Case report

Mark S. Johnson

Chief, Section of Community Health and Emergency Medical Services, State of Alaska, USA

Correspondence:
Mark S. Johnson
Chief, Section of Community Health and Emergency Medical Services
Division of Public Health
Department of Health and Social Services
P. O. Box 110616
Juneau, AK 99811-0616 USA

Key Words: aftershocks; aid; casualties; crush syndrome; earthquake; international responses; Neftegorsk; relief; relocation; responses; search and rescue; search dogs; survivors;

Date Received: 29 December, 1995

Accepted: 08 March, 1996

Abstract
An earthquake with a magnitude of 7.6 struck the town of Neftegorsk (population about 3,000) on 27 May, 1995. This paper describes the devastation and the human aspects of the catastrophe of the first week following the quake. A total of 1,995 persons were found dead under the rubble, including 268 children less than 16 years of age. There were 1,144 survivors. A total of 406 person were rescued alive from under the rubble of which an additional 37 persons died in a hospital following rescue. Most of the survivors have been relocated, but some remain in the area. There remains a need for psychological support for the survivors and rescuers.
Johnson MS: The Tale of the Tragedy of Neftegorsk, Prehospital and Disaster Medicine 1998;13(1):59-64.

At 23:04 hours (h) local time, on Saturday, 27 May, 1995, an earthquake with an estimated magnitude of 7.6 on the Richter scale struck northern Sakhalin Island in Russia. The epicenter was 125 km (75 miles) south of Okha, a city with a population of about 45,000. Sakhalin Island is more than 6,550 km (4,000 miles) east of Moscow, and the southern tip of the island is 90 km (55 miles) north of the Japanese Island of Hokkaido (Figure 1). The town of Neftegorsk is 60 km (37 miles) south of Okha, and had 3,176 residents prior to the earthquake. It virtually was leveled by the quake (nearly 100% destroyed).

The earthquake caused the collapse of 17 five-story apartment buildings, with 80 apartments each, as well as four apartment buildings with 16 apartments each, the town hall, the administration building, a heat generating building, and a number of shops. Most of the collapsed buildings had been built of prefabricated concrete panels with little or no reinforcement. Most of these buildings were built in the 1960s. Witnesses said the buildings in Neftegorsk collapsed in less than one minute. In Okha, balconies fell from apartment buildings, and in many houses, walls cracked and furniture was broken. Ten buildings, with 80 apartments each, were damaged beyond repair, but there were no reports of serious injuries or fatalities in Okha.

The initial quake also ruptured an oil pipeline running north from Neftegorsk ("oil field services town"), and destroyed oil wells. An unknown quantity of oil was spilled onto the land.

The following morning, rescue efforts were severely hampered by fog. Approximately 2,500 residents of Neftegorsk had been buried in the rubble. Aftershocks continued to rock the region Sunday. One man hacked himself free with a small saw, then dug out his daughter with the saw and his hands after seeing his daughter's hand and hearing her voice (3.5 hours). Another man had saved his wife and children by pushing them out of a second story window as the building collapsed.

As rescuers arrived, tent camps were set up for those evacuated from the town. Russian authorities sent field hospitals and other relief supplies.

The nearest airport capable of handling large cargo planes was 656 km (400 miles) to the south in the capital, Uzhno-Sakalinsk, and fog and poor roads made the trip to the north difficult and impeded relief efforts.

By the end of the first day, local rescue and medical teams from Sakhalin Island, as well as from Khabarovsk and the Kamchatka Peninsula, arrived in Neftegorsk by road or with helicopters. These personnel included more than 200 rescue workers, aboard six helicopters and 10 airplanes. Other rescue teams were flown into the area, including a special urban search and rescue team and equipment from Moscow.

As cranes arrived from neighboring towns, they were engaged to lift large chunks of concrete from the rubble. Several survivors may have been killed when the cranes lifted these panels too quickly, thereby jarring the piles and shifting some of the concrete rubble. After hearing the screams, rescuers began to work more slowly.

By Sunday evening, 224 injured victims, including 42 children, had been taken to the 500 bed central hospital in Okha, or to hospitals in Khabarovsk, 820 km (500 miles) away on the Russian mainland.

Now, more than 500 rescue workers and dozens of helicopters had arrived in the Neftegorsk area. Moans could be heard as rescue workers frantically tried to free trapped victims from the rubble. As victims were freed, doctors amputated crushed legs and arms.

