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Ambulances transport those injured in the Oct. 29 crowd crush in Itaewon to hospitals. (Yonhap)

Activity reports issued by the disaster medical assistance teams (DMATs) dispatched to provide on-site emergency medical support during October’s deadly crowd crush in Seoul’s Itaewon nightlife district detailed problems in the medical response to the disaster and made suggestions for improvements.

In particular, DMATs faulted the lack of a disaster treatment control tower and communication breakdowns and recommended that the authority to lead emergency medical stations — currently concentrated in the local director of public health — be dispersed.

The teams also called for reforming the communication system to enable smooth communications between the police, medical teams and the fire department, too.

A comprehensive reading of activity reports from 14 Seoul-area hospitals and 15 DMATs, obtained through the office of Democratic Party lawmaker Youn Kun-young, reveals that at the time of the disaster, DMATs had difficulty in providing on-site emergency care due to insufficient direction by the on-site emergency medical station.

DMATs file activity reports in accordance with the “Disaster Emergency Medicine Response Manual,” which calls for teams dispatched to the scene of a disaster to file reports with recommendations for handling patients and improving the disaster medicine system to the National Emergency Medical Center’s central emergency medicine situation room within a week after their deployment.

There was no emergency medicine control tower at the scene of the disaster on Oct. 29 because Yongsan District’s director of public health, Choi Jae-won, the person who should have led the emergency medical station, didn't arrive at the scene until nine minutes past midnight.

Even though Choi had arrived near the scene at around 11:30 PM, Oct. 29, he returned to Yongsan District Office, complaining that he “could not get to the scene because of the crowds.”

The jurisdiction’s director of public health must set up an emergency medical station and command and control medical support efforts at the scene.

Ultimately, an emergency medical station was set up at the scene a full two hours and 48 minutes after the disaster.

As a result, Seoul National University Medical Center's DMAT reported that it was “wandering around the scene of the disaster,” tending to patients on the street.

The DMAT of Ewha Womans University Mokdong Hospital arrived at the scene but was given nothing to do.

Medical teams also wasted time because the emergency medical station failed to apprehend the situation on the ground.

Korea University Guro Hospital’s DMAT received an order from the emergency medical station’s chief to move to the area in front of Hana Bank’s Itaewon branch, but there were no casualties there.

The team spent more than 20 minutes in vain making their way through the crowds to the emergency medicine station.

DMATs also complained of difficulties because of poor communication between the police, medical teams and fire department.

The manual calls for relevant agencies and the local government to communicate by creating a mobile situation room.

At the scene of the Itaewon disaster, however, agencies shared information on the situation using a group chat room on the messaging app KakaoTalk rather than the Public Safety Mobile Broadband, or PS-LTE, the national communication network.

DMATs said they couldn't ascertain the situation on the ground because the mobile situation room “wasn't organized, with too many posts going up in real time.”

They also complained that poor communication with the police meant teams “had to carry medical equipment from far away on foot” because the police weren't controlling the crowds and that “nobody was stopping ordinary people and journalists from entering the emergency medical station.”

DMATs called for a reorganization of the on-site emergency medicine command system.

Many teams proposed the splitting of authority between an emergency medicine specialist from the DMAT, the head of the control team (the fire department chief) and the public health director.

Seoul National University Medical Center’s DMAT wrote that “The DMAT doctors first dispatched to the scene should decide whether to set up an emergency medical station (tents) and designate and operate the DMAT's on-site roles such as the triage team, treatment team and transportation team.”

Roh Sam-kew, the former head of the National Disaster Management Research Institute, said that during a disaster, “in principle, experts with much knowledge or experience in the relevant field (medicine, rescue, etc.) should assume command instead of administrative managers.”

“DMAT teams could assume duties such as dividing roles or making additional deployment requests,” he said.

By Cheon Ho-sung, staff reporter; Um Ji-won, staff reporter

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