Colombia earthquake: Hospitals adapt to save lives amid widespread damage

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The rear of the hospital – a major public medical centre in Colombia’s Cali – had partially collapsed on Monday, after a magnitude 7.4 earthquake struck the west of the country, killing at least 273 people and injuring at least 3,800 others. The National Unit for Disaster Risk Management said 377 people are still missing as the crucial three-day rescue window passes. Carlos Naranjo, a general practitioner at the hospital, said some 50 percent of the facility was damaged. “There is extensive structural damage; some walls are no longer stable, some ceilings have collapsed, and it is still dangerous to walk through,” he told Al Jazeera. With most of the hospital off-limits, medical staff now have to turn away the vast majority of patients. They are able to treat only those who require immediate resuscitation. The facility is one of four major hospitals that were damaged and forced out of operation on Monday. Six clinics were also damaged. Amid an influx of injured people, city authorities on Monday warned that public hospitals in Cali, home to two million people, were at 100 percent capacity and declared a “red alert for hospitals” there. Cali, Colombia’s third-largest city and the capital of the Valle del Cauca province in the Pacific region, is one of the worst-affected areas. At least 96 died here, while 1,224 others were injured and 111 are officially missing. Authorities say some 45 buildings collapsed, while 832 suffered damage. But on Wednesday – less than 72 hours into the crisis – a combination of effective organisation, plentiful volunteers, and support from the national government has led local health officials to describe the situation as stable. The United Nations’ Office for the Coordination of Humanitarian Affairs (OCHA) said on Wednesday that the “hospital system has stabilised as patients have been discharged and the number of new admissions has decreased”. But “a red alert remains declared for hospitals in the city”, it said. The city averted disaster despite the collapse of key health institutions by enacting a strategy to boost the capacity of the institutions less affected by the earthquake, officials said. German Escobar, Cali’s public health secretary, told Al Jazeera that the city had implemented a plan to create “expansion zones”, largely in and around existing health institutions, to handle the surge in patients. These include utilising operating rooms that were previously not in use and recovery areas – where patients go after surgery – that were partially or fully closed before the earthquake. In other hospitals – like the private Clinica Nuestra – the expansion zones come in the form of temporary field clinics. The hospital was forced to relocate patients after a partial collapse. Here, an ambulance lies crushed by fallen debris, with a buckled “Emergency Room” sign hanging loosely above it. “The situation is now stable,” Escobar said. He noted that while there is still stress on the healthcare system, particularly for patients with chronic illnesses struggling to access medications, the threat of hospitals being overwhelmed and unable to attend to those in need has now been contained. “Unless another major mass event occurs that overwhelms emergency and inpatient services, the system should be fully stabilised,” he added. The health secretary credited the recovery of the city’s hospital system to successful coordination between government officials, relief organisations and volunteers. Relief efforts also depended on vast resources and manpower from civil society organisations. Enrique Zapata, head of logistics at Cali-based health NGO SARES, stood in front of a crowded medical tent at the foot of the Vanessa apartment – a six-storey building that collapsed on August 10. The medical tent primarily serves volunteers, treating them as they carry out rescue operations. As rescuers hurried past carrying buckets and shovels, he described the first moments after the earthquake. “Everyone first checked on their family, and after that, all of us who are first responders, we immediately got in touch with the organisations we belong to,” said the medic. He explained that emergency responders followed a plan, named the Incident Command System, which guided their immediate response – a system set up in advance to prepare for disasters that coordinates how government agencies and civil society groups can work together in the event of disasters. “Personally, I think the city was well-prepared,” Zapata told Al Jazeera. Beyond protocol, rescue workers were spurred to work through the night by a sense of duty. “Even though your body often tells you, ‘I want to rest’, the adrenaline and the desire to help keep you from doing so,” explained Zapata. Ricardo Castillo, an army veteran volunteering as a nurse at another collapse site in Cali, described a similar mobilisation. “The work of the people in charge of all this has been spectacular,” he said. Behind him, volunteers worked alongside firefighters, police and military personnel among the shattered concrete and metal rebar, removing debris in buckets by passing them hand to hand along chains of rescuers. “The support is infinite. These people are wonderful,” added Castillo. The quake’s timing and location – just weeks after magnitude 7.2 and 7.5 earthquakes struck neighbouring Venezuela on June 24 – has prompted comparisons between the two countries’ responses. The scale of the disaster in Venezuela was far greater than in Colombia, with more than 6,000 killed. Venezuela’s government has faced sharp criticism over its response, with survivors saying help never arrived in the crucial first hours and days. Civilians led much of the relief effort, especially in the first two days, while delayed orders from senior military commanders and widespread confusion hampered the deployment of troops, according to media reports. “It is inevitable to compare the responses of both countries,” said Marianella Herrera, Director of the Caracas-based Venezuelan Health Observatory. “In one country, there is clearly a much more coordinated and coherent response, while in the other – which is, of course, Venezuela – the response is much more fragmented from an institutional standpoint.” While Herrera noted a great deal of solidarity and support from the Venezuelan population, she blamed inadequate coordination within the country’s health system for the comparatively poor response to the tragedy. “The lack of organisation and leadership in the Venezuelan healthcare system exacerbates a situation that calls for a well-coordinated and robust healthcare system,” said the health expert. Venezuelan authorities have rejected criticism of their response as the product of “media laboratories”. In Cali, rescuers say the crisis is far from over. With dozens still missing in the city and more than 500 officially recorded as missing nationwide, health workers say the emergency is unlikely to ease anytime soon. Emergency workers are still calling for all the help they can get. “In these situations, there is no such thing as too much. Every little helps,” said Castillo Advertisement AboutAboutShow moreAbout UsCode of EthicsTerms and ConditionsEU/EEA Regulatory NoticePrivacy PolicyCookie PolicyCookie PreferencesAccessibility StatementSitemapWork for usConnectConnectShow moreContact UsUser Accounts HelpAdvertise with usStay ConnectedNewslettersChannel FinderTV SchedulePodcastsSubmit a TipPaid Partner ContentOur ChannelsOur ChannelsShow moreAl Jazeera ArabicAl Jazeera EnglishAl Jazeera Investigative UnitAl Jazeera MubasherAl Jazeera DocumentaryAl Jazeera BalkansAJ+Our NetworkOur NetworkShow moreAl Jazeera Centre for StudiesAl Jazeera Media InstituteLearn ArabicAl Jazeera Centre for Public Liberties & Human RightsAl Jazeera ForumAl Jazeera Hotel PartnersFollow Al Jazeera English: