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Experiencing both recurrent small-scale events as well as devastating large-scale catastrophes, no other region in the world is affected by disasters as is East Asia and the Pacific. In the last decade, Ho Chi Minh City, Jakarta, Manila, and many other cities have been repeatedly hit by floods. In the last five years, Asia has experienced a large share of wide-scale natural catastrophes, including earthquakes in the Tohoku region in 2011, Padang in 2009, and Wenchuan in 2008; typhoons in 2009 in the Lao People's Democratic Republic, the Philippines, and Vietnam; a cyclone in Myanmar in 2008; and large-scale floods in 2011 in Cambodia, Thailand, and the Philippines. The year 2011 was the costliest year on record for natural disasters with cascading effects (Japan) and trans-boundary consequences (Thailand), adding up to US

It has become clear that disaster relief needs to transition from good intentions or a charity-based approach to a professional, outcome-oriented response. The practice of medicine in disaster and conflict is a profession practiced in environments where lack of resources, chaos, and unpredictability are the norm rather than the exception. With this consideration in mind, the World Health Organization (WHO; Geneva, Switzerland) and its partners set out to improve the disaster response systems. The resulting Emergency Medical Team (EMT) classification system requires that teams planning on engaging in disaster response follow common standards for the delivery of care in resource-constraint environments. In order to clarify these standards, the WHO EMT Secretariat collaborated with the International Committee of the Red Cross (ICRC; Geneva, Switzerland) and leading experts from other stakeholder non-governmental organizations (NGOs) to produce a guide to the management of limb injuries in disaster and conflict. The resulting text is a free and open-access resource to provide guidance for national and international EMTs caring for patients in disasters and conflicts. The content is a result of expert consensus, literature review, and an iterative process designed to encourage debate and resolution of existing open questions within the field of disaster and conflict medical response. The end result of this process is a text providing guidance to providers seeking to deliver safe, effective care within the EMT framework that is now part of the EMT training and verification system and is being distributed to ICRC teams deploying to the field. This work seeks to encourage professionalization of the field of disaster and conflict response, and to contribute to the existing EMT framework, in order to provide for better care for future victims of disaster and conflict. Jensen G, Bar-On E, Wiedler JT, Hautz SC, Veen H, Kay AR, Norton I, Gosselin RA, von Schreeb J. Improving management of limb injuries in disasters and conflicts. Prehosp Disaster Med. 2019;34(3):330–334.

On August 4, 2020, a massive explosion struck the Beirut Harbor in Lebanon. Approximately 220 people were killed and around 7,000 were injured, of which 12% were hospitalized. Despite being weakened by economic crisis and increasing numbers of coronavirus disease 2019 (COVID-19) cases, the national health care system responded promptly. Within a day, international health care assistance in the form of International Emergency Medical Teams (I-EMTs) started arriving. Previous studies have found that I-EMTs have arrived late and have not been adapted to the context and dominating health care needs. The aim of this study was to document the organization, type, activity, and timing of I-EMTs deployed to Beirut and to discuss their relevance in relation to medical needs. Data on all deployed I-EMTs were retrieved from all available sources, including internet searches, I-EMT contacts, and from the World Health Organization (WHO) EMT coordination cell (EMT CC) in Lebanon. The WHO EMT classification was used to categorize deployed teams. Information on characteristics, timing, and activities was retrieved and systematically assessed. Nine I-EMTs were deployed to Beirut following the explosion. Five were equivalent to EMT Type 2 (field hospitals), out of which three were military. The first EMT Type 2 arrived within 24 hours, while the last EMT set up one month after the explosion. Four civilian I-EMTs provided non-clinical support as EMT Specialized Care Teams. A majority of the I-EMTs were focused on trauma care. Three of the four I-EMT Specialized Care Teams were rapidly re-tasked to support COVID-19 care in public hospitals. A majority of the deployed I-EMT Type 2 were military and focused on trauma care rather than the normal burden of disease including COVID-19. Re-tasking of EMTs requires flexible EMTs. To be better adapted, the I-EMT response should be guided by a systematic assessment of both health care capacities in the affected country as well as the varying health effects of hazards before deployment.

