Tahira Ayub Malik, Tayyab Afghani, Asif Kiani.
Pakistan earthquake 2005: the role of subspecialty hospitals in national disasters - the scope and limitations: modeling the eye hospital response.
Al-Shifa J Ophthalmol Jan ;8(1):20-7.

Purpose: To study the role of subspecialty hospitals in national disasters, its scope and limitations in context of an eye hospital response during Pakistan October 2005 earth quake. Study Design: A retrospective observational study Subject and Method: The study was carried out at Al Shifa Trust Eye Hospital Rawalpindi (ASTEH) and comprises of the scope and limitations faced by ASTEH, a subspecialty eye hospital, when it offered its services to the victims of October 2005 earthquake. A special trauma management team from UK with over two dozen specialists joined the hospital voluntarily. A total of 156 patients admitted to the hospital were managed surgically and medically, the limitations and scope analyzed and the patients interviewed at the time of presentation regarding the age, district, mechanism of injury, time elapsed under debris, delay in reporting to the health care facility, type of injury and type of surgery undergone. Results: The limitations faced by the hospital included overwhelmed resources ( ASTEH being a charity hospital), budget reallocation, emergency planning, collecting additional donations, funds and grants, providing medical and surgical care to a different class of patients, and provision of accommodation, food, water and electricity to the patients and their attendants. With the help of donations from Pakistan Red Crescent Society and Islamic Help Charity of UK as well as personal donations Al Shifa Trust Eye Hospital effectively managed all the patients. Psychological and emotional support was also provided. 59% of the affected were females. The most common injury was bony fractures in 64% of cases and the most common mechanism of injury was roof collapse. Among ocular injuries again fractures caused by roof collapse were more prevalent. Conclusion: Disaster management is everyone’s responsibility. Being a specialized hospital should not bar any health facility to contribute to the national disaster management in hours of need. Al-Shifa Trust Eye Hospital effectively proved that with proper management and networking, a subspecialty hospital can play vital part in national emergencies. The pattern of ocular injuries observed was a unique opportunity for ophthalmic research workers and health policy makers.

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