BACKGROUND

The Philippines faces a challenge in addressing the mental health needs of internally displaced persons (IDPs) following disasters. The lack of an integrated mental health triage system within evacuation centers and the shortage of specialists trained in post-traumatic stress triaging have hindered effective emergency response. Existing interventions primarily focus on traditional trauma and psychiatric symptoms, often lacking standardized mental health triage classifications and leading to data gaps, complicating resource allocation decisions.

To develop a culturally relevant mental health triage system, this study proposes the "Unahon Tool" to meet the needs of Filipino IDPs. Integrating with existing medical triage protocols equips frontline responders to identify stress-related concerns, enables informed decision-making for mental health and psychosocial support (MHPSS) allocation, and optimizes resource utilization.

The study involved key informants, including disaster responders, mental health specialists, and government officials, who participated in interviews and focus group discussions. Thematic analysis was used to identify behavioral aspects affecting IDP communities. The Unahon Tool development incorporated disaster response frameworks, mental health interventions, and other existing triage tools. A red-yellow-green categorization system was employed based on the severity and urgency of observed behaviors. Stakeholder consultations and expert reviews guided tool refinement.

The final Unahon Tool includes 17 behaviors categorized into red (urgent), yellow (moderate), and green (low) severity levels. It provides corresponding recommended interventions to aid responders. During direct observations, yellow-category behaviors like shouting and cursing were prevalent. Responders focused on reminders for peace and order in response to these behaviors. The tool's "Notes" section was identified as a potential area for contextual information inclusion.

The Unahon Tool fills a crucial gap in the Philippine disaster response infrastructure by offering a behavior-based mental health triage system. It enables responders to prioritize mental health resources effectively, reducing the burden on specialists and enhancing overall disaster response effectiveness. Future directions   include expanding tool adoption beyond Metro Manila, translating it into regional languages, and developing a version for children and teenagers. Collaboration with other regions and age groups will ensure broader applicability and effectiveness in addressing mental health needs among diverse IDP populations.

OBJECTIVE: To explore the feasibility of establishing a temporary trauma team led by trauma experts in primary hospitals for disaster medical rescue. METHODS: In the coal mine flooding accident in Xiaoyi City, Shanxi Province on December 15, 2021, according to the local emergency plan and the characteristics of the accident, the trauma experts trained the medical staff from the local primary hospital on advanced trauma life support (ATLS) and damage control surgery (DCS) in the short time interval between the occurrence of the mine disaster and the admission of medical staff to the disaster scene. A temporary trauma team composed of trauma experts, ATLS team, and DCS team was formed to provide early diagnosis and treatment for survivors before and in the hospital. RESULTS: The miners were found on the 36th hour of the disaster. All 22 miners were male, and 2 died underground. Another 20 people were rescued 39－43 hours after the disaster, with a median age of 48 years (34-57 years). All the survivors suffered from hypothermia, dehydration, maceration of feet and other injuries. There were 18 cases of acute inhalation tracheobronchitis, 14 cases of electrolyte acid-base disturbance, 6 cases of trunk contusion, 1 case of psoas major hematoma, and 1 case of lower extremity hematoma. Deep vein thrombosis was in 4 cases. The ATLS team focused on injury assessment, rewarming and rehydration within 50－60 minutes before admission, and completed auxiliary examinations within 2 hours after admission to clarify the diagnosis. The DCS team evaluated 6 patients with mechanical blunt trunk injury and excluded the indication of emergency surgery. The trauma experts conducted the whole process of supervision and quality control of disaster rescue. The positive rate of capillary refill test in the all survivors at the third hour of admission was significantly lower than that immediately after being rescued (75.0% vs. 15.0%, P=0.000 3), and they were discharged 4－7 days after admission. CONCLUSION Under the leadership of trauma experts and relying on the medical staff of primary hospitals, it is feasible to establish and train a temporary trauma team with ATLS and DCS functions to participate in the medical rescue of disasters, which is in line with the current national conditions of China.
Humans ; Adult ; Middle Aged ; Male ; Rescue Work/organization & administration* ; China ; Disasters ; Patient Care Team/organization & administration* ; Wounds and Injuries/therapy* ; Advanced Trauma Life Support Care/organization & administration* ; Disaster Planning/organization & administration* ; Emergency Medical Services/organization & administration*

