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Tag: disaster management

Mass casualty triage

Mass casualty incidents, from terrorist attacks, floodings, earthquakes to bus accidents, are chaotic. With proper knowledge about the principles of triage, even those with no medical training can help.

Mass casualty triage was the topic of SAI’s second webinar of the semester, on Nov. 19, on disaster management with Dr. Usha Periyanayagam (@uperiy), MD, MPH, International Emergency Medicine Fellow, Department of Emergency Medicine, Brigham & Women’s Hospital; Harvard Medical School.

Eight universities from three countries in South Asia participated in the interactive session, using videoconference software provided by the Higher Education Commission of Pakistan (HEC), with a participation of around 100 students in South Asia, with many more watching online.

Watch the presentation.

Dr. Periyanayagam has worked with SAI and the Aman Foundation to improve disaster response in Karachi, and has extensive experience in emergency settings around the world.

During the webinar, Dr. Periyanayagam explained that “triage” is not treatment – it is a method of sorting injured people and deciding who gets treatment first. “The goal of triage is doing the greatest good for the greatest number – it’s not doing everything you can for every patient,” Dr. Periyanayagam explained. She cited the 2013 Boston marathon bombing as an example of triage working correctly – of the 250 who were injured, no one who was transported to hospital died.

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Responding to disasters

Dr. D’Andrea, right, interacts with universities in South Asia

South Asia is particularly vulnerable to disasters, from terrorist attacks, to floodings, to earthquakes that can affect large populations. In order to address these humanitarian crises, the fundamentals of mass casualty management are critical. 

Watch the webinar.

On Wednesday, October 1, SAI hosted its first webinar of the semester on disaster management with Shawn D’Andrea, MD, MPH, Instructor of Emergency Medicine, Harvard Medical School, Brigham and Women’s Hospital. With the support of SAI and the Aman Foundation, Dr. D’Andrea has been working on a project in Karachi, improving mass casualty response and disaster response for first responders, and developing hospital leadership.

Using videoconference software provided by the Higher Education Commission of Pakistan (HEC), the interactive session included participation from five universities, in South Asia, allowing around 250 students and administrators in the region to interact directly with Dr. Andrea about the fundamentals of Incident Command.

An Incident Command System (ICS) is, by definition, “a tool used for the command, control, and coordination of emergency response.” Further, it is “a set of personnel, policies, procedures, facilities, and equipment, integrated into a common organizational structure designed to improve emergency response operations of all types and complexities.”

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‘The bright side of Pakistan’ – Harvard Gazette

The South Asia Institute was featured in a story in the Harvard Gazette, published on March 14, 2014. The story profiles SAI’s growing involvement in Pakistan, and the Contemporary South Asian City Conference in Karachi in January. 

The bright side of Pakistan

By Alvin Powell, Harvard Staff Writer

The initial idea was a lecture by a noted Harvard design professor and a quiet discussion with a small group of interested local partners.

By January, however, the event had grown into a three-day conference on South Asian cities, attracting upward of 800 people, with concurrent sessions in large tents erected for the occasion in the Pakistani port city of Karachi.

In addition to a Harvard delegation of seven, the conference drew urban design professionals, government officials, and academics from across Pakistan and elsewhere in South Asia, including India and Bangladesh. Tarun Khanna, director of Harvard’s South Asia Institute, said the event grew through regional collaboration and was symbolic of a “narrative of peace” that seeks to counterbalance the history of strife in the area.

Organizers said the conference was just the initial discussion in what they hope will be an ongoing conversation about the problems and opportunities confronting cities across the region. Further, officials at Harvard’s South Asia Institute (SAI) say the conference is both part of the Institute’s growing engagement with Pakistan and a sign of the enthusiasm of Pakistani partners for further collaboration.

SAI’s engagement is multifaceted and includes conferences and training programs in Pakistan, workshops, fellowships, and Pakistani students on Harvard’s campuses, as well as webinars spanning both locations, featuring Harvard faculty in Cambridge and viewed by students at dozens of Pakistani universities.

Meena Hewett, executive director of the South Asia Institute, said the Pakistan programs are an expression of the institute’s focus on India, Pakistan, Bangladesh, Sri Lanka, Nepal, and Bhutan. Though India is the region’s largest country, it’s important, Hewett said, that the institute promote an agenda that encompasses all of South Asia.

In addition to fostering an understanding of the country itself, Pakistan has a lot to offer to the regional dialogue, Hewett said. Pakistan is the world’s sixth-most populous nation, with a long history and enormous diversity. It is struggling with many of the same issues as many of its neighbors, including urbanization, poverty, water security, public health, religious differences, and governance.

“Beyond the narrative of violence and terrorism, there is all this good development work going on,” Hewett said.

Click here to read the full story.

Karachi, Pakistan: Disaster Mitigation in the City of Migrants by Satchit Balsari

By Satchit Balsari, Fellow, FXB Center for Health and Human Rights, Harvard University; Director, Global Emergency Medicine Program, Weill Cornell Medical College / NewYork-Presbyterian Hospital

Earlier this year, a delegation from SAI visited the Aga Khan University Hospital and observed some of Pakistan’s unique emergency care challenges.

