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Earthquake disaster in Turkey

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7210.648a (Published 04 September 1999) Cite this as: BMJ 1999;319:648

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IDF Field Hospital in an Earthquake in Adapazri - Structure and Function

The Israeli aid consisted of two teams: a rescue team based in
Gulcuk, which was involved in search and recovery of survivors at the
wreck sites as well as retrival of the deads from the ruins; a military
field hospital was set up in Adapazari to function as a primary and
secondary medical care with intensive care and surgical facilities.

The IDF Field Hospital arrived at Istanbul, on day 3 after the quake. The
team consisted of 102 medical personnels. Of them 23 doctors, 13 nurses, 9
paramedics, 13 medics and the rest, support personnel, technicians,
logistics and communication. Six other airplanes including military
supplies arrived at the airport over several hours. The convoy left for
200 km journey around midnight and arrived at Adapazari around 04:30 hrs
Friday morning, day 4. Normally the journey should have taken two hours but
the traffic due to quake destruction delayed the arrival of the team.

The
location of the field hospital was preplanned by the surgeon-general of
the IDF in coordination with local authorities. It was situated in the
premises of the Turkish Ministry of Forestry assuring no tents would be
needed. Six hours after arrival the hospital was settled within the
building and ready to receive patients. As soon as the team settled inside
the building it became clear after shocks were abundant and the risk of
collapse existed. The patients were horrified to enter the building and
the crew was also hesitant. The hospital was transferred to the garden
within the Forestry premises and the tents sent from Italy were provided
by the local authorities. Transferring to the garden did not effect the
medical service given to the patients, however, the load on the support
crew, responsible for settling the hospital, was heavy.

The structure of the field hospital: The field hospital consisted two main
divisions: medical and logistics.
The logistic support team of the hospital consisted of 44 personnel.
Service departments for energy, food, communication, transportation and
other necessities were setup by qualified technicians. The communication
crew consisted of a spokesman, a deputy who handled the numerous media
teams reporting from the hospital and a Turkish volunteer providing
internet and e-mail services. Satellite telephones, cellular phones, fax
and radio services provided easy access to homebase. This enabled
transmission of needs for extra supplies and other necessary supports as
well as access to the local authorities and to the other medical compouds.

The medical division of the field hospital included seven clinical
sections: emergency room and triage, internal medicine, intensive care
unit, surgery, orthopedics, pediatrics and obstetrics and gynecology. The
medical support departments were: radiology unit, operating room, pharmacy
and laboratory. Specialists in their particular medical field ran each
department. Registered nurses as well paramedics and medics provided
backup for the few number of physicians.

Turkish volunteers were constantly arriving to the hospital. They were
willing to contribute in any way needed. According to their abilities they
were allocated as coordinators, translators and physicians and they
functioned in coordination with the Israeli team and took part in every
medical and logistic activity of the staff. The total number of the
Turkish doctors, coordinators and translators was an average of 10 a day,
who added up to 50 people all together.

The delegation commander was an ENT surgeon, ranking colonel. The hospital
was managed by an intensive care specialist, normally holding a post of a
hospital manager, and all operating theatre activity was coordinated by a
general and trauma surgeon. The heads of each department were all heads of
departments or senior physicians in tertiary hospitals throughout Israel.

Regular staff meetings of the medical team and the logistic team took
place every day. Information about the logistics and the medical function
of the hospital was presented to the department heads and to the logistic
officers. Paramedical personnel reallocation from one department to the
other were scheduled according to the changing situations of the
departments in these staff meetings.
Collaboration between different medical facilities in the city was formed.
Meetings with existing medical team managers and the governor of Adapazari
were regulary held in the IDF Field Hospital.

Competing interests: No competing interests

06 September 1999
Y Bar-Dayan
IDF Field Hospital Mission Team
P Beard, D Mankuta, A Eldad, C Gruzman, P Benedek, G Martinovitz
IDF Medical Corps