









































9 J Global Clinical Engineering Vol.5 Issue 2: 2022

Received February 28, 2022, accepted July 7, 2022, date of publication July 22, 2022

Earthquake Early Warning System: A Solution for Life Rescue 
in Health Facilities and Risks Mitigation for the population 
of the Virunga Region 

By Jean Marie Vianney Nkurunziza, Jean Claude Udahemuka, Francine Umutesi, Jean Baptiste Dusenge 

Medical Technology Division, Rwanda Biomedical Center, Kigali, Rwanda

ABSTRACT

The desire for earthquake hazard mitigation has been the focus of many researchers and governments for decades. This is 
paramount because an earthquake disaster can quickly cause many injuries, fatalities, and damages. The global database of 
the 21,000 most devastating disasters (earthquakes included) since 1900 indicates that 50% of them with the most significant 
number of injuries occurred only during the past 20 years. In human history, the Xaanxi earthquake is ranked third among the 
disasters that claimed more lives. In addition, earthquakes contributed to six of the most deadly disasters of the past two decades 
and 21% of the economic losses. In the same period, the earthquakes due to the Virunga volcanic activity were responsible 
for more than 100 deaths and extensive material and infrastructure damage. The referenced information and statistical data 
about the earthquake occurrence process, adverse effects, economic losses, and the current technological success in reducing 
its risks through warning systems are the basis for developing this paper. The authors aim to raise awareness and recommend 
that the Virunga region countries (Democratic Republic of the Congo, Rwanda, and Uganda) be a good place for an Earthquake 
Early Warning System and Earthquake Management Plan. An Earthquake Early Warning System even caught the attention of 
the United Nations, where the endorsed Sendai Framework for Disaster Risk Reduction (UNISDR, 2015) specified that early 
warning must be a priority and has to be substantially evolved by 2030.   

Keywords – Earthquake, early warning, Rwanda, Virunga region, health facilities, Disaster, Seismic activity.

Copyright © 2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY): Creative Commons - Attribu-
tion 4.0 International - CC BY 4.0. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) 
are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is 
permitted which does not comply with these terms.

http://www.globalce.org
http://globalce.org
http://globalce.org


J Global Clinical Engineering Vol.5 Issue 2: 2022  10

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

BACKGROUND

An earthquake is a weak to violent ground shaking 
produced by the sudden movement of rock materials 
below the Earth’s surface.1 Over the past 40 years, natu-
ral disaster effects have drastically increased in terms of 
reported number, total deaths, total people affected, and 
economic loss (Figure 1).2

Earthquakes are the most destructive natural hazards 
throughout human history. Hundreds of thousands of 
people lost their lives, and the loss of billions of dollars 
of properties occurred in these disasters.3 Earthquakes 
occur naturally (i.e., tectonic and volcanic) or as a re-
sult of human activity (i.e., explosion, mine collapse, or 
reservoir-induced).4 The Earth is made of different lay-
ers classified rheologically or chemically. Rheologically 
speaking (classification based on the liquid state of rocks 
under tremendous pressure and temperature), the Earth 
is divided into five layers: lithosphere, asthenosphere, 
mesosphere, outer core, and inner core.5 Chemically speak-
ing, the Earth’s geological structure comprises four layers: 
the crust, the mantle, the outer core, and the inner core, 
though researchers of the Australian National University 
have, in 2021, uncovered a fifth layer within the Earth’s 
inner core.6 The different earth layers and corresponding 
thicknesses are shown in Figure 2.7

An earthquake happens when two blocks (tectonic 
plates) of the Earth’s lithosphere or upper mantle sud-
denly slip past one another. The surface where they slip 
is called the fault or fault plane. The location below the 
Earth’s surface where the earthquake starts is called 

the hypocenter, and the location directly above it on the 
surface of the Earth is called the epicenter.8

Diverging and converging tectonic plates’ action in the 
Earth’s crust is responsible for the creation of volcanoes. 
The volcanic activity is rooted in molten rock called  magma,  
which is squeezed onto the Earth’s surface.9

A key control on the eruptive processes is the tectonic 
setting, which determines how magma is generated, the 
pathways by which it reaches the Earth’s surface, and the 
characteristics of eruptions.10 A volcano may be active, 
dormant, or extinct.9

The activity of the tectonic plates responsible for the 
volcanic eruption can have divergent boundaries (when 
tectonic plates move apart) (Figure 3).11 Or convergent 
boundaries (two tectonic plates are moving toward each 
other, often causing one plate to slide below the other in 
a process known as subduction) (Figure 4).12 

FIGURE 1. Disaster impact 1980-2019, showing that in the last 
two decades, disasters have significantly increased. 

FIGURE 2. A cut-away of the Earth’s layers. 

FIGURE 3. Diverging tectonic boundaries.



11 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Convergent plate boundaries are often the sites of 
earthquakes, volcanoes, and other significant geological 
activity.12

The Earth’s crust is divided into six continental-size 
plates (African, American, Antarctic, Australia-Indian, 
Eurasian, and Pacific) and about 14 of sub-continental 
size (Caribbean, Philippine, etc.) 

As per 2014, about 1,900 volcanoes on Eartare consid-
ered active, meaning they show some occasional activity 
and are likely to erupt again.9 Earthquakes are measured 
by their magnitude, energy release, and intensity. 

From 1935 to 1970, the Richter scale was the method 
for measuring earthquake magnitude. 

Measurements on the moment magnitude scale are 
determined using a complex mathematical formula to 
convert motion recorded with a seismometer into a 
magnitude number that represents the amount of energy 
released during an earthquake.13

This method suffered from being only used in Califor-
nia and measuring earthquakes within only 370 miles 
from seismometers. Today, the Moment Magnitude Scale 
method is used and it works by measuring the movement 
of the rock along the fault.14 The classes of earthquake 
magnitude are presented in Figure 5.14

The second way of earthquake measurement is by 
intensity, whereby measurement is an on-the-ground 
description. 

Earthquake intensity is very different from earthquake 
magnitude. Earthquake intensity is a ranking based on 
the observed effects of an earthquake in each particular 
place. Therefore, each earthquake produces a range of 
intensity values, ranging from the highest in the epicenter 
area to zero at a distance from the epicenter. 

Earthquake intensity values follow either the modi-
fied Mercalli Intensity Scale (1 to 12) or the Rossi-Forel 
Scale (1 to 10).14 However, the Modified Mercalli Intensity 
(MMI) is now dominantly used worldwide (Figure 6).13,15

Worldwide, more than one million earthquakes occur 
yearly, an average of about two every minute.16 A data-
base including the 21,000 most devastating disasters 
worldwide since 1900 indicates that 50% of disasters, 
including earthquakes, with the most injuries, occurred 
only during the last 20 years.17 In 2000-2019, earthquakes 
affect few people but are responsible for claiming more 
lives than floods, droughts, and storms (3% and about 
59% of total disasters).2

Between 1998-2017, according to WHO, earthquakes 
caused nearly 750 000 deaths globally. The extent of 
destruction and harm caused by an earthquake depends 
on the magnitude, intensity, and duration, local geology, 
time of the day, building design and materials, and the risk 
management measures put in place.18 In 2021, the worst 
magnitutde earthquake (8.2) occurred in Alaska, USA. 

FIGURE 4. Converging tectonic boundaries.

FIGURE 5. Earthquake Magnitude Classes.



J Global Clinical Engineering Vol.5 Issue 2: 2022  12

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

The earthquake prompted a tsunami warning (lifted 
within 1 hour) and residents in towns and cities took 
protective cover.19 This earthquake resulted in minimal 
damage, and no big wave was recorded.20 According to 
USGS data, this quake was the seventh-largest recorded in 
US history, tied with another Alaskan quake from 1938.21 

On August 14 2021, a 7.2 magnitude earthquake hit Haiti’s 
southwestern departments of South, Grand’ Anse, and Nip-
pes. Over 2,200 people died, 12,700 people were injured, 
and 137,000 homes were destroyed, putting thousands of 
people in urgent need of assistance.22 The countries with 
the greatest number of earthquakes were Mexico (9572), 
Indonesia (5484), and New Zealand (3544).23

The Indian Ocean earthquake and tsunami caused the 
most casualties of all earthquakes that have taken place 
in the 21st century thus far. In the same period, top 15 
deadliest earthquakes killed 558340 persons.24

Earthquakes contributed to six of the top deadliest 
disasters of the last two decades, contributing 21% of 
the economic losses.

FIGURE 6. Comparison of intensity and magnitude methods of 
earthquake measurement.

FIGURE 7. The proportion of various types of impacts by dis-
aster sub-group (2000-2019).2 

FIGURE 8. Top 10 deadliest disasters (2000-2019).2 



13 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Hospital systems play a critical role in treating injuries 
and preventing additional deaths during earthquakes 
and other disasters. Hospital systems are at the core of 
disaster resilience because they must provide timely 
essential healthcare services to communities during 
and after an emergency response.17 However, like other 
types of infrastructures, hospitals are not invulnerable 
to an earthquake. 

