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Hurricane Maria disaster relief offers lessons for the future

OCTOBER 22, 2018
Clinical Congress Daily Highlights, Monday First Edition

Rapid deployment of the 14th Combat Support Hospital (CSH) in Humacao, Puerto Rico, following Hurricane Maria demonstrated the utility of military disaster relief in emergency response and replacing lost or damaged infrastructure, a retrospective review presented Monday finds.

On October 7, 2017, the 14th CSH airlifted a 44 bed hospital along with a team of surgeons, emergency providers and anesthesia providers to Humacao, Puerto Rico, to provide military relief in the aftermath of Hurricane Maria, which hit the island on September 20, 2017. The mobile hospital was effective in the setting of semi-operational local infrastructure, said Bethany Heidenreich, DO, William Beaumont Army Medical Center, El Paso, TX.

The authors conducted a retrospective review of a database of patients screened by the 14th CSH in October and November 2017. Of the 1,815 patients evaluated, there were 64 (3.5 percent) hospital admissions, 57 (3.1 percent) operative cases, 84 (4.5 percent) transfers to other health care facilities and one (0.06 percent) death resulting from a myocardial infarction due to sepsis.

The predominant complaints from patients were musculoskeletal (32.7 percent), resulting from traumatic injury. Of the surgical cases, the majority were dental procedures (43.9 percent) while those that required the OR were dominated by orthopaedic procedures (58 percent), followed by oral (24 percent) and general surgery (18 percent).

During the discussion, Dr. Heidenreich explained the difference between disaster relief and emergency response teams, emphasizing that the CSH is deployed by the Department of Defense Support for Civil Authorities (DSCA) only when local and regional resources are exhausted. This explains why the majority of patient encounters were non-operative, with medical issues resulting from a lack of access to health care and medical refills.

Heidenrech said that based on these results, the deployment of a mobile hospital with a team of general practitioners and orthopaedic surgeons has demonstrated utility for future military disaster relief efforts.

“The CSH was mobilized quickly and was able to respond for disaster relief. However, in order to improve future disaster relief, we will need to deploy a larger number of general practitioners and also more orthopaedic surgeons to match the presenting complaints of the patients and their needs at that time,” Heidenreich concluded.

View this study’s abstract online here.

Additional Information

The Scientific Forum, Lessons Learned from the Humanitarian Hurricane Medical Relief Response of the US Army 14th Combat Support Hospital for the People of Humacao, Puerto Rico, was held October 22, at the 2018 Clinical Congress of the American College of Surgeons in Boston, CA. Program, webcast, and audio information is available online at

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