ReviewThe initial health-system response to the earthquake in Christchurch, New Zealand, in February, 2011
Introduction
Christchurch City (figure) has an urban population of about 400 000. On Tuesday Feb 22, 2011, at 1251 h local time, a 6·3 magnitude earthquake struck Christchurch. Its epicentre was 5 km deep, and 10 km southeast of the city centre (figure).1 Peak ground accelerations were among the highest recorded from this type of earthquake.1, 2, 3 Destruction and liquefaction were widespread.1 The central business district was extensively damaged, with two multistorey buildings collapsing, many others partly collapsing, and large amounts of rubble falling into the streets. A combination of high peak ground accelerations, the time of day, and the collapse of buildings resulted in injury and loss of life (table 1).
This report is presented in three major sections. The first section describes Christchurch Hospital's preparedness for a mass casualty event. The second section describes the challenges faced, health-care response, and injury burden within the first 24 h after the earthquake. The final discussion section reviews the response and injury burden in the context of responses to international earthquakes of similar magnitude in urban areas of high-income countries and outlines the lessons learned.
Section snippets
Health system
New Zealand has a publically funded health system with injury care funded by the Accident Compensation Corporation. Access to hospital care is free, and access to primary care is subsidised. A private health system operates in parallel. Panel 1 provides details of how the Accident Compensation Corporation scheme operates and how we collected injury data.
Christchurch has seven hospitals (figure). The Christchurch Hospital campus is on the western edge of the central business district (figure).
Challenges
During the earthquake the hospital was subjected to severe shaking. Staff could not stand unaided, trolleys were shunted across rooms, items fell from shelves and benches, and ceiling panels fell in many areas. Broken water conduits began flooding parts of the hospital, in particular the blood bank, and alarms sounded continuously. Power was lost immediately. Within seconds, six diesel-fuelled generators activated to provide power to electrical outlets designated as essential services. However,
Discussion
The health response to the Christchurch earthquake was unique because the city has only one hospital with an emergency department (which was compromised by earthquake damage). The hospital activated its well developed and practised internal and external incident plans and other non-acute hospitals and primary care facilities responded.
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