EARTHQUAKE DISASTER RESPONSE IN CHRISTCHURCH,NEW ZEALAND Authors: Brian Dolan, MSc (Oxon), MSc (Nurs), RN, Anne Esson, BA (Educ), RGON, Paula (Polly) Grainger, MN (Clinical), Dip HE (nursing), RN, PhD (C), Sandra Richardson, BA, RGON, Dip Soc Sci, DipHeal Sci, Dip Tert Teach, PhD (C), and Mike Ardagh, PhD, MBChB, FACEM, DCH, Christchurch, New Zealand Section Editors: Pat Clutter, MEd, RN, CEN, FAEN, and Carole Rush, MEd, RN, CEN, FAEN O n September 4, 2010, an earthquake that mea- sured 7.1 on the Richter scale struck the region of Canterbury, New Zealand. Even though it was the same magnitude as the Haitian earthquake in Jan- uary 2010 that killed more than 220,000 people, not one person lost his or her life in the city of Christchurch. Human survival was due to 3 interrelated elements: rigor- ously applied building codes, the earthquake’s depth of 6 miles (10 km) and distance of 25 miles (38 km) from Christchurch, and the early morning time of the occur- rence (4:35 AM). Although damage was significant, many of Christchurch’s major landmarks survived, and during the following months, locals began to tell with unerring accuracy the magnitudes of the thousands of aftershocks that are normal after these events. What came a few months later was a whole different situation. Tuesday, February 22, 2011, started out as an ordinary day in many ways in Christchurch. The continuing after- shocks were subsiding in both frequency and intensity, and although a number of buildings had been damaged or even destroyed by the earlier earthquake, most people were sim- ply getting on with their day in hospitals, schools, offices, and homes. In the Christchurch Hospital Emergency Department—one of the busiest emergency departments in the southern hemisphere, where more than 87,000 patients are seen each year— the day also started quite ordi- narily. This emergency department is almost unique in the developed world, because it is the only emergency depart- ment in a city of 400,000; the next nearest emergency department is a 4-hour drive away. When a magnitude 6.3 earthquake struck at 12:51 PM, staff struggled to stay on their feet as the lights went out. The emergency genera- tors were challenged to maintain a supply of electricity and failed over the course of the following hours as dozens of aftershocks struck (Figure 1). Unpredictable Movement of the Earth Earthquakes do not all feel the same. The September quake had people feeling they were rolling side to side, backward and forward, over and over as the earth convulsed beneath them. The February quake has been described as being like trying to walk on a trampoline while someone else was bouncing on it. It was located a mere 3 miles (5 km) deep and 6 miles (10 km) from the city centre. People in the city ran out of buildings, lost their balance, and lost their lives as masonry crashed onto their prone bodies. Even sitting in a car or bus didn’t always provide protection, as lives were lost there, too. Inside buildings, people were thrown to the floor, and unable to get up, they crawled under tables if they could, while those who could not protect themselves perished as walls and ceilings fell on top of them (Figure 2). Most of the unlucky ones, who were in the wrong place at the wrong moment, died within seconds of massive crush and head injuries. Initial Civilian Response and Communication Challenges Much of the emergency department had been newly built just a few years earlier, and although it shook violently, many staff dusted themselves off and got on with their work, not realizing that less than a mile away, the destruc- tion of lives and buildings was enormous (Figure 3). It was many hours before the location of the epicenter and scope Brian Dolan is Director of Service Improvement, Canterbury District Health Board, New Zealand. Anne Esson is Nurse Manager, Christchurch Hospital Emergency Depart- ment, Christchurch, New Zealand. Paula (Polly) Grainger is Nurse Coordinator, Clinical Projects, Christchurch Hospital, Christchurch, New Zealand. Sandra Richardson is Nurse Researcher, Christchurch Hospital Emergency Department, and Senior Lecturer with the Centre for Post Graduate Nursing Studies, University of Otago, Christchurch, New Zealand. Mike Ardagh is Professor of Emergency Medicine, Christchurch Hospital Emergency Department, Christchurch, New Zealand. For correspondence, write: Brian Dolan, MSc (Oxon), MSc (Nurs), RN, c/o Business Development Unit, Canterbury District Health Board, 33 St Asaph St, Christchurch, New Zealand; E-mail: brian@dolanholt.co.uk. J Emerg Nurs 2011;37:506-9. Available online 5 August 2011. 0099-1767/$36.00 Copyright © 2011 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. doi: 10.1016/j.jen.2011.06.009 INTERNATIONAL NURSING 506 JOURNAL OF EMERGENCY NURSING VOLUME 37 • ISSUE 5 September 2011