Earthquakes can significantly damage and disrupt a 
community’s interdependent infrastructure, including 
residential and commercial buildings; utilities (e.g., water 
and sewage); dams; levees; fires, tsunamis, flash floods, 
communications technology; healthcare facilities; chemical 
plants; industrial storage tanks; nuclear power plants and 
other hazardous materials storage locations; and bridges, 
tunnels, airports, roads, sea ports, and/or rail lines. In 
addition, outages may lead to secondary radiological or 
other hazardous materials incidents, transportation and 
supply chain disruption (including those used to transport 
food and medicines); and significant financial losses.25

Though natural disasters kill over 100,000 people 
and affect more than 150 million, the deadliest disaster 
is reported to be the 1931 Yangtze River floods which 
claimed over million deaths.26 

 Ranked third globally among other natural disasters 
to have claimed more lives, the worst humanitarian 
earthquake disaster in history is recorded in Xaanxi, 
China. An earthquake of magnitude 8 occurred in 1556 
and resulted in 830,000 deaths, and reports indicated that 
all 97 counties were affected. For some counties, 60% of 
the population died.27

It was seconded by an earthquake in Latin America 
and the Caribbean, where an earthquake struck Haiti on 
January 12, 2010. This quake killed an estimated 220,000 
people and displaced 1.5 million; damages included but 
were not limited to housing, agriculture, water and sanita-
tion, education, transport, health, and energy, valued at 
US$7.8 billion.28 According to the Haitian government.27 
316000 people were reported to have lost their lives in 
the disaster.

Volcanic Activity of the Virunga Mountains

The East African Rift System is one of the most outstand-
ing and significant rift systems on Earth and transects 
the high-elevation Ethiopian and East African plateau.39 
The African Rift Valley extends over almost one-fifth of 
the Earth and is one of few active rifts on the Earth’s land 
surface.40 It is often mentioned as the modern archetype 
for rifting and continental break-up showing the complex 
interaction between rift faults, magmatism, and pre-
existing structures of the basement.41 The East African 
Rift System (EARS) (Figure 11) forms a narrow (50–150 
km wide), elongated system of normal faults that stretch 
some 3,500 km in a sub-meridian direction.40 EARS results 
from continental extension and thinning of the crust.39 

FIGURE 9. Breakdown of recorded economic losses  (2000-2019).2 

FIGURE 10. Earthquakes and Critical Infrastructure Disruption.25 



J Global Clinical Engineering Vol.5 Issue 2: 2022  14

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Tectonic activity in East Africa is often attributed to mantle 
upwellings at various scales.10

The Virunga Mountains, which make up part of the 
EARS range North of Lake Kivu in East-Central Africa, 
extend about 50 miles (80 km) along the borders of the 
Democratic Republic of the Congo, Rwanda, and Uganda.42 
The volcanic mountain range features eight major volca-
noes, namely Nyiragongo (3470 meters), Nyamuragira 
(3058 meters), Mikeno (4437 meters), Kalisimbi (4507 
meters), Gahinga (3473 meters), Sabyinyo (3671meters), 

Muhabura (4127 meters), Bisoke (3711 meters). Only 
two (Nyiragongo and Nyamuragira) of these volcanoes 
are active, while the others are dormant.43 

The most earthquake-affected areas of the Virunga vol-
canic regions are the Northern and Western Provinces of 
Rwanda and the North-Kivu province on the DRC side. The 
two provinces of Rwanda have a population of 4,206,869 
(Data from the websites of both provinces) spread over 
9175 km2 in which 20 hospitals were constructed, while 
the North Kivu province has a population of 6 000,000 as 
per the 2015 Census, over a surface area of 59,483 km2.44

The active mountains/volcanoes are responsible for 
different earthquakes which ravaged the Virunga region 
(especially DRC and Rwanda). To mention some, two 
earthquakes of magnitude 6.0 and 5.0 struck the Great 
Lakes Region on February 3 2008, the first in the DRC 
and the second in Rwanda. It was reported that 34 died, 
434 were wounded, and considerable damage in the two 
countries.45

In 2002, Nyiragongo erupted, and the lava lake drained 
from fissures on its western flanks. The city center of 

TABLE 1. Examples of Health Facilities Damaged by 
Earthquakes

Medical facilities destroyed by 
Earthquake Country Year

Olive View Medical Center29 USA 1981
Kumamoto Hospital30 Japan 2016

Loma Prieta31 USA 1989
1059 health facilities destroyed, 401 

completely damaged32 Nepal 2015

In 2 minutes, 97% of City hospital 
beds were destroyed in Pisco City 

earthquake33
Peru 2007

50% of health facilities destroyed in 
Pakistan Earthquake Pakistan 2005

Bhuj Hospital, 150deads inside 
hospitals and 20000 overall died34 India 2001

10 hospitals destroyed to relacarion, 
and 50000 persons killed17 Turkey 1999

Maternité Solidarité hospital, a 75-
bed emergency obstetrics facility 
damaged,35 also 22% of hospitals 

were destroyed36 

Haiti 2010

Bushenge Hospital, 80% of its 
structure damaged37 Rwanda 2008

Mexico City Earthquake,13 
hospitals collapsed, 866 people died 

and 100 were health personnel38
Mexico 1985

Bam Earthquake, 3500 people 
injured, many health facilities 

destroyed38
Iran 2003

Maule and Bio-Bio Earthquake, 
20% of the hospitals in the region 

suffered, and 484 people died36 
Chile 2010

FIGURE 11. Tectonic plate boundaries for East Africa Rift Valley, 
including the Virunga Mountains.



15 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Goma town, the capital of the East Virunga province, had 
been destroyed by voluminous lava flows. Over 200,000 
people were left homeless, adding to the pre-existing 
human disaster caused by frequent civil wars.

From 1882 to 2021, Nyiragongo erupted at least46 35 
times.47 Between 2002-2008, 85 people died, and several 
infrastructure damages were recorded in Rwanda due to 
earthquakes.48 

TABLE 2. Natural Methods of an Earthquake Early Warning System49

Earthquake Detection method Explanation

Unusual animal behavior

Some animal (birds, dogs, swans, cats, deers, snakes, insects, worms, fishes, horses, donkeys, 
geese, fowls, ducks, pigeons etc) are endowed with sensory perception denied to human beings, 

upon which their change of behavior informs the public about the earthquake occurrence 
nearby. Before the earthquakes in Haichang (1975), Bahai (1969), Chile (1835), Ryakya (1896), 

Yogoslavia (1963), San Andreas (1906), Japan (1896), Tango 1927, Kanto 1923, Eddo (1855), 
India (1892), Uttarkashi (1991), Latur (1993), Jabalpur (1997), Chamoli (1999) and Bhuj (2001), 

different animals had already shown unusual behavior 
Hydrochemical precursors Concentration levels of dissolved minerals and gaseous components.

Temperature change
There seems to be a relation between temperature and earthquake. For example, a considerable 

rise of temperature by 10°C and 15°C was reported before earthquakes in Lunglin in China 
(1976) and Przhevalsk in Russia (1970).

Water level

Drastic changes in water level occurs before major earthquakes. The rise of water level by 3 and 
15 cm was reported before Lunglin (China) and Przhevalsk (Russia) earthquakes. Also, the 

decrease in water level before the Nankai earthquake in Japan (1946). Similarly, water level rose 
by 3 cm a few hours before the earthquake in Meckering in Australia (1968). In China rise in 

water level in wells was observed before earthquakes of Haicheng (1975), Tangshan (1976), Liu-
quiao and Shanyin (1979).

Radon gas
It is a radioactive gas which is discharged from rock masses prior to earthquake. It is dissolved in 
the well water and its concentration in the water increases. This happened before earthquakes of 

Tashkent (1972), Tangshan (1976), Luhuo (1973), and Uttarkashi earthquake (1991)

Oil Wells
Large scale fluctuation rate of oil flow from oil wells are observed before earthquakes. For 

example, such cases were observed in Israel, China, Northern Caucasus before 1969, 1971 and 
1972 earthquakes.

Foreshocks
Foreshocks provide valuable dues to the occurrence of a strong earthquake. Haichang earthquake 

in China (February 4, 1975), Oaxaca, Mexico earthquake of November 1978Anantnag (1967), 
Dharmasala (1968), Kashmir (1973), Kinnaur (1975) were forecast by studying the foreshocks

Changes in Seismic Wave Velocity: The lead time (time difference between primary and shear waves) and a longer period of 
abnormality in wave velocity presaged a larger quake.

