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Limca Book of Records

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Coping with Natural Disasters: The Role of Local Health Personnel and the Community

ANNEXES

Annex 1. Diseases to be monitored when people are housed in temporary shelters

Disease1

Main Causes

Diarrhoeal diseases

Overcrowding. Contaminated water and food.

Measles

Overcrowding.

Respiratory complaints

Poor housing conditions. Shortage of blankets and clothing.

Malaria

A new environment with a type of malaria against which the refugees have no protection. Stagnant water becoming a mosquito breeding ground.

Meningococcal meningitis

Overcrowding in a region where the disease is endemic (it is often seasonal in certain places).

Tuberculosis

Overcrowding.

Helminths, particularly hookworm

Overcrowding. Poor sanitation.

Scabies (a skin disease caused by mites)

Overcrowding. Poor bodily hygiene.

Xerophthalmia (infant blindness)

Vitamin A deficiency (xerophthalmia is often provoked by measles or some other acute infection).

Anaemia

Malaria, hookworm, shortage or poor assimilation of iron and folate.

Tetanus

Injuries in an unvaccinated population. Poor obstetrical practice may cause tetanus of the newborn.

¹People suffering from malnutrition are particularly at risk of serious attacks of all these diseases. Good nutrition therefore constitutes an effective preventive measure.

Annex 2. Specimen record card for use by person in charge of family grouping in preparing health report in collaboration with local health personnel

Date

Grouping


Prepared by

SHELTER No.

FEVER
Name and age of person concerned

DIARRHOEA
Name and age of person concerned

DOES NOT FEEL WELL
Name and age of person concerned and description of complaint





Annex 3. Nutrition

Recommended daily energy and protein intakes for healthy individuals1

Proteins (g)


Group

Energy in MJ(kcalth)

Mixed diet with some animal protein

Cereals, possibly with legumes

Approximate proportion of the population in a developing country %

0-1 year

3.4 (820)

14

(breast-feeding, supplemented after 6 mths by weaning foods)

3.0

1-3 years

5.7(1360)

21

27

9.0

4 - 6 years

7.7 (1830)

25

33

8.7

7-9 years

9.2 (2190)

29

37

8.5

10-14 years:

boys

11.7 (2800)

46

58

6.3

girls

10.3 (2450)

40

50

6.2

Male adult (moderately active)

12.6 (3000)

49

62

29.2

Female adult (moderately active)

9.2 (2200)

39

48

26.2

Pregnancy (latter half)

10.7 (2550)

49

63

1.5

Lactation

11.5 (2750)

60

77

1.4

1Adapted from DE VILLE DEGOYET, C., SEAMAN, J. & GEUER, U., The management of nutritional emergencies in large populations. Geneva, World Health Organization, 1978.

If an adequate energy supply is not provided, some protein will be burnt to provide energy and not used for body growth or repair, i.e. it will be used in the same way as carbohydrate or fat, which are much less expensive.

A part (20-40%) of the energy requirement should be supplied from fats or oils, which greatly enhance the palatability of the diet, diminish its bulk (important for younger children) and reduce transport requirements.

Energy requirements vary widely even in normal individuals. They are also increased by physical activity. For example, a 65-kg man requires daily:

6.3 MJ (1500 kcal) when resting in bed day and night.

11.3 MJ (2700 kcalth) if lightly active in the daytime (clerk, office worker).

12.6 MJ (3000 kcalth) if moderately active 8 hours a day.

14.6 MJ (3500 kcalth) if doing heavy work 8 hours a day (labourer).

Much higher intakes are required for the treatment of malnutrition.

Weight-for-height1

A. Young children (both sexes)


Weight (kg)

Height (cm)

