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N Engl J Med. The Israeli Field Hospital in Haiti ? Ethical Dilemmas in Early Disaster Response

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  • N Engl J Med. The Israeli Field Hospital in Haiti ? Ethical Dilemmas in Early Disaster Response

    The Israeli Field Hospital in Haiti -- Ethical Dilemmas in Early Disaster Response (N Engl J Med., extract, edited)
    Published at www.nejm.org
    March 3, 2010 (10.1056/NEJMp1001693)

    The Israeli Field Hospital in Haiti ? Ethical Dilemmas in Early Disaster Response

    Ofer Merin, M.D., Nachman Ash, M.D., Gad Levy, M.D., Mitchell J. Schwaber, M.D., and Yitshak Kreiss, M.D., M.H.A., M.P.A.


    Within 48 hours after the massive earthquake that struck Port-au-Prince, Haiti, on January 12, the government of Israel dispatched a military task force consisting of 230 people: 109 support and rescue personnel from the Israel Defense Forces (IDF) Home Front Command and 121 medical personnel from the IDF Medical Corps Field Hospital. The force's primary mission was to establish a field hospital in Haiti.

    We landed in Port-au-Prince 15 hours after leaving Tel Aviv and began to deploy immediately. The first patients arrived at our gates and were admitted even before the hospital was fully built, within 8 hours after our equipment arrived. In its 10 days of operation, the field hospital treated more than 1100 patients.

    Our mission was to extend lifesaving medical help to as many people as possible. The need to manage limited resources that fell far short of the demands continuously presented us with complex ethical issues. Every mass-casualty event raises ethical issues concerning the priorities of treatment, but the Haiti disaster was exceptional in several ways. Haiti is a poor country with minimal civil facilities, and the earthquake's destruction of infrastructure left millions of people homeless and hundreds of thousands in need of medical assistance. When we arrived, there was no functioning authority coordinating the distribution of the available medical resources. We were faced with the challenge of establishing an ethical and practical system of medical priorities in a setting of chaos.

    Our hospital was designed to contain 60 inpatient beds, including 4 in the intensive care unit (ICU). It had one operating room with a single table. In view of the initial absence of functioning nearby medical facilities and the dire need for medical services, we extended our hospitalization capacity to its maximum of 72 patients and added a second operating table.
    (...)
    [Free Full Text is available at NEJM.org website, following the link below...]
    <cite cite="http://content.nejm.org/cgi/content/full/NEJMp1001693?query=TOC">NEJM -- The Israeli Field Hospital in Haiti -- Ethical Dilemmas in Early Disaster Response</cite>
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