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August 24, 1994

Nearly Two Millenia Later, 'Under the Volcano' Military Medicine Stresses Disaster Preparedness

JAMA. 1994;272(8):577-579. doi:10.1001/jama.1994.03520080015006

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TOWERING NEARBY is Mount Vesuvius, the volcano that—1915 years ago today—became active after centuries of quiescence and buried the Roman communities of Pompeii, Herculaneum, and Stabiae under 20 m of heated mud and ash. And in a volcanic crater of its own, amid escaping jets of steam and a strong sulphuric odor, is the US Naval Hospital, Naples, Italy.

Because of its location and for a variety of other reasons, the hospital's staff and US military medical personnel from elsewhere in Europe have just completed their fourth major disaster-preparedness exercise since 1987. It tested their ability to respond—successfully, as it turned out—"to a series of seismic events that render the hospital unusable and produce a number [224] of casualties and displaced persons."

Difficult Decisions  "In my opinion," says US Navy LT Joseph DaCorta, MSC, head of the hospital's Plans and Programs Department and the exercise's coordinator and planner, "the single

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