Problem: On 17 December 2024, a magnitude 7.3 earthquake struck the Pacific Island country of Vanuatu, affecting over 80 000 people and causing 14 deaths and 265 injuries. Facing limited specialist clinical capacity, increased patient load and strained facilities, Vanuatu’s Ministry of Health requested support from emergency medical teams. Context: Vanuatu, highly disaster-prone and geographically dispersed, has a health system constrained by limited human resources and recent cyclone-related damage. The country’s national emergency medical team, the Vanuatu Medical Assistance Team, was established in 2017 and plays a central role in health emergency response in the country. Action: Within 24 hours of the earthquake, the Vanuatu Medical Assistance Team was activated and established an Emergency Medical Team Coordination Cell within the national health emergency operations centre. National and international emergency medical teams from Australia, Fiji, Indonesia, Japan and New Zealand were deployed over the subsequent weeks and provided clinical, mental health and information management support. The World Health Organization’s emergency medical team Minimum Data Set was implemented to monitor health trends and inform response actions. Outcome: Eight national and international emergency medical teams deployed alongside local health services. Together, they reported more than 5500 consultations to the Emergency Medical Team Coordination Cell, and a specialized team provided mental health and psychosocial support to 521 people. Minimum Data Set analysis showed a rapid decline in trauma-related presentations and detected increases in influenza-like illness, guiding the transition from emergency to recovery. Discussion: This response underscored the value of emergency medical teams following disasters, the importance of national leadership and coordination, and the significance of regional solidarity and partnerships. It also highlighted the importance of information management during emergencies and demonstrated potential innovations in this space.

OBJECTIVE: This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. METHODS: The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. RESULTS: A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06-2.81) and during the night shift (OR 2.29, 95% CI 1.30-4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97-2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70-2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47-3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76-4.84). CONCLUSION Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.
Case-Control Studies ; Cerebral Palsy ; epidemiology ; etiology ; Delivery, Obstetric ; statistics & numerical data ; Health Facilities ; statistics & numerical data ; Humans ; Incidence ; Infant, Newborn ; Japan ; epidemiology ; Parturition ; Perinatal Care ; statistics & numerical data ; Retrospective Studies ; Time Factors