Volume 2020, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094


Mass casualty incidents (MCIs) in disasters across the globe are inevitable, and the emergency medical services (EMS) system has played a significant role during such events. This historical review seeks to examine the history of EMS response to MCIs in disasters in Saudi Arabia. Since the first recorded disaster in 1964, the Kingdom has witnessed a range of catastrophic events, causing many deaths and injuries and related economic damage. The country's EMS system dates back to 1934 when it was first incorporated into the health care system. Since then, EMS have responded to various MCIs by providing critical pre-hospital care to casualties during disasters. However, barriers affecting the service delivery often complicate those responses. Additionally, elderly people manifest unique challenges due to their age, which constrains EMS system effectiveness. Therefore, future studies should focus on such barriers to ascertain future EMS system efficiency.


Article metrics loading...

Loading full text...

Full text loading...



  1. Mayner L, Smith E. The conceptual basis of disaster management: Definitions and terminology. In: Fitzgerald GTarrant MAitken PFredriksen M, eds. Disaster health management: A primer for students and practitioners. Oxon, England: Routledge 2017;:320.
    [Google Scholar]
  2. Bin-Shalhoub AA, Khan AA, Alaska YA. Evaluation of disaster preparedness for mass casualty incidents in private hospitals in Central Saudi Arabia. Saudi Med J. 2017; 38:3:302306.
    [Google Scholar]
  3. Substance Abuse and Mental Health Services Administration-SAMHSA. Types of disasters 2018;. Available from: https://www.samhsa.gov/find-help/disaster-distress-helpline/disaster-types (Accessed 10 October 2018).
    [Google Scholar]
  4. DeNolf RL, Kahwaji CI. EMS, Mass Casualty Management. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2019.
    [Google Scholar]
  5. Al-Shaqsi S. Models of international emergency medical service (EMS) systems. Oman Med J. 2010; 25:4:320.
    [Google Scholar]
  6. Catlett CL, Jenkins JL, Millin MG. Role of emergency medical services in disaster response: resource document for the National Association of EMS Physicians position statement. Prehosp Emerg Care. 2011; 15:3:420425.
    [Google Scholar]
  7. Al Arabiya. Bahraini man who circumambulated Kaaba during 1941 floods dies [press release]; 2015, May 17. Available from: http://english.alarabiya.net/en/perspective/features/2015/05/17/Bahraini-man-who-circumambulated-Kaaba-during-1941-floods-dies.html (Accessed on 10 October 2018).
  8. Hijji M, Amin S, Iqbal R, Harrop W. The significance of using “expert system” to assess the preparedness of training capabilities against different flash flood scenarios. Lecture Notes on Software Engineering. 2015; 3:3:214.
    [Google Scholar]
  9. Amin S, Hijji M, Iqbal R, Harrop W, Chang V. Fuzzy expert system-based framework for flood management in Saudi Arabia. Cluster Comput. 2017;118.
    [Google Scholar]
  10. Tammar A . Assessing resilient post-disaster recovery of a flash-flood-Prone area: A study of the city of Jeddah. Kingdom of Saudi Arabia [Doctoral dissertation]: Wilfrid Laurier University; 2017. Availble from: https://scholars.wlu.ca/etd/2013/?utm_source = scholars.wlu.ca%2Fetd%2F2013&utm_medium = PDF&utm_campaign = PDFCoverPages (Accessed on 20 October 2018).
  11. Al-Otaibi A . An assessment of the disaster preparedness knowledge of emergency medical services providers in Hajj of 2016 [Doctoral dissertation]: University of Louisville; 2018. Availble from: https://ir.library.louisville.edu/etd/2993/ (Accessed on 24 October 2018).
  12. Center for Research on the Epidemiology of Disasters – CRED. Saudi Arabia profile: natural disasters. Available from: https://www.emdat.be/emdat_db/ (Accessed 02 January 2019).
  13. Al-Thobaity A, Plummer V, Innes K, Copnell B. Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia. Aust Emerg Nurs J. 2015; 18:3:156164.
    [Google Scholar]
