1. Chile Earthquake Reconnaissance Trip March 2010Rick Bissell, PhD UMBC Dept. Emergency Health Services

2. Where is Chile?
3. Geographic Background
Source: NYTimes 3 March 2010
4. Tectonics
Source; http://www.google.com/imgres?imgurl=http://www.showcaves.com/maps/Big/Plates.png&imgrefurl=http://www.showcaves.com/english/explain/Geology/PlateTectonics.html&h=354&w=572&sz=19&tbnid=t1wGiEg-aGOQiM:&tbnh=83&tbnw=134&prev=/images%3Fq%3DNazca%2BPlate&usg=__FrbMqwx3nrcN963FgA3NcAYWoHo=&ei=CJGnS_zLHYe-NoSAqf0C&sa=X&oi=image_result&resnum=5&ct=image&ved=0CBkQ9QEwBA
5. Trip Background
Rapid reconnaissance grant from NSF through the Earthquake Engineering Research Institute (EERI).
Focus of our subgroup: Effects of earthquake building damage on health care provision.
Focus of larger group: Examination of reasons structures failed (or didnt) in the most powerful earthquake in recent history.
6. Team Members
Rick Bissell
U. of Maryland, Baltimore County
Francisco de la Masa
Ministerio de Salud
Judith Mitrani-Reiser
Johns Hopkins University
Bill Holmes
Rutherford & Chekene
Tom Kirsch
Johns Hopkins University
Mike Mahoney
FEMA
Nicolas Santa Cruz
Pontificia Universidad Catolica
7. Earthquake Description
Magnitude 8.8, by far the largest since 1964.
Lasted 1.5 3.5 minutes
Subduction-type quake; tend to be most damaging.
3:34 AM; timing saved many lives.
Tsunami followed almost immediately in 3 waves.
> 150 aftershocks at mag. 5 or greater
8. Earthquake Description - 2
Santiago (~ 450km from epicenter) moved 24cm to the west.
Earthquake felt as far away as Buenos Aires, Argentina (~1,500km ) and Sao Paulo, Brazil (~3,000km).
Coastal area elevation increases are expected but not confirmed.
9. Destruction Summary
~ 450 deaths, ~ 500 injured, 800,000 homeless
> 60% of deaths due to tsunami
Most destruction in Concepcin, Talcahuano, Valdivia, Arauco, Coronel, Los Angeles, Talca and Maule areas.
Destruction area covers 80% of Chiles pop.
Tsunami severely damaged several occupied coastal areas and the port of Talcahuano.
10. Destruction Summary - 2
Most modern buildings (p 1995) did pretty well, except for a few catastrophic failures.
Major failures in older adobe-based housing and historical buildings.
Some 1940s era hospitals w/very thick walls fared pretty well.
Numerous bridges were lost, roads suffered major damage.
11. Destruction Summary - 3
Water systems in Concepcin, Talcahuano and other coastal towns suffered major failures due to broken piping.
Electrical system for the entire country was out for 4-7 days. Subsequent shorter outages.
Communications out for 3-5 days.
Few notable fires, except at Univ. Concepcin.
12. Concepcin OHiggins Bldg.
13. Talca
14. Talca
15. Prat Bldg Concepcin
16. Prat Bldg top
17. Prat Bldg west side split
18. Prat Bldg bottom
19. Prat Bldg rescue hole bottom
20. Prat Bldg rescue holes east side
21. Prat Bldg rescue holes east side
22. New Prat Bldg beam/column damage 6th Fl
23. Concepcin bridge
24. Concepcin bridge
25. Universidad Concepcin Chemistry Bldg
26. Talcahuano water line w/Judy MitraniReiser
27. Talcahuano water damage housing
28. Talcahuano bldg and boat
29. Bissell in drydock
30. Talcahuano port damage
31. Concepcin crushed cars
32. Concepcin water
in streets
33. Concepcin grain storage silos
34. Concepcin street tents
35. Hospital Damage
No hospital (to our knowledge) suffered a complete structural failure.
Of 79 affected hospitals, 54 require minor repair, 8 major repair, and 17 a complete rebuild. (Source: http://www.redsalud.gov.cl/noticias/noticias.php?id_n=761&show=3-2010) 22 Mar 2010
Many had extensive loss of equipment.
All lost power, external water supply, communications.
36. Talca Hospital
37. Talca Hospital
38. Talca Hospital
39. Talca Hospital
40. Talca Hospital
41. Talca Hospital
42. Impressive field hospital in Talca run by Chilean military
43. Summary of Physical Damage:Nonstructural
Severe damage to suspended (American) ceilings.
Loss of power, water, and communication.
Mechanical equipment damage resulted in loss of hot water forcing hospitals to be creative with kitchen, laundry, and sterilization services (e.g., water boilers and chillers).
Medical equipment damage forced hospitals to do their sterilization off site, and disrupted diagnostics (e.g., damaged radiology equipment)
Water damage forced hospitals to shut down entire buildings, disrupted dialysis treatment, and had severe sterilization implications (e.g., surgical ward).
Standalone shelving damage, resulting in disorganization of medical records for few days to several weeks (e.g., Talcahueno still organizing now!).
44. Hospital Physical Damage Impact
Damage resulting from very small details can shut down a hospital.
Water damage from even a small pipe break can shut down operations.
Securing both mechanical and medical equipment can be critical to maintaining hospital operations.
Distributions to systems are not as critical in Chile and were more redundant.
45. Hospital Operability Issues:Redundant Systems
All hospitals had backup systems for water and electricity, although the systems were not always sufficient.
None had adequate backup for sewer.
Communications systems needed planning and redundancy.
Hospitals proved remarkably adept at using ambulance radios for local communications.
46. Hospital Operability Issues:Pre-event Emergency Planning
Hospital emergency committees were very helpful in providing leadership.
All directors said emergency plans needed to be redone in a practical way, which includes local decision making.
Current plans have decisions being made in Santiago, but did not take into account communications problems.
47. Hospital Operability Issues:Evacuations and Transfers
Some hospital s did an excellent job in evacuating patients, while others did not; loss of elevators impacted evacuation capability; many had to carry patients (old style ramps actually were very efficient).
Hospitals were very resourceful at relocating patients within their own facilities.
US hospitals should reconsider policy of mass transfer of patients to other hospitals based on damage.
Most hospitals reduced patient load by:
Discharging patients to families with instructions for care.
Some hospitals sped up normal transfer of patients back to their home hospitals, especially maternity.
48. Summary
This is a preliminary investigation, hopefully leading to a more thorough one.
Hospitals do not have to collapse to be rendered inoperable.
Hospital directors noted the need for more local preparedness planning and training and more decision-making autonomy.
Recent collaboration with EMS (SAMU) led to a very effective use of EMS as a communications and coordinating unit when other systems failed.