Six months on from the Whakaari/White Island eruption, hospital staff across the country are being thanked for going "above and beyond" during the disaster.
Twenty-one people died following the December 9 eruption, with the majority being overseas tourists visiting the volcano on a day trip. A further 26 people were injured - many with severe burns - and were flown to hospitals around the country.
Dr Peter Watson, the Chief Medical Officer in the Counties Manukau District Health Board, said initially no one understood what was happening.
"We started to receive patients here at Middlemore and into the burns unit. The scale of it unfolded very rapidly… the scale was something beyond what we had seen and we had to essentially stop doing a whole lot of other work to deal with this tragedy," Dr Watson said.
While health professionals are prepared for emergencies, he said it still takes time to "click into that mode". It was then "full-on" for weeks.
"It happened at a time when we were going into Christmas/New Year. In some ways, that was a bit fortunate because that was a time when we were scaling back on some other work.
"We were also really supported by overseas burn surgeons who arrived. We had experts from overseas supporting us and supplies coming in."
Some victims suffered burns to more than 80 percent of their body and 1.2 million square centimetres of skin was ordered from the United States. International experts arrived in New Zealand to assist local health professionals.
With both White Island and COVID-19, Dr Watson said the last six months have been "really, really busy".
"Since we had Whakaari on the December 9, we had 114 days of patients from the eruption in our hospital, in our burns unit, in intensive care. Our last patients were discharged back to their home countries just as were going into level 4 lockdown. It's been all COVID since then.
"There was an incredible effort by health professionals across the country. That's after all of the people had done so much to rescue people off the island. Here in the hospital, it was a massive effort by our surgeons, anaesthetists, our special nurses and other staff at the hospital."
He called the event, which saw patients sent to four burn units across the country and hospitals activate mass casualty plans, a "unique experience".
"We had never encountered that, in fact, I think globally this is one of the few occasions where such a situation has arisen. It was a first in New Zealand and it was a time when everybody had to do so much above and beyond their normal day jobs and it was a tremendous effort to do what we ended up managing to do.
"We learnt a lot in terms of how to provide for so many people who were suffering severe burns. It will be helpful if we ever have to encounter that situation again. But, moreover, we learnt again the resilience of the health system, the support from the public and the community to help us do what we need to do."
He said in the aftermath many people turned up to the hospital to support the medical teams.
"It was a massive effort by so many and really the hospital felt enormously supported by the community in lots of different ways, from food and other gifts and providing other services to the hospital during that time to help us deliver what we needed to."
Many survivors will be dealing with the impacts of the eruption for the rest of their lives. Newshub recently spoke to teenage tour guide Jake Milbank who suffered burns to 80 percent of his body and is in and out of appointments to learn back basic movements.
"Every day you notice 'oh I can take my sock off a little bit further' or something like that, it is pretty cool to see," Milbank said in May.
Another survivor, Stephanie Browitt, posted pictures on her Instagram account in May showing her first home-visit since the eruption. Browitt had burns up to 70 percent of her body.
"To say I got the best welcome back hug and cuddles from my dog is honestly an understatement! Mum had to try and stop him from jumping on me so I wouldn't get clawed (she failed miserably and I honestly didn't care lol)," Browitt wrote.
Dr Watson said the tragedy will be felt by the survivors "forever".
"It was a disaster unparalleled and has left deep scars whether they are physical or psychological on many people. It is a long road to recovery.
"We send our sympathies to those people who lost loved one and those people who couldn't be saved, and the tragedy of that is something that is very, very difficult and takes a long time for all of us to work through."
He paid tribute to hospital staff who went "above and beyond".
"People worked incredibly long hours, whether they were hospital staff or people supporting the hospital staff and I just want to pay tribute to all those people who really did an amazing job in responding."
