ISN Announcements
Padang-Sumatra Earthquake: ISN Renal Disaster Relief Task Force report
The ISN Renal Relief Disaster Task Force (RDRTF) assessment team reached the disaster zone on Saturday October 3rd at 17.00 local time, which is 3 days after the disaster. The team left from Brussels national airport together with the Médecins sans Frontières (MSF) team in the evening of October 1st, one day after the earthquake. The team consisted of
- Dr Arjan van der Tol, nephrologist
- Mr Stefaan Claus, renal nurse
- Mr Peter Stockman, dialysis technician
Shortly after arrival, it appeared already that the number of crush patients was extremely low due to two reasons:
1) in Padang city a substantial number of high buildings had collapsed, but the dimensions of the earthquake were so huge that rescue came too late. When our team arrived, unfortunately, thousands of people were still under the rubble, but signs of life had disappeared since one day, making chances of successful extrication extremely low; as of today, Monday October 5th, all extrication efforts have been abandoned completely;
2) in the rural area surrounding the city, on the other hand, buildings are very light, decreasing the chances of crush. Most fatalities there have been caused by landslides causing suffocation. A large part of this rural area had not yet been reached by rescue teams by Sunday night, October 4th.
A shipment with material consisting of 4 dialysis machines, one reverse osmosis machine, together with infusion fluids (saline, bicarbonate and mannitol) will be shipped to Indonesia via cargo today Monday, October 5th.
In the absence of Acute Kidney Injury (AKI) , the RDRTF concentrated its effort on the treatment of chronic dialysis patients. In the hospital in Padang, there had been a well working dialysis unit, with 7 posts, however serving the whole city (900,000 inhabitants) and its surroundings. The dialysis machines of this unit are intact, but the hospital building had to be abandoned for safety reasons. As a consequence, chronic dialysis was taking place outdoors, with improvised water treatment systems and tubings exposed to the tropical sun, hence creating an undesired rise in dialysis water temperature. The Task Force started advising and helping in the reallocation of the dialysis unit to safer area, making first use of a provisory tent, but with the intention of moving this night (Monday, October 5th), to a solid and safe building.
To allow the installation of this dialysis unit to take place, S. Claus and P. Stockman will stay on the spot for a few more days. They will also install the reverse osmosis and dialysis machines shipped by MSF via cargo and instruct local caregivers about their use. Contact has been taken also with the manufacturer of the RDRTF dialysis machines to send an Indonesian instructor from Jakarta to Padang. A van der Tol will also liaise with Dr Sjakul Azmi, an Indonesian nephrologist from Jakarta coming to support his colleagues from Padang.
MSF will remain active in the area by offering primary health care, psychologic support and help in reconstruction.
In view of the dimensions of the disaster, several volunteers had been kept in standby. From the beginning we were aware that we were facing two options: either a huge number of fatal cases, hence reducing the number of crush patients to a minimum; or a huge number of rescued people with treatable crush. Unfortunately for the local people, the first option was the true one, making vast logistic efforts at the start of the action seem futile only a few days later. Nevertheless, we are convinced that all logistic measures we took had to be taken, because of the uncertainty about outcome from the beginning.
We are indebted to the following people who were volunteering but could not take part in the intervention:
- Dr Vivekanand Jha, India, contact person and volunteering for the assessment team
- Dr Rogier Caluwé, Belgium, who was planned to take care of the preventive fluid in the assessment team
And the foreseen members of the first rescue team:
- Dr Neil Boudville, Australia, nephrologist
- Dr John Paul Killen, Australia, nephrologist
- Mr Francis Grainer, Australia, renal nurse
- Mrs Kelly Avery, Australia, renal nurse
- Mrs Carol Wang, Australia, renal nurse
- Mrs Fleur Veronica May, Australia, renal nurse
- Mr. Philip Barry Wilson, Australia, renal nurse
- Mrs Nathalie Eyhartz, France, renal nurse
- Mr Roland Van Dam, Belgium, renal nurse
- Mrs. Linda Rottiers, Belgium, renal nurse
We are also indebted to Dr David Harris, for the swift composition of the Australian rescue team.
We are aware of the fact that it is the second time that an Australian team has been composed without the possibility to go into action. We are sorry for that, but this is the problem of standby; there are always teams prepared that not necessarily will be able to go. Also for Mrs Eyhartz, it was her second time in standby. We nevertheless hope that also in the future we will be able to count on the generous help of these and many other people and thank all of them for their generosity and support.
Raymond Vanholder,
Chairman ISN/RDRTF ISN/RDRTF
Coordination Center
Assistant : Chantal Bergen
General e-mail address ISN/RDRTF : RDRTF@ugent.be
Nephrology Section MCA, University Hospital Ghent
De Pintelaan 185, BE-9000 Ghent, Belgium
Phone +32 9 3324522 Fax +32 9 3324599