In 2016, the combined effect of disasters in Rwanda 
were forecast to cost the country a massive Rwf 100 bil-
lion, earthquakes contributing Rwf 21.6.51

In May 2021, following the eruption of Congo’s Mount 
Nyiragongo volcano, a 5.3 earthquake struck the border 
of Congo and Rwanda, resulting in the demolition of 17 
villages and damaging infrastructure including roads and 
hospitals. In addition, about 1,000 houses were destroyed, 

and more than 5,000 people were displaced by the erup-
tion, killing at least 32 people.52,53 Reports indicate that 
21,000 Congo residents cross into Rwanda for refuge.54 
According to UNHCR, the eruption led to the displacement 
of over 500,000 individuals to the surrounding areas of 
Goma, Sake, Minova, Kiwanja in Rutshuru, Bukavu, and 
Rwanda.55 The total recovery of Rubavu will cost a whop-
ping Rwf 91,430,692,000, according to officials.54



J Global Clinical Engineering Vol.5 Issue 2: 2022  16

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Weak shaking might have been felt in Ruhengeri, 
located 28 km from the epicenter, Sake 40 km away, Gi-
tarama 66 km away, and Kigali 83 km away.56 During the 
same disaster of Nyiragongo eruption and consequent 
earthquakes, there were 92 earthquakes and tremors 
of which only 4 were felt by humans. The rest were only 
picked up by instruments.57

Considering the human and material losses caused by 
earthquake, an early warning system and management 
plan would contribute to saving lives. The technological 
advances have made it practical to design and implement 
Earthquake Early Warning System Based on Internet of 
Thing.58

Traditionally, before the invention and development 
of recent advanced technologies for earthquake detec-
tion and warning, other methods were used to detect 
the occurrence of the earthquake in the near future, as 
presented in Table 2.

EARTHQUAKE EARLY WARNING SYSTEM (EEWS)

The immediate resilience after the earthquake is be-
coming an important aspect worth being investigated.59 
An Earthquake Early Warning System (EEWS) is both a 
scientific and a societal challenge. It would be wonderful 
to see EEW save many lives and reduce societal losses in 
future earthquakes.60

The success of EEWS will be attributed to advances 
in communications, digital seismology, and automatic 
processing.61,62 The first successful EEWS were developed 
by Japan and proved useful before the 1975 Haicheng, 
China earthquake. Shortly after receiving the warnings, 
the government urged the residents to evacuate to a safe 
place, and on February 4, an M7.3 earthquake struck the 
region.63

Japan invested $600 million in such a system after 
the 1995 Kobe earthquake killed 6,400 people. Today, 
Japan’s system allows every citizen to receive an advance 
alert of an earthquake ground shaking from the Japan 
Meteorological Agency. Thanks to this system, no trains 

TABLE 3. Challenges in Disaster Management, Earthquakes Included38 

Challenge category Examples

Lack of preparedness No previous training of personnel and lack of training programs, Lack of prior planning for 
disaster situations, Lack of attention to the experiences and lessons of previous disasters 

Logistics challenges Inappropriate places for providing services to the injured, Management of donations, No 
emergency fund, Security management, Human resources management 

Technical challenges Evacuation of hospitals, Patient security, Admission, Entry and exit management and discharging 
of injured, Triage and prioritization of patients 

Communication and information 
management

Contact with the media, Communication within the hospital, Out-of-hospital communications, 
Management of very important people and visitors 

Lack of coordination 

Coordination problems with volunteers who were referred to help, Lack of coordination among 
hospital officials, Lack of coordination among the authorities in different hospitals, No Incident 
Command System, Disobeying the orders of officials by personnel, Intractable performance of 

tasks by staff, Absence of command unity and single commander, Frequent examinations of some 
injured, Bewilderment of personnel and officials, Fragmentation and repetition, Inappropriate 

interventions of unrelated individuals 

FIGURE 12. The technical principles of an earthquake early 
warning system.50



17 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

derailed in the magnitude 9.0 2011 Tohoku earthquake, 
and according to a poll in Japan, 90% of the citizens think 
the system is worth the investment.64

Today, the technology exists to detect earthquakes 
so quickly that an alert can reach people before strong 
shaking arrives. EEWS entail detecting initial earthquake 
shaking and rapid estimation and notification to users 
before imminent, stronger shaking.60

EEWS are beneficial as they allow organizations to take 
either automated or procedural actions to counter the 
impacts of the shaking. Examples of organizational actions 
include slowing trains, halting surgeries, elevators, and 
traffic, evacuating hospitalized patients, securing sensi-
tive machinery, and turning off dangerous or essential 
equipment (Figure 13).65,66

The emerging computing technologies such as mobile 
computing and Internet-of-Things (IoT) systems are 
equipped with various MEMS (Micro Electro Mechani-
cal Systems) sensors (e.g., accelerometers, gyroscopes, 
GPSs), Wi-Fi, Bluetooth, making it possible to build and 
operationalize earthquakes early warning stations. How-
ever, the project is not only expensive but also difficult to 
realize a countrywide network.67 The idea of using early 
warning for earthquakes was first considered by J.D. 
Cooper in November 1868; he proposed the installation 

FIGURE 13. Examples of EEWS applications categorized in terms 
of procedure complexity and potential action cost.66

of seismic sensors near Hollister, California, that would 
send an electric signal via telegraph to San Francisco 
once an earthquake was detected.68 However, the first 
practical EEWS was UrEDAS installed in Japan for Railway 
Systems in 1988.66

Today, EEWS  are used to deliver public warnings in 
Japan, Mexico, South Korea, Romania, Turkey, China, Italy, 
Switzerland, Canada, India, Taiwan, and along the west 
coast of the United States of America.63,66,69,70  For example, 
following the 2008 Wenchuan earthquake, China’s central 
government encouraged the establishment of a national 
EEWS. It resulted in a high-quality national seismologi-
cal network with 15 000 stations, 1928 seismic stations 
(equipped with collocated broadband seismometers and 
force-balanced accelerometers), and 3114 strong-motion 
stations (equipped with force-balanced accelerometers), 
and 10 349 sensors based on low-cost MEMS.71 Post-
earthquake engineering reconnaissance missions play 
an important role in learning about the performance of 
structures and infrastructure under seismic loading, the 
social impacts of disasters, disaster management pro-
cesses, and the science of seismic events.72 The complete 
scope of the EEW problem can be summarized in four 
steps (Figure 14).66

Seismic waves detection and transmission

When an earthquake occurs, energy is released due to 
tectonic plates moving relative to one another. The energy 
generated from the collisions propagates through and 
around the surface of the Earth as seismic waves. Seismic 
waves are not generated by earthquakes only because 
explosions, volcanic eruptions, wind, supersonic planes, 

FIGURE 14. Scope of Earthquake Early Warning System problems.



J Global Clinical Engineering Vol.5 Issue 2: 2022  18

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

people’s footsteps, vehicles, and bikes can generate them. 
Seismic waves can be divided into surface waves that travel 
on Earth’s surface and body waves that travel through 
Earth. There are two types of body seismic waves.15

• Primary waves, compression waves, or dilatation 
waves (P-waves) are waves that reach the Earth’s 
surface first. They can travel through all mediums 
of liquid, solid, and gases. They possess high velocity 
(4-8 km/sec) with low destructive power and move 
radially from the focus of the earthquake.50

• Secondary waves (S-waves, also called Shear waves) 
reach the Earth’s surface following primary waves. 
Such waves travel only through solid media and get 
aborted in liquid media. They are characterized by 
lower speed (2-4 km/s) compared to primary waves 
and scatter in all directions from the earthquake 
focus point (they displace material at right angles to 
their path). These waves are more damaging, caus-
ing maximum destruction during an earthquake.50

The S wave carries the major destructive energy, and 
the smaller amplitude P wave precedes the S wave by the 
time equal to 70% of the P-wave travel time to the station.61 

When measuring seismic waves, the time difference 
between the P- and S-waves tells us the distance the 
earthquake is from the seismograph. Data from a seis-
mometer, also called a seismogram, shows velocity on 
the y-axis and time on the x-axis (Table 4).73

The fundamental observations used in seismology are 
seismograms , a record of the ground motion at a specific 
location. Seismograms come in many forms, on  smoked  
paper, photographic paper, common ink recordings on 
standard paper, and digital format (on computers, tapes, 

CD ROMs). The strength of shaking can practically be 
represented by peak ground acceleration (PGA), peak 
ground velocity (PGV), and peak ground displacement 
(PGD).61  

The ground vibration measurements by seismograms 
are used for estimation earthquake source parameters 
(origin of the earthquake and rupture duration, earth-
quake location including epicenter and depth, sie of the 
earthquake expressed in magnitude), getting seismic 
wave travel path information (seismic velocity model, 
attenuation model).74

Different instruments are used to detect and measure 
the seismic magnitude, and their difference depends on 
the parameter to measure, types of sensing transducers, 
bandwidth, and signal intensity. They detect the seismic 
waves created by subsurface ruptures and convert ground 
motions into electronic signals suitable for transmission. 
Generally, seismometers, accelerometers, and gyrophones 
are standard for measuring earthquake magnitude.

