Disasters
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Terrorist attacks can occur in remote areas causing mass-casualty incidents MCIs far away from level-1 trauma centres. This study draws lessons from an MCI pertaining to the management of primary and secondary evacuation and the operational mode practiced. Data was collected from formal debriefings during and after the event, and the medical response, interactions and main outcomes analysed using Disastrous Incidents Systematic Analysis through Components, Interactions and Results (DISAST-CIR) methodology. ⋯ We introduce a novel concept of a 'semi-evacuation hospital'. This mode of operation should be selected for small-scale events in which the evacuation hospital has hospitalization capacity and is not geographically isolated. We suggest that level-3 hospitals in remote areas should be prepared and drilled to work in semi-evacuation mode during MCIs.
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Hurricane Katrina struck the United States at the end of August 2005. The consequent devastation appeared to be beyond the US government's ability to cope with and aid was offered by several states in varying degrees of conflict with the US. Hurricane Katrina therefore became a potential case study for 'disaster diplomacy', which examines how disaster-related activities do and do not yield diplomatic gains. ⋯ The literature's case studies are then categorised using a new typology: propinquity, aid relationship, level and purpose. Hurricane Katrina and its aftermath are then placed in the context of the US government's foreign policy, the international response to the disaster and the US government's reaction to these responses. The evidence presented is used to discuss the potential implications of Hurricane Katrina disaster diplomacy, indicating that factors other than disaster-related activities generally dominate diplomatic relations and foreign policy.