A record of morbidity and medical request profiles in international humanitarian aid, taking the earthquake in Bam in Iran in 2003 as an example

Abstract

Objective: With the humanitarian work of the International Red Cross after the earthquake in Bam, Iran, it should be noted that international and national cooperation is possible according to recognised standards and concepts, and therefore morbidity records can be included uniformly in the context of day-to-day work even in post-disaster situations. The data ascertained show changes in the disease spectrum. Basic health provision according to the primary health care concept has priority in the post-disaster response (> 6 days) to the earthquake compared to more surgically oriented medical acute aid from abroad. Material and methodology: In the international consensus conference at the beginning of January 2004, uniform morbidity recording was fixed to simple standardised disaster case definitions. The recording of traumatic, infectious and non-infectious diseases was carried out during the routine work in the outpatient facilities of the emergency response units of 3–31 January 2004. Examination was according to the following indicators: proportional morbidities and sum of the proportional morbidities. Results and discussion: The complete examination time period included 16,677 new cases. The health facility rate only gradually increased. Temporal fluctuations in the numbers treated may be caused by secondary care of the injured, by a possible lack of accessibility (transport problems) or an increased acceptance of facilities. A written specification of the case definitions was not carried out in Bam, and so a comparison is not possible for recorded morbidities at the same time, and consistency cannot be reached for some of the data. Nine diagnoses/categories cover 98.68% of the consultations in the complete time period. Non-traumatic health problems predominate for the whole of the month. The category "others" is too high with 57.94%. Therefore, it may be assumed that certain diagnoses were overestimated, underestimated or not recognised. Vulnerable groups (children, women, the old) were not completely included. Conclusion: Standards and guidelines for health care in humanitarian aid exist and are of help during planning, decision finding, execution and communication. Data acquisition instruments (registering books and patient files) should be developed and standardised by national and international humanitarian groups. The recording of morbidity is a simple instrument in the context of outpatient facilities and provides valuable information for further work during disasters.