Sichuan Earthquake 2008

1. Sichuan Earthquake 2008 Personal Experience and Afterthoughts Dr. Poon Tak Lun

2. Location

5. Geology • Plate tectonics: • India plate converging towards Eurasian plate • Uplifting of Tibetan plateau • Crushing against Sichuan basin

6. Longmenshan fault • Thrust fault

7. Classification of faults

9. Complex geology • Difference of 6000m altitude within 60 km • Convergent plates moving at 50mm/yr • Expected to have further major earthquakes in the future years

10. Historical events • Since 1973, one major earthquake every 5 years

14. The Tremor and the Fault • Magnitude: 8.0 • Longmenshan Fault: a displacement of 9 meters along a fault 240 km long and 20 km deep • Hard terrain, shallow centre, dense population, weak buildings

15. Nearly 8000 aftershocks • Many major ones were very destructive

16. The Expedition • 12 May 2008 1428 hours: earthquake • 13 May 2008 1400: notification and confirmation of team member availability • 14 May 2008 1930: expected time of departure

17. The Mission • Local Red Cross emergency medical team at Beichuan county entrance • Taking care of escaping victims • First aid, simple medical care, simple surgical care • Escort to hospital • Already exhausted after first 2 days • Desperately needing relief personnel

18. Our Medical Team • One A&E doctor • 2 surgeons • 1 orthopaedic surgeon • 1 nurse • 1 liaison officer

21. Preparation of the mission • Estimation • Nature • Duration • Service required materials • Staffing • Briefing • Transport • Personal requirements

22. Preparation according to Nature of the mission • Simple medical and surgical care • Simple drugs • Plenty of simple wound dressing sets and antiseptic fluids, surgical gloves, surgical masks (proved to be the most useful) • Packaging within 1 hour • Food and water

23. Staffing • Formation of team • Medical profession and specialty required for job • At least someone must be well experienced and able to work independently

24. Duration of mission • At the time of briefing, this was unknown • We prepared for one week of work

25. Personal preparation • Simple personal belongings: travel light • Appropriate clothing and equipment • Personal protection: according to expected situation of work • Personal working equipments: stethoscope, headlights etc • Certain level of risk taking • Simple food and drink

26. Personal preparation • Travel documents • Professional license • Insurance • Arrangement of normal job and work and appointments etc

27. Psychological preparation • What do you expect to see? • What is your limit of tolerance? • With experience you will become seasoned and able to lead your comrades along difficult missions • Responsibility for oneself and team members • Goal: to accomplish mission and return

28. Expectations before arrival • Difficult travel: true, no confirmation of flights, long hours of road traffic, burst tire, final strip on foot, carrying all materials on shoulders • Heavy casualties: true, but in a way not very heavy workload, a lot of victims were dead • Sad scenes: true, and very true

35. Arrival: last km on foot • No electricity • No mobile phone network • No hot water, difficult supply of hot meal • No bathing or toileting provisions • Sleeping on chairs in thunderstorm and aftershocks • Started working immediately

40. 15 – 19 May 2008 • Around 400 cases • Mainly superficial wounds from minor lacerations, some of them infected • Dressing and suturing • Several fractures: humeral neck, distal radius and hip, all old people • One CPR, unfortunately failed • Minor diarrhoea • Dehydration and heatstroke in rescue personnel • Escaping villagers would board buses to Mianyang temporary shelter

41. Official rescue work • Command centre at Beichuan Highschool • Daily marching in of troops of rescuers and soldiers from Hunan, Liaoning, Beijing, Hainan etc • Bulldozers, cranes and other equipments • Army rescue medical centre: 2 tents, 5 beds, but not enough dressing sets or antiseptic fluids

42. Changing scene • First day: many survivors rescued • Difficult transfer to hospital • Slightly more serious injuries • 4 ° C at night

43. Second day • Main road passable • Ambulances going down to rubbles • Escaping villages, dehydrated, hungry, minor wounds all over • People going back to look for relatives and valuables • Team was told to stay

44. Third day • Risks of flood • Rescue personnel were evacuated • Fewer and fewer survivors • Fewer and fewer escaping villagers

45. Fourth day • Thunderstorms and aftershock • All civilians evacuated • Few survivors expected, if at all • Main entrance blocked to all unofficial personnel and volunteers • Our mission terminated at 165 hours after the first shock • Rescue operations: also coming to a reluctant halt

46. Difficulties and Dangers • Persistent rain, including thunderstorm • Aftershocks • Quake lakes and risks of floods • Over-saturated roads and vehicles • Scale of damage • No sanitation • Garbage and flies everywhere • Physical dangers: landslides, road blocks • Personal supplies or relief did not come

47. Work during the present few weeks • Caring for displaced victims: shelter, food, clean water, sanitation, schooling • Caring for the injured and sick: medical and surgical care in hospital, outpatient clinics

48. Statistics as of today • Death toll: > 69,000 • Missing: 20,000 • Injured: 360,000 • Diverted to many provinces now

49. How should we evaluate our mission? • Caring for 400 minor injuries out of 360,000? • Have we altered the outcome?

50. Have we altered the outcome? • Sichuan Red Cross personnel desperately in need of relief when we arrived • Victims with minor injuries were basically ignored: had we not been there • Symbol of warmth and care from Hong Kong • We should have been there one day earlier