• Geophones: these are electricity-powered devices 
that have been used for measuring seismic data.75 
They are ingenious devices with active elements 
hanging over a spring, amplifier, and magnet, as 
shown in Figure 15.76

The magnet moves up and down around the mass 
when the Earth moves. The magnetic field of this mov-
ing magnet produces an electrical voltage in the wire. 
This voltage can be amplified and recorded by a simple 
voltmeter.76

TABLE 4. Various Minerals and their P and S Wave Velocities

Mineral P-wave velocity 
(m/s)

S-wave velocity 
(m/s)

Soil 300-700 100-300
Dry sand 400-1200 100-500

Limestone 3500-6000 2000-3300
Granite 4500-6000 2500-3300
Basalt 5000-6000 2800-3400

FIGURE 15. Basic principle of a gyrophone.



19 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

An important feature of geophones is that they can 
only monitor frequencies above their natural frequency, 
up to a specified spurious frequency (10Hz-250Hz).77

• Seismometers are instruments used to identify 
vibrations brought about by the plates’ movement. 
The device measures the velocity of a point on the 
ground during an earthquake. A seismometer, a 
clock or time-signal receiver, and a recording system 
constitute a seismograph. The basic seismometer 
is presented in Figure16.

The output of the seismometer is usually measured 
in volts/rnrn/s. The damping is typically measured 
as a ratio of critical damping, and is normally set to a 
value of about 0.7 critical. The natural frequency of the 
seismometer is measured in hertz and for local earth-
quakes normally has a value less than 2 Hz, with 1 Hz 
often used. Each seismometer can measure motion in 
one direction, either vertical or horizontal.74 Seismom-
eters are classified into broadband (capable of sensing 
ground motions over a wide range of frequencies) and 
short period types (cover the frequency band from 1 
Hz to 100 Hz).

Seismometers are classified by type (Tele seis-
mometers, Strong-Motion Seismometer, Strain-Beam 
Seismometer), range (50 to 750 V/m, 1500 V/m, and 
20,000 V/m), and varieties (Short Period, Long Period, 
and Broadband).78

• Accelerometers: Accelerometers give information 
about forces that a subject experiences during a 
seismic activity.79 They measure the acceleration 
of the shaking ground and are designed to measure 
the large-amplitude, high-frequency seismic waves 

typical of large local earthquakes. In addition, the 
double integration of the accelerometer output gives 
the distance function, which can detect the distance 
from the epicenter. 

Nowadays, there has been considerable interest in 
the seismic exploration industry in MEMS microchips as 
acceleration-measuring sensors.75 Though accelerom-
eters and geophones are used in seismometry, attention 
to seismometer and its market up to 2022 was shown to 
grow in recent applications (Figure 17).78

According to the configuration of the networks/sen-
sors, an EEW system can be conceptually classified as a 
regional or an onsite system. A regional EEW system is 
based on a dense sensor network covering a geographical 
area of high seismicity, and when an earthquake occurs, 
the relevant source parameters are estimated from the 
early portion of recorded signals at sensors close to the 
rupture. Regional EEW systems typically require many 
stations triggered on the arrival of the P-wave signal to 
provide stable early estimates of earthquake location.50,80  

The regional EEWS takes 10-15 secs to detect an 
earthquake, and by the time the damaging S-waves 
reach some locations close to the epicenter, a warning 
is not possible. The areas without warning are termed  
blind zones  and may range around 40–60 km from the 
epicenter, depending upon how quickly an earthquake is 
located. The problem of the blind zone can be overcome 
by the onsite EEW system, under which a single station 
installed in the target area will immediately sense the 
earthquake and issue a warning.80 

FIGURE 16. Basic seismometer [Image from IRIS Website]

FIGURE 17. Seismometers Market growth from 2016 to 2022.



J Global Clinical Engineering Vol.5 Issue 2: 2022  20

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Site-specific or onsite EEW systems consist of an array 
of sensors or a single sensor located in the vicinity of a 
single target site or structure /infrastructure of interest. 
Site-specific systems provide estimates of peak-ground-
motion IMs [e.g., PGA, or PGV] based directly on the am-
plitude and/or predominant period of the initial recorded 
P-wave signal (Figure 18).50 Generally an EEWS consists of:

• Remote Station: The remote station is generally lo-
cated in the neighborhood of the earthquake source. 
It contains different sensors for seismic waves detec-
tion, the data acquisition and processing system, the 
power supply, and the data transmission system. The 
remote station monitors and detects earthquakes 
based on seismic networks. The station processes 
can estimate the earthquake location, magnitude, 
maximum seismic intensity, earliest arrival time, 
and alert notification decisions.36

• Communication Network: the rapid development 
in communication technologies, especially in satel-
lite communication, has impacted the evolution of 
the seismic network. Communication technologies 
used in seismometry help exchange seismic data 
between stations and warn the target users. Each 
communication network has five elements for the 
successful transmission of information. Data, send-
ing, receiving, channel, and communication protocol 
are elements.81

Communication technologies can be wired, wireless, 
or satellite-based. There are different topologies used in 
seismic networks, which differ based on the distance at 
which data are to be transmitted, data rates, efficiency, 
and robustness (Table 5).82

The communication system is entitled to strong com-
puter algorithms to quickly estimate an earthquake’s loca-
tion, magnitude, and fault rupture length and to map the 
resulting intensity. It should also be capable of delivering 
quick and reliable mass notifications, and end-users must 
be educated on how to use the alerts.64 

FIGURE 18. The two possible approaches to earthquake early warning.

FIGURE 19. Earthquake Communication Network for Maryland 
Geological Survey.83



21 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

The different earthquake prediction methods include 
support vector regressor, ElarmS or epic, machine learning 
algorithm models, deep neural networks, or VS models.29

• Base Station: The base station is generally located 
at the site whose warning is addressed. The base 
station is composed of Mast/Tower, Sectorial an-
tennas, PDH & SDH Microwave, Waveguide cables, 
Rectifier, Generator, Radio Base Station, Duplexers, 
Data Distribution Frame rack, Transceiver Unit (TRU), 
Trunking, TX cabinet & Shelter a short-haul modem, 
and a computer for data processing, display, storage 
and Internet distribution of data.83,84 The base station 
is meant to give alarms to the region to be warned.

Currently, there are successful EEWS in the world, but 
most of them were initiated and installed after the con-
cerned countries were seriously struck by earthquakes. 
Successful EEWS implementations include UrEDAS for 
Japan, ShakeAlert for USA, and Sasmex for Mexico. 

Japan has the most widespread network for earthquake 
warnings worldwide, and China is currently building a 
nationwide EEWS which will be completed in June 2023. 
The seismic network can be broadband, short period, or 
MEMS-based.85

The Global Seismographic Network (GSN) is a perma-
nent, digital network of more than 150 modern stations in 
over 80 countries. It is composed of a globally distributed, 
state-of-the-art digital seismic network that provides 
free, real-time, open-access data through the IRIS DMC.86

Since its operation, the GSN has produced high-quality 
digital data from widely distributed, similarly equipped, 
and well-calibrated stations.87

GSN instrumentation is capable of measuring and 
recording with high fidelity all of Earth’s vibrations, from 
high-frequency, strong ground motions near an earthquake, 
to the slowest free oscillations of the Earth. As a result, 
GSN seismometers have recorded the greatest earth-
quakes on scale (for example, the 1994 Mw-8.2 Bolivia 
earthquake at 660 km depth) and the nano-earthquakes 
(M < 0) near the sea floor at the Hawaii-2 Observatory. 
In addition, GSN sensors are accurately calibrated, and 
timing is based on GPS clocks.88 

The GSN, together with the USGS National Earthquake 
Information Center (NEIC), are the principal global sources 
of data and information for earthquake locations, earth-
quake hazard mitigation, and earthquake emergency 
response. The real-time seismograms provided by NEIC 
for different regions update every 30 minutes. 

To achieve this telemetry coverage, a wide range of 
solutions—geosynchronous satellites employing antennas 
in the 1 to 4 m range, Inmarsat, Iridium, landlines, local 

TABLE 5. Seismic Network Topologies: Nodes Represent Sta-
tions and Lines the Communication Links

Topology Characteristics

 

Short distance, different data on 
each link, data exchange passes 
through other nodes, not robust 

because link outage can affect 
different nodes

 

Short distance, different data 
rates, data exchange passes 

through other nodes, not robust 
because link outage can affect 

different nodes

 

Large distance, same data on 
links, data exchange travels 

through central node, Robust 
because link outage only effects 

one node

 

Large distance, same data on 
links, rate in links can differ, 

Robust because link outage only 
affects one node



J Global Clinical Engineering Vol.5 Issue 2: 2022  22

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Internet Service Providers, submarine cable, etc.—has been 
implemented, in cooperation with NASA/Jet Propulsion 
laboratory the US National Imaging and Mapping Agency, 
the US. National Weather Service, Japan’s National Research 
Institute for Earth Science and Disaster Prevention, and 
the Comprehensive Nuclear Test Ban Treaty Organization 
(CTBTO) (Figure 21 and 22).88-90 

CONCLUSION

In conclusion, this paper highlighted the natural 
process behind volcanic activity and the role of EEWS in 
mitigating earthquake risks. In addition, this paper pre-
sented the historical statistics of earthquakes in fatalities, 
infrastructure damages and economic losses caused, and 
the stand of earthquakes among other disasters. 

