Preparedness for medical rehabilitation of casualties in disaster situations

Natural and man-made disasters produce large numbers of severely and multiply injured casualties, many of whom survive with severe impairments that require comprehensive and protracted rehabilitation (brain and spinal cord damage, peripheral nerve injuries, amputations). In a disaster situation, even adequately developed rehabilitation services are unable to provide care to the large number of casualties, without advance planning and preparation. Such planning has to consider expansion of available rehabilitation institutions and conversion of other facilities into settings for rehabilitation, and integrating all into a rehabilitation referral system consisting of levels of care. It should further consider strengthening community service for the provision of continuity of rehabilitation care and the preparation of guidelines for adequate management of various categories of disablements at various levels. The paper offers guidance to those in disaster-prone areas, or in anticipation of a disaster, who might wish to undertake the planning, as well as to those who need to organize available services or to set up new ones, once the disaster has occurred.