The 2008 World Conference on Disaster Management, Part 1
By Scott Baltic
One of the themes running through the sessions covering both public- and private-sector issues was global climate change, which I'll discuss in a commentary next week. Meanwhile, here's an overview of this very worthwhile conference, seen through indvidual sessions.
— Scott Baltic, Homeland1 Managing Editor
Part 1 of 2: Read Part 2
The black swan
In his plenary presentation, "Global Threats, Local Risks," Dr. Carl A. Gibson, director of the Risk Management Unit at La Trobe University, Melbourne, Australia, noted that resilience depends on predictability, and that unfortunately our ability to predict is poor, far more so than we'd like to believe. He cited the recent book "The Black Swan: The Impact of the Highly Improbable," by Nassim Nicholas Taleb, as a good resource in this area.
Bridging the gap
Former Disaster Medical Assistance Team member Tom Phelan, Ed.D., presented a breakout session titled "Emergency Management and Tactical Response Operations: Bridging the Gap," in which he challenged attendees to rethink some of the field's fundamentals.
He suggested, for example, that emergency managers might be prepared by college courses than by experience in fire, EMS or law enforcement, and pointed out that as of January 2010, the IAEM will require a bachelor's degree for its Certified Emergency Manager designation. Fortunately, he added, there are currently about 150 college programs in emergency management or homeland security in the U.S.
Is it back to school for emergency managers? (AP Photo/Mike Derer)
Phelan also recommended that emergency officials think of the Incident Command System structure not as revolving around the Incident Commander, but instead as focused on supporting the Operations Chief's needs. As the only one who's in charge of tactical operations, the Ops Chief is the real commander, he contended, and incident command should be thought of as incident management.
In his session, "Cyclone Larry: A Health Perspective," Alex McGill of the Queensland (Australia) Health Emergency Management Unit described the health consequences and response after that cyclone hit the city of Innisfail in Queensland in March 2006.
The cyclone was a Category 5, and most homes in Innisfail had been built in the early 1900s and were therefore not up to current codes. At least two factors mitigated what could have been an even worse disaster: The storm was moving about 15 mph (much more rapidly than Hurricane Katrina, for example), and it made landfall near low tide, limiting the storm surge. In addition, evacuating the families of emergency responders had been made a priority before the cyclone hit, so that responders could focus full-time on their jobs.
Following the cyclone's departure, and with many physicians' offices damaged or unusable, a general practitioner service was established at the local hospital to absorb some of the load on the emergency department there. Although there was a low rate of severe emotional reactions, mental health consequences were initially underestimated, and it was later found that the very term "mental health" was an obstacle in engaging clients and their families. Factors cited for the low rate of severe emotional reacions included the lack of fatalities and "stress inoculation" from previous cyclones in northern Queensland,
Self activation of volunteer groups
A panel titled "Self Activation of Volunteer Groups: A problem or a blessing in disguise?" was hosted by Arthur Rabjohn, an emergency manager, former London police officer and author of the Management of Volunteers Guidance Manual for coastal pollution incidents, which was part of the European Union's Emergency Response to Coastal Oil, Chemical and Inert Pollution from Shipping (EROCIPS) Project.
The other panelist was John Saunders, Ontario director of the Canadian Red Cross, who commented, "I don't think a disaster can be managed without volunteers," though the key is managing them effectively. One aspect of that, he said, is recognizing the diversity of volunteers, from those affiliated with established volunteer groups ("'Volunteer' does not mean 'unprofessional'") to "episodic" volunteers who basically just show up and expect to be allowed to help.
One of Rabjohn's themes was "home and away" considerations, that is, that volunteers who are valuable on or near home turf won't necessarily be as valuable, or even worthwhile at all, at an incident in another country. Some well-meaning people, for example, jetted to Hong Kong as soon as they heard of the recent Chinese earthquakes and were dismayed to discover that the Chinese government wouldn't accept their services.