Major natural disasters seriously threaten human life and health. After earthquakes and other catastrophes, survivors are often trapped in the confined spaces caused by the collapse of ground and buildings, with relative separation from the outside world, restricted access, complex environment, and oncoming or ongoing unsafety, leading to the rescue extremely difficult. In order to save lives and improve the outcome more efficiently in the confined spaces after natural disasters, it is very important to standardize and reasonably apply the trauma assessment and first aid workflow. This study focuses on trauma assessment and first aid. From the aspects of trauma assessment, vital signs stabilization, hemostasis and bandaging, post-trauma anti-infection, and the transportation of patients, a trauma first aid work process suitable for a small space of a major natural disaster is formed, It is helpful to realize the immediate and efficient treatment of trauma in the confined spaces after natural catastrophes, to reduce the rate of death and disability and improve the outcome of patients.
Humans ; Disasters ; First Aid ; Confined Spaces ; Earthquakes

The development of burn units in our country is now undergoing a trend of geographic centralization and regionalization. To solve the problems like severe burn patients are too far away from burn units, overloaded operation in regional burn centers when mass burn accidents happen, and growing requirement for aeromedical transportation, etc., it is now the top priority to improve national aeromedical transportation system for burn patients. Expert teams from Chinese Burn Association, National Aeromedical Rescue Base, and China Association for Disaster & Emergency Rescue Medicine discussed and reached a consensus on the key points of aeromedical transportation of burn patients, including organizational structure, staff and materials, and three links before, during, and after aeromedical transportation. The consensus aims to provide guidance for a safe, efficient, and standardized operation of aeromedical transportation for burn patients in China.
Accidents ; Air Ambulances ; Burn Units ; Consensus ; Disasters ; Humans

Introduction: In the event of a disaster, an airport serves two essential roles, as the central hub for incoming supplies such as food and medication and provide a lifeline to the affected communities, and as a coordination and information center to register, brief, and task for the incoming humanitarian organizations and rescue teams. What happens if the disaster itself impacts the airport? This paper describes the conditions at Palu airport during an earthquake and the state one year after. Method: This is a qualitative study, utilizing information gathered from interviews, articles in newspapers, and reports from official websites. Findings from the official websites were confirmed with findings from newspapers or other printed media and were also confirmed with the results of the observations and interviews. The interviews were conducted with several key informants at the airport. Data were then analyzed verbatim and written in a narrative description. Result and Discussion: Many factors contributed to the chaos at Palu Airport. The earthquake's impact was significant enough for a small airport such as Palu Airport. There was no clear incident command system and coordination between institutions within the airport and the city. There was a lack of disaster readiness planning and regular training before the earthquake. The first initial training in 2009 was not followed up. Conclusion The 2018-earthquake in Palu was a big disaster that impacted the airport. Lack of capacity was related to the discontinuity of the 2009 training into a continuous disaster management program. The unclear management system inside the airport and the local authority worsened the impact of the disaster on both the airport and the community.
Natural Disasters

BACKGROUND: To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan. METHODS: This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children's Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster. RESULTS: Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03-1.87) to 1.92 (95% CI, 1.42-2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18-2.38) to 2.19 (95% CI, 1.60-2.99). CONCLUSIONS The lack of pre-disaster data in the Japan Environment and Children's Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.
Adolescent ; Adult ; Disasters ; Earthquakes ; Female ; Humans ; Japan/epidemiology* ; Pregnancy ; Pregnancy Complications/psychology* ; Pregnant Women/psychology* ; Prevalence ; Psychological Distress ; Tsunamis ; Young Adult

