Myths of Disaster; Revisited

November 12th, 2008

Whether propagated through the media, folklore, and/or misinformation – disaster myths have been apart of our landscape since the beginning of time. Some myths are well known, others emerging, regardless when they manifested; there is much responders and E-managers can learn from these fables; especially in preparedness planning during quiescence times.

So with all that said, the following represents the more common myths of disaster response:

Myth: Wide-spread responder abandonment

Reality: With the exception of the New Orleans Police Department, where they had 200 +/- officers fail to report in, there has been no documented history of responder abandonment. In-fact, the contrary occurs with the migration of responders (intra/extrajurisdictional) to the disaster zone.  Furthermore, despite media reports, much of New Orleans PD’s absenteeism occurred as a result of inaccessibility to the disaster zone.

Myth: Mass fatality incidences, with exposed dead bodies pose, a significant health risk

Reality: as reported by the World Health organization (WHO), dead bodies pose no more health risk than live ones. Mass burials only serve to demoralize the survivors, disrupt burial arrangements, and when needed, impede the ability to conduct autopsies.

Myth: Epidemic diseases is the byproduct of disaster

Reality: rarely do disasters contribute directly to the genesis of disease, and never in epidemic proportions.

Myth: Large-scale-disasters require a large global medical response

Reality: indigenous populations almost always cover immediate lifesaving needs (WHO). Only medical specialists with unique skills, not readily available, are usually needed.

Myth: Disaster kills, universally, no matter population demographic

Reality: the poor, disabled, and elderly die in significantly higher proportions

Myth: Earthquakes are responsible for higher death tolls

Reality: Collapsing buildings are responsible for the vast amounts of deaths during a earthquake. Though earthquakes cannot be prevented, anti-seismic building construction methods can minimize fatal occurrences from collapse. Concerning collapse, most successful rescues occurs within the first 24-hours. With a good pocket, and good airflow, 5-days is plausible. In exceptional cases, reported cases, of entrapment with successful extrication, has occurred up to 18-days.

Myth: Panic and mass evacuation occurs during a disaster

Reality: the local population tends to converge to the disaster zone and often behaves rationally & contributes to disaster efforts.

Myth: Disaster incidences contribute to looting and other displays of maladaptive behaviors

Reality: looting occurs sporadically, rarely, and when preconditions are ripe for this occurrence. Acts of bravery, cohesion, and generosity tend to be the norm

Myth: Post disaster normality occurs within a few weeks of the occurrence

Reality: disaster recovery usually takes many months and sometimes years. The depletion of a country’s financial and material resources usually occurs in the preliminary stages of the incident.

Myth: Apathy and dismay are often exhibited by post disaster survivors

Reality: quite the contrary, many find new strength and contribute to response and relief efforts post disaster

Listen folks, though disaster cannot be eliminated, its detrimental affects can be minimized though proper planning and commingled responses by first response, public health, disaster, and the medical communities.

Just some prevailing myths from the bottom rung – W’s world

Understanding disasters

November 12th, 2008

OK the answer is that a “disaster” is anytime the local resources are overwhelmed.This is a commonly misunderstood point that needs to be understood to really get a handle on how to deal with disasters. As soon as resources arrive it is no longer a “disaster”.In the big scheme of things starting a disaster is much easier than ending it.  A lot of time and money goes into disaster preparedness. People and institutions buy warehouses full of supplies but they rarely understand what they are preparing for. Disasters only last 3 days! That’s right - most anywhere in America within 3 days ‘the calvary’ will arrive with resources and the overwhelming conditions will end.

Don’t believe me? Look at 9/11 how long were the planes grounded? 3 days. Hurricane Katrina, how long were people stranded on roof and at the convention center? 3 days.

Rebuilding takes forever! (There is STILL some rebuilding happening from the Northridge earthquake) but the DISASTER ends in 3 days. So when you are talking about stocking up to survive a disaster think just 3 days.

The next riddle to understand in disaster planning is “What is the biggest predictor of survival in disasters?” What ONE ELEMENT best predicts who lives or dies in a disaster.

No formal Education means trainees are always on the job

November 9th, 2008

It is a true statement that disaster managers are NOT professionally trained in their field because there aint any PROFESSIONAL training programs for them!

