Tsunami's effect on the country of Sweden

[InfRN]

I would have prefered to have posted this on the "Current Events Discussion" forum, where it would be more appropriate, but as this is my first post to allnurses.com, I don't have that privilege. The current discussions there regarding this tragedy are shockingly petty and trivial, which compels me to provide this group a little perspective about how some of us are more directly effected by this enormous tragedy. I have been lurking here at allnurses.com and reading the threads for a long time, both as a guest and as a registered user.

When the wave hit South Western Asian on early Boxing Day, there were an estimated 30,000 Swedish citizens in the country of Thailand celebrating the Christmas school break, the majority of them in the resort areas of Phuket, Khoa Lak and Phi Phi Islands. These were the worst hit regions in the area. At present, it is estimated that as many as 1500 Swedes have lost thier lives, many of them children, but the numbers could be far worse. 2000 Swedish people on charters are still missing. Backpackers and others who are travelling outside of the organized charter tour agencies can be as many as 10,000 more individuals.

I work at Scandinavia's largest university hospital and we are at this point in time anticipating the arrival of many hundreds, if not more, severely injured and traumatized Swedish families. More than 20 jumbo jets are needed to get people home. Our preparations are intense, to put it mildly.

The logistics of evacuating 20,000 people, many of whom are severely injured and septic, are beyond comprehension. Children have who have lost thier parents are arriving alone at the airport here in snow covered Stockholm in bathing suits and shorts. Mothers and fathers have had their babies ripped out of their arms while frolicing on the beach. Grandparents have been washed to sea and drowned while eating breakfast on the terasses of beach hotels. Thousands of families are separated and people here in Sweden have no idea what has happened to their vacationing relatives, amongst them thousands of backpacking teenagers in unclear circumstances.

The tsunami disaster in South West Asia will be this Northern European nation's worst national tragedy in modern time and we are literally on the other side of the world.

The millions of people of the local populations in the area around the Bay of Bengal have lost absolutely everything and the situation is desparate. My heart goes out to these people as I prepare myself for my incoming patients.

Thank you for listening and sending a thought to the millions upon millions of human beings that are effected by this disaster.

[jnette, ASN, EMT-I]

Sorry, I apologize for forgetting my manners, I forgot to say thank you to all that have responded with kind words of sympathy.

InfRN

(((((((((((((((((((((((((ifnRN)))))))))))))))))))))))))

If only we could physically wrap you in our arms and just hold you.

Please continue to post.. as hard and heartbreaking as it is to read, I know this is at least one small avenue for you to release much of the anguish and heartbreak... keep on.

Know that we're supporting you in our thoughts and prayers... keep on.

[suzanne4, RN]

After being a resident of Thailand for so long, and now currently back in the US for a short time, it is still hard for me to imagine all of the detruction to areas where I used to play.

One minute everything is beautiful and peaceful, and the next minute it is taken away from you.

To all of my friends from Sweden that I have met in my journeys, I hope that all of you have made it home safely, but I am sure that some of you are now among the missing.

((((((((((((((((((((((((((((((((((hugs to all of you)))))))))))))))))))))))))))))))))

[fergus51]

Take care InfRn. I can't even imagine how difficult the coming days and weeks will be for people affected by this. They said on the news today that Sweden's losses will be equivalent to Indonesia's when compared to the total populations of each country. They are thinking that only Sri Lanka will have lost more as a percentage of population.

[InfRN]

Sorry for not reporting yesterday, needed the "awake time" between shifts to get myself and things in shape here at home. Some of the stress I was feeling Sunday has been resolved after achieving some order again in my personal physical world. Thanks for all of your words of encouragement and support, I am feeling quite a bit better now, than the last time I posted.

The air bridge involved in the evacuation of our Swedish nationals in Thailand has been successful and is now winding down. I reviewed my first reports in this thread where I said we would need 20 jets to get people home again, little did I realize .... 14 or more passenger jets per day were arriving at Arlanda International airport in Stockholm during the peak of the evacuation, which has been in progress since last Wednesday.

The last of the injured are now being air-lifted on 2 hospital planes and will arrive at Arlanda sometime during the night. There is a small amount of patients (

Social services, psychiatric services and local community services such as district nursing will, on the other hand, continue at a higher level of readiness to support those returning. Many, many, families have lost children, mothers, fathers, husbands, wives, grandparents and are in need of psycological support. Many of the survivors returning are battered and bruised, having sustained flesh wounds from the churning debris in the wave. The superficial flesh wounds will be managed by district nursing stations on an out-patient basis. This will also provide an opportunity for nurses within community care to meet with the families affected to assess their crisis coping skills.

We are now in a new phase of this immense and catostrophic event. Schools opening again after the holidays will have hundreds of empty chairs in their classrooms as will kindergartens and work places all across the country.

The recovery of our dead and missing is an on-going process. As of today's press conference, 1,903 Swedish nationals are still unaccounted for.

Thks for listening, it has helped to be able to come here. If anyone has any questions, I have time now to answer if I can, I am thankfully off now for the next 3 nights.

