Incorporating the Lessons Learned from the 2012 East Azerbaijan Earthquakes in Iran's National Health Emergency Plan

Abstract

Revisions to Iran's National Public Health Emergency Operation Plan (PHEOP) are currently underway. 1 Lessons learned from the recent twin earthquakes in East Azerbaijan in northeast Iran can be incorporated to enhance the health sector response.On August 11, 2012, two consecutive magnitude 61 earthquakes hit East Azerbaijan (EA) province in Iran at 4:53 PM and 5:04 PM local time. The quakes led to 303 deaths and 2,600 injuries, and affected 60,000 people across 182 villages.The Ministry of Health and Medical Education deployed an assessment team to Tabriz (the capital of province) along with a team of technical advisers. Massive medical and search and rescue operations were undertaken during the first 24 hours, and were followed by public health operations. 2 Here, we would like to address two main challenges that have bearing on revisions to the PHEOP.The health system in three affected districts of East Azerbaijan province was severely damaged. According to the existing emergency plan, the District Public Health Centers (DPHCs) are focal points for management of disaster response. In this event, all three DPHCs in addition to 89 health houses were damaged, and failed in their functions. 2 As a result, mutual assistance was invoked from neighboring districts. While health workers were able to take on some of the functions of the damaged centers, they could not effectively take on the coordinating role for disaster response. To prevent this problem in the future, we propose the development of Disaster Public Health Assistance Teams (DPHATs) to be incorporated into Iran's new emergency plan. Disaster Public Health Assistance Teams must be equipped for two functions: (1) to support the DPHC in terms of command and coordination functions; and (2) to augment the provision of health services in damaged centers for the first 72 hours.A second lesson learned in this disaster was the lack of real-time integration and georeferencing of data collected. This limitation of the health information management system (HIMS) caused delays in assessment and response to this disaster. In addition, it was difficult to adapt instruments to evolving data needs. The current disaster plan underestimated the ability to re-establish telecommunications service in the wake of an earthquake. In fact, we found that coverage was provided quickly to most areas, within 24-72 hours after the event. We propose that the new plan should emphasize the use of crowd-sourced, geo-referenced data using GSM (Global System for Mobile Communications) messaging from a trusted network of health staff.

Investment on Education of Future Parents: the Best Measure for Enhancement of a Community Disaster Resiliency

“…This was evident in recent disasters even in developed countries, like the super storm Sandy (2012) and the Japan tsunami and earthquake (2010). We witnessed the same situation in Iran’s disasters, e.g., Bam (2003), Zarand (2005), Lorestan (2006), East Azerbaijan (2012) earthquakes (1) and Golestan flash floods (2001 and 2005). These events revealed the crucial role of communities for better response and faster recovery.…”

Policies on Protecting Vulnerable People During Disasters in Iran: A Document Analysis

“…Here again, the documents paid little attention to the concepts of disaster and vulnerable people. Measures such as the Iranian national emergency operation plan (36), community-based vulnerable people rehabilitation and empowerment programs, self-care education to people with hearing problems, and the national program for psychosocial support during disasters (40, 42) were among the many initiatives addressed by the reviewed documents. Moreover, facilitating interagency coordination among governmental and nongovernmental organizations for providing the most-effective disaster care measures during the preparedness and the recovery phases had been introduced by the Iranian five-year development plans and the national emergency and rescue plan (35, 45).…”

“…One of the key aspects of the Iranian national public health disaster and emergency operations plan is providing medical care and psychological support to vulnerable people (36). Moreover, offering insurance and free medical care services to disaster victims was addressed by the reviewed documents (39, 40).…”

“…The reviewed documents paid special attention to providing financial support and loans to suffering people (35, 36, 39, 40, 46) as well as providing housing or renovating the houses of all Iranians (35, 36, 40, 43, 44, 46). Employment and granting business loans to people supported by the Iranian welfare organization, providing employment opportunities for women, and facilitating all Iranians’ self-sufficiency were among the other items found in the reviewed documents (32, 33, 40, 42, 43).…”

Reflecting on the Challenges encountered by nurses at the great Earthquake in the West of Iran: A qualitative study

“…The participants had experienced several challenges in this eld. Ardalan et al reported that due to communicational problems and the demolition of three health centers and 89 local clinics failed to play an e cient role during the rst phase of reaction to Azerbaijan earthquake [24]. Infrastructure disruption after disasters have been mentioned in several study as a serious challenge [25,26].…”