International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake

Introduction:International Emergency Medical Teams' (I-EMTs) response to disasters has been characterized by a late arrival, an over-focus on trauma care, and a lack of coordination and accountability mechanisms. Analysis of I-EMT performance in past and upcoming disasters is deemed necessary to improve future response.Objective:This study aimed to describe the characteristics, timing, and activities of I-EMTs deployed to the 2015 Nepal earthquake, and to assess their registration and adherence to the World Health Organization Emergency Medical Teams' (WHO-EMT; Geneva, Switzerland) minimum standards compared to past disasters.Methods:An online literature search was performed and key web sites related to I-EMT deployments were purposively examined. The methodology used is reported following the STARLITE principles. All articles and documents in English containing information about characteristics, timing, and activities of I-EMTs during Nepal 2015 were included in the study. Data were retrieved from selected sources to compile the results following a systematic approach. The findings were validated by the Nepalese focal point for the coordination of I-EMTs after the earthquake.Results:Overall, 137 I-EMTs deployed from 36 countries. They were classified as Type I (65%), Type II (15%), Type III (1%), and specialized cells (19%). Although national teams remained the first responders, two regional I-EMTs arrived within the first 24 hours post-earthquake. According to daily reporting, the activities performed by I-EMTs included 28,372 out-patient consultations (comprising 6,073 trauma cases); 1,499 in-patient admissions; and 440 major surgeries. The activities reported by I-EMTs during their deployment were significantly lower than the capacities they offered at arrival. Over 80% of I-EMTs registered through WHO or national registration mechanisms, but daily reporting of activities by I-EMTs was low. The adherence of I-EMTs to WHO-EMT standards could not be assessed due to lack of data.Conclusion:The I-EMT response to the Nepal earthquake was quicker than in previous disasters, and registration and follow-up of I-EMTs was better. Still, there is need to improve I-EMT coordination, reporting, and quality assurance while strengthening national EMT capacity.Amat Camacho N, Karki K, Subedi S, von Schreeb J. International Emergency Medical Teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260-264.