Background: Due to the devolved nature of Philippine local governance, disaster management systems such as relief work and food aid pipelines, have been managed by local government units during natural disasters. Objectives: This study assessed the nutrient adequacy of food aid packs provided during natural disasters in the province of Albay. Specific objectives included assessment of the types of food and food sources, as well as the practices in the food aid pipeline, and assessment of the nutritional quality of food aid packs through comparison with the recommended energy/nutrient intake (REI/RNI) for Filipinos Methods: Key informant interviews were conducted to gather information on food sources and pipelines. Information on the quantities of food components in food aid packs distributed was also collected, and the free iFRNI software used to derive nutrient content. These quantities compared with the REI/RNI for the general population. Descriptive statistics on Microsoft Excel were used to calculate the mean, median and mode for macronutrients as well as Vitamin A and iron to determine the overall intake of individuals relying on these foods. Ethical clearance was secured from the University of the Philippines REB. Results: Analysis of the food components showed that the food aid packs were insufficient to meet the REI/RNI for the general population, particularly for food packs distributed on the barangay and city/municipal levels. Food was sourced from local suppliers as an emergency purchase during the forecast of a disaster, in place of the prescribed practice of stockpiling. Procured food would then be repacked and distributed on the provincial, city/municipal and barangay levels in a staggered schedule depending upon the length of the disaster or evacuation. Conclusion The food packs distributed by the barangay and city/municipal sub-units of the provincial government of Albay are insufficient to meet the daily caloric and micronutrient needs of a general population purely reliant on food aid after a natural disaster.
Natural Disasters Diet ; Vegetarian

The fatality rate of a disaster is associated with the impact of the disaster and the case fatality rate. The severity of the disaster can be reduced by an efficient disaster management system, and the capacity of the trained disaster response system can lower the case mortality rate. The severity of a disaster is determined by the interaction of risk factors and vulnerabilities in a particular area, and the case-fatality rate is determined by a correlation between the capacity of the disaster response team and the survivability of the victims. The disaster management system and the disaster response system are complementary and interconnected, and the efficiency of cooperation and linkage can be improved by developing well organized digitalization. Efforts to increase the survival rate of victims through digitalization has been a continued process and new alternatives are being developed in accordance with the advances in information and communication technology to manage disaster risk factors and to improve disaster response capabilities. However, in case of mass casualty incidents, it is still difficult to reduce the case mortality rate by securing the survival time limit of the victims. Often, sharing the disaster scene information and communicating with the victim is not feasible. A lack of ability to provide real time escape route to exit or safe zone proves fatal. The communication revolution of the next generation wireless wide area network called 5G can overcome the disruption of communication network during the disaster incidents. It can enable real time tracking of the position of victim and linking the victims with its rescuers. Hence, it is possible to increase the survival rate of victims during mass casualty incidents by associating information and communication technologies with appropriate disaster management and response strategies, real-time information exchange and education and training of rescuers and citizens.
Disasters ; Education ; Emergencies ; Mass Casualty Incidents ; Mortality ; Risk Factors ; Survival Rate ; United Nations

Disasters have frequently been a problem in Korea. Many initiatives have been carried out to mitigate this problem and to respond to disasters properly. The National Medical Emergency Center organized the Disaster Medical Response Center, which operates 24 hours a day. Regional emergency medical centers were designated as hospitals that receive disaster victims. Along with the designated disaster hospitals, the Ministry of Health and Welfare, city and district governments, and community health centers were all assigned standard roles to carry out in case of disasters. Disaster medical assistance teams were developed to respond to disaster events in their regions. This system has enabled a more rapid and systematic response to disaster events, and has standardized disaster-related medical equipment and vehicles to ensure the proper treatment of disaster victims. Although many valuable systems have been developed to respond to disasters, practical training within each institution and community-wide team training are still lacking; therefore, the government needs to further develop and support such programs.
Community Health Centers ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medical Services ; Korea ; Medical Assistance

The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.
Disaster Medicine ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medicine ; Humans ; Military Medicine ; Mortality ; Triage