General Information
The ISN’s Renal Disaster Relief Task Force (RDRTF) provides essential medical care to people in the wake of natural disasters. The Task Force consists of a worldwide network of experts in the management of patients with acute renal failure. It was created after the severe earthquake in Armenia in 1988 to provide future renal aid in action wherever needed around the globe. The Task Force works in close collaboration with the Medecins sans Frontiéres.
Reports on the Sichuan- Chengdu, China earthquake of May 12, 2008
Final Report: Status on May 23
- The number of AKI in Chengdu finally stabilized around 130 without further substantial influx any more from the First and second line.
- The material purchased by Médecins Sans Frontières (MSF) was distributed by our assessors the last few days.
- Other material was made available by the Hong Kong Society of Nephrology.
- Our assesors left Chengdu Thursday afternoon May 22 at 17.45 local time (12.45 Brussels time) to reach Brussels in the late afternoon of Fiday May 23.
This brings to an end the renal aspect of this mission of the ISN/Renal Disaster Relief Task Force and MSF.
Report 4: Status on May 20
- Activities have the last two days essentially focused on teaching
and screening of hospitals outside Chengdu. - The influx of AKI seems to stabilize although occasionally cases of
crush are detected in outside hospitals, which are then immediately
transported to Chengdu. - Pamphlets have been distributed highlighting the characteristics of
crush and also how AKI can be prevented. - The same messages have also been broadcasted via radio and TV.
- The preliminary draft of crush recommendations (M. Sever) Istanbul
were translated in Chinese to be distributed among health workers. - P. Li (Hong Kong) returned home after a fruitful mission. We thank
him for the kind cooperation. - Dialysis material was provided by Médecins Sans Frontières on one
hand and by the Hong Kong Society of Nephrology on the other. - The nephrological situation seems well under control. No additional
rescue teams are necessary. - Our two assessors will start their return home Thursday night or at
the latest Friday morning. - We thank everybody who cooperated in this action, especially all
Chinese and Hong Kong colleagues and nurses, Médecins Sans Frontières,
the International Society of Nephrology, and all who contributed
either in China or here on the home front. - I would like to suggest that, once things have calmed down a bit,
the next step to take for our Chinese colleagues is to work on advance
planning, so that action plans are ready for future disasters.
Report 3: Status on May 18
- Our assessors, A Van der Tol and Stefaan Claus reached Chengdu by 17.30 local time on Friday May 16.
- They were joined by Philip Li, nephrologist from Hong Kong.
- Visit to the main hospitals in Chengdu started on Saturday, May 17.
- Reception by Chinese nephrologists was cordial and cooperation efficient. Teaching activities were planned. The situation in Chengdu was well under control, with enough nephrologists (also flowing in from elsewhere in China) and approximately 120 dialyzed AKI patients. Fruitful contacts with Fu Ping and Wang Li. Questionnaire distributed.
- There was not much influx of new AKI patients
- Needs were essentially material (dialyzers, tubings ?). Material to be bought on a 50/50 bases (MSF/RDRTF and Hong Kong Society of Nephrology).
- Chinese doctors kindly translated crush recommendations (preliminary version, Sever et al) provided by the RDRTF into Chinese.
- Team probably to be joined on Monday May 19, by a nurse from Hong Kong: Sandy Hui Yun Ho.
- This morning, restriction on travelling outside Chengdu was relaxed by Chinese authorities. Visit to one external hospital today (70 km from Chengdu). Some obvious cases of crush (red-brown urine; swollen limbs). Transfer to Chengdu arranged, where there are better therapeutic possibilities.
- Further screening of other external hospitals in the region warranted (Monday).
Report 2: Status on May 16 (correction of May 15 - see hyphen 6):
- The Belgian members (Arjan van der Tol, nehrologist, and Stefaan Claus, renal nurse) of our assessment team received their visa for China this morning. They are member of a team of Médecins Sans Frontières.
- They left Brussels this afternoon at 17.15 for Munich and from there to Bejing and Chengdu, to arrive in Chengdu tomorrow afternoon (16/5/8), 17.25 local time.
- We insisted several times vis à vis our Chinese colleagues on the potential help and advice they could get from this team, in view of their ample experience with previous mass disasters.
