Citation

von Schreeb J, Kalmykov A, Riddez L, Rosling H. Int. J. Disaster Med. 2004; 2(1-2): 41-47.

Copyright

(Copyright © 2004, Informa - Taylor and Francis Group)

DOI

10.1080/1503140410026578

PMID

unavailable

Abstract

Introduction: On 1 September 2004, more than 1300 people were taken hostage in a school in the town of Beslan in the republic of North Ossetia-Alania, Russian Federation.  The crisis ended 52 hours later in extreme violence with gunshots, grenade explosions, and fire that killed 329 persons, including 164 children, and injuring many hundreds. As external assessors, we rapidly reviewed the medical care provided to the injured.

Results: We found more than 500 doctors, 1000 regular hospital beds, and 100 intensive care beds were well prepared to care for the victims at their arrival to the 4 hospitals situated with 20 km of the school in Beslan. In the rapidly unfolding emergency with many hundreds of injured, only limited on-site triage was carried out. Civilians took the majority of injured directly to the hospitals in private cars in spite of 57 ambulances being available at the site. Following a few chaotic hours, adequate emergency care was available to all the injured. Of the 661 hospitalized victims, 110 required intensive care. Seven deaths were recorded during the first 24 hours and 12 more during the next 6 days, yielding a case fatality ratio of 3 percent. Within 7 days all 110 injured patients in intensive care had been evacuated to more specialized care in Moscow or Rostov. In contrast to earlier emergencies, Russia requested international assistance and up to 11 September, 15 cargo planes from 10 countries delivered medical materials, drugs, and food to Beslan, but an estimated 70 percent of the drugs were deemed inappropriate. Substantial amounts of toys and other goods were delivered to aid the victims.  Within a month, private initiatives also raised more than 30 million USD in cash, mainly from Russian sources. Following the first week of emergency care, the focus in Beslan was to provide psychological support through a variety of national and international initiatives.

Conclusion: We conclude that the medical emergency care was well handled by local and national health staff under the coordination of the Ministry of Health and the Russian Ministry for Civil Defense and Emergencies. The international response was largely in excess and not adapted to the local needs, probably because the international community underestimated the local and national capacity and the Russian authorities underestimated the international willingness to help.