By late Monday, rescuers had found 938 survivors. Bodies lay on the ground under blankets and cloth scraps and limbs poked out of the rubble as cranes plucked concrete slabs from mountains of debris. Stunned survivors combed through ruins or examined lists of the dead. Some wept. Others simply stared off into space. According to Raisa Mikhailova, municipal spokeswoman for Okha, about 500 people who lived in four, three-story brick buildings in Neftegorsk, had managed to get out safely.

An icebreaker was sent from the Russian mainland to clear a path for a hospital ship through the one-meter (3 feet) thick ice around the northern end of the island. Some of the injured also were taken to Vladivostok, 1,475 km (900 miles) to the southwest on the mainland.

As night came, temperatures dipped below freezing, adding to the urgency to free the trapped victims. According to a Russian television reporter, "When the sun sets and the rescue equipment stops, the town starts moaning. These are the moans of those buried under the rubble." Eight people were arrested for looting, so police were closing the town.

Japan offered to send aid. South Korea offered [US]$1 million in emergency relief. Sakhalin has a large ethnic Korean minority.

On Tuesday, cranes and bulldozers fell silent for an hour as rescuers strained to hear the cries of injured people buried in the debris. During that day, they found 32 people still alive in the rubble. By the end of Day 3, they had found 372 people alive, many in critical condition, and 377 dead bodies in the rubble. Regional government officials feared the death toll could surpass 2,000 and declared that the town would not be rebuilt.

The small airport at Okha was a flurry of activity as soldiers unloaded supplies and crews carried victims on stretchers. Some women and children cried as they waited to be evacuated. Throughout the day, cargo planes loaded with rescue and subsistence supplies and wood for building coffins arrived; and then the aircraft returned to the Russian mainland carrying injured survivors. Many survivors refused to leave Neftegorsk, keeping campfire vigils near their ruined homes. Rescuers worked through the night under the glare of floodlights. One rescue team from a mining town had spent 8 1/2 hours Tuesday digging out a woman and a little child.

Mikhail Yalch, a 42 year-old survivor said there had been no time to react during the earthquake. "My 12 year old son, Anton and I were watching TV, when one powerful shock threw me off the sofa and the ceiling crashed down." He told the ITAR-TASS news agency. "I woke up in complete darkness and discovered that I was in a small, narrow hole between two panels, and that my legs were hopelessly pinned down." Yalch, whose wife also survived, said he later found his son. "He was still on the sofa, and his head was broken in....We lost in one day, all that was so precious: our son, our home, our health, our peace of mind, and confidence in the future." Another survivor, Ivan Laryushkin, a 33 year old oil worker, described the quake as "a sound like a Grad missile [surface-to-surface]being fired... I grabbed my daughter and we ran outside with my wife...There was a terrible silence. And then, as one, people began to moan and scream for help. I stood there and thought: there is nothing I can do...There was no town, only smoke and darkness. The buildings had collapsed, and they were burning." His family had escaped because they were living in a small, wooden house, but his parents were buried in the rubble. "They are telling us to leave, threatening to take us away, but I won't leave until we find all the dead and bury them."

On Day 3, international aid began arriving on Sakhalin. Japan airlifted 50 tons of food, water, tents, generators, and other equipment into the area. Another 27 tons of medical supplies and equipment from the aid group Doctors Without Borders, was on its way from Belgium.

In Okha, many residents, fearing aftershocks, abandoned their apartments and took shelter in garages or summer cottages. They were keenly aware that their homes are the same type of shoddy-style buildings that collapsed like a house of cards in Neftegorsk. Many of Okha's unreinforced concrete buildings dating from the 1960's were left with major cracks. "I'm still very afraid of earthquakes," said Elena Azizova, a 17 year-old student, shivering from cold and fear as she sat at a makeshift table drinking tea late Tuesday night. A heavy mist was falling, and patches of snow lay on the ground. No one in her family was hurt in the quake, but it terrified them. "The walls were shaking like jelly and I couldn't understand what was happening. We didn't know what to do," she said. She and her family had fled into the night, taking only blankets with them. They found shelter in a garage a few hundred meters away. They did not intend to return to their apartment for several days, despite temperatures dipping below freezing at night.