In response to the increasing burden of recent health emergencies and disasters, the World Health Organization (WHO) and its partners established the WHO thematic platform for health emergency and disaster risk management research network (health EDRM RN) in 2016, with the purposes of promoting global research collaboration among various stakeholders and enhancing research activities that generate evidence to manage health risks associated with all types of emergencies and disasters. With the strong support and involvement of all WHO regional offices, the health EDRM RN now works with more than 200 global experts and partners to implement its purposes. The 1st and 2nd Core Group Meetings of the health EDRM RN were held on 17–18 October 2019 and 27 November 2020, respectively, to discuss the development of a global research agenda that the health EDRM RN will focus on facilitating, promoting, synthesizing and implementing, taking into account the emergence of the coronavirus disease 2019 (COVID-19) (health EDRM RN research agenda). A focus of the meetings was the establishment of an online platform to share information and knowledge, including the databases that the health EDRM RN accumulates (WHO health EDRM knowledge hub). This paper presents a summary of the discussion results of the meetings.

According to the Sichuan Bureau of Health (SBH), with a few exceptions, all of the severely wounded victims in the affected area had been evacuated to periphery hospitals in Chengdu 3 days after the earthquake. According to the SBH, the first team of psychologists arrived in the epicentre 8 hours after the quake.

PurposeThis study looked into the scope of integrating the aspirations of zakah and corporate social responsibility (CSR) to counter poverty, inequity, illiteracy, malnutrition and environmental pollution to ensure peace, happiness, prosperity and sustainability as envisaged in sustainable development goals (SDGs).Design/methodology/approachThis is a qualitative research study conducted using both primary and secondary data. Primary data were collected from 29 business enterprises in Bangladesh employing a semi-structured interview protocol. The secondary data were collected through content analysis of annual reports, websites and CSR publications of sample organizations. Finally, collected qualitative data have been analyzed thematically following the due procedures to address the research questions.FindingsThe findings reveal that integration of the aspirations of zakah and CSR is a convenient and wholehearted approach for entrepreneurs resulting in pursuing SDGs. In addition, business entrepreneurs in Bangladesh consider such practices as killing two birds with one stone because this approach warrants performing both religious and social obligations simultaneously. Interestingly, the study explores that shariah compliance acts as a guiding force for selecting well-being-oriented projects in zakah-funded CSR resulting in pursuing the priority goals – No Poverty (1), Zero Hunger (2) – of SDGs, thereby addressing some of the most critical issues of emerging economies such as Bangladesh.Practical implicationsThe findings of this research can be used as a guide to incorporate the spirit and principle of zakah into the CSR programs aimed at pursuing SDGs mainly in Muslim countries representing one-fourth of the world population.Originality/valueIntegration of the aspirations of zakah and CSR is an innovative move and net addition to the literature on sustainability, CSR and zakah because Muslim business entrepreneurs will now conveniently be able to use the entrepreneurs' zakah money – readily available in each financial year – to fund the entrepreneurs' various CSR projects (within shariah framework) relating to poverty alleviation, humanitarian and disaster relief, health and sanitation and environmental conservation which will eventually contribute to pursuing various SDGs.

Background: Previous research has found higher than expected suicide mortality among rescue/recovery workers (RRWs) enrolled in the World Trade Center Health Registry (WTCHR). Whether any enrollee suicides are related to the decedents’ experiences on 9/11 is unknown. We abstracted medical examiner file data to learn more about 9/11-related circumstances of suicides among WTCHR enrollees. Methods: We identified 35 enrollee suicide cases that occurred in New York City using linked vital records data. We reviewed medical examiner files on each case, abstracting demographic and circumstantial data. We also reviewed survey data collected from each case at WTCHR enrollment (2003–2004) and available subsequent surveys to calculate descriptive statistics. Results: Cases were mostly non-Hispanic White (66%), male (83%), and middle-aged (median 58 years). Nineteen decedents (54%) were RRWs, and 32% of them worked at the WTC site for >90 days compared to 18% of the RRW group overall. In the medical examiner files of two cases, accounts from family mentioned 9/11-related circumstances, unprompted. All deaths occurred during 2004–2018, ranging from one to four cases per year. Leading mechanisms were hanging/suffocation (26%), firearm (23%), and jump from height (23%). Sixty percent of the cases had depression mentioned in the files, but none mentioned posttraumatic stress disorder. Conclusions: RRWs may be at particular risk for suicide, as those who worked at the WTC site for long periods appeared to be more likely to die by suicide than other RRWs. Mental health screening and treatment must continue to be prioritized for the 9/11-exposed population. More in-depth investigations of suicides can elucidate the ongoing impacts of 9/11.