Go ahead and name ALL the baccalaureate level (or higher) educational pathways that lead to a degree after study in the documented field of emergency management. You can count them on one hand (if there are even that many) Oh sure there are as you note lots of on line, weekend, part time experiences that produce wallpaper but this is not real study.

All this is not real professional study because Emergency Management is barely an embryo of a profession among the other established professions. The published journals on the topic of emergency & disaster management are few, if any. How many journals are devoted EXCLUSIVELY to emergency management (and are not based on fire, medicine or law topics) and publish current, peer reviewed research? Without a body of knowledge there is no profession. Which is why The International Association of Emergency Managers requires ‘making a contribution to the field’ (e.g publishing) to become a CEM.

And NO somebody who ‘spent their life’ in emergency RESPONSE is NOT automatically qualified to become an emergency manager. The word that is used is management for a reason. It takes an understanding of administration, finance and cooperation to make a manager/leader and just because somebody spent their working years on the dry side of a fire nozzle or hanging out in an ED or hauling people around in a red light taxi does not mean that they are automatically qualified. In fact I would say that a lifetime doing something else make the categorically UNqualified!

Want an example? Look no further than the Maryland State Patrol officers who are ‘managing’ the NDMS. Hey, cops managing medical teams? That’s a good idea. Retired Maryland cops managing a NATIONAL system?  Uhhh. . . I think we can do better.

Oh wait, how about the professionalism of FEMA? Michael Brown sure brought a background of formal training in disaster management to the gulf coast didn’t he? And JUDGE Michael Chernoff who heads DHS, who heads FEMA must understand disasters real well? More cops in charge of disasters.

I am not saying all these folks are 100% incompetent, but I am saying that they all came to their position of disaster management only AFTER their career elsewhere. (careers that were commonly totally unrelated to disasters)

California? Yeah, I think we got it much better out here than the rest of the nation. But have you ever wondered where our tradition of preparedness came from? It wasn’t from formal education; it was our own particular natural disaster – Earthquake. 

In the years before 1905 the Anglo easterners who were settling in California had been told by the Mexicans and Native Americans that “sometimes the ground shakes”. Yeah right, nobody really believed it. Then a ‘minor trembler’ happened in 1906 and folks said, WOW! Those things are real and they can do some real damage. Because earthquakes are totally unpredictable we learned that only preparedness was going to save us and we developed better building codes, better response systems, better cooperation. Places where the disaster hazard is a predictable weather pattern naively believe that they can somehow control or escape the event so they historically have not (and are not) as prepared as we are in California. 

Heinze Sight

What 1 factor predicts who lives or dies during a disaster?

November 6th, 2008

“What is the biggest predictor of SURVIVAL in disasters?”What ONE ELEMENT best predicts who lives or dies in a disaster????This is a riddle and people sometimes think the answer is dumb common sense, but not understanding the answer consistently leads to needless deaths.

What is the biggest predictor of LIFE and DEATH???

Some people call it the B-O-O-T strategy. “Be Out Of Town”!

People who are not in the area of a disaster do not die from the disaster!  Pure and simple.

Nobody in Seattle died from Katrina.

Nobody in Florida died in the Northridge earthquake.

There has never been a blizzard victim in Los Angeles.

OK that is stupid you say. Anybody could have figured this out. Simple? Yes. Understood? NO!

Where is this concept reflected in disaster preparedness? E-V-A-C-U-A-T-I-O-N.

What is the biggest complaint about the New Orleans response to Katrina?  People died while the city buses that could have evacuated them were unused and flooded.

The most important predictor of SURVIVAL is leaving the area.  Sometimes evacuation is not possible. The warning periods are too short. (like earthquakes)  But in many disaster situations the warnings were present but they were ignored.

Consider the following information about the victims of the Mt St Helens volcano:

In May of 2000, a memorial plaque was placed in a grove of trees at the Hoffstadt Bluffs Visitor’s Center in memory of the victims of the eruption.   Fifty-seven names are etched into the plaque.  Fifty-seven lives needlessly lost.  They were loggers, campers, reporters and scientists.  In all, there were 36 victims brought out of the devastated area.  But after all of the searching, rescues and recoveries, there were still many people who were never found. By the third week following the blast, 25 people were confirmed dead but 47 were still on the missing list.  Luckily, 15 of the missing were later found alive.

