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Post-Preparedness Medical Disaster Response in Costa Rica

Published online by Cambridge University Press:  28 June 2012

Richard A. Bissell ,
Ernesto Pretto ,
Derek C. Angus ,
Bern Shen ,
Victor Ruíz ,
Norma Ceciliano ,
Roberto Sawyers ,
Dawn Shurtleff  and
Joel Abrams
Richard A. Bissell*
Affiliation:
University of Maryland, National Study Center for Trauma and EMS; Department of Emergency Health Services, University of Maryland, Baltimore Campus, and Disaster Reanimatology Study Group, Baltimore, Md.
Ernesto Pretto
Affiliation:
University of Pittsburgh, Department of Anesthesiology and Critical Care Medicine, and International Resuscitation Research Center, Disaster Reanimatology Study Group, Pittsburgh, Pa.
Derek C. Angus
Affiliation:
University of Pittsburgh, Department of Anesthesiology and Critical Care Medicine, and International Resuscitation Research Center, Disaster Reanimatology Study Group, Pittsburgh, Pa.
Bern Shen
Affiliation:
University of Pittsburgh, Division of Emergency Medicine and Department of Clinical Epidemiology and Preventive Medicine, and Disaster Reanimatology Study Group, Pittsburgh, Pa.
Victor Ruíz
Affiliation:
Comisión Nacional de Emergencia, San José, Costa Rica, and Calderón Guardia Hospital, Costa Rica
Norma Ceciliano
Affiliation:
Hospital de Niños, San José, Costa Rica, and University of Pittsburgh, International Resuscitation Research Center, Disaster Reanimatology Study Group, Pittsburgh, Pa.
Roberto Sawyers
Affiliation:
Instituto Nacional de Seguro Social, San José and Puerto Limón, Costa Rica
Dawn Shurtleff
Affiliation:
University of Maryland, Baltimore Campus, Department of Emergency Health Services, Baltimore, Md.
Joel Abrams
Affiliation:
University of Pittsburgh, Department of Engineering, Pittsburgh, Pa.
*
National Study Center for Trauma and EMS, 701 West Pratt St.-001, Baltimore, MD 21201-1023USA
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Abstract

Introduction:

The 1991 earthquake in the Limón area of Costa Rica presented the opportunity to examine the effectiveness of a decade of disaster preparedness.

Hypothesis:

Costa Rica's concentrated work in disaster preparedness would result in significantly better management of the disaster response than was evident in earlier disasters in Guatemala and Nicaragua, where disaster preparedness largely was absent.

Methods:

Structured interviews with disaster responders in and outside of government, and with victims and victims' neighbors. Clinical and epidemiologic data were collected through provider agencies and the coroner's office.

Results:

Medical aspects of the disaster response were effective and well-managed through a network of clinic-based radio communications. Nonmedical aspects showed confusion resulting from: 1) poor government understanding of the roles and responsibilities of the central disaster coordinating agency; and 2) poor extension of disaster preparedness activities to the rural area that was affected by the earthquake.

Conclusion:

To be effective, disaster preparedness activities need to include all levels of government and rural, as well as urban, populations.

Keywords

communicationscoordinationCosta Ricadisaster managementdisaster medical caredisaster preparednessdisaster reliefdisaster responseearthquakeGuatemalainternational responselife-supporting first-aid (LSFA)Nicaraguaplanningruralurban
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 9 , Issue 2 , June 1994 , pp. 96 - 106
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1994

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