Unpredictable, unpreventable and impersonal medicine: global disaster response in the 21st century.

The United Nations has recognized the devastating consequences of "unpredictable, unpreventable and impersonal" disasters-at least US $2 trillion in economic damage and more than 1.3 million lives lost from natural disasters in the last two decades alone. In many disasters (both natural and man-made) hundreds-and in major earthquakes, thousands-of lives are lost in the first days following the event because of the lack of medical/surgical facilities to treat those with potentially survivable injuries.