Standard

90% standard

80% standard

70% standard

60% standard

50

3.4

3.1

2.7

2.4

2.0

51

3.5

3.2

2.8

2.4

2.1

52

3.7

3.3

3.0

2.6

2.2

53

3.9

3.5

3.1

2.7

2.3

54

4.1

3.7

3.3

2.9

2.5

55

4.3

3.9

3.4

3.0

2.6

56

4.6

4.1

3.7

3.2

2.8

57

4.8

4.3

3.8

3.4

2.9

58

5.1

4.6

4.1

3.6

3.1

59

5.3

4.8

4.2

3.7

3.2

60

5.6

5.0

4.5

3.9

3.4

61

5.9

5.3

4.7

4.1

3.5

62

6.2

5.6

5.0

4.3

3.7

63

6.5

5.8

5.2

4.6

3.9

64

6.7

6.0

5.4

4.7

4.0

65

7.0

6.3

5.6

4.9

4.2

66

7.3

6.6

5.8

5.1

4.4

67

7.6

6.8

6.1

5.3

4.6

68

7.9

7.1

6.3

5.5

4.7

69

8.2

7.4

6.6

5.7

4.9

70

8.5

7.6

6.8

6.0

5.1

71

8.7

7.8

7.0

6.1

5.2

72

9.0

8.1

7.2

6.3

5.4

73

9.2

8.3

7.4

6.4

5.5

74

9.5

8.6

7.6

6.6

5.7

75

9.7

8.7

7.8

6.8

5.8

76

9.9

8.9

7.9

6.9

5.9

77

10.1

9.1

8.1

7.1

6.1

78

10.4

9.4

8.3

7.3

6.2

79

10.6

9.5

8.5

7.4

6.4

80

108

9.7

8.6

7.6

6.5

81

11.0

9.9

8.8

7.7

6.6

82

11.2

10.1

9.0

7.8

6.7

83

11.4

10.3

9.1

8.0

6.8

84

11.5

10.4

9.2

8.0

6.9

85

11.7

10.5

9.4

8.2

7.0

86

11.9

10.7

9.5

8.3

7.1

87

12.1

10.9

9.7

8.5

7.3

88

12.3

11.1

9.8

8.6

7.4

89

12.6

11.3

10.1

8.8

7.6

90

12.8

11.5

10.2

9.0

7.7

91

13.0

11.7

10.4

9.1

7.8

92

13.2

11.9

10.6

9.2

7.9

93

13.5

12.2

10.8

9.4

8.1

94

13.7

12.3

11.0

9.6

8.2

95

14.2

12.8

11.4

9.9

8.5

96

14.5

13.0

11.6

10.2

8.7

97

14.8

13.3

11.8

10.4

8.9

98

15.0

13.5

12.0

10.5

9.0

99

15.3

13.8

12.2

10.7

9.2

100

15.5

14.0

12.4

10.8

9.3

101

15.8

14.2

12.6

11.1

9.5

102

16.1

14.4

12.9

11.3

9.7

103

16.4

14.8

13.1

11.5

9.8

104

16.7

15.0

13.4

11.7

10.0

105

16.9

15.2

13.5

11.8

10.1

106

17.2

15.4

13.8

12.0

10.3

107

17.5

15.8

14.0

12.2

10.5

108

17.8

16.0

14.2

12.5

10.7

109

18.2

16.4

14.6

12.7

10.9

B. Adults

Height (cm)

Males (weight in kg)

Female (weight) in kg)


