If “the big one” that seismologists have been warning about hits Dhaka, it is unlikely that the health care system will be able to cope.
Most hospitals, including the country’s largest – the Dhaka Medical College Hospital (DMCH) – do not have emergency plans to deal with the aftermath of a major earthquake.
For instance, the DMCH has a 15-member rescue team and the capacity to treat 200 patients at a time in its emergency unit, Brig Gen Mizanur Rahman, director general (DG) of the DMCH, told the Dhaka Tribune.
But that capacity is not nearly enough. The 7.8 magnitude earthquake that hit Nepal on April 25, 2015 killed over 8,000 people, injured over 21,000 and displaced nearly 450,000.
The May 12, 2015 aftershock in Nepal that registered 7.3 on the Richter scale left over 200 dead and over 3,500 injured.
Indian seismologist Vinod Kumar Gaur told The Hindu newspaper as early as 2013 that calculations indicate there is enough energy accumulated along the Himalayan arc to produce an 8 magnitude earthquake in this region. This year’s January 4 earthquake measured 6.7 on the Richter scale.
“We will very likely face problems providing treatment if a massive earthquake takes place,” admitted Director General Prof Dr Deen Muhammad Nurul Haque of the Directorate General of Health Services (DGHS). “Earthquakes are a new emergency scenario for us.”
’We already have enough difficulties’
The country’s hospitals and health complexes have proved to some extent their capacity to handle cyclones and flooding, but a major earthquake is another matter altogether.
“If a big disaster like an earthquake takes place – which is totally new for us – we might not be able to deal with it,” the DMCH’s Brig Gen Mizan said. “We have enough difficulty dealing with regular problems.”
The 2,600-bed hospital routinely serves 3,600 inpatients year-round.
“We have orthopaedic facilities that can hold a maximum of 200 patients,” he said, but added that there is neither space nor equipment to handle more patients than that.
“Even if we were able to coordinate a disaster response by calling in staff from around the country and bringing in volunteers, we would still have to deal with a serious shortage of space.
“We need the equipment to operate mobile hospitals of the type used by the defence forces,” the DMCH director general said.
“Another problem is that our building may not be safe in the event of a major earthquake. The operating theatres and storerooms where emergency equipment is kept could be damaged,” he said.
Mizan said steps were being taken to inspect the hospital building’s earthquake-resistance status.
He suggested that ministries concerned create storage space for equipment to be stored outside the medical building.
Sundry shortages
In addition to a shortage of space, there will also likely be a shortage of ambulances.
The DMCH has just three. Private ambulances number over 10,000, but they are rarely equipped to provide on-board treatment.
The hospital conducts disaster-preparedness training but most staff members have not been trained to deal with a catastrophic quake.
The DG said a major disaster would be a national issue requiring a national response.
In the aftermath of a major tremor, survivors would require treatment from organisations like the Centre for the Rehabilitation of the Paralysed (CRP) and the National Institute of Traumatology and Orthopaedic Rehabilitation (Nitor).
CRP Director Shafiqul Islam agreed that his organisation would have to rise to the occasion. He told the Dhaka Tribune that although CRP staff were not specifically trained to deal with earthquake-like disasters, they would still be able to treat four or five thousand patients.
“But if the casualty numbers are higher, it is definitely beyond our capacity,” Shafiq said. “Currently, we do not have plans to train staff for such an eventuality.”
He added: “The CRP building can likely withstand smaller tremors, but it is anybody’s guess how well it will handle a major earthquake.”
Nitor’s 500-bed facility can accommodate twice as many patients in the event of a major disaster, the institute’s authorities said.
“Yet a shortage of space still remains the biggest concern in the event of a catastrophic earthquake,” acting director Prof Dr Goni Mollah told the Dhaka Tribune.
“We fear that our ability to provide treatment would collapse because there is no space around our premises.
“We may have all the manpower and equipment that we need, but where would we put the patients?”
About the safety of Nitor’s building, Prof Goni said: “Our building should hold up, but we will not know how well it will hold up until it is tested. Damage is a possibility. We must have alternatives.”
DGHS Director General Dr Deen Muhammad Nurul Haque said Fire Service and Civil Defence personnel were being trained to deal with such an emergency.
“We hope to tackle this threat the way we have other disasters,” he said.
