Disaster Medicine – serie

This first manuscript on cold injuries was written in the period 1945-1946 as the result of personal experience gained in the winter months of the years 1941-1943 on the Northern Front in Russia and subsequent experimental work at the "Chirurgische Uni­ versitatsklinik" in Breslau (Wroclav) between 1943 and 1945. The intention at the time of writing was to present a summary of our experiences, so that they might serve as a basis for further scientific and clinical work. The manuscript has continually been revised and brought up to date. For purely external reasons publication has been delayed until today. Our experience of cold preservation and of increased resistance to oxygen deficiency in chilled tissue, acquired during the winter periods of the Second World War in Russia, served as a basis for the development of local cryanaesthesia and hibernation, which retroactively furthered to a considerable degree our knowledge of cold and frost injuries. See my monograph on the biology and clinical treatment of the cold injury and general loss of temperature, which appeared separately in 1966 and discusses all biological changes. A comprehensive report on cold injuries was written in English in 1952 at the instigation of Captain A. R. Behnke jr. USA (M.C.), (not available commercially).

F.A. Bauhofer, Geneva In disaster situations, the particular concern of WHO is not so much to offer immediate relief and assistance for affected communities, but to have ready prepared plans for the provision of primary medical care as well as for resuscitation and casualty services. Disast­ ers are characterized by a need for rapid assistance and by the inability of affected communities to cope with the large scale mortality, morbidity, and damage to essential installations and homes. In some highly elaborate and centralized societies even small­ scale events may assume the proportion of a disaster, if they result in the serious break­ down of vital services. The Executive Board of the World Health Organization has defmed disasters or "emergencies", as situations where there are unforeseen, serious, and immediate threats to public health. Particularly severe disasters may be classified as catastrophes; such -occurrences, whether natural or man-made, disturb or overthrow the existing order. For planning purposes, it is important to distinguish between different types of catastrophes since they require special relief measures. In the past, medical assistance was primarily needed in epidemics of, for example, plague, cholera, and smallpox. Today, health authorities face emergency problems brought about by major accidents and outbreaks of chemical pollution and poisoning, which may have long-term effects. The role of health services may differ quite extenSively in different types of cata­ strophes, and an attempt must be made to draw up specific plans to deal with them.