Only four of the victims were known to be inside the restricted areas set up by federal and local governments.  David Johnston was on duty for the USGS stationed at Coldwater II only 5 miles from the summit.  There was the stubborn Harry Truman who refused to leave his lodge at Spirit Lake and was eventually given special permission to stay.  And amateur vulcanologists Bob Kaseweter and Beverly Wetherald who had permission to take readings near Spirit Lake at their own risk.   The other victims, some as far as 13 miles from the mountain, were in areas considered safe.  The thick clouds of ash and raging mudflows caught many people off guard.

57 needless deaths solely because people did not leave the area. Sadly some died because the restricted area was not large enough, but again it proves the value of evacuation. The value of getting away.

A wildlands fire fighting problem has always been the residents in the area. Residents who do not leave early enough or not at all. Needless deaths every one.

Disaster preparedness is a common topic of public education. I have never seen it clearly explained enough that the most important preparedness activity that can be performed (if survival is your goal) is being ready to leave the area quickly and efficiently.

Do you teach disaster preparedness? What do you teach as the most important aspect of being prepared? Do you teach that having “A 3 day supply of food and water” is the most important thing a person/family/business can do?

Perhaps now you will reconsider what you teach. Having an evacuation plan is the most important thing to save your life and the life of your loved ones.

Heinze Sight

Do you even know what a “disaster” is?

November 3rd, 2008

Disaster - Lots of folks throw the word around but few have an understanding of what it means.What is a disaster? What is disaster preparedness?Can you recognize (or determine exactly) when a disaster starts? More importantly do you know when it ends? When are things back to “normal”.All Disaster response and preparedness is “USELESS” if you cant even define or recognize your opponent!Without being able to recognize a “disaster” no organization knows when to activate their disaster plan or even open up their disaster supplies.

Without a theoretical base or paradigm to define and shape ALL the disaster related activities an organization might get involved with, all preparations are guaranteed to fail!

The readers of this site/blog will most likely be from response organizations. Hospitals, ambulance services, Fire departments, Governmental agencies. Do all these groups define a ‘disaster’ the same way?

If all the groups cannot agree on what a ‘disaster’ is guaranteed that the help and interrelationships that are written into every disaster plan are not going to materialize.

I have my ideas about what a “disaster” is and how to determine when a “disaster” starts and ends but before I spout off my own opinion tell me what YOU think! Tell me how YOUR organization defines a “disaster”. (maybe you will have to dig out and read your organization’s disaster plan?)

We can then discuss the relative merits of these definitions and by exposing the failings, then maybe we can strengthen disaster response in California.

Heinze

 

 

Mass Fatality Incidences; who’s really in charge?

October 14th, 2008

As we’ve discussed in previous blog entries, disasters are local events under the jurisdictional control of local government. So what are the ramifications, given the above statement, for our fire and law enforcement agencies? With the exception of a catastrophic WMD incident, in which case the Department of Homeland Security (DHS) would assume ownership of the incident, local government’s frontline responders (FD & PD) would assume scene command of the disaster incident within its boundaries. Are we clear on that detail? This should not be an issue, the expectations of local government obligation during a disaster is further affirmed/reinforced in the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1974, in which it states: the local jurisdiction is expected to take the lead and to stay in the driver’s seat throughout the incident.

So why am I passionate all of a sudden about Mass Fatality Incidences, you say? Just happen to be doing some casual Sunday reading on a suggested Mass Fatality model by an influential Medical Examiner/Coroner (ME/C) association. Suffice it to say, the content was very insightful to say the least. It appears from this article that the role of first response is subordinate to their command controls and relegated to what equates to manual labor (body wash down, litter bearers, decon issues, etc). We’ve been identified as a source of manpower for their efforts! Don’t know about you all, but I have a few thoughts about that! The first thought that comes to mind is who owns the scene? Think we clarified this old horse up top. The second thought is who is in a better place to manage the incident? As Heinz has stated previously; it’s the fire service! The FS lives, breaths ICS/NIMS every day. Can’t learn this in a weekend class and be competent with this command structure.

