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Environmental Health in Emergencies and Disasters: A Practical Guide
  1. J Ryan
  1. St Vincent’s Hospital, Ireland; j.ryanst-vincents.ie

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    Edited by B Wisner, J Adams. World Health Organization, 2003, £40.00, pp 252. ISBN 9241545410

    I have the greatest admiration for doctors who dedicate themselves to disaster preparedness and intervention. For most doctors there will, thank god, rarely be any personal involvement in environmental emergencies and disasters. For the others who are involved, the application of this branch of medicine must be some form of “virtual” game of medicine, lacking in visible, tangible gains for the majority of their efforts.

    Reading this World Health Organization publication however has changed my perception of the importance of emergency planners, administrators, and environmental technical staff. I am an emergency physician, blinkered by measuring the response of interventions in real time; is the peak flow better after the nebuliser? Is the pain less with intravenous morphine? But if truth be known it is the involvement of public health doctors and emergency planners that makes the biggest impact in saving lives worldwide, as with doctors involved in public health medicine.

    This book served to demonstrate to me my ignorance on matters of disaster responsiveness. But can 252 pages of General Aspects and Technical Aspects be comprehensive with regards to disaster planning? Can it provide me with what I need to know? I was confused by the end of my involvement with this book or perhaps overwhelmed by the enormity of the importance of non-medical requirements such as engineering and technical expertise in planning for and managing environmental catastrophes.

    Who is this book for? I am still not sure. The everyday emergency physician? I think not. It serves a purpose to be educational about what is required, in a generic sort of way, when planning disasters. Would I have turned to it last year during the SARS outbreak? No. When I feared a bio-terrorism threat? No. When I watched helplessly the victims of the latest Iranian earthquake? No. To have done so would have been to participate in some form of voyeurism on other people’s misery. Better to embrace the needs of those victims of environmental disasters in some tangible way than rush to the book shelf to brush up on some aspect of care which is so remote for the majority of us in emergency medicine.

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