InfRN

Recently, I heard an American pediatrician who had spent time practicing medicine in Sweden on a radio broadcast. He described how incredulous he was when he first realized that he was unable to make assumptions about his patients' soc.ec.status just by assessing their status of health and nutrition as was his experience back home. Every single kid or their pregnant mother in this country receives the exact same generous, excellent quality prenatal/pediatric care, regardless of their parents' income. It's a great equalizer and provides an optimal start in life, no matter who your parents happen to be. Not having to worry about who's taking advantage of whom is pretty liberating.

"... some places ban clogs all together, most of these are 20 yrs behind anyway" surely you're not claiming that sweden is 20 years behind as i can assure you that is certainly not the case. we don't wear all white, either. .... behind whom or what, by the way?

It was just after 3 pm here, I was in the car with my ex, A. on the way to a high street pet store to get something or other. I remember the news was on the car radio and the announcer came on with a sketchy report that a plane had crashed into one of the twin towers. The naive mental image I got at the time was that of a small cessna-like plane having a freak accident grazing one of the buildings. Both A. and I have been over to visit NYC several times and I have enjoyed a most elegant and luxurious meal in the Windows on the World restaurant at the top of the North Tower of the WTC. Once out of the shop with purchases in hand and in the car again, the reports on the radio came in more detailed and all normal progamming was cancelled. We rushed home to turn on the TV and were in complete,utter shock as we watched live the events in NYC unfolding. I didn't turn off the TV for several days, I literally lived on the couch. I just sat there, terrified, watching the different footage over and over, thinking this is the end of life as I have known it up till now.

OT, my apologies, but which Europe are you speaking of?

In a serious, balanced and honest discussion of potentially controversial issues, I always find it beneficial to start out by examining the facts available.This helps me avoid speculation or opinions based on hearsay. A comprehensive, factual and nonpolitical report regarding Universal Healthcare can be found here, where the Wikopedia entry (4th item down) has the most info: http://www.answers.com/topic/publicly-funded-medicine This link will bring you to a comparative analysis of the Canadian and American health care systems: http://www.answers.com/main/ntquery?method=4&dsid=2222&dekey=Canadian+and+American+health+care+systems+compared&gwp=8&curtab=2222_1 Perhaps some members here might find the above enlightening. InfRN

The OP has asked for international responses .... here comes one from Scandinavia. Prefixing anything as "socialized" in the US is asking for a major migraine and pretty much dooms any moderate and informed discussion from the start. Perhaps a more appropriate term is the widely used apolitical "Universal Healthcare", which implies all individuals, regardless of social class or finances, are entitled to the exact same high standards of medical services via a public health insurance scheme. As far as I am aware, The US of A is the only western industrialized nation that doesn't have Universal healthcare, but please don't hesitate to correct me if I am wrong. I'm way too tired after working all night to be posting coherently right now, so I will have to return after a few hours sleep, when I will gladly share any and all information about the healthcare system in Sweden. As a parting aside, all our pats. get pillows, blankets, 3 square meals plus snacks and a all day coffee/tea buffet with assorted swedish coffee breads, heck they get socks and jammies and toothpaste/brushes, lypsyl, too ....... you name it ..... they can even get stemcell transplants if the need be. More later since I'm fading fast here ..... ZZzZZzzz InfRN Sweden

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

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

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

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

Finding it more and more difficult to fight exhaustion but I will try to continue my reports here. The strain is getting harder to ignore after a week, have 2 more nights to go before I have a scheduled rest period of 3 days. Sleeping between shifts is fitfull and nearly impossible. I charge my batteries working, as soon as I am at the hospital, I am energized. Here at home, I feel useless. I should go to store because the fridge is empty, or maybe wash the dishes that are piling up in the sink but I'm just too tired. Early this morning, the world's largest freight plane in existence, an Antonov 124 Condor, requisitioned from the Russians by the Swedish gov't, lifted from Stockholm to go get our dead. The scheduled landing in Phuket is a problem, this machine is so big there is a risk it will interfere with much of everything else going on at that airport. On this plane are 12 refridgerated shipping containers each able to hold 110 deceased, along with thousands of body bags and coffins. It is filled to the max with diesel generators, forensic supplies, and what ever else they put in there, 120 tons. We have to clean up down there so the Thais can have their beaches back. Our Hercules planes are in other countries, doing their jobs. I don't know what else to say, I'm too tired to think. I'll go get some rest. Thks for listening InfRN

