The 2008 earthquake in the Sichuan province of China was among the deadliest in history, killing an estimated 69,000 individuals and leaving millions displaced. Anesthesiologists are critically important medical responders to such disasters, as they have the skills required to resuscitate and stabilize patients while their injuries are surgically treated. The March issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS), presents a remarkable account of the experience of anesthesiologists and health care responders to the Wenchuan earthquake in Sichuan, China.
Woven from eight personal accounts written shortly after the earthquake, the narrative tells of the response of physicians from Daping Hospital in Chongqing, and West China Hospital in Chengdu. Within 22 hours of the earthquake, a team of 27 medical personnel, including three anesthesiologists, set out for the epicenter. Within seven hours they reached the city of Dujiangyan, halfway to Wenchuan. There they found that hundreds had been killed when the local hospital collapsed.
A Harrowing Trip to Provide Aid to Earthquake Victims
Despite the acute needs for medical care in Dujiangyan, the team continued to push towards the epicenter in Wenchuan. They had to divert over 650 miles due to closed roads, and along the way their minivan was crushed in a rockslide. They reached Wenchuan 96 hours after the earthquake, only to find that the medical facilities there had been completely destroyed.
In the days that followed, the team provided care to thousands of injured patients. Physicians were forced to ration scarce resources, leaving patients with the most severe injuries to die so that resources could be devoted to those patients who could be saved. Highlighting the need for teams with special training in disaster response, many victims of crush injury survived long enough to be rescued—only to die when their crushed limb was freed from the rubble and their body was flooded with toxins.
Back in Chengdu, the West China Hospital shook violently during the earthquake. Dr. Yunxia Zuo, Vice-Director of the Department of Anesthesiology, describes finding "surgeons, anesthesiologists, and nurses scrambling toward nearby stairwells." For those health care providers involved in ongoing surgery, the nearly uniform response of health care providers was to stay with patients until the patient and staff could be safely relocated. Buildings typically collapse within 10 seconds of the onset of an earthquake, so the steely resolve of these providers was remarkable.
In an accompanying editorial, Dr. Kenneth Hudnut of the U.S. Geological Survey assesses earthquake risks in the United States. He writes, "Many aspects of damage from great earthquakes elsewhere in the coming years to decades could be disturbingly similar, even in some of the most highly developed areas of the world." Dr. Hudnut encourages citizens to develop and regularly practice earthquake preparedness drills, as described by the physicians who responded to the Sichuan earthquake. The warnings take on new relevance in the aftermath of the recent Haitian earthquake, for which the reported death toll is well over 200,000.
Dr. Steven L. Shafer of Columbia University, Editor-in-Chief of Anesthesia & Analgesia, echoes the call for hospitals and health care providers to prepare for and practice their response to large-scale disasters, including earthquakes. He comments, "When the 'big one' hits the San Andreas Fault in California or New Madrid Fault in Missouri, if we are not prepared, then we have failed to learn from the experiences of the Chinese physicians who responded to the Wenchuan earthquake."
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