Unable to identify the deceased people | Identification problems | The challenge of dead body management | Workers' concerns about their families | Lack of attention to the safety and security of the personnel’s family | Psychosocial support for the responders | Unfamiliarity of the paramedics with the basics of triage | Lack of EMS paramedics’ and officers’ individual preparedness | Lack of preparedness |
Failure to effectively deal with the dead bodies | The importance of family status | Inadequate training of the paramedics and the lack of necessary skills |
Failure to properly define the mission for the deceased | Not having a developed program | Authorities’ failure to support the responder' families | Lack of paramedics’ readiness to provide services in disaster situations |
Carrying corpses instead of injured people with ambulances | Psychological disorders developing in the personnel | Lack of mental support | Personnel’s lack of familiarity with earthquake signs |
Not properly equipping the responders | Lack of equipment | Lack of facilities, equipment, supplies and ambulances | Employees’ fatigue because of large volumes of work | Lack of familiarity about how to respond to an earthquake |
Lack of equipment in the early hours | Failure to deal with personnel problems after the disasters | Lack of prior organization | Lack of organizational preparedness |
Equipment disproportionate to geographic area | Lack of personal security | Low attention to the safety and security of the responders | Lack of accurate planning to cover the costs of the crisis |
Lack of basic relief supplies | Fear of showing up on the field and its impact on decision-making | Lack of readiness to confront the disasters |
Failure to supply appropriate medications | Lack of supplies | Failure to supply water and food to the responders | Lack of support |
Lack of triage tags | The difficulty of making decisions in the early moments | The difficulty of decision-making in emergency situations | Failure to perform specialized exercises (between organizations and between relief agencies) |
Shortage of first-aid means | Simultaneously treating several patients | Lack of a disaster management room in EMS |
Small number of ambulances in the early hours | Lack or inappropriate ambulances | Lack of access due to the severe destruction of the villages | Closure of rural roads and alleys | Lack of access to villages and damaged areas | The ordinary people disrupting the first responders | Lack of community preparedness |
The number of ambulances being disproportionate to the mission volume in the first hours | The entrance of villages being obstructed |
Ambulances being disproportionate to the region | Lack of access to the areas in the early hours | Lack of familiarity of the residents with relief issues |
Ambulances not appropriate for disaster situations | Poorly-constructed regional roads | Poorly-constructed rural roads | The local people’s inability to perform proper triage |
Lack of advanced facilities and ambulances | Geographical conditions |
The impossibility of landing helicopters | Damage to the roads and bridges | Destruction of communication routes | The people’s inability to perform medical first aids |
Inviting people to help the responders | Community relief | Managing Volunteers and People's Aid | Road traffic | Misalignment in missions by ambulances | Lack of inter-sectional coordination | Lack of coordination |
People transferring the patients to health centers | Road closure |
Community members rescuing and prioritizing the injured | Failure to transfer experiences to other relief forces | No lessons learnt from the past | No lessons learnt from the past | Inconsistencies between pre-hospital and hospital emergencies |
People dominating the management of the scene | No lessons learnt from the past | Uncoordinated forces’ decisions |
The abundance of popular and organizational gifts | Community donations | Suspension of measures after the change of management | Uncoordinated management of ambulances |
The existence of spontaneous help from the people | Failure to improve post-earthquake affairs | Not learning from this earthquake | Lack of full access to all the facilities available at the local level |
People’s insistence on receiving services themselves | Challenges of people’s presence on the scene | Failure to act on the experiences of the Ahar-Haris incident | Non-therapeutic intervention in treatment | Lack of intra-sectional coordination |
The influx of people and residents into health and service centers | Not taking advantage of past experiences | Lack of document actions | | Unfamiliarity of the organizations involved in responding with each other’s tasks |
Involvement of ordinary people in therapeutic measures and triage | Failure to record the response experience | Lack of coordination between the organizations |
The gathering of people and residents in health centers | | | Lack of coordination in supplying staffing needs |
Calling on all the ready forces | | Recall and management of volunteers | Disconnection from all sources of communication in the early hours | Communication interruptions | The challenge of communicating with earthquake-affected areas and between teams | Relief turmoil in the affected villages | Lack of unity of commands |
Quickly sending donations from other provinces | Satellite phones not operating | Lack of access to the authorities |
Deployment of forces from different routes | Calling on and dispatch of forces | Unaccountability of the officials |
Rapid deployment of responders from Tabriz center | Difficulty of communication with the rescue teams | Lack of communication equipment | Not offering a definition of responsibility to the forces |
Cooperation and readiness of other provinces | Lack of communication equipment | Lack of time management for helping in the early hours |
The arrival of auxiliary forces from neighboring cities | Lack of private communication systems | Poor allocation of paramedics to the areas |
High sense of responsibility among the personnel | High motivation to provide services | Lack of communication equipment in ambulances | Collecting earthquake information by visiting the site | Failure to perform a quick assessment in the first hours |
Rapid arrival of equipment and assistance from Tehran | Lack of physical facilities for communication | Dispersed information in the first minutes of the incident |
Fast delivery of equipment | Lack of access to SMS | Results from communication problems | Failure to perform an early initial needs assessment |