ASEAN Journal of Disaster Health Management (AJDHM)

2019 Pasir Gudang Chemical Incidents: The Impact of Transdisciplinary Approach on Emergency Medical Services

2025-12-01T13:02:54+07:00

Introduction: Managing mass casualty incidents (MCI) is always challenging, requiring a well-coordinated transdisciplinary approach (TDA) due to its complexity. Between 7th and 20th March 2019, a state-level chemical incident occurred in Pasir Gudang’s heavily industrialized area. Illegal dumping of tonnes of waste into Kim Kim River released a mix of volatile organic compounds (VOCs), including acrolein, acrylonitrile, and benzene, causing mainly respiratory and gastrointestinal symptoms. Objective: To coordinate an effective response to the Kim Kim chemical incident. Methods: Government agencies, industrial players, and NGOs collaborated under the coordination of Malaysia’s National Disaster Management Agency (NADMA), following Directive No. 20 of the National Security Council. Key agencies such as the Department of Environment, Fire and Rescue Department, Ministry of Health, and Johor State Disaster Management Committee, with support from Pasir Gudang Emergency Mutual Aid (PAGEMA), led containment efforts. A patient management center was established near the site to prevent overwhelming healthcare facilities. Ambulance transportation and logistics were systematically organized. Results: Approximately 6,000 victims, including medical staff, received treatment over the two-week period. The coordinated effort effectively contained the incident. Conclusions: The incident highlights the importance of public-private partnerships and shared understanding among agencies in managing complex disasters through TDA.

Kanjuruhan Football Stampede (2022): Gaps in Disaster Preparedness and Response Mass-Casualty Management at A Mass Gathering Event

2025-12-01T13:10:56+07:00

Introduction: On October 1, 2022, a post-match crowd disturbance at Kanjuruhan Stadium in Malang gave rise to a mass-casualty incident, highlighting deficiencies in disaster preparedness and readiness of medical care teams who are responsive to potential disasters occurred soccer event. Objective: This paper analyses the Kanjuruhan tragedy within the framework of disaster preparedness and mass-casualty management using only data from the initial report and presentation slides. Methods: A qualitative case study based on the Joint Independent Fact-Finding Team report, media reports, and medical responders' testimonies in webinars, as well as an interview with a pre-hospital care coordinator. Data were thematically coded by 5 areas: risk assessment, medical readiness, events timeline, hospital response and coordination. Results: Spectator venues were fit for purpose from the athlete’s point of view but not so much from a spectators. No formal coordination system for command, evacuation, referral, communication between emergency medical service and hospital existed before the event. The use of tear gas caused problems with respiratory distress and crowd crush, while hospitals experienced a lack of patient coordination during influxes, poor triage and resource limitations. Conclusions: The event demonstrates major deficiencies in large-scale events and mass casualty management. Tougher regulations, unified command systems, compatible communications and risk-based planning can help prevent such catastrophes

Disaster Health Management Framework and the ASEAN Collective Measures for Rapid, Effective and Quality Operations of Emergency Medical Teams in The ASEAN Region

2025-12-02T14:53:46+07:00

Introduction: The Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) has contributed regional collaboration in disaster health management (DHM). Key achievements include the ASEAN Leaders’ Declaration on DHM (ALD DHM), and its Plan of Action (POA) (2019-2025). In 2019, the ASEAN Collective Measures (ACM) were initiated to support ASEAN Member States (AMS) in meeting the World Health Organization (WHO)’s Emergency Medical Teams minimum requirements (EMT-MR) and to strengthen coordination capacity for International EMTs (I-EMTs) operations. Objective: This study analyzes the progress and challenges in implementing the ACM work plan, and explores future strategies for sustainable DHM development in ASEAN. Methods: A qualitative review was conducted using reports and deliverables from ACM activities. The work plan included five areas: development of an AMS DHM database, confirmation of I-EMT receiving procedures, clarification of medical coordinator (MC) role, EMT item stockpile development, and joint EMT Operations. Results: A draft AMS DHM database was developed. Malaysia confirmed I-EMT receiving procedures and tested a joint EMT operation with Japan. Joint research on EMT items is ongoing. Conclusions: ACM serves as a regional problem-solving mechanism, supporting sustainable DHM through regional DHM activities and EMT operations

Indirect Disaster-Related Death Associated With Cognitive Decline Among Older People Following Evacuation During A Radiation Disaster: A Case Report

2025-12-01T13:21:51+07:00

Introduction: During disasters, older adults are vulnerable to indirect health effects caused by evacuation-related environmental changes. Despite existing reports of depression and cognitive decline in this population, detailed case-based analyses during prolonged evacuations following radiation disasters remain limited. Objective: This case study aims to examine the impact of evacuation on cognitive function and subsequent health decline in an older adult. Methods: We analyzed medical records, evacuation documents, and semi-structured interviews with the bereaved family. These sources were integrated and chronologically organized to assess the health impact of prolonged displacement. Results: An 88-year-old man, evacuated following the Fukushima Daiichi Nuclear Power Plant accident, experienced initial delirium, a temporary recovery upon returning home, and a relapse upon re-evacuation. Continuous displacement and repeated environmental changes led to progressive cognitive and physical decline, ultimately resulting in a disaster-related death. Conclusions: This case illustrates that evacuation during disasters can have serious impacts on the cognitive function and overall health of older adults. In particular, older individuals who are at risk of cognitive decline should be promptly relocated to evacuation sites where they can receive immediate and continuous medical and social support. Such measures are essential for mitigating health risks among older populations in future disasters.

The Mutual Growth of International and National Emergency Medical Teams (EMT): Synergetic Growth and Reinforcement Between Japan’s Disaster Relief Team and Disaster Medical Assistance Team

2025-12-01T13:55:24+07:00

Introduction: Japan, situated on the seismically active Pacific Ring of Fire, frequently experiences natural disasters. Consequently, Japan’s disaster medical response system has evolved significantly, leveraging both international and domestic experiences. This study reports the development of Japan’s disaster medical teams, emphasizing the synergistic relationship between international and domestic response efforts while highlighting key milestones in the system’s evolution. Methods: This study utilizes a case study approach to report the historical evolution of Japan’s disaster medical response system. Data were gathered through document reviews and a rapid review approach, which assessed major events and structural developments. Results: Japan’s early international disaster medical efforts began with its response to the Cambodian refugee crisis in the 1970s, leading to the establishment of JMTDR and later JDRT. Domestically, the Great Hanshin-Awaji Earthquake in 1995 catalysed the establishment of DMAT and Japan NDMS. The J-SPEED system, inspired by international deployments, further standardized WHO EMT for rapid and informative medical data collection. Conclusion: The evolution of Japan’s disaster medical teams highlights key milestones and the synergetic collaboration between JDRT and DMAT. Japan’s international and domestic disaster response systems have facilitated the advancement of disaster response capabilities, leading to more sophisticated response abilities.