Standard weight

80% standard

standard

60% standard

Standard

80% standard

70% standard

60% standard

140

44.9

36.0

31.5

27.0

141

45.4

36.4

31.8

27.3

142

45.9

36.8

32.2

27.6

143

46.4

37.2

32.5

27.9

144

47.0

37.6

32.9

28.2

145

51.9

41.6

36.4

31.2

47.5

38.0

33.3

28.5

146

52.4

42.0

36.7

31.5

48.0

38.4

33.6

28.8

147

52.9

42.4

37.1

31.8

48.6

38.9

34.0

29.2

148

53.5

42.8

37.5

32.1

49.2

39.4

34.5

29.6

149

54.0

43.2

37.8

32.4

49.8

39.9

34.9

29.9

150

54.5

43.6

382

32.7

50.4

40.4

35.3

30.3

151

55.0

44.0

385

33.0

51.0

40.8

35.7

30.6

152

55.6

44.5

39.0

33.4

51.5

41.2

36.1

30.9

153

56.1

44.9

39.3

33.7

52.0

41.6

36.4

31.2

154

56.6

45.3

39.7

34.0

52.5

42.0

36.8

31.5

155

57.2

45.8

40.1

34.4

53.1

42.5

37.2

31.9

156

57.9

46.4

40.6

34.8

53.7

43.0

37.6

32.2

157

58.6

46.9

41.1

35.2

54.3

43.5

38.0

32.6

158

59.3

47.5

41.5

35.6

54.9

44.0

38.5

33.0

159

59.9

48.0

42.0

36.0

55.5

44.4

38.9

33.3

160

60.5

48.4

42.4

36.3

56.2

45.0

39.4

33.8

161

61.1

48.9

428

36.7

56.9

45.6

39.9

34.2

162

61.7

49.4

43.2

37.0

57.6

46.1

40.4

34.6

163

62.3

49.9

43.6

37.4

58.3

46.7

40.8

35.0

164

62.9

50.4

44.1

37.8

58.9

47.2

41.3

35.4

165

63.5

50.8

44.5

38.1

59.5

47.6

41.7

35.7

166

64.0

51.2

44.8

38.4

60.1

48.1

42.1

36.1

167

64.6

51.7

45.3

38.8

60.7

48.6

42.5

36.4

168

65.2

52.2

45.7

39.2

61.4

49.2

43.0

36.9

169

65.9

52.8

46.2

39.6

62.1

49.7

43.5

37.3

170

66.6

53.3

46.6

40.0

171

67.3

53.9

47.1

40.4

172

68.0

54.4

47.6

40.8

173

68.7

55.0

48.1

41.2

174

69.4

55.6

48.6

41.7

175

70.1

56.1

49.1

42.1

176

70.8

56.7

49.6

42.5

177

71.6

57.3

50.2

43.0

178

72.4

58.0

50.7

43.5

179

73.3

58.7

51.3

44.0

1 From DE VILLE DE GOYET, C., SEAMAN, J. & GEIJER, U., The management of nutritional emergencies in large populations. Geneva, World Health Organization, 1978.

Arm-circumference-for-height, young children (both sexes)1, 2

Height (cm)

Standard arm circumference (cm)

90% standard

85% standard

80% standard

75% standard

70% standard

60% standard

54

11.1

10.0

9.4

8.9

8.3

7.8

6.7

56

11.6

104

9.9

9.3

8.7

8.1

7.0

58

12.2

11.0

10.4

9.8

9.1

8.5

7.3

60

13.0

11.7

11.0

10.4

9.7

9.1

7.8

62

13.9

12.5

11.8

11.1

10.4

9.7

8.3

64

14.2

128

12.1

11.4

10.6

9.9

8.5

66

14.4

13.0

12.2

11.5

10.8

10.1

8.6

68

14.8

13.3

12.6

11.8

11.1

10.4

8.9

70

15.4

13.9

13.1

12.3

11.5

10.8

9.2

72

15.6

14.0

13.3

12.5

11.7

10.9

9.4

74

15.7

14.1

13.3

12.6

11.8

11.0

9.4

76

15.8

14.2

13.4

12.6

11.8

11.1

9.5

78

159

14.3

13.5

12.7

11.9

11.1

9.5

80

15.9

14.3

13.5

12.7

11.9

11.1

9.5

82

15.9

14.3

13.5

12.7

11.9

11.1

9.5

84

16.0

14.4

13.6

12.8

12.0

11.2

9.6

86

16.1

14.5

13.7

12.9

12.1

11.3

9.7

88

16.2

14.6

13.8

12.9

12.1

11.3

9.7

90

16.2

14.6

13.8

13.0

12.1

11.3

9.7

92

16.3

14.7

13.9

13.0

12.2

11.4

9.8

94

16.4

14.8

13.9

13.1

12.3

11.5

9.8

96

16.5

14.9

14.0

132

12.4

11.5

9.9

98

16.6

14.9

14.1

13.3

12.4

11.6

10.0

100

16.7

15.0

14.2

13.4

12.5

11.7

10.0

102

16.8

15.1

14.3

13.4

12.6

11.8

10.1

104

16.9

15.2

14.4

13.5

12.7

11.8

10.1

106

17.1

15.4

14.5

13.7

12.8

12.0

10.3

108

17.3

15.6

14.7

13.8

13.0

12.1

10.4

110

17.4

15.7

14.8

13.9

13.1

12.2

10.4

112

17.6

15.8

15.0

14.0

13.2

12.3

10.6

114

17.8

16.0

15.1

14.2

13.3

12.5

10.7

1 From DE VILLE DE GOYET, C., SEAMAN, J. & GEIJER, U. The management of nutritional emergencies in large populations. Geneva, World Health Organization, 1978.

2 This method is not used by the League of Red Cross and Red Crescent Societies for its assessment of nutritional status because it is more reliable as a means of measuring malnutrition.