According to a report from Japan's Kyodo News Service, entry to Neftegorsk was banned to all but rescuers because of fears of a possible epidemic. Police had been ordered to blockade the town.

Rescuers decided they should first dig into debris where children were believed trapped. Crews already working at sites where people were screaming from beneath the rubble were diverted to the search for the children. Some relatives screamed with anger and disbelief as crews diverted to other sites.

Trapped by the fallen walls of her apartment, a woman named Alla waited for help as she lay near her dead husband. At times, she could hear moans through the rubble. Combing through the ruins of apartment block no. 7, rescuers found Alla first with her husband lying dead next to her on the bed. Alla, 35, was still trapped and immobilized. Rescuers shored up the walls that formed a dark, triangular cave around her, and gave her a mask against the smell of decomposing flesh until she could be freed. She told rescuers that she thought the nearby moans were coming from her neighbors' children, 6 year-old Masha and 8 year-old Alexei. The rescuers frantically began to race to save the children. It was Tuesday night-nearly three days since the quake.

By dawn Wednesday, the rescue team had determined that Masha and Alexei were a few yards above and to the right of Alla near the top of a huge pile of rubble. Their parents, who according to another survivor had been sleeping nearby, were dead. Using crowbars, shovels, and their bare hands, the workers - who hadn't slept in four days - cleared just a portion of the terrible heap, a compressed pile of concrete, brick, furniture, belongings, and bodies. Masha was okay, her arms and legs were intact. Alexei was not answering, just moaning." We were speaking with Masha and suddenly she started to shout that stones were falling on her. A while later, a tiny hole opened in the concrete panel directly on top of Masha. One worker crawled to it on his belly and lowered a plastic tube through which Masha could drink water - though workers still could not see her. "Masha my sweet. Don't be afraid. This is the last panel," the worker implored. "Here, can you see my flashlight? Is it closer to your head now? Or, to your legs?" The others kept digging, using a crane to lift heavy pieces of wood to try to reach Alexei. "Stop!," came a sudden shout. "A panel is sliding down on her. She has stopped talking." Finally, the workers saw Masha through another crack. With the help of a periscope-like gadget, they also could make out Alexei lying on some metal mesh. Access to both children was blocked by broken pieces of furniture. After an agitated discussion, the workers decided to cut through to the children by removing a side panel - despite the risk that it could tilt the whole fallen house, bringing concrete and bricks down on them. The rescuers proceeded quickly, but carefully, using an air pillow and pneumatic devices to push the panel aside.

Suddenly, it gave way! From that moment, Alexei's life hung on a minute's hesitation. Tainted blood could rush into his body from his suddenly freed limbs, killing him from blood poisoning. "A tourniquet, give me a tourniquet!" one worker shouted as others frantically dug debris from the widening crack. Then, the child's small body emerged like a prize, lifted by a dozen hands. Wrapped in a blanket, he was carried down and rushed away in a hospital van. "It seems he'll live," one tired rescuer said. "His color was all right."

More than 13 hours had elapsed since Alla, still lying in her concrete cave, had told them about the children. Rescue workers still were stymied by the precarious position of the walls that trapped her. But, first, there was another child to worry about.

"Masha! Don't worry. We'll get you out!" a worker shouted into the hole. "It's your turn now." After freeing Masha, the rescuers finally returned to Alla and freed her. Alla, Masha, and Alexei all survived.

Rescuers continued to poke periscopes into the rubble, searching desperately for more survivors. The body count had reached 445, but everyone knew the final toll would be much higher. At mid-morning and mid-afternoon, rescuers switched off all the cranes and machines. Amid the quiet, they would shout at the heaps of rubble: "Is there anybody alive?" Sometimes the answer was "yes" amid muffled groans and pleas for help. Most of those pulled out had critical injuries and crushed limbs, so rescuers were stunned when they removed a slab of concrete and discovered 58 year-old Vladimir Chichin, who had been buried beneath his apartment building. Rescuers had talked to him constantly during the five hours it took to dig him out. When finally freed, he pulled on his pants and walked out, taking a drink from a flask someone handed him. "Thank you my sons," he said. "Thank you for keeping me alive." Then he was taken to a hospital to be checked over.

According to the Ministry for Emergency Situations, by Wednesday afternoon, 388 injured had been found. Across Russia, flags flew at half-staff, and television stations canceled regular programming to observe a national day of mourning. According to news reports, offers of help from abroad continued to pour in.

