'Significant gaps' reported in disaster medical system
Copyright 2006 Gannett Company, Inc.
All Rights Reserved
By MIMI HALL
Emergency medical teams that rush in to save lives after a natural disaster or terrorist attack don't have necessary supplies, training or staff and should be overhauled, according to members of Congress, former Bush administration officials and team leaders.
The National Disaster Medical System (NDMS), which includes 55 teams of doctors, nurses, emergency medical technicians and pharmacists who are sent in when hospitals are deluged, ran into major problems after Hurricane Katrina. Ten teams that handled thousands of evacuees needing immediate medical help at New Orleans International Airport experienced communications trouble and a shortage of basic life-saving equipment and medicine.
Amid the continuing danger of terrorism and the specter of a flu pandemic, team members and health experts said it's essential that the government maintain a robust emergency medical response system. The teams often provide the only medical care during the first hours after a catastrophe.
"The NDMS does not meet the expectations of our citizens," said Jeffrey Lowell, who served as senior medical adviser to former Homeland Security secretary Tom Ridge. "We need and expect much more."
The system was created in 1984 and was run by the federal Department of Health and Human Services (HHS) until 2003, when Congress moved it into the new Homeland Security Department. There, it was put under the Federal Emergency Management Agency (FEMA).
Former HHS secretary Tommy Thompson said the system, which also includes mortuary and veterinary teams, "fell apart" after going to Homeland Security.
A report written by Lowell a year ago found that the NDMS was in rough shape. Lowell warned of "significant gaps" in the system and said the medical teams, each of which operates with at least 35 members, were unprepared to handle major emergencies. He said teams lacked the supplies, training, logistics support, equipment and staff to operate effectively.
In New Orleans, 23 of the city's 26 hospitals were knocked out. The 10 teams working round-the-clock at the airport ran out of basic supplies, such as heart medication. They also didn't have enough ventilators and other equipment. An Oregon-based team's "after-action report" on the situation complained that the "FEMA/NDMS operations at the airport were extremely disorganized" and poorly managed.
Homeland Security spokesman Russ Knocke said the system is under review by department leaders looking at how to "retool" FEMA so that it responds better to future disasters. Knocke said the results of that review are expected as early as next month.
Although Lowell had reported to Ridge that the system was suffering "under FEMA's inflexible and inappropriate management for medical response circumstances," Knocke said that the system has improved under FEMA and that "the American public can be very proud of NDMS." One improvement, he said, is that teams now have the authority to "pre-position" to potential disaster areas before a storm hits.
Emergency Medical Technician Bill Engler, whose Seattle-based team flew into the region ahead of Katrina, said pre-positioning made little difference. Because the team's "cache" of medical supplies wasn't flown in with them and had to be trucked in from Washington state, team members had to share medicine and equipment with other teams. As a result, supplies ran out fast, he said.
Rep. Henry Waxman, D-Calif., who last month released a scathing report on NDMS, said it needs "new leadership and a major overhaul."
Many team members agree.