Indicators of likely need for a supplementary feeding programme (SFP)1

Major indicator2

Other factors

Type of SFP

General ration averaging less than 1500 kcal per person/day

None

For all vulnerable groups, as soon as possible

Over 20 % children malnourished



10-20% children malnourished

General ration averaging less than 2000 kcal per person/day



Severe public health hazards



Significant diseases (esp. measles) prevalent or imminent



None

Selective within vulnerable groups: at least for all malnourished

5-10% children malnourished

Any of above



None

No SFP: individual attention to malnourished. (Whatever the other factors, available resources are probably better used correcting/minimizing them)

Under 5% children malnourished

Any of above


1Adapted from Handbook for emergencies. Geneva, United Nations High Commissioner for Refugees, 1982.

2 Percentages are of children under 5 years old under 80% weight-for-height.

Annex 4. What to do in an earthquake

When an earthquake surprises people indoors, the spontaneous reaction is often to rush outside, but be careful... If your house is built of adobe, banco, cob or similar materials, and if the street is wide enough - wider than the buildings are high - go out and make your way along the middle of the street towards a square.


If the streets are narrow, however, stay indoors and get under a doorway or into an inside corner of the room or under a table.

If your house is of concrete or steel and you are on the ground floor, go out and walk along the middle of the street towards a square.


The ground floor collapses first. The higher floors offer greater resistance.

If you live on a higher floor, remain indoors near an internal pillar.


Staircases are a weak point.

If your house is of stone, brick or the like and you are above the ground floor, do not go into the stairwells but position yourself under a doorway in a load-bearing wall.


Figure

If you are on the ground floor and the street is wide enough - wider than the buildings are high - go out and walk along the middle of the street towards a square.

Annex 5. Mercalli scale of earthquake intensities (MS)1

Intensity


I

Only detected by seismographs, not felt by persons.

II

Detected indoors by a few persons, particularly on the upper floors of buildings.

III

Detected indoors by several persons: windows may vibrate and objects swing.

IV

Detected out of doors by a few persons and indoors by many; crockery rattles and floors and ceilings creak as they would if a heavily laden lorry were passing along a cobbled street.

V

Detected by the whole population of a locality. Awakens many sleepers. Causes liquids to spill. Makes suspended objects swing considerably and small objects move. Some bells ring.

VI

Awakens all sleepers. Frightened people leave their homes. The shock makes all bells ring and lighting fitments swing. Clocks stop. Trees shake, books and small objects fall off shelves and furniture. In badly built dwellings roughcast surfaces crack and plasterwork falls.

VII

General alarm, but well-built structures suffer no damage. Church bells ring. Cracks appear in some buildings. Chimneys in a poor state of repair fall and may damage roofs. Windows are broken. The mud in ponds is stirred up. Waves form on some watercourses. Variations occur in the level and width of sources of water. There are landslips on river banks and cracks appear in roads. Dwellings in tropical areas made of interwoven leaves and branches and the wooden houses of Japan remain intact.

VIII

General alarm and panic. Gaping cracks appear in well-built structures. Tree branches break off. Furniture moves about or is overturned, lighting fitments are damaged. Fissures several centimetres wide appear in the ground. Lake water becomes muddy. New lakes may be formed. Springs may disappear or appear and their level and capacity may change several times. Church belfries and factory chimneys are most damaged. Rocks fall from mountain slopes. Driving is made difficult. Statues twist round on their pedestals or fall.

IX

General panic. Partial or total destruction of about 50% of buildings. Numerous cases of damage to furniture and objects in houses. Animals flee. Monuments and statues fall. Reservoirs are damaged. Some underground pipes are broken.

X

Most stone buildings are destroyed. Solid wooden buildings and bridges suffer damage and some are destroyed. Water and gas mains are broken. Cracks appear in the streets. Fissures are formed in loose ground and landslides occur along slopes and river banks. The water of lakes and watercourses is thrown up on to the banks.

XI

Stone buildings completely destroyed. Solid structures of timber and branches only survive in isolated cases. Even the best-built bridges are destroyed. Railway rails are twisted. Dykes disintegrate.

XII

No manmade structures survive. Changes in topography occur: fault slips, important horizontal displacements, mountain landslides, lake formation, the appearance of new watercourses, etc.

¹Some countries use the Rossi_Forel of one to ten. The Richter scale measures the magnitude of an earthquake, i.e. the energy relesed. Above Richter magnitude 5.5 damage is generally caused.

Annex 6. Community risk maps

Risk maps drawn up by the community and local health personnel are not professional cartographic productions. They serve rather to underpin the community activity of discussing and assessing the risks.

