Circulating antigen levels and antibody responses in Schistosoma bovis-infected West African Dwarf goats were evaluated during infection and following treatment with praziquantel (60 mg/kg) 13 weeks post-infection. One day, 1 week and 4 weeks post-treatment, subgroups of goats were sacrificed and perfused for worm recovery. For comparison, parasite-free control animals were included. Blood and faecal samples were collected biweekly. Two gut-associated schistosome antigens, circulating cathodic and circulating anodic antigen (CCA and CAA) and 3 specific antibody responses (total Ig, IgG and IgM) were measured. For specific antibody detection, crude S. bovis adult worm and egg homogenates were used. The level of CCA in the infected groups was significantly elevated from the time of onset of egg excretion onwards. However, following treatment, the CCA litres dropped to control levels within 1 week post-treatment. Strong positive correlations were found between CCA levels and worm counts and faecal egg counts during peak egg excretion. The correlations of CAA and specific antibody litres to egg and worm counts were poor. The antibody responses were all significantly elevated in the infected goats during patency, but only marginally affected by the treatment. Hence, CCA proved to be superior by correlating strongly to the level of infection and by being a sensitive indicator of the effect of treatment.

This paper outlines each aspect of coordination as it relates to the responses made by various organizations in the disaster-affected areas. It is a synthesis of the presentations and discussions pertaining to coordination during the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO), in Phuket, Thailand, 04–06 May 2005. Coordination is defined, and two important questions are answered: (1) What coordination was done well?; and (2) What coordination could have been done better?.

This is a summary of the proceedings of the Conference on the Health Aspects of the Tsunami Disaster in Asia that was convened by the sunami World Health Organization in Phuket, Thailand from 04–06 May 2005. It contains reviews of the experiences of the health sector and early recovery fol following the Earthquake and Tsunami with emphasis onwhat was done well and what could have been done better and the lessons learned that can be incorporated into actions that will mitigate the damage created by future events. It outlines the national and international responses and recovery and the actions taken and not taken by the international community in support of the countries affected. Specific issuesaddressed include: (1) needs assessments; (2) coordi- coordination; (3) filling gaps in essential services, and (4) capacity building at the country level. Each of these aspects is analyzed as to its: (1) appropriateness; (2) adequacy; (3) effectiveness; (4) efficiency; and (5) connectedness.

Much of what occurred provided benefits to the stricen population, but there is substantial room for improvement through implementation of the lessons learned. These lessons must be converted into actions in order to mitigate the damagesustained and to enhance our responses to the damage from future

This is a summary of the presentations and discussion of Panel 2.13, The Role of Media and Communication, of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04–06 May 2005. The topics discussed included issues related to the role of media and communication as pertain to the responses to the damage created by the Tsunami of 26 December 2004.

A fire developed in a facility being used as a discotheque that resulted in death for 63 young people. The rescue operations, ambulance responses, medical care provided at the scene, hospital operations, and psychosocial responses are described. Bodies blocked the exit and many survivors had to evacuate by leaping from windows. A total of 16 ambulances were used. Survivors and people not directly involved in the incident created disturbances and some even attacked responders. Many of those who escaped early suffered mild inhalation injuries and those who escaped later, sustained more severe inhalation injuries. High levels of both carbon-monoxide and cyanide were detected at autopsy. A total of 213 persons were transported to hospitals, 85 by ambulance. Most who died at the scene had severe burn injuries, were unconscious, or suffered from fire-gas injuries. A total of 150 victims were admitted to a hospital, of which 74 (49.3%) required intensive care. Only one of the four hospitals actuated a disaster alert. Psychosocial support was complicated due the multicultural characteristics of those involved. Support to the survivors and relatives of the victims was provided by representatives of various religious organization, non-profit organizations, and by the government of Gothenburg. Many recommendations are provided to better prepare for future events.

Natural and complex disasters can cause a dramatic increase in the demand for emergency medical care. Local health services can be overwhelmed, and damage to clinics and hospitals can render them useless. Many countries maintain mobile field hospitals for defense or humanitarian purposes. Dispatching these facilities to disaster-affected countries would seem an ideal response to emergency medical needs. Unfortunately, experience has shown that in the case of natural disasters, field hospitals often have not met the expectations of recipients and donor institutions.

In July 2003, the World Health Organization and Pan American Health Organization sponsored a workshop in El Salvador to discuss the pros and cons of using foreign fieldhospitals in the aftermath of natural disasters. These guidelines are the result of that workshop. The workshop participants identified different phases when foreign field hospitals and specialized medical personnel are most useful. They can provide advanced trauma care and life support if at the disaster site within 48 hours of the impact of an event; they would provide follow-up care for trauma victims and resumption of routine medical care in the two weeks following the event; during rehabilitation and reconstruction phases (from two months to two or more years), a field hospital might serve as a temporary replacement for damaged health facilities. These guidelines propose conditions that field hospitals and their staff should meet for each ofthese phases. The guidelines also outline issues that authorities in donor countriesand disaster-affected countries should discuss before mobilizing a field hospital.

The purpose of research is to discover or change laws and theory while the purpose for evaluations is to affix a value to the process or outcome. Research is used to define a cause:effect relationship between independent and dependent variable(s). Currently, such experimental studies either are impossible to conduct in the setting of a disaster or are considered unethical. Until recently, reports of disaster responses primarily have been anecdotal and descriptive with little or no structure. They have had little value in the elimination of hazards, reduction of risks, improvement in the absorbing and/or buffering capacities, reduction in vulnerability, and or enhancement of disaster preparedness. They have served to shape our perceptions of the medical and public-health needs associated with certain events. During the last two decades, methodologies used in the social sciences gradually have been adapted to the study of disasters. Such studies have contributed greatly to our understanding of the pathophysiology of disasters and the effects of specific interventions on the affected populations or populations at risk for an event. Not all aspects of such interventions can be measured, but most can be assessed using qualitative methodologies. The importance of using both qualitative and quantitative assessments of effects is discussed.