  14. Chakraborty A, Mujumdar M, Behera SK, Ohba R, Yamagata T. cyclone over Saudi Arabia on 5 January 2002: A case study. Meteorol Atmos Phys. 2006; 93:1-2:115122.
    [Google Scholar]
  15. Abosuliman SS, Kumar A, Alam F. Disaster preparedness and management in Saudi Arabia: an empirical investigation. International Journal of Social, Human Science and Engineering. 2013; 7:12:295299.
    [Google Scholar]
  16. Abosuliman SSKumar AAlam FRasjidin R, eds. Disaster planning and management in Jeddah, Saudi Arabia. In: Proc 2013 International Conference on Economics and Social Science (ICESS 2013) 2013;2021.
    [Google Scholar]
  17. Alamri YA. Rains and floods in Saudi Arabia. Crying of the sky or of the people? Saudi Med J. 2011; 32:3:311313.
    [Google Scholar]
  18. Ameur F . Floods in Jeddah, Saudi Arabia: unusual phenomenon and Huge Losses. What Prognoses. 3rd European Conference on Flood Risk Management: EDP Sciences , 2016110.
  19. Khan AA, Noji EK. Hajj stampede disaster, 2015: Reflections from the frontlines. Am J Disaster Med. 2016; 11:1:5968.
    [Google Scholar]
  20. The Guardian. Saudi Arabia tightens up hajj planning to avoid repeat of 2015  disaster [press release]; 2016, September 05. Availble from: https://www.theguardian.com/world/2016/sep/04/saudi-arabia-tightens-up-hajj-planning-avoid-repeat-2015-disaster (Accessed 07 January 2019).
  21. General Authority for Statistics. Population characteristics surveys2017. Availble from: https://www.stats.gov.sa/sites/default/files/population_characteristics_surveysar.pdf (Accessed on 16 December 2018).
  22. Saudi Geological Survey. The Empty Quarter2010;. Available from: https://www.sgs.org.sa/english/earth/pages/emptyquarter.aspx (Accessed on 16 December 2018).
  23. Ministry of Foreign Affairs. About Saudi Arabia. Available from: https://www.mofa.gov.sa/sites/mofaen/aboutKingDom/Pages/KingdomGeography46466.aspx (Accessed on 17 December 2018).
  24. General Authority for Statistics. Hajj statistics of 2017. Available from: https://www.stats.gov.sa/sites/default/files/haj_1438.pdf (Accessed on 17 December 2018).
  25. Alraga SM. An Investigation into Disaster Health Management in Saudi Arabia. Journal of Hospital & Medical Management. 2017; 3:2:114.
    [Google Scholar]
  26. Hegghammer T, Lacroix S. Rejectionist Islamism in Saudi Arabia: The Story of Juhayman al-‘Utaybi Revisited. Int J Middle East Stud. 2007; 39:1:103122.
    [Google Scholar]
  27. GlobalSecurity.org. 1979 Makkah - Grand Mosque [aka Holy Mosque] Makkah. Available from: https://www.globalsecurity.org/military/world/war/mecca-mosque-1979.htm (Accessed on 14 January 2019).
  28. Hijji M, Amin S, Harrop W, Iqbal R. Towards the development of a capability assessment system for flood risk management. Flood Risk Management. 2017;293316.
    [Google Scholar]
  29. Wallace C . 402 die in clashes of Saudis, Iranians: killings at shrine in Mecca trigger attacks on four embassies in Tehran [press release]. Los Angeles Times; 1987, August 02. Availble from: https://www.latimes.com/archives/la-xpm-1987-08-02-mn-971-story.html (Accessed on 14 January 2019).
  30. The Guardian. Iranians protest against Saudi Arabia before hajj pilgrimage [press release]2016;. September 09. Available from: https://www.theguardian.com/world/2016/sep/09/iranians-protest-saudi-arabia-hajj-pilgrimage (Accessed on 14 January 2019).
  31. Ngai KM, Burkle FM, Hsu A, Hsu EB. Human stampedes: a systematic review of historical and peer-reviewed sources. Disaster Med Public Health Prep. 2009; 3:4:191195.
    [Google Scholar]
  32. Al-Mughassil A . Suspect in Khobar Towers bombing arrested [press release]; 2015, August 26. Available from: http://america.aljazeera.com/articles/2015/8/26/suspect-in-1996-khobar-towers-bombing-arrested.html (Accessed on 15 January 2019).
  33. Al-Masud SMR, Bakar AA, Yussof S. Determining the types of diseases and emergency issues in Pilgrims during Hajj: A literature review. Stat Inf. 2016; 5::7.
    [Google Scholar]