On 11 September 2001, attacks on the World Trade Center (WTC) killed nearly three thousand people and exposed hundreds of thousands of rescue and recovery workers, passersby, area workers, and residents to varying amounts of dust and smoke. Former New York City Mayor Rudy Giuliani ordered the emergency evacuation of Lower Manhattan below Canal Street, but not all residents evacuated. Previous studies showed that those who did not evacuate had a higher incidence of newly diagnosed asthma. Among the 71,424 who enrolled in the WTC Health Registry in 2003–2004, we evaluated the bivariate association of educational attainment, household income, and race or ethnicity with reported evacuation on or after 9/11/01. We used log binomial regression to assess the relative risks of not evacuating from their home following the 9/11 attacks, adjusting for age, gender, and marital status. Out of a total of 11,871 enrollee residents of Lower Manhattan, 7345 or 61.79% reported evacuating their home on or after 9/11. In a fully adjusted model, the estimated relative risk for not evacuating was elevated for those who identified as non-Hispanic Black, Asian/Pacific Islander, and Hispanic residents compared to non-Hispanic White residents. Residents with a high school diploma/GED had an elevated estimated risk compared to those with at least a bachelor’s degree. Those with lower household incomes had an elevated estimated risk compared to those with the highest income category. These significant inequities will need to be prevented in future disasters.

Background Although many studies have investigated agreement between survey and hospitalization data for disease prevalence, it is unknown whether exposure-chronic disease associations vary based on data collection method. We investigated agreement between self-report and administrative data for the following: 1) disease prevalence, and 2) the accuracy of self-reported hospitalization in the last 12 months, and 3) the association of seven chronic diseases (rheumatoid arthritis, hypertension, heart attack, stroke, asthma, diabetes, hyperlipidemia) with four measures of 9/11 exposure. Methods Enrollees of the World Trade Center Health Registry who resided in New York State were included ( N  = 18,206). Hospitalization data for chronic diseases were obtained from the New York State Planning and Research Cooperative System (SPARCS). Prevalence for each disease and concordance measures (kappa, sensitivity, specificity, positive agreement, and negative agreement) were calculated. In addition, the associations of the seven chronic diseases with the four measures of exposure were evaluated using logistic regression. Results Self-report disease prevalence ranged from moderately high (40.5% for hyperlipidemia) to low (3.8% for heart attack). Self-report prevalence was at least twice that obtained from administrative data for all seven chronic diseases. Kappa ranged from 0.35 (stroke) to 0.04 (rheumatoid arthritis). Self-reported hospitalizations within the last 12 months showed little overlap with actual hospitalization data. Agreement for exposure-disease associations was good over the twenty-eight exposure-disease pairs studied. Conclusions Agreement was good for exposure-disease associations, modest for disease prevalence, and poor for self-reported hospitalizations. Neither self-report nor administrative data can be treated as the “gold standard.” Which source to use depends on the availability and context of data, and the disease under study.

We examined the association of post-9/11 rheumatoid arthritis (RA) diagnosis with opioid pain medication overuse among enrollees in the World Trade Center Health Registry (WTCHR). Opioid overuse was defined as the self-reported intake of prescribed opioids at a higher dosage or more often than directed in the last 12 months on one of the two most recent WTCHR surveys (2015–2016, 2020–2021). Post-9/11 RA was ascertained through self-reports and subsequently validated following medical record release by the enrollees’ physicians or medical records review. We excluded those with self-reported RA that was not validated by their physicians and those who did not report being prescribed opioid pain medication in the last 12 months. Multivariable log-binomial regression was conducted to examine the relationship between post-9/11 RA diagnosis and opioid pain medication overuse, adjusting for sociodemographic characteristics and 9/11-related posttraumatic stress disorder (PTSD) symptoms. Of the 10,196 study enrollees, 46 had confirmed post-9/11 RA. The post-9/11 RA patients were mostly females (69.6% vs. 37.7%), less frequently non-Hispanic White (58.7% vs. 73.2%) individuals, and less often had attained a higher level of education (76.1% vs. 84.4%) compared to those without post-9/11 RA. Opioid pain medication overuse was significantly associated with a post-9/11 RA diagnosis (Adjusted Risk Ratio: 2.13, 95% CI: 1.44–3.17). More research is needed to better understand the use and management of prescribed opioids among WTC-exposed individuals with RA.