Saunders stressed the need for a Volunteer Coordination Center as part of disaster management and also emphasized the importance of pretraining and prescreening volunteers, as well as preassigning them to roles in likely disaster scenarios. He reported that, in the context of pandemic planning, the Ontario government has looked at healthcare jobs and which require certification versus which ones could be filled by volunteers. In any situation with spontaneous volunteers, he said, clear expectations are crucial.
Rabjohn said that at the Prestige oil spill off Spain's northwest coast in 2002, spontaneous volunteers created a problem by booking up all local hotel rooms, campsites and so forth, making it hard for World Wildlife Fund to bring in trained, experienced bird cleaners.
More could probably be done to engage volunteers in disaster preparedness and mitigation, such as public education, instead of just during recovery, said Saunders, who closed with this simple formula: Emergencies + Egos + Agendas = Catastrophes.
Alternate care facilities
In his session, "An Emergency Manager's Guide to Establishing Alternate Care Facilities," K.C. Rondello, MD, MPH, a DMAT member and assistant professor of emergency management at Adelphi University, Garden City, N.Y., covered the wide range of considerations that go into preplanning where such facilities will be set up in case of a pandemic or similar scenario, to deliver vaccinations or prophylactic medications.
One set of factors, for example, is whether there's adequate utility support at the prospective site, including electricity, water, climate control (taking waste heat into account), sanitation (which might have to rely on rainwater, seawater and/or gray water) and containment of infectious waste during a period when normal garbage pickup has been disrupted.
Clinical issues are another consideration, including infection control, patient flow (keeping patients moving smoothly through the facility) and record-keeping, which might be reduced to such basics as "Who are you?" and "Where can we find you?"
Administrative concerns have to include taking good care of onsite personnel, with adequate nutrition/hydration/sleeping accommodations for staff. These need to be available 24/7 and isolated from clinical care areas, with policies for logging in and out to guard against staff burnout.
James Lukaszewski, president of The Lukaszewski Group, White Plains, N.Y., gave an interesting presentation on victim psychology. One of his observations is that "Victimization ends when the victim says it's over," and not before.
Victims are typically in an emotional state that includes "intellectual deafness," he said, yet companies and organizations tend to pour out information in response to a victim's emotions. "Emotional issues," he emphasized, "have to be met with emotional responses."
Similarly, Lukaszewski advised, answer victims' questions, even if you think they're asking the wrong questions. "Fail to tell them something," he warned, "and they will make something up."
Div. Chief Jim Sideras of Sioux Falls (S.D.) Fire/Rescue, a contributor to Homeland1 sister sites Fire/Rescue1 and EMS1, described his agency's response to an unusual mass-casualty incident, one that occurred indoors at a Sioux Falls meat-packing plant that experienced a leak of anhydrous ammonia in mid-winter. More than 100 people were treated, with more than 65 transported by ambulance and another 20 to 30 self-transporting.
In somewhat of a reverberation with one of Dr. Phelan's comments, Sideras said that, in part because of the difficulty of setting up a full command post at the plant, the Planning, Logistics and Finance sections under ICS were all based at the local EOC.
Public education starts with you
In one of the closing plenary sessions, "Changing People's Readiness Behavior," Dr. Dennis Mileti, emeritus professor at the University of Colorado, explained that public education programs should talk less about why preparedness is needed and more about exactly what the public should do.
"The public education you do is not about the public," he commented. "It's about your organization." In other words, he explained, it's typically about the organization looking good and trying to show that it's carrying out its mission — and it ignores years of research on how to best reach the public. "It's not about your favorite message or your unique program."
"How do you get belief? Simple. You repeat it over and over and over and over again," he said. "Risk perception doesn't equal behavior. . .People really don't perceive risk; they perceive safety."
He concluded with this comment on the enduring strength of networking: "The real power of emergency management in the 21st century is who you have lunch with."