So here’s my point, given the changing face of our hazard zones post 9-11, Katrina – isn’t more likely, more now than ever (due to technological hazards {man made}) that we will witness/experience a large mass fatality event? Given the legal mandates established federally, what role should first responders play? With the grasp that the FS holds on ICS/NIMS; what should their role be? Now for the million dollar question, what role should the FS play in Mass Fatality Incidences involving disasters (natural or technological)? Need some prompting on this? Who managed the “pile” at the World Trade Center? FDNY, your right. Who managed the incident at the Pentagon? Yep, the local municipal FD. In fact, FEMA and the DOD had to ask for permission to play. Want another one? Who managed the Oklahoma City bombing at the Alfred Murrah Federal building? Again, the local FD. The commonality with all the highlighted incidences above is that when rescue efforts ended, and recovery efforts began (including mass fatality), it was still the local response teams that maintained control.

This piece is not here to toot the horn of the FS. The FS still has some growing-up to do before we can assert ourselves in the disaster playground. We can, however, actively embrace an all hazard approach, work on establishing closer ties with all the other players (PH, ME/C, Law), and educate/ equip ourselves to play a greater role in disaster preparedness.

Part 2 of this piece will look into the Mass Fatality model much more closely

Just some random thoughts from the bottom-rung   W’s World

How long do you wait to move (admit) your patient upstairs?

October 11th, 2008

Once again, this time of the year we are seeing more pnuemonia, URI, flu-like symptoms; and quess what?  They all need ICU.  Without enough critical care beds, we hold these patients from hours to days being taken care of by emergency nurse specialties, not ICU nurse specialty skill sets.  And so we hold them in the ED while the paramedics cannot rapidly report off due to lack of ED beds, which becomes a delayed response back to the field and finally our firefighter paramedics are on scene taking medical care of patients that cannot make it to the hospital in a timely fashion. What would we think if our house were to burn down due to the lack of our crosstrained firefighter/paramedics on a medical call without transport capabilities because of an in-hospital problem???? Sounds like waiting for gas due to no fuel in the 70’s.  Please share your experience as this affects the whole hospital and prehospital care and resource needs of all of us.

The dirty little secret in disaster preparedness is …

October 10th, 2008

APATHY! The “apathy” factor more than any human and/or organizational behavior has hindered our abilities to learn/evolve from past disaster incidences, as well as; maintain a perpetual, proactive effort with regards to disaster preparedness efforts.

Never has there come as time where our abilities to successfully mitigate the destructive effects of a disaster have become so relevant! Why now, you say? Oh, I don’t know … could it because, unlike in previous periods, purposeful human behavior is constantly augmenting the risk, and ultimately placing us in the path of a catastrophic event? Gee, let’s think about this one.  Are we; are we not developing homes in disaster prone areas? Areas historically ravaged by floods, hurricane, wildland fires, mud slides, and hurricanes? How about terrorist incidences, think that is a human cause? Think our airline industry could have gotten their head out of their a.. and maybe fortified the cockpit doors prior to 9-11? Yeah, I know, it would have caused the loss of a first class seat! Think our government could have been a little more proactive in the 90’s, as were attacked every year by terrorist and not been so concerned with jurisprudence (thanks Miss Reno)? Listen, all I’m saying is, we’re our own worsted enemy when it comes to the catastrophic events of a disaster!

I get the “Apathy” factor, I really do. As we were all taught, “disasters events are low probability occurrences competing with the daily priorities of real like, blah, blah.” You know, thinks like food, a roof over our head, employment issues, etc.  What we should never accept, however; is this pervasive apathy within our governmental bodies charged with preventing and mitigating disaster events. The aftermath of 9-11 and Katrina serve as prime examples of governmental apathy.

Your thoughts?

Coming to you from the bottom rung  - W’s World!

Los Angeles Firemen’s Credit Union Establishes FF Fund

September 3rd, 2008

Los Angeles Firemen’s Credit Union Members and Staff Donate Time and Resources so that 100% of Donations Will Pass Through to Beneficiaries

LOS ANGELES, California—Fire Family Foundation, the first of its kind in California, will help firefighters and their families in times of crisis, fund firefighter training programs, provide firefighting equipment to fire departments around the state, and support other firefighter-focused charities, announced Los Angeles Firemen’s Credit Union (LAFCU), which set up the foundation through volunteer members and staff and will similarly manage the Foundation so that 100% of donations will pass through to beneficiaries.