One of the most populous cities in the world, yet one of the least understood, especially in the West, is the bustling port-city of Karachi, home to over 20 million residents and financial capital of Pakistan. Spread over 1360 square miles, Karachi is a dense urban agglomeration accommodating over 15,000 people per square mile. Tracing its roots back to the old town of Kolachi, settled by Sindhi and Baloch tribes, Karachi saw exponential growth in the second half of the 20th century. Starting with a population of about 400,000 on the eve of Pakistan’s Independence in 1947, the city absorbed wave after wave of migrants—first Muhajirs from partitioned India, then immigrants from the newly independent Bangladesh (erstwhile East Pakistan), and finally Pashtuns from Khyber Pankhtunkhwa, the Federally Administered Areas, northern Balochistan, and Afghanistan.

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Symposium highlights ongoing research projects

SAI held its Annual Symposium on April 24 and 25, 2014, titled ‘South Asia Regionalism: Workshops on Shared Challenges and the Way Forward.’ The workshops highlighted and showcased ongoing multi-year faculty research projects supported by SAI. Each workshop was well attended, with about 40 participants at each session.

Tarun Khanna, left, and JP Onnela

Mobile Technology (April 24)

This workshop, led by Tarun Khanna, HBS, and JP Onnela, HSPH, focused on the promise of data from mobile technology and the challenges of using this data. One of the major current challenges is the tension between data privacy, sharing of data to promote scientific research, and the potential insights this data may be able to generate. This project aims to increase knowledge of, and provide better access to services in areas of mobile-healthcare, banking, education, and improve livelihoods.

Participants also discussed the varying ways societies have adjudicated or ignored tensions about privacy, as well as some of the methodological challenges raised by large datasets.  The data and research work done during the Kumbh Mela was also highlighted, which provided powerful insights for further research and teaching on understanding social networks and behavior through studying large data gathered from cell phones used at this mass gathering. In addition, issues about governmental, institutional and regulatory guidelines were also raised.

Next steps for this research project: A small group of faculty and practitioners will meet at the Radcliffe Institute of Advanced Study for a seminar in September to discuss tools that would allow researchers to better understand the dataset’s potential, evaluate options for cross-associating it with other relevant information, and as a result, frame valid research questions that can be empirically answered using info-analytics performed on these datasets.

Full list of participants.

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Symposium Preview: Disasters and Mental Health



This is the first story in a weekly series previewing SAI’s Annual Symposium in April, ‘South Asia Regionalism: Workshops on Shared Challenges and the Way Forward,’ in which SAI will interview the faculty leaders of each workshop. SAI is hosting a series of workshops on April 24 and 25 to highlight ongoing faculty research projects supported by SAI.

Workshop: Disasters and Mental Health

Thursday, April 24, 2014, 11:15 am – 1:45 pm
Charles Hotel, 1 Bennett St, Cambridge, MA 02138
Faculty lead: Jennifer Leaning, François-Xavier Bagnoud Professor of the Practice of Health and Human Rights, HSPH; Director, FXB Center for Health and Human Rights and Ruth BarronAssistant Professor of Psychiatry, HMS

Disasters, natural or man-made, put enormous stress on virtually every function of society. What are the best practices in urban disaster planning and response, and how can trauma care be implemented effectively in dense urban settings? In recent years, cities where disasters have been prevalent, such as Karachi, have experienced an increased incidence of mental illness related to the pervasive psychological trauma of recurrent disasters and violence. Moreover, mental health services, in areas without pervasive trauma, are an ongoing challenge throughout South Asia, with involving issues of stigma, access to adequate treatment, and awareness.

Jennifer Leaning speaking at the urbanization conference in Karachi in January

This workshop will highlight the progress of this initiative, and gather experts in the fields of disaster response and mental health to evaluate the way forward and identify goals for the future of the project, which include a needs assessment, policy research, and new research, and how the Aman Foundation in Karachi can serve as a model in the area of emergency response and mental health.

SAI recently talked to faculty leader Jennifer Leaning to learn more about the goals of the workshop and the ongoing project:

Q: What led you to get involved in this project?

A: I have been doing research and teaching on disaster response for many years.  When Junaid Razzak at the Aman Foundation approached SAI and said that he was very interested in building emergency capacity for response to mass casualty events in the city of Karachi, I was impressed by his ambition and intrigued by his approach.  We had a planning meeting last June, where we invited Harvard colleagues involved in disaster medical and mental health response both in the US and internationally.  The project began then and has involved four separate assessment trips to Karachi (two in October 2013 and two in January 2014).  The SAI workshop in April allows us to share our findings with the wider expert community at Harvard.

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‘Urban planning and disaster management’ in The News on Sunday

‘Urban planning and disaster management’ an article by Beena Sarwar about the Contemporary South Asian City Conference was published in The News on Sunday. Sarwar interviewed Rahul Mehrotra of the Graduate School of Design and Jennifer Leaning of the School of Public Health so that they could share their experiences at the conference in Karachi.

Read the full article here.


Rahul Mehrotra is no stranger to Karachi. From his base in Mumbai, he built Amin Hashwani’s house in Karachi some years ago — a project for which he visited the city several times. “By the time we did the interiors though, we couldn’t get visas,” he added, when we spoke in Cambridge recently.

He recounts a moving story about one of his visits to Karachi. As they landed in the city, he noticed tears in the eyes of an engineer, Subit Deshpande, who was accompanying him from Mumbai. “He told me that his late father was a Bombay-based contractor who built that airstrip, when Karachi was part of the Bombay Presidency.”

Mehrotra, Chair and Professor of the Department of Urban Planning and Design at the Harvard Graduate School of Design (GSD), conceived the Conference on the Contemporary South Asian City, held in Karachi last month and co-sponsored by Karachi’s Aman Foundation and Harvard’s South Asia Institute. Coordinating the Harvard delegation was SAI’s Executive Director, Meena Hewett.