A quick note to report that: 12,000 of the estimated 30,000 Swedish nationals who were in SW Thailand when the wave came have so far been evacuated and have arrived home. Norway has adjusted the total number of missing Norwegian nationals to 1440. individuals. An international forensic team has been in place for a couple of days, I'm loosing track of time myself. They report that occular identification of dead bodies is no longer possible and hasn't been for at least two days. Gov't of Thailand says 6000 corpses have been collected in the area, the overwhelming majority of these are tourists. Collection of identifiable DNA is limited to dental pulp which is extracted after dental x-rays of every single corpse, along with rings, etc and recorded for analysis. Refridgeration (sp?) equipment to support this gigantic effort is now in place, whether it is enough I don't know. Mobile radiological equipment arrived quite a few days ago with the forensic teams. These guys know what they are doing. They have all worked together before, on the Bali bombing most recently. My heart goes out to them. The mathematics and logistics of managing this disaster in just a relatively tiny geographical region of the totally affected area are beyond comprehension. I don't have enough English words to report all this as well as I could in Swedish, and I apologize if my language skills are too limited to embroider my text properly. I hope I don't sound cold and detached. The little boy, H-a-n-n-e-s, is back in Sweden now with his father. His mom hasn't been found. over and out for now InfRN

I don't know where to start .... but here goes .... Our national efforts regarding our own citizens are concentrated on evacuation of the living and injured, retrieval and identification of the deceased, and finally transport or funereal services on site of the deceased. Yesterday, 14 flights of regular passenger long distance jets arrived at Arlanda International Airport from Thailand, though I am hard pressed to keep track of numbers anymore. The flight time for these flights has been something like 13-14 hours. The status of the people on these flights are being assessed upon arrival, food and warm clothes and councelling services are provided where necessary and any wounds are cleaned and dressed by the first level medical teams. Social services are working with the unaccompanied children where no relatives have survived. All is being shielded well from journalists, there is a press secretary for each team of professionals providing suitable and adequate information to the public. Transport from the airport consists of furthur domestic flights within Sweden to home municipalities, as well as fleets of regular vehicles such as wheel chair taxis etc. and of course relatives and friends. The more seriously injured are also arriving and our set up is coping and working well. 2 MD-80 hospital planes landed in the night, one at 04:40h, one at 05:50h, ca. 20 hours after leaving Bangkok. These machines are forced to land en route for fueling and service.These 2 planes are flying hospital wards with full medical service up to vent-level. These 2 planes together were over full and delivered 124 seriously injured patients home. After cleaning, restocking and refueling, a new flight crew with a new shift of medical staff will return and get the next load. Transport from the airport for these patients after medical handover consists fleets of ambulance helicopters and regular ambulance vehicles. Emergency services are distrubuting the injured across the country to awaiting teams. At the other end of this air bridge in place in Thailand is also an organization of Scandinavian and Thai medical professionals, I don't have much info on that, but they are obviously working hard and doing an enormous job. Our hope is to get all levels of transportable patients back by Tuesday. There is also a considerable forensic team on site doing their jobs. The visuals I have seen from this work makes it impossible for me to describe it. Thousands and thousands of bodies, most of them ours, in advance stages of decomposition in Khao Lak alone. I'll leave it at that, otherwise I'll fall apart. Sweden's official list of missing and feared lost in Thailand 6 days after the disaster is 3559 individuals who are unaccounted for, 59 others are identified and confirmed dead. Norway, Denmark and Finland have also suffered, I apologize that I can't say their exact numbers but it is something like Norway 600 missing nationals, Denmark 500 and Finland 200. I just woke up after working all night and missed the press conference at 15.00h. I will go see if I can find it on line, now. I might be able just adjust some figures after that. Thks for listening. Feedback is appreciated. I can hardly bear to say Happy New Year InfRN

One more thing .... thanks to this forum for letting me post here among colleagues. I need a place to sort my thoughts out and gather strength where hopefully few journalists will find me. Thks again, InfRN

Anger isn't the foremost of the psychological reactions to this tragedy, though admittedly time, distance and the tropical heat are working against us. Sorrow, and worry are certainly in everone's hearts, mine too, none of us here are untouched personally by this, we are a small country. The magnitude of the effects of this disaster is beyond comprehension and noone was prepared for it. The coastal area of Khao Lak, which is where most Scandinavian lives have been lost, is a remote lengthy stretch of beach resorts 100 miles north of the Island of Phuket on the mainland. Everything was wiped out, not the least of which, telecommunications. Accurate information has been difficult to obtain. It takes time to set up rescue operations from across the other side of the world. The need for help is far too urgent to waste energy pointing blaming fingers. We are a country united to work and get through this. The 2 first hospital planes with the more seriously injured are scheduled to arrive later tonight after 24.00h. I've just been called in for these 2 transports and will be working all night tonight. As I said, I have to be careful about details on here, even dx's. These people are traumatized enough without journalists buzzing about. Thks for listening. InfRN