The EEWS came to the attention of researchers as 
a solution to reduce the adversity of earthquake risks. 

Though the conceptual idea about EEWS started many 
decades ago, today, technological advancements have 
transformed the dream into reality. 

Across the world, many operational seismic stations 
and networks are used to monitor and provide real-time 
information about seismic activity. Even if, in many cases, 
the public is warned a few seconds before destructive 
seismic waves, the alert can enable immediate actions that 
protect people and property. The activities which must 
be urgently performed include halting delicate medical 
procedures and moving patients to safe assembly points, 
pausing airplane landings, students exiting classrooms, 
turning off household appliances, and safely stopping 
and exiting vehicles. Also, automated responses must be 
addressed, such as opening elevator doors, shutting down 
production lines, securing chemicals, stopping trains, and 
protecting power stations and grid facilities.

FIGURE 20. Per-country distribution of disasters with the highest number of injuries since 1900.17 It is observed that earthquakes 
dominated the disasters which ravaged and shocked mankind.



23 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

FIGURE 21. Distribution of stations pertaining to Global Seismographic Network.

FIGURE 22. Components of Global Seismographic Network System.



J Global Clinical Engineering Vol.5 Issue 2: 2022  24

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

Although there is no EEWS  for the earthquakes occur-
ring in the Virunga volcanic region, hospitals in Rwanda 
have safe assembly points where people can gather in case 
of an emergency or disaster. However, this good initiative 
is not enough compared to the technological progress of 
the current generation of EEWS, and the development 
achievement of other countries with the same earthquake 
challenges. 

In 2005, at the 2nd World Conference for Disaster Re-
duction in Kobe, Japan, 168 countries ap¬proved the Hyogo 
Framework for Action and they agreed to:  promote the 
goal of ‘hospitals safe from disasters’ by ensuring that all 
new hospitals are built to a level of safety that will allow 
them to function in disaster situations and implement 
mitigation measures to reinforce existing health facilities, 
particularly those providing primary health care.  

In addition, in 2015, the member states of the United 
Nations endorsed the Sendai Framework for Disaster Risk 
Reduction (UNISDR, 2015), where it is specified that early 
warning must be a priority and early warning systems 
have to be substantially evolved by 2030.

Therefore countries affected by the Virunga volcanic 
activity are first recommended to join efforts to exchange 
how the EEWS can be implemented to warn the residents 
about the likelihood of earthquake occurrence in the near 
future. Furthermore, the EEWS should also send a warning 
to healthcare care facilities for better preparation before 
the occurrence of destructive seismic waves. Since the 
residents are warned, congestion at a health facility can 
be reduced, and the physicians will have fewer patients 
to care for.

Due to the high cost of EEWS infrastructures, it would 
be paramount to have a cost-effective Earthquake Man-
agement Plan which can intervene, face and solve chal-
lenges linked to earthquake disasters. In this regard, the 
high seismic risk zones should be mapped based on past 
earthquakes and the safe shelters available for residents 
of the mapped zones. Individuals can use the alert time to 
Drop-Cover-Hold On or move to safer locations within a 
building, reducing injuries and fatalities, or if the warning 
time allows, evacuate hazardous buildings. Furthermore, 
the plan should engage trained personnel to manage lo-
gistics, communications, and transportation and provide 
healthcare aid services and treatment.

REFERENCES

1. P. I. o. V. a. Seismology,  Introduction to Earthquake,  
Philippine Institute of Volcanology and Seismology, 
January 31 2022. [Online]. Available: https://www.
phivolcs.dost.gov.ph/index.php/earthquake/intro-
duction-to-earthquake. [Accessed January 31 2022].

2. D. G.-S. Mami Mizutori,  The Human Cost of Disasters 
- An overview of the last 20 years 2000-2019,  United 
Nations Office for Disaster Risk Reduction, Centre for 
Research on the Epidemiology of Disasters (CRED), 
Geneva, 2020.

3. B. Y. e. al,  Earthquakes and Structural Damages,  in 
Earthquakes - Tectonics, Hazard and Risk Mitigation, 
London, IntechOpen, 2017. 

4. S. J. Baxter,  EARTHQUAKE BASICS,  State of Delaware, 
Dover, 2000.

5. T. Nace,  Layers Of The Earth: What Lies Beneath 
Earth’s Crust,  forbes.com, January 16 2016. [On-
line]. Available: https://www.forbes.com/sites/
trevornace/2016/01/16/layers-of-the-earth-lies-
beneath-earths-crust/?sh=60ccb85a441d. [Accessed 
31 January 2022].

6. D. Sarkar,  Earth has been hiding a fifth layer in its in-
ner core,  astronomy.com, March 26 2021. [Online]. 
Available: https://astronomy.com/news/2021/03/
earth-has-been-hiding-a-fifth-layer-in-its-inner-core. 
[Accessed January 31 2022].

7. B. Geiger,  Explainer: Earth - layer by layer,  Scien-
ceNewsforStudents, 11 November 2019. [Online].
Available:https://www.sciencenewsforstudents.
org/article/explainer-earth-layer-layer. [Accessed 31 
January 2022].

8. L. Wald,  The Science of Earthquakes,  USGS, [On-
line].Available:https://www.usgs.gov/programs/
earthquake-hazards/science-earthquakes. [Accessed 
February 6 2022].

9. Nationalgeographic,  Plate Tectonics and Volcanic 
Activity,  Nationalgeographic, 30 October 2014. [On-
line]. Available: https://www.nationalgeographic.org/
article/plate-tectonics-volcanic-activity/. [Accessed 
31 January 2022].

https://www.phivolcs.dost.gov.ph/index.php/earthquake/introduction-to-earthquake
https://www.phivolcs.dost.gov.ph/index.php/earthquake/introduction-to-earthquake
https://www.phivolcs.dost.gov.ph/index.php/earthquake/introduction-to-earthquake
http://forbes.com
https://www.forbes.com/sites/trevornace/2016/01/16/layers-of-the-earth-lies-beneath-earths-crust/?sh=60ccb85a441d
https://www.forbes.com/sites/trevornace/2016/01/16/layers-of-the-earth-lies-beneath-earths-crust/?sh=60ccb85a441d
https://www.forbes.com/sites/trevornace/2016/01/16/layers-of-the-earth-lies-beneath-earths-crust/?sh=60ccb85a441d
http://astronomy.com
https://astronomy.com/news/2021/03/earth-has-been-hiding-a-fifth-layer-in-its-inner-core
https://astronomy.com/news/2021/03/earth-has-been-hiding-a-fifth-layer-in-its-inner-core
https://www.sciencenewsforstudents.org/article/explainer-earth-layer-layer
https://www.sciencenewsforstudents.org/article/explainer-earth-layer-layer
https://www.usgs.gov/programs/earthquake-hazards/science-earthquakes
https://www.usgs.gov/programs/earthquake-hazards/science-earthquakes
https://www.nationalgeographic.org/article/plate-tectonics-volcanic-activity/
https://www.nationalgeographic.org/article/plate-tectonics-volcanic-activity/


25 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

10. J. B. e. al,  Volcanic activity and hazard in the East Af-
rican Rift Zone,  Nature Communications, vol. 12, no. 
6881, pp. 1-12, 2021. 

11. A. Alden,  Divergent Plate Boundaries,  ThoughtCo., 
17 January 2020. [Online]. Available: https://www.
thoughtco.com/divergent-plate-boundaries-3874695. 
[Accessed 8 February 2022].

12. B. Mitchell,  Introduction to Convergent Plate Boundaries,  
ThoughtCo., March 18 2020. [Online]. Available:https://
www.thoughtco.com/convergent-plate-boundaries-
3866818#:~:text=A%20convergent%20plate%20
boundary%20is,mountains%2C%20and%20other%20
geological%20events.. [Accessed 8 February 2022].

13. U. o. Kansas,  Measuring earthquake magnitude and 
intensity,  University of Kansas, [Online]. Available: 
https://geokansas.ku.edu/measuring-earthquake-
magnitude-and-intensity. [Accessed February 19 2022].

14. C. E. Authority,  Earthquake Measurements: Magnitude 
vs Intensity,  California State, July 22 2020.[Online].
Available:https://www.earthquakeauthority.com/
Blog/2020/Earthquake-Measurements-Magnitude-
vs-Intensity. [Accessed January 1 2022].

15. J. S. e. al,  Understanding the Fundamentals of Earth-
quake Signal Sensing Networks,  Analog Devices, vol. 
53, no. 3, pp. 1-11, 2019. 

16. M.R.Naghil,  Public health impact and medical impact 
and medical of earthquakes,  Pan Am J Public Health, 
vol. 18, no. 3, pp. 1-6, 2005. 

17. L. C. e. al,  Effective plans for Hospital System Response 
to Earthquake Emergencies,  Nature communications, 
vol. 11, no. 4325, pp. 1-12, 2020. 

