Principles and Practice of Disaster Medicine: What Every Anesthesiologist Should Know About Responding to Medical Disasters

摘要

In the past the devastating impact of disasters was accepted as fate. The human and economic losses were considered irreducible. The attitude toward natural disaster was portrayed as divine punishment; the invisible hand of God, as mirrored in the cliche "act of God."The twentieth century, however, was witness to a marked escalation in the frequency and magnitude of man-made disasters, such as world wars, regional armed conflicts and civil wars, famine, complex cross-border humanitarian emergencies causing the displacement of millions of people, and the epidemic of terrorism. The latter has brought the specter of the terrorist use of weapons of mass destruction (WMD).Arguably, in human history the sum total of all man-made disasters has killed and maimed more people and caused more devastation and economic losses than all the natural disasters combined. A new term, "act of man," more aptly describes present reality about the root causes of disaster. The twenty-first century seems headed in the same direction at an accelerated pace. The roots of human conflict, hatred, violence, and lawlessness, are escalating at rapid rates worldwide, constituting a public health crisis of unprecedented proportions. Increasingly, the dark side of human nature is manifested in the form of ethnic cleansing and genocide (ie, the Holocaust 1939-1945; Bosnia 1991-1995; Rwanda 1994; Sudan 2006-2008).