In Neftegorsk, a man walked the dusty road with his wife, carrying the tiny body of their child wrapped in a carpet. A truck passed, filled with coffins. Dozens of bodies, wrapped in blankets, carpets, and brightly covered pieces of clothing awaited identification. According to Russian television, Neftegorsk had its first mass burial Wednesday for 26 people, .

Rescuers worked through the night, in 33º F (0º C) degree temperatures, digging by the light of miners' lamps, headlights, and generator-powered floodlights. They did much of the work by hand. Death was everywhere, and the overpowering stench grew stronger by the day.

Two strong aftershocks shook the ground in Neftegorsk on Thursday. Some seismologists predicted that another major quake could hit the area soon. Dozens of angry, grumbling, earthquake survivors confronted regional officials, demanding money to flee to mainland Russia. The homeless crowd erupted in shouts when told the government planned to resettle them elsewhere on Sakhalin Island. "Give us money. We'll decide where we want to live! We want to go to the mainland! Let us leave!" the townspeople shouted. Officials had offered to resettle people in Okha or the regional capital, Uzhno-Sakhalinsk, 656 km (400 miles) south, or to Nogliky, 200 km (120 miles) to the south.

While townspeople and officials talked, rescue crews continued to search desperately for survivors. So far, they had found 401 survivors in the rubble, and 619 bodies.

While some rescuers carefully picked through the ruins by hand, other crews began attacking mountains of rubble with bulldozers and heavy cranes.

"There are fewer and fewer chances, but there are still people alive in there," said Yuri Vorobyov, Russia's Deputy Emergency Situations Minister. Earlier that day, one woman had been pulled out alive.

Prosecutors opened a criminal case to investigate claims that, according to the Interfax news agency, shoddy construction contributed to the deaths.

On Friday, a small boy was pulled out alive from the rubble. Crews that painstakingly had been digging through the debris by hand, were preparing to leave. More bulldozers and cranes were moving in. Sergei Shoigu, Russian Minister for Emergencies, said that although there were faint signs of life under the rubble in five places, rescuers weren't hopeful anyone could be extricated alive. But he said that the search would continue.

By Friday, 861 bodies and 405 survivors had been found in the rubble. The people trapped under the debris faced daunting odds: crush injuries, freezing temperatures, thirst, hunger, shock, and despair. Officials were reluctant to declare the search hopeless. But rescue workers said privately there was scant hope. Several said Thursday's hour of silence, when bulldozers and cranes shut down to let rescuers listen for cries and moans beneath the wreckage, was likely the last. People collected their dead at a dirt courtyard between a ruined school and a sandy road. One woman was busy gluing a piece of paper, with an address, to a coffin. A man, naked to the waist, his torso criss-crossed with cuts and smears of bright green antiseptic, was busy pacing endlessly. He carried a blanket wrapped around the body of his dead baby. "I'm just walking her," he said when someone approached. "Just walking her."

Swollen and disfigured, the dead lay on the ground wrapped in carpets, old clothes, or scraps of cloth. Later, the scraps were burned in a constantly smoking pit nearby. Relatives lined coffins in white, then, wrapped them in red. Nearby, the body of a naked woman lay in an open coffin. A grown daughter sat on the ground, holding the corpse's arm. The bodies stayed for a day or two. If no one claimed them, they were hauled away in trucks with the word "unknown" written in chalk on the lid.

On Saturday, the stench of death wafted throughout the area. Lina Abanashenko's grief was tempered with anger. Her mother was buried under tons of concrete. Searchers were on a dinner break, and no one was looking for her mother, dead or alive. "There are not enough crane operators here," she said, pointing to a line of idled machinery.

Survivors, relatives, and searchers seemed to agree: rescuers had worked as hard as they could, but some said that aid had come too slowly, and often it was discouraged by officials. A total of about 1,500 people had taken part in the search. Half the searchers were professionals, the other half were conscripted soldiers and volunteers. Cranes had been mobilized from around the island, but some took more than four days to arrive. Seven fire department volunteers from Nogliky, a town 200 km (120 miles) to the south, had been delayed two days because an official from Nogliky first decided to travel to the quake zone to confirm that their help was needed. When they finally received permission to go, the drive took nine hours on unpaved roads. Meanwhile, several fires had started under the concrete piles.