The essential point in drawing up risk maps is precisely the work of community education and preparation on which they are based. It is during meetings to compile risk maps that it is possible to tackle the subject of the kinds of preventive action to take in each particular situation in the event of disaster.

Thus, as each risk is catalogued in the course of these meetings indications can be given on how to reduce it. Examples are the strengthening of flimsy dwellings, sanitation, the listing of places of refuge in the event of floods, etc.

It is useful to encourage the establishment of a group of volunteers ready to work more intensively with the local health personnel. In the event of a disaster, this group, which will have taken part in drawing up the risk map, can help to monitor the situation at all the points at risk. This will give a rapid idea of what has happened on the basis of the points considered to be most exposed to risk, so that relief priorities can be organized in the most effective way. If the area to be covered has been shared out beforehand, the damage and the requirements can be assessed more easily and quickly.


Figure


Risks to buildings


Other risks


District risk map prepared by schoolchildren (1986)

Annex 7. The signs of danger in disaster-damaged buildings

After an earthquake or any other happening that damages houses, the inhabitants:

... feel insecure and anxious because of the danger, the cracks, doors that will no longer shut, etc.

... suddenly rediscover signs of damage, even those that existed before,

... always have the feeling that the damage, the cracks and the subsidences are getting worse day after day.

It is essential to be ready to reply to such questions as:

Is there a risk of my house collapsing?

What if there is another earthquake shock?

What can be done to strengthen the house?


How buildings behave in a disaster

NB: almost always an earthquake has several linked effects so that a mixture of different types of damage and cracks is found.

Floods reduce the cohesion of soils; there is therefore a risk that foundations may collapse.

Structures of cob, masonry or lean concrete become engorged with water and may collapse even if there is no subsidence of the foundations.


The cracks indicate the point which has given way.
The longer the flooding lasts, the greater the risks: check the cracks!

Cyclones cause damage above all to roofs and windows and sometimes also to load-bearing elements that are not sufficiently rigid.

Because of the drop in atmospheric pressure that precedes a hurricane, a building may “burst” and cracks may appear in the walls.

Landslides cause the subsidence of foundations or smash down outer walls; this damage is similar to that caused by floods or cyclones.

Whatever the cause of the damage, it is essential to be able to recognize dangerous situations:

- cracks that weaken load-bearing structural elements,

Vertical cracks in load-bearing walls or horizontal cracks in the floors near to and parallel with the facade.

Vertical cracks in the internal walls, running along the same axis on all storeys.

The facade is as if separated from the building frame and may therefore collapse.

The building is as if cut open vertically. The various parts may come away in the event of another shock.

Cracks in the comers, growing larger from the bottom upwards.

Cracks on vaulting, parallel with the outer walls.

In this case there are horizontal thrusts on the tops of the walls that tend to burst the building open.

In this case there are horizontal thrusts on the walls that are not counterbalanced and tend to burst the building open.

- cracks that show that load-bearing elements have been broken.

Cracks that are transverse in relation to the orientation of the floors or the beams.

Cracks at the base of stair treads supported on the walls. Cracks all along the balcony floor.

In this case the bearing elements are broken. The floor may cave in.

The stairs and balconies are now left with only a single point of support. If it gives way, they will collapse.

Cracks on both sides of light partitions and the length of the ceiling.

Cracks in reinforced-concrete structures, exposing the reinforcement rods.

In this case the partition is not anchored and may fall.

In this case the shock has been considerable and the rods are no longer doing their job. The structure may collapse.

Other sorts of crack, even though they may seem important, are not dangerous.

Slanting cracks.

Cracks in the floors parallel with the girders and joists.

There is no loosening of the vertical load-bearing elements (walls, pillars, etc.) or the horizontal ones (floors, etc.).

Girders and joists are separated from each other but each of them remains firm.

Irregular cracks in the walls on various storeys.

Cracks in arches or vaulting which are not supported on the outer walls.

The loadbearing elements are weakened but on the whole the building is holding.

If the support perimeter cannot sag outwards, the arches and vaulting are very unlikely to give way.

What can be done right now to avoid the damage increasing and enable people to live in safety?

Protect the building from later damage by rain or infiltration:
· replace the broken tiles or protect the roof with plastic sheeting, corrugated iron, etc.
· repair the damage to piping.

Demolish elements that are not holding firm and which are not necessary to make the house inhabitable: false ceilings, balconies, chimneys, etc.

