Humanitarian aid and local power structures: lessons from Haiti's 'shadow disaster'

Differences in the rates of admission and major orthopedic surgery care between Turkish and displaced children injured in a major earthquake

BACKGROUND

The burden of displacement makes child refugees, asylum seekers, and migrant children less resistant to medical problems. On February 6, 2023, the southeast and the southcentral regions of Türkiye were struck by two sequential large earthquakes. The study aimed to analyze the characteristics of musculoskeletal injuries and the initial orthopedic surgery data resulting from the earthquake and compare the differences between Turkish and displaced children, particularly those who underwent major musculoskeletal interventions at the four state hospitals of the Adana metropolitan region.

METHODS

The retrospective study analyzed the medical records of the survivors admitted to the four general hospitals run by the government in the Adana, Türkiye metropolitan area between February 06, 2023, and February 13, 2023, the first seven days following the earthquake. The analysis data included age, gender, nationality, time of admission, types and localization of injuries, and treatment methods.

RESULTS

The number of cases under 18 years of age requiring orthopedic intervention was 969. The distribution of the cases based on nationality was as follows: there were 517 Turkish (53.35%), 371 Syrian (32.71%), and 81 children of unknown nationality (CUN) (8.36%). The files show that the patients requiring surgery, including fasciotomy, fracture surgery, and amputation (n = 281), were mainly treated at the level I trauma center (n = 171, 60.85%). In terms of the daily distribution of admissions based on the type of musculoskeletal injuries, the admissions of children with foot fractures in the first days were significantly increased (p = 0.0134). Regarding surgery rates, the fracture surgery and fasciotomy rates were significantly higher in cases admitted earlier. (p < 0.0001 and p = 0.0009, respectively). In terms of nationality, there were no significant differences regarding the date of admission, the number of cases who underwent amputations, and the discharge number and types.

CONCLUSION

The study revealed that after the severe earthquake disaster, the state hospitals of the Adana metropolitan region provided unbiased healthcare for all the region's children. Regarding orthopedic care, the response was given accordingly in this particular disaster, highlighting that level I trauma centers should always be ready for such intensity due to the short preparation time in case of a severe disaster.

Managerial models for disaster and humanitarian operations: enhancing empirical validation through case studies of disaster responses in Haiti

Purpose

The research areas of humanitarian supply chain (HSC) and disaster and humanitarian operations (DHO) have evolved through the use of managerial models. Recent studies, however, point to the need for the empirical validation of such managerial models in real-life scenarios. Therefore, the present study aims to investigate the validation of recent managerial models based on empirical data of two disasters in Haiti: the earthquake in 2010 and Hurricane Matthew in 2016.

Design/methodology/approach

This research developed two case studies from the perspective of the Brazilian Navy (BN), a part of the Brazilian Armed Forces that led the United Nations Mission for Stabilization in Haiti (MINUSTAH) in both disasters. The case studies focused on empirically validating managerial models for stakeholder identification, stakeholder satisfaction, response processes, strategies for collaboration and the integration of these models.

Findings

The results revealed that compared to the response to the earthquake in 2010, the response to Hurricane Matthew in 2016 was superior. The collaborative strategies of the BN and other stakeholders used after the earthquake were more reactive, while the strategies after Hurricane Matthew aimed more at planning and anticipating adverse situations.

Originality/value

This research reinforces the investigated managerial models and indicates their suitability as planning tools for practitioners of HSC and DHO, which is essential for the further development of academic contributions related to integrating the models into more robust solutions.