One man, who went almost three nights without sleep as he pulled at ruins to find friends and relatives, shook with rage as he described the arrival of the first professional rescuers. "There were so many screams of survivors coming from the piles," said Sergei Dzhashkhunov, 40. "But the first thing the rescuers did was set up their tents." One medical team appeared to work with speed and efficiency. It turned out it had been in Chechnya. Another group that was given high praise, was a seven member group of professional alpine rescuers from the Siberian city of Kurgan. But, according to some reports, many rescuers clearly were unable to cope with the situation. "I saw some of the soldiers were drinking vodka yesterday," said Abanashenko, the woman whose mother was among the missing. "Maybe this is because of the terrible things they are seeing." She said a friend, who came from the mainland to search for his buried parents, had to pay bribes at security checkpoints to enter the town, and that some rescue workers were hoarding bottled water sent as emergency foreign aid.

Families of those still missing, watched in agony as weariness and loss of hope began slowing the search effort. "They are now working very slowly, because they believe that no one is left alive," said Anna Krepkova, 60. Nine members of her family still were missing. Krepkova said that she would stay at the ruins until all were accounted for. "Just because they can't hear any more voices doesn't mean no one is left alive," she said, weeping. Rescue workers found no survivors on Saturday, but two people had been found alive on Friday night, according to the ITAR Tass news agency. Yuri Vorobyov, of the Emergency Services Department, said survivors' anger was understandable, but misplaced. "There are many relatives here that are angry because they want us to work on their houses first," he said. "There have been a lot of confrontations ... but it's impossible to work everywhere immediately."

According to Sakhalin Vice Governor, V.I. Belonosov, a total of 1,995 people were found dead in the rubble, including 268 children under 16 years old. Thirty-seven people later died in hospitals. Four hundred, six people were rescued from under the ruins, including 40 children. The 405th person rescued was a little girl, 1 month old, on the 6th day. She was not seriously injured and was in good shape. Seventy-one children lost both parents. As of early July, over 3,000 families from throughout Sakhalin Island had offered to adopt these children, and 12 of them already had been placed. Of the 1,144 survivors from Neftegorsk, there were 156 children 12 years old or younger. The Regional Health Minister, Konavolov said that 26 victims had suffered amputations, including 10 children under 16 years of age. Four of the children had been sent to Japan for recovery and rehabilitation, and were to be fitted with prosthetics. The remaining children had been sent to hospitals in Khabarovsk and Vladivostok. He said that there is a workshop in Khabarovsk for making prosthetics, but, in his opinion, the technology was not as good as in the United States. He expressed hope that better, state-of-the-art prosthetics could be provided to the children.

According to Minister Konovalov, Neftegorsk had been built as an oil field-support center in the late 1950s and early 1960s. It had been touted as a model town, with modern apartments, summer dachas and gardens, and a town hall with a disco and movie theater. He said that, on the night of the quake, many students were in the town hall at a dance celebrating the end of the school year. Most of them died when the building collapsed. Governor Farkhutdinov and several of his deputies had spent 10 days in Neftegorsk, arriving about 14 hours after the earthquake struck.

Mr. Belonosov praised the rescue teams from Moscow sent by Sergei Shoigu, Russian Minister for Emergency Situations. He said that this rescue team, which had modern rescue equipment and search-dog teams, had arrived about 40 hours after the quake. One of the search dogs had found 28 people alive under the rubble. Mr. Belonosov also said that the rescue could have been better coordinated if all of the rescuers had had personal radios. He said all of the rescue teams were Russian. Some were from coal mines, some were loggers and lumber workers, and others were construction workers primarily from other areas of the Russian Far East. Mr. Belonosov said that he thought there was a need for crisis mental health counseling for rescuers and victims. He said most rescuers had worked 18 to 20 hour days. He concluded that more people needed to be trained on what to do in major disasters, including earthquakes. He also said that people should be taught how to give signals if buried under ruins, and not to panic. There had been reports that most cats had run away two days before the quake (although others expressed skepticism at this report). After the quake, rescuers had to shoot some mad dogs. Mr. Belonosov said that there were no reports of any infectious disease problems following the quake.

By early July, there were approximately 300 to 400 people still left homeless in Neftegorsk, living in summer dachas on the perimeter of the town, most with no running water, plumbing, electricity, or heat.

