The surgical and obstetrical activity at the ICRC Field Hospital in Banda Aceh in the aftermath of the tsunami 2004

Abstract

Objectives: The tsunami of 26 December 2004 caused death and devastation along the whole coast of Sumatra, Indonesia. The International Committee of the Red Cross (ICRC), in cooperation with the Indonesian Red Cross, set up a complete multidisciplinary 100‐bed field hospital in the city of Banda Aceh to function as a temporary facility to substitute for damaged health care structures pending final reconstruction. The primary aim of this study was to evaluate the specific pattern of injuries caused by the tsunami but also to describe the surgical and obstetrical problems treated in the absence of a functioning health care system. Methodology: All patients admitted to the surgical or obstetrical wards between 16 January and 10 March 2005 were registered by name, age, diagnosis and surgical or obstetrical procedure. Postoperative complications and special problems caused by the tsunami or by the field hospital conditions was recorded. Results: During the period a total number of 355 surgical interventions were recorded. Trauma led to 166 (46%) operations. Tsunami injuries were seen in 53 patients, and 103 (29%) surgical operations were performed due to repeated wound debridements of severely infected wounds. Traffic injuries accounted for 40 (11%) and domestic traumas for 23 (6%) operations. The number of surgical procedures for acute abdominal or urological problems was 25 (7%). Tumour surgery was performed in 34 (10%) cases. The number of surgical procedures considered to be non‐urgent was 122 (34%). Among these, the most frequent surgical indication was hernia, followed by bladder stones. Conclusions: In the aftermath of the tsunami 2004, the ICRC multidisciplinary field hospital activity in Banda Aceh soon became a major substitute for the extensively weakened health care facilities in the whole province. The importance of being self‐sufficient but integrated in the local culture should be emphasized. The wounds caused by the tsunami that were not treated until several weeks after the disaster were mainly located in the limbs, were severely infected and necessitated repeated surgery. The capacity of the hospital was sufficient to cover all kinds of obstetrical and surgical emergencies and, to a certain extent, also allowed safe surgery for non‐urgent cases.