- Philip Li (nephrologist from Hong Kong) will join the assessment team on his own force. He will leave Hong Kong tomorrow around 10.00 and arrive in Chengdu around 13.00.
- A second nephrological member from Hong Kong will also join the team, probably a nursing officer. Andrew Wong (president of the Hong Kong Society of Nephrology) takes care of the selection.
- We are aware of 14 AKI patients at the hospital of Wang Li, our nephrologist contact person in Chengdu. We do not know how many of them require dialysis. The influx of wounded has increased lately. According to certain sources, some 500 traumatized patients have been admitted to another large hospital in Sichuan than Wang Li's hospital, among which there certainly still should be more crush patients (information from Philip Li).
- The death toll has risen to > 50,000. This, the density of the population, and the type of the buildings makes us expect a large number of AKI patients, if rescue and transportation possibilities are sufficient.
- There are reportedly 65,000 wounded of whom 10% (6,500) heavily wounded. This fits perfectly with the statistics displayed by Ron et al in Arch Intern Med 1984. If we further extrapolate the Ron data, there should be 7/10 heavily wounded with crush, i.e. 4550!
- This would be a renal disaster of unprecedented dimensions.
- If these figures are correct, and if most patients do not die before they can reach the hospitals, a tremendous load of AKI can be expected, and further help will be needed. We again wish to emphasize that possibilities to offer this help in a swift way would be very welcome.
Report 1: Status on May 13
- The number of deaths is constantly increasing.
- In view of the structure of the buildings and the numbers of wounded and deaths, the number of AKI might be high.
- It was difficult to find contact persons. Many of the provided email addresses bounced back. Via Dr Philip Li, HongKong, we finally got the coordinates of Dr Wang Li, who is nephrologist in Chengdu.
- Dr Wang Li is on her way back home after the ERA-EDTA congress in Stockholm. So, we could not come in direct contact with her yet, but sent several e-mails, and they did not bounce back.
- MSF is ready to compose a scouting team. From Belgian nephrological side this would include Dr A van der Tol (Nephrologist) and Mr Stefaan Claus (renal nurse).
- The scouting team should also contain a member from HongKong, prefarably a nurse, or a nephrologist with technical skills. A HongKong member would have several interesting advantages: no need for visa, knowledge of language and culture, living nearby. Travel and transport should be organized via MSF HongKong.
Activities
View an article that appeared in the Washington Post (written by David Brown) in light of the China Earthquake for which the RDRTF's Chairman, Raymond Vanholder was interviewed.
The task Force has recently offered crucial assistance in the aftermath of the below disasters:
2007- August: Earthquake in Peru
In an immediate response to the dreadful Peru quake the RDRTF sent a volunteer, S. Claus, to join the MSF assessment team for a one week intervention.
2006- July: Israelo-Lebanese War
The RDRTF teamed up once more with MSF colleagues to bring aid, supplies and relief to Lebanon within just three days of the initial alert.
2006- May: Earthquake in Indonesia
Following the devastating earthquake that hit Indonesia on May 26, 2006, Task Force members underwent a 10 day intervention which consisted of the extensive screening of more than 1,000 hospitalized victims, as well as providing education on the identification and treatment of crush syndrome and acute renal failure.
2005- October: Earthquake in Pakistan
In collaboration with colleagues from Médecins Sans Frontières (MSF), Task Force members were on the ground in Islamabad within days of the quake. The mission marked over two weeks of ISN intervention and relief work.
Committee Membership (January 2008 - January 2011)
Chair: Raymond Vanholder (Belgium) raymond.van.holder@telenet.be; raymond.vanholder@ugent.be
Contact: Chantal Bergen (Belgium) chantal.bergen@ugent.be
Ana Cusumano (Argentina)
Elizabeth Escudero (Peru)
David Harris (Australia)
Vivekanand Jha (India)
Norbert Lameire (Belgium)
Raul Lombardi (Uruguay)
Valerie Luyckx (Canada)
Ravindra Mehta (USA)
Heru Prasanto (Indonesia)
Seong Hooi (Malaysia)
Sever Mehmet Sukru Sever (Turkey)
Bruno Van Vlem (Belgium)
Ibrahim Mauricio Younes (Brazil)
Luis Yu (Brazil)
