Armenia 1988 earthquake and telemedicine: lessons learned and forgotten.

Purpose: To showcase the observations and lessons learned from the first large-scale international telemedicine program addressing the medical and health consequences of disasters.

Background: Almost 24 years ago a major earthquake devastated the northwestern region of Soviet Armenia. The National Aeronautics and Space Administration deployed a telemedicine spacebridge, which operated uninterrupted for 3 months, extending its services to the remote region of Ufa to help the burn victims, mostly children, from a railroad explosion accident. Expert consultations were provided by four major medical center from the United States and several military and civilian medical services of the Soviet Union.

Lessons Learned: Disasters continue to contribute to increased morbidity and mortality with significant economic impacts worldwide. Psychological, physical, and social sequelae persist years after the events. Many pre-existing socioeconomic conditions are aggravated following disasters. Telemedicine is a useful medical and public health technology that continues to be underutilized due to the lack of inclusion in the preparedness planning, training, availability of networks, and connectivity costs.

Policy Implications: Natural and human-made disasters require both near-term and long-term interventions to reduce morbidity and mortality among the surviving victims. Telemedicine, information technology, and modern portable communication devices should be incorporated in disaster preparedness and recovery training and operations.