Prehospital and disaster medicine
-
Over the past two decades, terrorism has exacted an enormous toll on the Republic of Turkey, a secular democracy with a 99.8% Muslim population. From 1984 to 2000, an estimated 30,000 to 35,000 Turkish citizens were killed by a nearly continuous stream of terrorism-related events. During this period, the Partiya Karekerren Kurdistan (PKK), a Kurdish separatist group (re-named KADEK in 2002), was responsible for the vast majority of terrorism-related events (and casualties), which disproportionately affected the eastern and southeastern regions of Turkey, in which the PKK has focused its activities. ⋯ The maximum number of casualties produced by any of these events was 93 in the Hotel Madimak arson attack by the Turkish Islamic Movement in 1993. This pattern suggests that terrorist attacks in Turkey rarely required more than local systems of emergency medical response, except in rural areas where Emergency Medical Services (EMS) are routinely provided by regional military resources. The last decade has seen the development of several key systems of local emergency response in Turkey, including the establishment of the medical specialty of Emergency Medicine, the establishment of training programs for EMS providers, the spread of a generic, Turkish hospital emergency plan based on the Hospital Emergency Incident Command System, and the spread of advanced training in trauma care modeled after Advanced Trauma Life Support.
-
Colombia is a poor country that has been plagued by ongoing violence for more than 120 years. During the 1940s, subversive terrorist groups emerged in rural areas of the country when criminal groups came under the influence of Communism, and were later transformed into contemporary groups, such as the Ejercito de Liberacion Nacional (ELN) or National Liberation Army and Fuerzas Armadas Revolucionares de Colombia (FARC) or Revolutionary Armed Forces of Colombia). Paramilitary terrorist groups emerged in response to subversive groups and were later transformed into contemporary groups, such as the Autodefensas Unidas de Colombia (AUC) or United Self-Defense Forces of Colombia. ⋯ In addition to political, military, and commercial targets, terrorists have specifically targeted healthcare infrastructure and personnel. At the national and local levels, much emergency planning and preparedness has taken place for terrorism-related events. The Centro Regulador de Urgencias (CRU) or Emergency Regulation Center in Bogota plays a major role in coordinating local prehospital and hospital emergency response in the capital city and the national level where necessary.
-
Prehosp Disaster Med · Apr 2003
Comparative StudyMedical preparation for terrorism in Australia. Is luck running out for "the lucky country?
Recent world events have forced Australia to re-examine its role on the world stage and its susceptibility to terrorist attacks. The authors examine the brief historical exposure of Australia to the phenomenon of terrorism, and review the geopolitical climate and features that may render it more susceptible to attack in the future. Australia's emergency management structure is outlined, and its current state of medical preparedness for a terrorist incident is critically reviewed.
-
The Republic of Bulgaria is one of the smallest countries in southeastern Europe and has little experience with terrorist acts. During the past 20 years, only nine terrorism-related events have been recorded in Bulgaria, and no unconventional weapons have been used. Factors contributing to terrorism in Bulgaria have been: (1) Communist Party domination of the government and political process from 1944 to 1989; (2) ethnic and religious conflicts between the Bulgarian Orthodox Christian majority and the Turkish Muslim minority from 1983 to 1987; and (3) the relatively high level of organized crime after the Communist regime ended in 1990. ⋯ Institutional components of the Disaster Relief System structure responsible for the emergency response to terrorism-related events include: (1) the Government of Bulgaria; (2) the State Agency for Civil Protection with 28 regional directorates; (3) the Ministry of Health with five national hospitals, 28 regional hospitals, and 28 EMS systems; (4) the Ministry of Defense with special military units for response to unconventional terrorist events, including nuclear, biological, and chemical weapons; (5) the Ministry of Internal Affairs with 28 police departments, 28 fire departments, and specialized anti-terrorist units; and (6) the Bulgarian Red Cross. A major future challenge in Bulgaria is the prevention of terrorism through political stability, economic prosperity, ethnic and religious tolerance, and more effective measures against organized criminal activities. A related challenge will be to improve the level of preparedness of all components of Disaster Relief.
-
A terrorism movement has been active in Spain during the last 20 years, with a painful number of victims. Civil Defense is in charge of the coordination of all the structures that are implicated in a terrorist incident. There are three typical patterns of attacks: (1) individual attacks; (2) group attacks; and (3) mass attacks. ⋯ Emergency Medical Services integrated in to "Civil Defense" try to minimize the damage by initializing treatment on-scene and with the rapid provision of definitive care. During the last year, post-traumatic stress disorder treatment groups have been providing care to the victims and personnel. Chemical or biological weapons have not been used, although this is a great concern to the authorities.