[How to solve hospital operating problems based on the experience of the Hanshin earthquake?]

Immediately after the Hanshin (Kobe-Osaka) earthquake, electricity, water and gas supplies were discontinued at Kobe General Hospital, causing difficulties with many important hospital functions including the water cooled independent electric power plant, respirators, and sterilizers. A large water storage facility is needed to keep the water cooled type independent power plant operating. Alternative plans including the introduction of an air cooled independent power plant and a sea water to fresh water exchange system should be considered. Portable compressors are needed to retain the function of respirators in the absence of a water supply. The emergency use of propane gas should also be considered for sterilization and cooking facilities. There were very great problems in communication after the earthquake. The only method was the use of public phones, which have priority over private lines. Therefore, each hospital should have phones with similar priority. In addition, the use of personal computers and/or computer network methods should be considered to preserve a high level of communication after an earthquake. Otherwise, a hospital should be equipped with wireless phones. Immediately after the earthquake, the care of critically ill patients could not be achieved. Therefore, 20 cardiac patients requiring intensive care had to be transferred to other heart centers. The best method for the transfer is by helicopter. Kobe City suffered a transport crisis which occurred immediately after the earthquake and continued up to the end of March. A big helicopter or a special bus guided by a police car should be considered for hospital staff transport.(ABSTRACT TRUNCATED AT 250 WORDS)