18. WHO,  Earthquakes,  WHO, Geneva, 2018.
19. C. H. Derrick Bryson Taylor,  8.2-Magnitude Earthquake 

Strikes Off Alaskan Coast,  New York TImes, July 29 
2021. [Online]. Available: https://www.nytimes.
com/2021/07/29/us/alaska-earthquake-tsunami-
warning.html. [Accessed February 6 2022].

20. M. Krakow,  Only minimal damage reported after Alaska’s 
largest earthquake in over a half century,  Nachorage 
Daily News, July 30 2021. [Online]. Available:https://
www.adn.com/alaska-news/2021/07/29/a-day-after-
alaskas-largest-earthquake-in-over-half-a-century-

no-big-wave-minimal-damage/. [Accessed 6 February 
2022].

21. Y. R. Shubham Kalia,  Alaska rocked by powerful earth-
quake, no major damage or injury reported,  Reuters, 
July 30 2021. [Online]. Available: https://www.reuters.
com/world/us/magnitude-72-earthquake-strikes-
alaska-peninsula-usgs-2021-07-29/. [Accessed Feb-
ruary 6 2022].

22. J. Crickx,  Securing health in Haiti when the earthquake 
ruined hospitals,  Unicef, September 13 2021.[Online].
Available:https://www.unicef.org/lac/en/stories/
securing-health-haiti-when-earthquake-ruined-
hospitals. [Accessed February 6 2022].

23. VolcanoDiscovery,  Top 20 quakes in the world by 
country in 2021,  VolcanoDiscovery, January 29 2022. 
[Online].Available:https://www.volcanodiscovery.com/
largest-recent-by-country/earthquakes/archive/2021.
html. [Accessed 2 February 2022].

24. J. Shvili,  The Deadliest Earthquakes Of The 21st 
Century,  WorldAtlas, December 14 2020. [Online]. 
Available: https://www.worldatlas.com/articles/
the-deadliest-earthquakes-in-the-21st-century.html. 
[Accessed February 1 2022].

25. E. R. e. al,  Major Earthquakes & Cascading Events: 
Potential Health and Medical Implications,  ASPR 
Tracie, Virginia, 2021.

26. T. M. Stephanie Pappas,  Top 10 deadliest natural 
disasters in history,  Livescience.com, December 17 
2020.[Online].Available:https://www.livescience.
com/33316-top-10-deadliest-natural-disasters.html. 
[Accessed February 15 2022].

27. H. Ritchie,  What were the world’s deadliest earth-
quakes?,  Our World in Data, October 5 2018. [Online]. 
Available: https://ourworldindata.org/the-worlds-
deadliest-earthquakes. [Accessed February 15 2022].

28. T. W. Bank,  Strengthening Disaster Risk Management 
and Transport Infrastructure after a Disaster: The 2010 
Haiti Post-Earthquake Experience,  The World Bank, 
October 12 2010. [Online].Available:https://www.
worldbank.org/en/results/2021/10/12/strengthening-
disaster-risk-management-and-transport-infrastructure-
after-a-disaster-the-2010-haiti-post-earthquake-expe. 
[Accessed 8 February 2022].

https://www.thoughtco.com/divergent-plate-boundaries-3874695
https://www.thoughtco.com/divergent-plate-boundaries-3874695
https://www.thoughtco.com/convergent-plate-boundaries-3866818#
https://www.thoughtco.com/convergent-plate-boundaries-3866818#
https://www.thoughtco.com/convergent-plate-boundaries-3866818#
https://geokansas.ku.edu/measuring-earthquake-magnitude-and-intensity
https://geokansas.ku.edu/measuring-earthquake-magnitude-and-intensity
https://www.earthquakeauthority.com/Blog/2020/Earthquake-Measurements-Magnitude-vs-Intensity
https://www.earthquakeauthority.com/Blog/2020/Earthquake-Measurements-Magnitude-vs-Intensity
https://www.earthquakeauthority.com/Blog/2020/Earthquake-Measurements-Magnitude-vs-Intensity
https://www.nytimes.com/2021/07/29/us/alaska-earthquake-tsunami-warning.html
https://www.nytimes.com/2021/07/29/us/alaska-earthquake-tsunami-warning.html
https://www.nytimes.com/2021/07/29/us/alaska-earthquake-tsunami-warning.html
https://www.adn.com/alaska-news/2021/07/29/a-day-after-alaskas-largest-earthquake-in-over-half-a-century-no-big-wave-minimal-damage/
https://www.adn.com/alaska-news/2021/07/29/a-day-after-alaskas-largest-earthquake-in-over-half-a-century-no-big-wave-minimal-damage/
https://www.adn.com/alaska-news/2021/07/29/a-day-after-alaskas-largest-earthquake-in-over-half-a-century-no-big-wave-minimal-damage/
https://www.adn.com/alaska-news/2021/07/29/a-day-after-alaskas-largest-earthquake-in-over-half-a-century-no-big-wave-minimal-damage/
https://www.reuters.com/world/us/magnitude-72-earthquake-strikes-alaska-peninsula-usgs-2021-07-29/
https://www.reuters.com/world/us/magnitude-72-earthquake-strikes-alaska-peninsula-usgs-2021-07-29/
https://www.reuters.com/world/us/magnitude-72-earthquake-strikes-alaska-peninsula-usgs-2021-07-29/
https://www.unicef.org/lac/en/stories/securing-health-haiti-when-earthquake-ruined-hospitals
https://www.unicef.org/lac/en/stories/securing-health-haiti-when-earthquake-ruined-hospitals
https://www.unicef.org/lac/en/stories/securing-health-haiti-when-earthquake-ruined-hospitals
https://www.volcanodiscovery.com/largest-recent-by-country/earthquakes/archive/2021.html
https://www.volcanodiscovery.com/largest-recent-by-country/earthquakes/archive/2021.html
https://www.volcanodiscovery.com/largest-recent-by-country/earthquakes/archive/2021.html
https://www.worldatlas.com/articles/the-deadliest-earthquakes-in-the-21st-century.html
https://www.worldatlas.com/articles/the-deadliest-earthquakes-in-the-21st-century.html
http://Livescience.com
https://www.livescience.com/33316-top-10-deadliest-natural-disasters.html
https://www.livescience.com/33316-top-10-deadliest-natural-disasters.html
https://ourworldindata.org/the-worlds-deadliest-earthquakes
https://ourworldindata.org/the-worlds-deadliest-earthquakes
https://www.worldbank.org/en/results/2021/10/12/strengthening-disaster-risk-management-and-transport-infrastructure-after-a-disaster-the-2010-haiti-post-earthquake-expe
https://www.worldbank.org/en/results/2021/10/12/strengthening-disaster-risk-management-and-transport-infrastructure-after-a-disaster-the-2010-haiti-post-earthquake-expe
https://www.worldbank.org/en/results/2021/10/12/strengthening-disaster-risk-management-and-transport-infrastructure-after-a-disaster-the-2010-haiti-post-earthquake-expe
https://www.worldbank.org/en/results/2021/10/12/strengthening-disaster-risk-management-and-transport-infrastructure-after-a-disaster-the-2010-haiti-post-earthquake-expe


J Global Clinical Engineering Vol.5 Issue 2: 2022  26

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

29. V. F. Grasso,  Seismic Early Warning Systems:Procedure 
for Automated Decision Making,  Università degli Studi 
di Napoli Federico II, Napoli, 2006.

30. M. M. Nebil Achour,  Post-earthquake hospital function-
ality evaluation: The case of Kumamoto Earthquake 
2016,  Earthquake Spectra, vol. 36, no. 4, pp. 1-25, 2020. 

31. C. B. Janet Michaelis,  The 1989 Loma Prieta earthquake: 
Impact on Hospital Patient Care,  Annals of Emergency 
Medicine, vol. 21, no. 10, pp. 1-7, 1992. 

32. WHO,  NEPAL EARTHQUAKE 2015:Country Update 
and Funding Request,  WHO, Cathmandu, 2015.

33. P. Moszynski,  Campaign is launched to protect health 
facilities from disasters,  BMJ, vol. 336, no. 7637, pp. 
1-7, 2008. 

34. R. Sharma,  India plans massive hospital rebuilding 
after earthquake,  BMJ, vol. 322, no. 7284, pp. 1-1, 2001. 

35. MSF,  Hundreds injured and serious damage to medical 
facilities after Haiti earthquake,  MSF, January 13 2010. 
[Online]. Available: https://www.msf.org/hundreds-
injured-and-serious-damage-medical-facilities-after-
haiti-earthquake. [Accessed February 6 2022].

36. T. D. e. a. Kirsch,  Impact on Hospital Functions Follow-
ing the 2010 Chilean Earthquake,  American Medical 
Association, vol. 4, no. 2, pp. 1-8, 2010. 

