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Post-preparedness medical disaster response in Costa Rica
R A Bissell1, E Pretto, D C Angus
1University of Maryland, National Study Center for Trauma and EMS 21201-1023, USA.
Introduction:
The 1991 earthquake in the Limón area of Costa Rica presented the opportunity to examine the effectiveness of a decade of disaster preparedness.
Hypothesis:
Costa Rica's concentrated work in disaster preparedness would result in significantly better management of the disaster response than was evident in earlier disasters in Guatemala and Nicaragua, where disaster preparedness largely was absent.
Methods:
Structured interviews with disaster responders in and outside of government, and with victims and victims' neighbors. Clinical and epidemiologic data were collected through provider agencies and the coroner's office.
Results:
Medical aspects of the disaster response were effective and well-managed through a network of clinic-based radio communications. Nonmedical aspects showed confusion resulting from: 1) poor government understanding of the roles and responsibilities of the central disaster coordinating agency; and 2) poor extension of disaster preparedness activities to the rural area that was affected by the earthquake.
Conclusion:
To be effective, disaster preparedness activities need to include all levels of government and rural, as well as urban, populations.