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Last Updated: Monday, 6 September, 2004, 16:35 GMT 17:35 UK
The strain on Russia's health service
By Nick Triggle
BBC News Online health staff

A young victim of the school siege arrives at a hospital
The sheer scale of the Russian school siege tragedy has meant the health services and aid agencies have been stretched to the limit.

With more than 700 people, the majority children, hurt in the siege in the southern Russian town of Beslan last week, victims have been evacuated to hospitals across the country.

Nearly 400 wounded remain in hospitals in North Ossetia with burns and blast and gunshot wounds.

But some of the most seriously injured have been flown to Moscow for specialist treatment.

When Russian security forces stormed the school on Friday the hostages were taken to the Beslan hospital and treated at an emergency field hospital.

But as the storming started unexpectedly there were reports of injured children being ferried to hospitals by car.

Struggle

The health service in Beslan, which only has a population of 40,000 people, soon started to struggle with the numbers of injured.

Within hours many of the wounded were sent to the three main hospitals in Vladikavkaz, the capital of North Ossetia.

The children's hospital took the majority. More than 200 children were being treated there on Monday.

Chief doctor Boris Digorov outlined the Herculean task facing staff treating horrific bullet wounds, mutilations caused by mines and bombs, and gaping cuts after a three-day hostage crisis that ended in carnage.

The biggest problem they faced was having enough equipment
Vincent Lusser, of the International Committee of the Red Cross

He told the AFP news agency: "What we are lacking above all is medication and the equipment used in neurosurgery as we have patients who have been badly wounded in the head.

"We don't have proper beds for the hostages who have been seriously injured and are coming out of intensive care.

"The Red Cross has already given us boxes of medicine, but even if we have not asked for anything we are takers of any kind of aid in the shape of medicine, radiological equipment and ultrasound apparatus."

On Sunday, 17 of the most seriously injured victims were flown from Beslan airport to Moscow for specialist treatment.

Burns

Doctor Andrei Seltsovsky, the head of Moscow City's Health Department, said the majority of them were children suffering from burns and wounds from gunshots and shrapnel.

He told Associated Press: "There were fairly serious wounds requiring a great effort from the doctors to save their lives and help them recover."

Doctors have also had to treat children who have lost eyes and been crushed when a roof collapsed. Many will be left permanently handicapped by their injuries.

Russians have been giving blood to help the wounded

Aid has already started flooding from humanitarian agencies and other countries.

Immediately after the siege the International Committee of the Red Cross donated 60,000 of medical equipment.

While Italy sent emergency supplies over the weekend, including antibiotics, first aid kits, medicines and antidepressants, which arrived at hosptials in Vladikavkaz on Monday.

The US has promised to send two planes with "many tonnes" of medical equipment and supplies and Germany 100,000 euros of medicines and equipment.

French aid agency Medecins Sans Frontieres (MSF) is also on the ground, supplying surgical kits and bandages and hundreds of Russians have also queued to give blood an haematology centres.

But on Sunday the Russian Red Cross appealed for more international aid, saying the North Ossetian hospitals were short of 10 ventilation machines and an equal number of machines to administer anaesthetic through breathing masks.

Equipment

Vincent Lusser, who is helping to co-ordinate the International Committee of the Red Cross (ICRC) response in Russia, told BBC News Online the country had a large pool of medical staff and good co-ordination between the regional health ministries.

"The North Ossetian Health Ministry has received help from other ministries and doctors and other staff have been transferred from Moscow.

"The biggest problem they faced was having enough equipment.

"They needed medicines, monitors, ventilation equipment and anaesthetics to treat people with bad burns."

On Monday, Mr Lusser said the health service had enough resources but tomorrow that could change.

Injured child
Children have suffered burn, gunshot and shrapnel injuries

"With disaster on this scale the situation changes every day. At the moment the hospitals are coping but there are just so many wounded."

But MSF also believe the strain on the health service will last beyond treating the physical injuries.

A spokeswoman said: "In the future we will have to deal with the psychological trauma these kids have suffered.

"Some have terrible injuries, others have lost parents, they are not going to recover straight away."

Paediatric psychologist Zara Arbieva, based at the children's hosptial in Vladikavkaz, agreed. "So many of these children have lost their mother. This will make their recovery longer and more difficult."


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