37. UNICEF,  RWANDA EARTHQUAKES,  UNICEF, Kigali, 
2008.

38. U. S.P.Salamati Nia,  SAFETY AND SECURITY OF HOS-
PITALS DURING NATURAL DISASTERS: CHALLENGES 
OF DISASTER MANAGERS,  International Journal of 
safety and security, vol. 7, no. 2, pp. 1-13, 2017. 

39. U. RIng,  The East African Rift System,  Austrian Journal 
of Earth Sciences, vol. 107, no. 1, pp. 1-15, 2014. 

40. T. Davies,  Environmental health impacts of East Afri-
can Rift volcanism,  Environ Geochem Health, vol. 30, 
pp. 1-15, 2008. 

41. B. S. e. al,  Study and Monitoring of the Virunga Volca-
noes: Long-Term Involvement of Belgium and Grand-
Duchy ofLuxembourg,  Tervuren, 2017.

42. T. E. o. E. Britannica,  Virunga Mountains,  Britannica, 
January 6 2020. [Online]. Available: https://www.

britannica.com/place/Virunga-Mountains. [Accessed 
February 8 2022].

43. O. S. Nag,  Important Facts About The Virunga Moun-
tains In East Africa,  World Atlas, February 13 2018. 
[Online]. Available: https://www.worldatlas.com/
articles/important-facts-about-the-virunga-mountains-
in-east-africa.html. [Accessed 8 February 2022].

44. MONUSCO,  Nord Kivu,  MUNUSCO, GOMA, 2015.
45. F. Kimenyi,  Earthquake kills 34,  The New Times, 

3 February2008.[Online].Available:https://www.
newtimes.co.rw/section/read/2543. [Accessed 8 
February 2022].

46. Volcanodiscovery,  Nyiragongo volcano,  Volcanodiscov-
ery.com, January 17 2022. [Online]. Available:https://
www.volcanodiscovery.com/nyiragongo.html. [Accessed 
February 15 2022].

47. T. Reporter,  The dilemma of surviving an earth-
quake,  The New Times, February 20 2008. [Online].
Available:https://www.newtimes.co.rw/section/
read/2743. [Accessed February 8 2022].

48. MIDIMAR,  The National Risk Atlas of Rwanda,  MIDI-
MAR, KIGALI, 2015.

49. N. Mohita,  Earthquakes Prediction: 9 Methods to 
Predict Earthquake,  Yourarticlelibrary.com, [Online]. 
Available: https://www.yourarticlelibrary.com/earth-
quake/earthquakes-prediction-9-methods-to-predict-
earthquake/13915. [Accessed 13 February 2022].

50. O. V. e. al,  A Review of the Technical and Socio-Orga-
nizational Components of Earthquake Early Warning 
Systems,  Frontiers in Earth Science, vol. 8, no. 533498, 
pp. 1-19, 2020. 

51. P. Bigabo,  Disaster Risks Could Cost Rwanda Rwf100 
Billion,  KT Press, January 28 2016. [Online]. Avail-
able: https://www.ktpress.rw/2016/01/disaster-
risks-could-cost-rwanda-rwf100-billion/. [Accessed 
February 8 2022].

52. T. E. African,  Hell on earth: Survivors of DRC volcano 
tragedy share horror stories,  The East African, May 
31 2021. [Online]. Available: https://www.theeastafri-
can.co.ke/tea/rest-of-africa/survivors-nyiragongo-
volcano-tragedy-share-stories-3419752. [Accessed 
8 February 2022].

https://www.msf.org/hundreds-injured-and-serious-damage-medical-facilities-after-haiti-earthquake
https://www.msf.org/hundreds-injured-and-serious-damage-medical-facilities-after-haiti-earthquake
https://www.msf.org/hundreds-injured-and-serious-damage-medical-facilities-after-haiti-earthquake
https://www.britannica.com/place/Virunga-Mountains
https://www.britannica.com/place/Virunga-Mountains
https://www.worldatlas.com/articles/important-facts-about-the-virunga-mountains-in-east-africa.html
https://www.worldatlas.com/articles/important-facts-about-the-virunga-mountains-in-east-africa.html
https://www.worldatlas.com/articles/important-facts-about-the-virunga-mountains-in-east-africa.html
https://www.newtimes.co.rw/section/read/2543
https://www.newtimes.co.rw/section/read/2543
http://Volcanodiscovery.com
http://Volcanodiscovery.com
https://www.volcanodiscovery.com/nyiragongo.html
https://www.volcanodiscovery.com/nyiragongo.html
https://www.newtimes.co.rw/section/read/2743
https://www.newtimes.co.rw/section/read/2743
http://Yourarticlelibrary.com
https://www.yourarticlelibrary.com/earthquake/earthquakes-prediction-9-methods-to-predict-earthquake/13915
https://www.yourarticlelibrary.com/earthquake/earthquakes-prediction-9-methods-to-predict-earthquake/13915
https://www.yourarticlelibrary.com/earthquake/earthquakes-prediction-9-methods-to-predict-earthquake/13915
https://www.ktpress.rw/2016/01/disaster-risks-could-cost-rwanda-rwf100-billion/
https://www.ktpress.rw/2016/01/disaster-risks-could-cost-rwanda-rwf100-billion/
https://www.theeastafrican.co.ke/tea/rest-of-africa/survivors-nyiragongo-volcano-tragedy-share-stories-3419752
https://www.theeastafrican.co.ke/tea/rest-of-africa/survivors-nyiragongo-volcano-tragedy-share-stories-3419752
https://www.theeastafrican.co.ke/tea/rest-of-africa/survivors-nyiragongo-volcano-tragedy-share-stories-3419752


27 J Global Clinical Engineering Vol.5 Issue 2: 2022

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

53. F. M. Djaffar Al Katanty,  Earthquakes in Congo raze build-
ings, stoke fear of second volcanic eruption,  Reuters, 
May 25 2021. [Online]. Available: https://www.reuters.
com/business/environment/earthquakes-congo-border-
raise-fears-second-volcano-eruption-2021-05-25/. 
[Accessed 8 February 2022].

54. M. M. Bahati,  Rubavu district needs Rwf90bn to repair 
damages from volcanic quakes,  The New Times, July 
15 2021. [Online]. Available: https://www.newtimes.
co.rw/news/rubavu-district-needs-rwf90bn-repair-
damages-volcanic-quakes. [Accessed February 8 2022].

55. UNHCR,  UNHCR Emergency Update on Volcano Ny-
iragongo,  UNHCR, 2021.

56. EARTHQUAKEMONITOR,  Moderate magnitude 4.7 
earthquake 20 km northeast of Gisenyi, Rwanda,  VOL-
CANO DISCOVERY, May 25 2021. [Online]. Available: 
https://www.volcanodiscovery.com/earthquake/
news/131041/Moderate-magnitude-47-earthquake-
20-km-northeast-of-Gisenyi-Rwanda.html. [Accessed 
8 February 2022].

57. B. F. Larry Madowo,  92 earthquakes and tremors 
recorded in past 24 hours around Mount Nyiragongo 
volcano,  BBC, May 30 2021. [Online]. Available: https://
edition.cnn.com/2021/05/30/africa/drc-volcano-
tremors-intl/index.html. [Accessed February 8 2022].

58. G. Gunawan,  Design of Earthquake Early Warning 
System Based on Internet of Thing,  Journal of Physics: 
Conference Series, pp. 1-7, 2021. 

59. R. H. e. al,  Emergency Communication and Quick 
Seismic Damage Investigation Based on Smartphone,  
Advances in Materials Science and Engineering, vol. 
2016, pp. 1-16, 2016. 

60. M. David JWald,  Practical limitations of earthquake 
early warning,  EARTHQUAKE SPECTRA, vol. 36, no. 
3, pp. 1-36, 2020. 

61. H. K. Yih-Min Wu,  Development of an Earthquake 
Early Warning System Using Real-Time Strong Motion 
Signals,  Sensors, vol. 2008, no. 8, pp. 1-9, 2008. 

62. C. P. N. Ting-Yu Hsu,  On-Site Earthquake EarlyWarn-
ing Using Smartphones,  Sensors, vol. 20, no. 2928, 
pp. 1-18, 2020. 

63. T. H. Fumiko Tajima,  Earthquake early warning: 
what does  seconds before a strong hit  mean?,  
Progress in Earth and Planetary Science, vol. 5, 
no. 63, pp. 1-25, 2018. 

64. USGS,  ShakeAlert—An Earthquake Early Warning 
System for the United States West Coast,  USGS, 
Virginia, 2017.

65. J. S. B. e. al,  Earthquake early warning in Aotearoa 
NewZealand: a survey of public perspectives to guide-
warning system development,  Humanities&Social 
Sciences Communications, vol. 7, no. 138, pp. 
1-12, 2020. 

66. S. Wu,  Future of Earthquake Early Warning: Quan-
tifying Uncertainty and Making Fast Automated 
Decisions for Applications,  California Institute of 
Technology, California, 2014.

67. I. Khan,  Earthquake Detection in a Static and 
DynamicEnvironment Using Supervised Machine 
Learning and a Novel Feature Extraction Method,  
Sensors, vol. 20, no. 800, pp. 1-21, 2019. 

