From ‘Yezhenedelniy Zhurnal’ (Weekly Journal),

26.10.2003

UNASSIMILATED MATERIAL

Konstantin, an ambulance medic:

I got to work and right away there was a call.  They sent us out to ‘Nord-Ost’.  The GAI (highway patrol) was working well.  They set everyone up on the back streets, and everything was quiet.  Who and what, though, weren’t known.  It was also good that the radios were working and we could hear them talking things over.  As we started to take people out we could see right away that their blood pressures were dropping, but no one knew what to treat it with.

The doctors talked it over on the radio, but left us in the dark.

We could see that the usual therapy wasn’t helping, or any kind of antidepressants or hormones.  Nothing was working and their blood pressure kept falling and all, and then came respiratory arrest.  Suddenly one of the fellows who had picked up a casualty yells: “We need Nalaxone, that’ll perk them up.”  So we start injecting everyone.  Nalaxone is used against opiate overdoses.  They were all dehydrated as well.  One doctor told me that a woman he had drank all his water and even glucose straight from the bottle, everything.  The people at ‘Nord-Ost’ weren’t watered at all.  We were instructed not to enter the epicenter of the damage area.  That was the work of the MChS (emergencies ministry) and military medics, since it was a gas attack, so it was in fact a military operation.  The military medics were supposed to work there because they had the special training.  They were there, but there were very few of them.  There was no coordination at all between the military medics and us, and I didn’t see any of our leadership at ‘Nord-Ost’.  So there were a lot of vehicles but almost no way to get at the people.  They loaded everybody onto the buses, like cordwood, while the ambulances remained empty, and then sent us back empty-handed.

The best thing we could have done would have been not to take anyone anywhere, but to set up tents and give first aid right on the spot.  Right by the exit we should have been injecting antidote and carrying them into the tents.  If they had already called up the ambulances, then they should have assembled the resuscitation teams so that they were standing by with oxygen and all.  But take a look at what kind of oxygen bottles we have – clearly you could never get these open.  If something similar were to repeat itself nowadays it would be chaos.  Back then we at least had radios, but now just one or two back at the substation, and they practically don’t work.  The main thing is that no one has told us what we are supposed to do if such a thing happens again.  It will be the same mass pick up, load up, and drive off as before.  And that’s it.

Andrey Legoshin, chief of the department of management during crisis situations, Russian MChS (Disasters Ministry):

It’s clear that we derive lessons from every emergency situation, especially such sad ones; otherwise there’d be no reason for our existence.  Before anything is done, organizational measures are performed.  Usually in an emergency situation very different services are activated, from special to local, so this is why we have joint training.  It is very important that we coordinate our work, so specific documents are prepared in advance to allow us react better.  The struggle against terrorism has definitely been introduced into MChS training, and documents are ready, including those of the government and government commissions.  There have been some changes in the approach to medical planning, such as the stockpiling of the necessary drugs.  Any installation can fall under attack.  Special attention has been given to areas where large numbers of people assemble: any type of gathering such as cinemas, open air auditoriums, schools, hospitals, so that it’s clear where, how, and what, so that they don’t have to go looking for blueprints like we had to do at ‘Nord-Ost’.  All this work is being done not just in Moscow, but also in all the subject cities of the Russian Federation.  There are classified documents, yes, and it would be inadvisable to publish these, but that’s one thing we learned in working with the media at ‘Nord-Ost’.  There are internal orders that change the way we pass on information.  Information should flow quickly, so we have removed a few links in the chain that were completely unnecessary, or that didn’t need to be informed right away.  Of course, everything was carefully analyzed, but we really don’t want to have a second ‘Nord-Ost’.

Igor Sharipov, doctor of medical sciences, leading catastrophes specialist at the Sklifosovsky Institute:

Nothing has changed since then.  I can declare this with certainty – nothing.  I understand that many say that something has changed at the MChS.  All the changes are on paper, but no one will ever see the results.  Earlier, when there such ChP’s (emergency situations), the Sverdlovsk catastrophe back in the late 1970s, for example, we in the medical field published anthologies, performed analyses, gathered in meetings and conferences and analyzed all the mistakes.  Nowadays it’s mute.  No circulars have been sent anywhere; no one has gotten acquainted with the case.  It’s not a question of equipment, and there wasn’t any lack of equipment at ‘Nord-Ost’, but a lack of organization: mediocre people were in charge.  If something were to happen suddenly, it would be the same.  People simply don’t know what to do in such extraordinary circumstances.  There have never been any organized training exercises for the average physician.  I personally have no idea what to count on.

Professor Boris Blohin, doctor of medical sciences, Russian state medical university:

Why was it done?  Because of the people.

But later they tossed them on the ground and did not do anything.  In medicine there is the rule of catastrophes: never concentrate a large group of patients in one place.  340 casualties were at Hospital #13.  Even the most well trained personnel with the best thought-out plans could not keep up with such a flood.  This was absurd!