Shore up elements that are not holding firm but are needed to make the building inhabitable: stairs, lintels, floors, load-bearing walls.

Counter the horizontal thrusts which were counter-balanced before but are not any longer because of the collapse of an element.

Annex 8. Resource maps

Drawing up maps of the resources available in the event of a disaster is a good way of preventing or alleviating the consequences of such a disaster. Resource maps complement risk maps.

The local health personnel collaborate in preparing them with the community’s technical services and the local authorities. The aim is to determine beforehand the resources that could be used in the event of a disaster and to indicate the places where they can be obtained. Various types of resources are distinguished:

A. Those used to reach victims:

· four-wheel-drive vehicles, boats, lorries, cars, bicycles, other means of transport, petrol stocks,
· emergency lighting equipment, means of signalling to the victims.

B. Those used to extricate the victims:

· spades, picks, ropes, pulleys, buckets, ladders, chain saws, shears, saws, toolboxes, pocket torches, blankets,

· power shovels, earthmoving equipment, cranes.

C. Those needed for giving emergency care:

· general supplies for the health facility,
· emergency health equipment, medicaments,
· ambulances or other means of transport.

D. Those needed for providing temporary shelter:

· buildings considered to be disaster-proof and which can serve as rallying points (schools, public buildings),

· stores of tents, camping equipment, caravans and other structures and materials that can be used to provide shelter,

· the Site chosen for the first temporary shelters,

· shelters for animals.

E. Those needed for survival:

· foodstuffs,
· clothing, boots and other footwear,
· blankets, means of heating,
· means of lighting,
· products for personal hygiene, cleaning and disinfection,
· means of waste disposal,
· simple sanitary engineering equipment.

F. Those needed for transport:

· base point for transport (buses, lorries, cars, three-wheeled vehicles, other means of transport).


G. Those needed for communications:

· centre for coordinating information, with megaphones, dispatch riders, batteries, generating plant, priority telephone lines, other means of communications,

· local radio stations,

· amateur radio operators (‘radio hams’).

H. Those needed for evacuating the population:

· preferred routes,
· ways and means,
· rallying points and sites for temporary shelters.

I. Those needed for the transport and burial of the dead:

· means of transport,
· sheets, stretchers, leather gloves, rubber gloves, boots, disinfectants, quicklime,
· spades, power shovels, earth-moving equipment.


A resource map prepared by the community committee for emergencies

Maps of the resources available in the event of a disaster are discussed at meetings attended by the various senior officials of the public services and local authorities. The meetings are open to other bodies interested (associations, voluntary groups, etc.). A resource map is not a professional cartographic product but merely a graphic summary of what has been agreed. The ideal would be for the maps to be accompanied by one or more leaflets or notices summarizing instructions to the population on what to do if disaster should strike the area.

Annex 9. Medical equipment of the health centre or hospital for coping with a disaster

The following is a model list of medical equipment and supplies that would be useful in the event of a disaster. The items selected will depend on the professional skills available in the team.

Syringes, sterile disposable, Luer 2 ml
Syringes, sterile disposable, Luer 10 ml
Needles, sterile disposable, 0.8 x 40 mm/G21 x 11/2” (0.8 x 38 mm)
Needles, sterile disposable, 0.5 x 16 mm/G25 x 5/8”(0.5 x 15 mm)
Interchangeable glass syringes, Luer 2 ml
Interchangeable glass syringes, Luer 10 ml
Interchangeable needles, Luer, 144 assorted
Sterile swabs
Suture set
Needle-holder
Scalpel handle
Artery forceps
Dissecting forceps
Disposable blades
Scissors, straight
Scissors, suture
Thermometer, clinical
Stethoscopes, standard and fetal
Sphygmomanometer, aneroid
Vaginal speculum, Graves
Tongue depressor, metal
Urethral sounds, Foley type Nos 10-18
Drains or tubes for thoracic drainage with ancillary equipment and bottles
Tourniquets
Assorted tips
Tracheal cannulae
Kit for intravenous injections in children
Laryngoscopes for neonates, children and adults (complete)
Endotracheal tubes
Oxygen masks for children and adults + oxygen supply
Nasogastric tubes, infant No. 5 (premature baby) polyethylene
Nasogastric tubes, infant No. 8 (newborn) polyethylene
Nasogastric tubes No. 12 polyethylene
Needles, epicranial
Gloves, re-usable
Gloves, sterile disposabl