InfRN

[jnette, ASN, EMT-I]

Thank you for checking in with us again, ifnRN, and for the update. Am particualrly happy to note you are refreshed and feeling somewhat better. :kiss

There was a specail segment on the news here last night which featured Sweden's losses, and an Alan Olson of the Red Cross there. He went into quite a bit of detail about the missing (2300 still) and the dead.. I believe he stated it was 53 or 59. He explained the logistics of retrieving the dead and identifying them.. and it showed the dead being carried onto the huge transport planes in Swedish flag draped caskets. Very sad indeed.

And still, good news stories continue to trickle in.. one found here, another feared dead showing up there. It's not much, but every life counts, and every good news story is good news indeed.

(((HUGS))) to you, my Friend.

[Sharon]

InfRn,

Thank you for your reporting of events as you experience them. Your updates have been more valuable to me than any news reports since the first 24 hours of the disaster. Your words are an invaluable resource to me, other nurses, and to future nurses. I hope over the next few years you are able to continue periodic updates on how this disaster has impacted your country. The historical value as well as the practical value is immeasurable. There has already been much information in your reports that I am able to apply to disaster planning and response here in the U.S.

I hope you find the sharing of this experience helpful to your recovery. The feelings you have experienced while off of duty and away from work are normal and common among workers in a disaster. Here in the U.S. we actually assigned a nurse, usually an occupational health nurse, to ensure people are getting time away from the worksite because there is such a pull to stay work.

Again thank you for sharing what has happen to you and your country.

Sharon

[InfRN]

Thank you Sharon for your post. Many of us have and will learn a great deal from this disaster.

Some random info:

Mobile phones (or cell phones in America) have played a significant roll in accounting for Swedish nationals. Early on, not sure which day but can find out, the foreign office sent a text message to all Swedish mobile phone subcribers within SW Asia, encouraging them to contact next of kin at home and also to reply to the foreign office with a pre-texted message. Also, all the Swedish mobile phone service providers turned their meters off, so as to make phone traffic to and from the area free of charge. Apparently, the technology involved is a relativly simple exercise.

Medical and disaster services at home had, relatively speaking, tons of time to get set up, as did the receiving operations at the airport. One hard part was getting ahold of and diverting enough passenger planes fast. Another was locating and triaging patients scattered in literally hundreds of Thai hospitals.

The panorama of somatic injuries among survivors has been predictable and are as follows:

-various degrees of contusions, abrasions and flesh wounds, especially to the hands, feet and lower extremities. As time passed in the tropical heat, even minor scrapes became infected very quickly. Deeper soft tissue wounds have lead to more serious infections with necrosis and in many cases, sepsis. There will inevitably be some amputations.

- aspiration pneumonias

- orthopedic injuries

All returning patients are screened for MRSA.

Thailand's infrastructure away from the immediate disaster area is intact. The level of hospital care in Thailand was impeccable. Swedish doctors and nurses arriving on site to augment medical services if needed, noted that no competency deficits were to be found amongst their Thai colleagues and that Swedish patients who had made it to hospital were receiving the absolute best of medical and nursing care.

Identifying the dead is a long process. Bodies are still being retrieved.

The psychological impact is horrendous. The whole nation of Sweden is more or less in shock. People feel awful and will no doubt do so for a very long time.

Never in modern history have so many Swedish children died in a single day.

InfRN

[gwenith, BSN, RN]

Thank-you for your continued updates they have been invaluable as future reference.

[Tweety, BSN, RN]

What Gwenith said.

[NRSKarenRN, BSN, RN]

Thanks InfRN for taking the time to post. It is through sharing with the world nursing community that we US nurses become richer and wiser.

Right now I'm involved in the logisitcs of creating a disaster plan for my homecare agency, focusing on my Intake department. All communication electronics is housed in my office, computer server in room down the hall. We are planning on disaster evacuation of building in April. Learning lots regarding COMMUNICATION as a priority. However, what I'm doing is just a drop in a bucket compared to international efforts your describing.

Sending a (((((((hug)))))) across the Atlantic to you.

[InfRN]

Thanks for the hug NRSKarenRN. I'm doing okay now, I was admittedly feeling a little rough last Sunday, but after 3 days rest and reflection I am back to thinking straight again.

A couple things to think about when setting up a disaster plan:

For things to run smoothly, there should be no doubt as to who is in charge of what at any level. Rescue and recovery efforts shouldn't be slowed down because there is no one to tell them what to do or because of haggling about who is responsible for what. Natural, informal leadership (someone taking over in a leadership void) can be better than nothing, but without coordinated, decisive leadership, time and energy are quickly lost.

Multi-disciplinary teamwork is essential - I would liken this to a cascade of different factors/disciplines - ideally every factor joins and fills it's function exactly at the right time in the rescue/recovery cascade.

The question of communication is complex. In this day and age, wireless communication is invaluable. Optimizing communication between levels and between disciplines involved in rescue/recovery should be a priority - the left hand needs to know what the right hand is doing. This also prevents wasting rescue resources and promotes effectiveness.

Communication also involves providing information to the public and the media. Chief spokespersons for the various teams should be the only ones talking to journalists in order to prevent rumours and false information.

Just to keep things straight, the word logistics in the context of disaster means the provisioning and transport of people or material across distance. This includes rescue personnel.

Now I better get ready for work. Thanks for all the words of goodwill.

InfRN