  34. Mlybari E, Ahmed I, Khalil H. Current state of practice in disaster risk management. In: Komurlu RGurgun APSingh ASaha SZhang YYazdani S, eds. Interaction between theory and practice in civil engineering and construction: proceedings of the first european and mediterranean structural engineering and construction conference 2016 May 24–29. Istanbul, Turkey. North Dakota: ISEC Press 2016;:481486.
    [Google Scholar]
  35. Al Arabiya News. Timeline: Al-Qaeda and ISIS attacks in Saudi Arabia [press release]2015;, August 06. Availble from: http://english.alarabiya.net/en/News/middle-east/2015/08/06/Timeline-Al-Qaeda-and-ISIS-attacks-in-Saudi-Arabia.html (Accessed on 10 March 2020).
  36. Habtoor A . Establishment of a crisis and disaster management center in Makkah with 50 million. Al Eqtisadiah [newspaper on the Internet]; 2011, August 16. Availble from: http://www.aleqt.com/2011/08/16/article_570047.html (Accessed on 15 January 2019).
  37. McDowall A . At least 23 killed in Riyadh fuel truck blast [press release]; 2012, Nov 01. Availble from: https://www.reuters.com/article/us-saudi-riyadh-explosion/at-least-23-killed-in-riyadh-fuel-truck-blast-idUSBRE8A00BT20121101 (Accessed on 15 January 2019).
  38. Matthiesen T . Sectarianism after the Saudi mosque bombings [newspaper on the Internet]; 2015, May 29. Availble from: https://www.washingtonpost.com/news/monkey-cage/wp/2015/05/29/sectarianism-after-the-saudi-mosque-bombings/?noredirect = on&utm_term = .6e4af5c5f150 (Accessed on 15 January 2019).
  39. Tawfeeq M, Hanna J. Saudi mosque blast: 13 dead; ISIS claims responsibility [press release]; 2015, August 6. Availble from: https://edition.cnn.com/2015/08/06/middleeast/saudi-arabia-mosque-attack/index.html (Accessed on 15 January 2019).
  40. BBC. Mecca crane collapse: 107 dead at Saudi Arabia's Grand Mosque [press release]; 2015, September 11. Availble from: https://www.bbc.com/news/world-middle-east-34226003 (Accessed on 17 January 2019).
  41. Al-Shareef AS, Alsulimani LK, Bojan HM, Masri TM, Grimes JO, Molloy MS. Evaluation of hospitals’ disaster preparedness plans in the holy city of Makkah (Mecca): a cross-sectional observation study. Prehosp Disaster Med. 2017; 32:1:3345.
    [Google Scholar]
  42. Bacon J . Fire at Saudi residential complex kills 11, injures more than 200 [newspaper on the Internet]; 2015, August 30. Availble from: https://www.usatoday.com/story/news/world/2015/08/30/fire-saudi-residential-complex-kills-7-injures-more-than-200/71415250/ (Accessed on 17 January 2019).
  43. ABC. Saudi Arabia hospital fire in intensive care and maternity wards kills at least 25 people [press release]; 2015, December 25. Availble from: https://www.abc.net.au/news/2015-12-24/saudi-arabia-hospital-fire-in-intensive-care-and-maternity-wards/7053456 (Accessed on 17 January 2019).
  44. Al-Shammari T, Jennings P, Williams B. Evolution of emergency medical services in Saudi Arabia. Journal of Emergency Medicine, Trauma and Acute Care. 2017; 4:1:111.
    [Google Scholar]
  45. Saudi Red Crescent Authority-SRCA. Authority history 2018;. Available from: https://www.srca.org.sa/en/About/History (Accessed on 12 December 2018).
  46. Al-Mutairi M, Jawadi A, Al-Harthy N, Al-Enezi F, Al-Jerian N, Al-Qahtani A, et al.  Emergency medical service system in the Kingdom of Saudi Arabia. J Med Clin Res. 2016; 4:10:1308413092.
    [Google Scholar]
  47. D'Alessandro K, Leggio WJ, Al Mubaireek H. Muslim mass pilgrimage poses logistical & planning challenges. JEMS. 2013; 38:9:5257.
    [Google Scholar]
  48. Leggio WJ, Mobrad A, D'Alessandro KJ, Krtek MG, Alrazeeni DM, Sami MA, et al.  Experiencing Hajj: A phenomenological qualitative study of paramedic students. Australasian Journal of Paramedicine. 2016; 13:4:19.
    [Google Scholar]
  49. Al-Masud SMR, Bakar AA, Yussof S. A systematic review of technological issues in monitoring pilgrims’ health during hajj: Current state, challenges and future directions. J Theor Appl Inf Technol. 2018; 96:7:19351950.
    [Google Scholar]

Data & Media loading...

  • Article Type: Research Article
Keyword(s): DisastersEmergency Medical ServicesIncidentsMass Casualty and Saudi Arabia

Most Cited This Month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error