68. C. Gemma Cremen,  Earthquake early warning: 
Recent advances and perspectives,  Elsevier, vol. 
205, pp. 1-8, 2020. 

69. A. S. e. al,  An Earthquake Early Warning System 
for Southwestern British Columbia,  Frontiers in 
Earth Science, pp. 1-12, 2021. 

70. Y.-M. W. e. al,  Determination of earthquake early 
warning parameters,τ c and Pd, for southern Cali-
fornia,  Geophys. J. Int., pp. 1-12, 2007. 

71. M. Z. e. al,  Brief communication: Effective earth-
quake early warning systems:appropriate messaging 
and public awareness roles,  Natural Hazards and 
Earth System Sciences, pp. 1-8, 2021. 

72. H. s. e. al,  Earthquake Damage Data Collection Us-
ing Omnidirectional Imagery,  Frontiersin.org, 28 
September 2018. [Online]. Available: https://www.
frontiersin.org/articles/10.3389/fbuil.2018.00051/
full. [Accessed 1 February 2022].

73. E. O. F. EARTH,  Compare-Contrast-Connect: Seismic 
Waves and Determining Earth’s Structure,  Univer-
isty of Hawaii, October 12 2021. [Online]. Available: 

https://www.reuters.com/business/environment/earthquakes-congo-border-raise-fears-second-volcano-eruption-2021-05-25/
https://www.reuters.com/business/environment/earthquakes-congo-border-raise-fears-second-volcano-eruption-2021-05-25/
https://www.reuters.com/business/environment/earthquakes-congo-border-raise-fears-second-volcano-eruption-2021-05-25/
https://www.newtimes.co.rw/news/rubavu-district-needs-rwf90bn-repair-damages-volcanic-quakes
https://www.newtimes.co.rw/news/rubavu-district-needs-rwf90bn-repair-damages-volcanic-quakes
https://www.newtimes.co.rw/news/rubavu-district-needs-rwf90bn-repair-damages-volcanic-quakes
https://www.volcanodiscovery.com/earthquake/news/131041/Moderate-magnitude-47-earthquake-20-km-northeast-of-Gisenyi-Rwanda.html
https://www.volcanodiscovery.com/earthquake/news/131041/Moderate-magnitude-47-earthquake-20-km-northeast-of-Gisenyi-Rwanda.html
https://www.volcanodiscovery.com/earthquake/news/131041/Moderate-magnitude-47-earthquake-20-km-northeast-of-Gisenyi-Rwanda.html
https://edition.cnn.com/2021/05/30/africa/drc-volcano-tremors-intl/index.html
https://edition.cnn.com/2021/05/30/africa/drc-volcano-tremors-intl/index.html
https://edition.cnn.com/2021/05/30/africa/drc-volcano-tremors-intl/index.html
http://Frontiersin.org
https://www.frontiersin.org/articles/10.3389/fbuil.2018.00051/full
https://www.frontiersin.org/articles/10.3389/fbuil.2018.00051/full
https://www.frontiersin.org/articles/10.3389/fbuil.2018.00051/full


J Global Clinical Engineering Vol.5 Issue 2: 2022  28

Nkurunziza, Udahemuka, Umutesi, Dusenge : Earthquake Early Warning System: A Solution for Life Rescue in 
Health Facilities and Risks Mitigation for the population of the Virunga Region

https://manoa.hawaii.edu/exploringourfluidearth/
node/1336. [Accessed February 11 2022].

74. G. Gibson,  Seismic Instrumentation,  Royal Melbourne 
Institute of Technology, Melbourne.

75. M. S.Hons,  Seismic sensing: Comparison of geophones 
and accelerometers using laboratory and field,  Uni-
versity of Calgary, Calgary, 2008.

76. T. Boyd,  Geophones,  Geol.lsu.edu, [Online]. Available: 
http://www.geol.lsu.edu/jlorenzo/ReflectSeismol03/
Geophones_files/geophones.htm. [Accessed 16 Febru-
ary 2022].

77. M. Iskander,  Underground sensing,  in Geotechnical 
Underground Sensing and Monitoring, Academic Press, 
2018, pp. 141-202.

78. IndustryARC,  Seismometers Market - Forecast(2022 
- 2027),  IndustryARC, [Online]. Available: https://
www.industryarc.com/Report/16999/seismometers-
market.html. [Accessed 19 February 2022].

79. F. A. Levinzon, Ultra-Low-Noise Seismic Accelerometers 
for Earthquake Prediction and Monitoring, London: 
IntechOpen, 2017. 

80. H. M. Yih-Min Wu,  A Review on the Development of 
EarthquakeWarning System Using Low-Cost Sensors 
in Taiwan,  Sensors, vol. 21, no. 7649, pp. 1-14, 2021. 

81. M. Wilson,  What are the components of communica-
tion technology?,  Restaurantnorman.com, June 3 2021. 
[Online]. Available: https://www.restaurantnorman.
com/what-are-the-components-of-communication-
technology/#What_are_the_5_components_of_data_com-
munication. [Accessed 13 February 2022].

82. A. S. Michael Guenther,  Communication systems used 
in seismology,  GFZ German Research Centre for Geo-
sciences, Potsdam, 2013.

83. MGS,  Sismic Networko Components,  Maryland 
Geoogical Survey, [Online]. Available: http://www.
mgs.md.gov/seismic/components.shtml. [Accessed 
February 13 2022].

84. H. E. Aghanti,  CONFIGURATION & INSTALLATION OF 
A BASE TRANSCEIVER STATION (BTS),  Linkedin.com, 
16 February 2018. [Online].Available:https://www.
linkedin.com/pulse/configuration-installation-base-
transceiver-station-henry. [Accessed 2022 February 
2022].

85. C. P. e. al,  Perfoemcance evauation of an earthquake 
early warning system in the 2019-2020 M6.0 Changning, 
Sichuan, China, Seismic Sequence,  Frontiers in health 
science, vol. 9, no. 699941, pp. 1-13, 2021. 

86. USGS,  The Global Seismographic Network,  USGS, 
Virginia, 2010.

87. P. D. Jonathan Berger,  Ambient Earth noise: A survey 
of the Global Seismographic Network,  JOURNAL OF 
GEOPHYSICAL RESEARCH, vol. 109, no. B11307, pp. 
1-11, 2004. 

88. R. B. e. al,  he Global Seismographic Network Surpasses 
Its Design Goal,  EOS, vol. 85, no. 23, pp. 1-4, 2004. 

89. IRIS,  GSN Maps,  IRIS, [Online]. Available: https://
www.iris.edu/hq/programs/gsn/maps. [Accessed 16 
February 2022].

90. IRIS,  Instrumentation,  IRIS, [Online]. Available: https://
www.iris.edu/hq/programs/gsn/instrumentation. 
[Accessed 16 February 2022].

91. A. G. James Wood,  East Africa’s Great Rift Valley: A 
Complex Rift System,  Geology.com, March 26 2020. 
[Online]. Available: https://geology.com/articles/
east-africa-rift.shtml. [Accessed January 31 2022].

https://manoa.hawaii.edu/exploringourfluidearth/node/1336
https://manoa.hawaii.edu/exploringourfluidearth/node/1336
http://Geol.lsu.edu
http://www.geol.lsu.edu/jlorenzo/ReflectSeismol03/Geophones_files/geophones.htm
http://www.geol.lsu.edu/jlorenzo/ReflectSeismol03/Geophones_files/geophones.htm
https://www.industryarc.com/Report/16999/seismometers-market.html
https://www.industryarc.com/Report/16999/seismometers-market.html
https://www.industryarc.com/Report/16999/seismometers-market.html
http://Restaurantnorman.com
https://www.restaurantnorman.com/what-are-the-components-of-communication-technology/#What_are_the_5_components_of_data_communication
https://www.restaurantnorman.com/what-are-the-components-of-communication-technology/#What_are_the_5_components_of_data_communication
https://www.restaurantnorman.com/what-are-the-components-of-communication-technology/#What_are_the_5_components_of_data_communication
https://www.restaurantnorman.com/what-are-the-components-of-communication-technology/#What_are_the_5_components_of_data_communication
http://www.mgs.md.gov/seismic/components.shtml
http://www.mgs.md.gov/seismic/components.shtml
http://Linkedin.com
https://www.linkedin.com/pulse/configuration-installation-base-transceiver-station-henry
https://www.linkedin.com/pulse/configuration-installation-base-transceiver-station-henry
https://www.linkedin.com/pulse/configuration-installation-base-transceiver-station-henry
https://www.iris.edu/hq/programs/gsn/maps
https://www.iris.edu/hq/programs/gsn/maps
https://www.iris.edu/hq/programs/gsn/instrumentation
https://www.iris.edu/hq/programs/gsn/instrumentation
http://Geology.com
https://geology.com/articles/east-africa-rift.shtml
https://geology.com/articles/east-africa-rift.shtml