“Finally we will have a way of directing funds to California firefighters and the departments they serve on a consistent, organized basis,” said Pat Engel, Battalion Chief of the Los Angeles City Fire Department and LAFCU Board of Director.  “Fire Family Foundation will provide what no one in California does—the framework for the public to support firefighters and their families in times of need and provide much needed and significant equipment to small or underfunded departments so they can protect the public through safe and effective programs.”

“Firefighters go into life or death situations as a daily routine and become a family that relies on each other in life and death situations.  Los Angeles Firemen’s Credit Union is a financial cooperative made up of members of this family, and as such we support our fire family as a core business principle,” said Michael Mastro, CEO of LAFCU.  “We support multiple fire charities and have set up special accounts for the families of fallen firefighters in the past, and in the aftermath of 9-11 we raised funds to provide relief.  Fire Family Foundation formalizes these efforts as a permanent support system to our California firefighters.”

Volunteer members and staff provided hundreds of hours of work and expertise at no cost to establish the nonprofit so that the public could benefit from tax-deductible donations and firefighters and their departments could benefit from stable and ongoing support from the community.   Many people may be aware of families of firefighters that need help, or of the challenges of firefighters of small or underfunded fire departments, but in the past there has not been an organized way for the public to donate to these needs.   As an established nonprofit, Fire Family Foundation can turn individual efforts into ongoing support for firefighters, and can procure regular corporate sponsors as well.

Firefighters themselves are some of the biggest supporters of such efforts. “Small fire departments can’t always afford the equipment they need to run safely and effectively,” says Battalion Chief Engel. “We might be able to buy a defibrillator or other equipment for a rural fire department that can’t afford one, for example.   Fire Family Foundation will also enable firefighters to systematically support each other in this way.”

Fire Family Foundation is a non-profit 501(3)(c) corporation established in Los Angeles for the purpose of supporting firefighters, their families, and departments.  Tax deductible contributions may be sent to Fire Family Foundation, c/o Los Angeles Firemen’s Credit Union, 815 Colorado Boulevard, Los Angeles, CA 90041.  Contributors may also call 800-231-1626 ext. 2272 for more information, or visit

7 Years to Burn Out

August 13th, 2008

In a world of budgetary restraints and justification of services, we find ourselves running more calls than ever, doing more extra projects than ever, and becoming “Jacks of all trades”.   Add the fact that YOU are the medic on a busy crew, and there you have the recipe for a deliciously cooked Paramedic.  Yeah right!  Deliciously cooked only if you like your medic well done.

Being a Paramedic these days is very tough. Our friendly neighborhood Paramedics do just about everything when it comes to emergency services.  Join the fire department, and the list of competency requirements grows even longer.  I know some fire medics that are haz-mat Specialists, rescue specialists, assigned to wild-land management teams, ARFF trained AND they sit on 1 or 2 department committees.   Now, most of these things on their resume are voluntary, but how is a guy/gal supposed to earn brownie points without doing a lot of these things?

I am pretty sure that most people working in the emergency services field can agree that we are understaffed, under equipped, and inundated at times with the demands of service from those who need us.  A growing community calls for more use of our Paramedics.  Funding issues have been a huge contributing factor to creating an overworked and overstressed medic.  But a person can only run a finite amount of EMS calls before becoming burned out in that position.

All this brings me to an observation I have been able to make over the last decade:

In my opinion, it seems like if you start out enjoying being a Paramedic and truly care about how you serve as one, than you are well on your way to “Paramedic Burn out” in just 7 short years.  Any more years beyond that, and the once truly caring paramedic typically show signs of decreased compassion for our customers.  Now I’m not saying that this is the case with all medics, but it is something that I have noticed.

If I’ve upset anyone, let me know……..maybe that’s a good thing.

Chile P

Editor at Drama911.com

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It kinda helps when we wear our belts.

Buckle up. You’ll live to be cool.