Disaster Relief and Recovery after a Landslide at a Small, Rural Hospital in Guatemala

Abstract

Introduction:Though many reports have assessed hospital emergency responses during a disaster that affected the facility's operations, relatively little work has been dedicated to identifying factors that aid or impede the recovery of such hospitals.Problem:On 05 October 2005, Hurricane Stan triggered landslides that buried an impoverished Mayan community in Santiago Atitlán, Guatemala. The six-bed Hospitalito Atitlán also was in the landslide's path. Though opened just months earlier, the institution maintained 24-hour services until reopening in a new facility only 15 days after the landslides.Methods:This qualitative study examined the Hospitalito Atitlán's disaster recovery using unstructured interviews with key hospital personnel and community members. Participant observation provided information about institutional and cultural dynamics affecting the hospital's recovery. Data were collected retrospectively during June–September 2006 and June 2007.Results:The Hospitalito's emergency responses and recovery were distinct endeavors that nonetheless overlapped in time. The initial 12 hours of disorganized emergency relief work was quickly succeeded by an organized effort by the institution to provide inpatient and clinic-based care to the few severely injured and many worried-well patients. As international aid started arriving 2–3 days post-landslide, the Hospitalito's 24-hour clinical services made it an integral organization in the comprehensive health response. Meanwhile, a subset of the Hospitalito's non-clinical staff initiated rebuilding efforts by Day 2 after the event, joined later by medical staff as outside aid allowed them to handoff clinical duties. Effective use of the Internet and conventional media promoted donations of money and supplies, which provided the raw materials used by a group determined to reopen their hospital.Conclusions:Early work by a recovery-focused team coupled with a shared understanding of the Hospitalito as an institution that transcended its damaged building drove the hospital's rapid post-emergency revival. Encouraging a similar sense of mission, emulating the Hospitalito's handling of funding and material procurement, and conducting rebuilding and relief efforts in parallel may aid recovery at other health facilities.

Public health implications of multiple disaster exposures

“…136,137 One study looked at Hurricane Stan (2005) and a subsequent landslide in Guatemala and documented the immediate effects on one hospital, finding major structural damage but also a rapid recovery driven by a common vision shared by workers. 134 Across all identified cases, the affected hospitals continued functioning despite major logistical difficulties. Further research on indirect effects on patient care or on the health and wellbeing of hospital staff in multidisaster settings is warranted.…”

“…75,124 Indirect implications for public health Effects on health-care facilities Four articles focused on health-care facilities in settings of multiple disasters. [134][135][136][137] Three studies found staff shortages in the aftermath of the 3.11 triple disaster in Japan, 135 which persisted for up to 18 months after the disaster and affected local health-care facilities. 136,137 One study looked at Hurricane Stan (2005) and a subsequent landslide in Guatemala and documented the immediate effects on one hospital, finding major structural damage but also a rapid recovery driven by a common vision shared by workers.…”

A retrospective analysis of emergency department usage in rural and semi-urban indigenous Guatemalan populations

“…Emergency care is also available closer to home at the Hospital Parroquial de San Lucas Tolimán (Hospital Monseñor Gregorio Schaffer), and this hospital is the focus of this study. 35,58 A nonprofit organization, The Friends of San Lucas, in association with the San Lucas Mission, provides social services based on community needs, and helped establish a low-cost private hospital in San Lucas Tolimán in the late 1990's, Hospital Parroquial de San Lucas Tolimán (Hospital Monseñor Gregorio Schaffer). This hospital regularly employs one physician (on call 24 hours/day), along with several nurse practitioners, who help staff the emergency department after normal business hours.…”

Reducing patient surge: community based social networks as first responders

“…In these cases, it might be helpful to distinguish those persons considered 'worried well' who tend to self-diagnose themselves and are considered a psychological rather than medical patient from those individuals affected by psychosocial trauma or acute injuries. While this type of behavior is prevalent in CBRN type disasters where there is a far greater surge of psychosocial trauma patients to hospitals than physically injured (Beaton et al 2005), hospital surge among the worried well for natural disasters and terror acts can also initially outnumber those with physical injuries (Peltan 2009;Shalev and Freedman 2005).…”