conflict-this will not remain the case indefinitely. This systematic analysis of the combined civilian and military disaster response, offers vital evidence for informing future medical relief efforts-and provides considerable opportunity to advance knowledge pertaining to disaster response.

摘要

简介

2010 年 1 月 12 日,海地共和国发生 7.0 级地震。这场灾难造成了巨大的人员伤亡——据估计,有 31.6 万人遇难,另有 30 万人受伤。这场灾难的规模与应对规模相匹配,这仍然是迄今为止最大的多国人道主义应对行动。对相关文献进行了广泛的范围审查,以确定讨论平民和军事救灾工作的研究。目的是突出可以应用于未来灾难应对实践的关键经验教训。

方法

遵循系统评价和元分析扩展范围综述的首选报告项目指南。使用一致的搜索词搜索了七个科学数据库,随后对海地现有的文献进行了分析。这一过程还辅以审查现有的灰色文献。共审查了 2671 篇文章,其中 106 篇被纳入研究。通过将数据与 12 个关键领域对齐,对深入分析进行了结构化处理,同时还考虑了跨部门的相互作用(平民与平民、军事与军事、平民与军事)。确定并记录了主导主题和经验教训,并由一个国际研究小组在在线电子表格中记录。本研究侧重于明确分析人道主义应对的医疗方面。

结果

非政府组织、国际军队和当地利益攸关方之间前所未有的协作努力,使大量受灾民众获得了拯救生命和肢体的护理。然而,应对措施并非完美无缺。救援工作因大批缺乏经验的行为体涌入、初步需求评估不足、缺乏关于行为和机构间合作的现有政策以及在初始规划中对灾后重建考虑有限而变得复杂。此外,贯穿灾难应对各个方面的一个关键主题是国际社会未能确保海地的参与。

结论

没有现代灾难像 2010 年海地地震那样具有破坏性。鉴于正在发生的气候危机以及武装冲突带来的风险——这种情况不会永远持续下去。对平民和军事救灾工作的综合分析为未来的医疗救援工作提供了重要证据,并为推进灾难应对知识提供了巨大机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4192/9665839/d6f21867354c/fpubh-10-995595-g0001.jpg

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