On 31 May (Day 4), Alaska Governor Tony Knowles called Governor Farkhutdinov to ask what assistance Alaska could provide. Farkhutdinov said his number one priority was prosthetics and wheel chairs for the disabled victims. Following that conversation, Knowles formed a task group, including representatives from state agencies, the city of Kenai (which has a sister city relationship with Okha), the Kenai Peninsula Borough, an oil field services company doing business in Sakhalin, the Salvation Army, and the Red Cross. A statewide campaign was initiated to request cash donations, wheel chairs, prosthetics, and other medical and rehabilitation equipment and supplies. Over the next few weeks, 20,000 pounds of supplies were collected. A significant quantity of supplies (about 5,000 pounds of quality medical supplies and pharmaceuticals) was received from MAP International in Brunswick, Georgia, a Christian, non-profit, international relief agency that often works with the U.S. government. Other cash or supplies donations came from other state and national agencies, organizations, and private corporations. Governor Knowles then received approval from the U.S. Departments of Defense and State (under the Denton Program), and from the Russian government, to fly an Alaska Air National Guard C-130 aircraft to Okha to deliver the supplies to the central hospital where many of the victims had been treated. Governor Knowles personally accompanied this shipment along with a small delegation of other Alaskans. After stopping in the capital, Uzhno-Sakalinsk, to meet with Governor Farkhutdinov, the plane load of supplies was delivered to the chief doctor at Okha's hospital on 10 July. As the supplies were being unloaded, the Knowles-Farkhutdinov delegation was transferred to a helicopter and flown to Neftegorsk. By the time the Alaska delegation arrived, most of the town had been leveled by bulldozers. The center of what only a few weeks before, had been a thriving community of over 3,000 people, was a flat, level piece of sandy soil. A few partially collapsed buildings had not yet been bulldozed, and the periphery of the former town was dotted with summer dachas and gardens. Near the center of the former town, a statue of Lenin still was standing. The graveyards were crowded with row after row of nearly 2,000 fresh graves, many with fresh flowers and ribbons on the new wooden crosses. One grave marker read, "Unknown little girl, 0 to 5 years old."

After touring the devastated town, they were about to leave when some of the 300 to 400 remaining townspeople approached Governor Farkhutdinov to complain about being left virtually homeless and abandoned. Farkhutdinov told them he was doing everything in his power to get financial vouchers from Moscow so they could get free transportation and housing elsewhere in Russia. Unfortunately, the Russian Finance Minister had not yet signed the necessary papers. Farkhutdinov told them his plan was to relocate all remaining survivors, finish leveling what was left of the town, and build a monument to the victims. Despite his promises, several members of the crowd were angry or upset. Governor Knowles stood and watched this exchange for several minutes, and then began to address the crowd. He told them about Alaska's catastrophic earthquake in 1964, that Alaskans understood what they had experienced, and how Alaskans had donated over $1 million of medical supplies. He continued to address the crowd with Governor Farkhutdinov, and after another 15 to 20 minutes, the mood of the victims seemed to improve. By the time the delegation left, several people thanked the two governors for listening to their grievances.

On 16 August, President Yeltsin issued a decree allowing the Government of Sakhalin to use all oil revenue, through the end of 1995, for repairing earthquake-caused damage, or to rebuild facilities that were not repairable.

Despite discussions between the Alaska delegation and Sakhalin officials about possible follow-up assistance for the amputee victims to be fitted for prosthetics, no formal requests for this type of assistance had been received.

References
Most information for this article was obtained from Associated Press reports from Saturday, 27 May through Friday, 16 June. AP reporters included: Dave Carpenter, Moscow; Sergei Shargorodsky, Moscow and Neftegorsk; Simon Beadsworth, Uzhno-Sakhalinsk; Paul Ferguson, Khabarovsk and Okha; Natasha Alova, Moscow; and Jeffrey M. Bond, Okha.

Other information was obtained by the author in personal interviews with Russian officials on Sakhalin Island. Mark S. Johnson, Chief of the Emergency Medical Services Section, Alaska Department of Health and Social Services, served on Governor Knowles's Sakhalin Earthquake Assistance Task Group, and accompanied Governor Knowles and his delegation to deliver medical supplies to the central hospital in Okha on Sakhalin Island.

Return to Table of Contents

Return to PDM Homepage