Emergency medical care following the great Hanshin-Awaji earthquake: practices and proposals (a report from a university hospital located in the damaged region).

The major earthquake, which hit the southern portion of Hyogo Prefecture, Japan, just before dawn on January 17, 1995, caused a tremendous amount of damage in a very short time. It killed 6,348 individuals, injured more than 33,000, destroyed about 170,000 houses, and left more than 300,000 people homeless. The central area of Kobe City was almost completely destroyed. Communication and transportation networks as well as other life lines were severed in many places. As a result, Kobe city was almost completely cut off from the outside world. This paper will outline how the emergency care unit in the Kobe University Hospital, located in the center of Kobe City, provided emergency care after the great Hanshin-Awaji earthquake, in the face of the many unfavorable conditions encountered in a major disaster. Based on our experience, we will also propose modifications for future emergency care systems coping with large-scale disasters.