Mass Casualty

The Phi Phi Islands are isolated islands located about one hour by ship from the mainland in Krabi province of Thailand.There is a small medical facility where the director is the one physician that provides care to residents and tourists.This small medical facility faced an enormous mass casualty incident due to the 2004 Tsunami. The hospital was damaged by the Tsunami wave and was not functional, one crew member died and another was injured.. In the post-disaster debriefing, the Phi Phi Island hospital physician noted five major lessons concerning disaster management in such extreme situation in a small facility located in a remote area:(1) effective resistant communication facilities must be ensured; (2) clear, simple “evacuation plans” should be made in advance;(3) plans should be made to ensure automatic reinforcement of remote areas with evacuation vehicles, medical equipment and medical personnel; (4) efficient cooperation with medical volunteers must be planned and drilled;and (5) every team member of such a hospital must participate in an educational program and periodic drills should be done to improve the disaster and emergency medicine capabilities. This case report is an example for caregivers all over the world, of an amazing lesson of leadership and courage.

The Tale of Cities project was designed to bridge this gap by bringing together key leaders from selected countries with deep experience in responding to terrorist explosive events with public health, healthcare, first responders, homeland security, and military representative in the United States who are actively planning for such events, in a setting that provides considerable opportunity for sharing experiences, along with dialogue and interaction

Meta Leadership

Achievement of national preparedness – given current natural and man-made threats – requires a heightened capacity for effective crossgovernment coordination of effort. This objective is hindered by the tendency of leaders to advocate the specific interests and purposes of their narrow SILO of activity. META-LEADERS think and perform differently. They recognize that achieving genuine national preparedness demands a spirit of cooperation combined with tangible inter-agency mechanisms that activate JOINTNESS

Crowd control is essential to the handling of mass-casualty incidents (MCIs).This is the task of the police at the site of the incident.For ahospital,responsibility falls on its security forces,with the police assuming an auxiliary role.Crowd control especially is difficult when the casualties are due to riots involving clashes between rioters and police.This study uses data regarding the October 2000 riots in Nazareth to draw lessons about the determinants of crowd control on the scene and in hospitals.

In routine emergencies, official emergency organizations bear the responsibility to manage the event and treat the wounded. The principal role for bystanders is to alert the appropriate emergency organizations. In mass casualty events (MCE), bystanders are the first responders. Research conducted among rescues in the immediate aftermath of the 2010 Haiti earthquake indicates that bystanders can be an effective complement to professional rescue forces and a necessary substitute when professionals lack sufficient surge capacity. Policy makers and planners may be able to save lives and elevate resilience by sharing emergency preparedness responsibility with the general public.

Public Health Crisis Response

In this paper, the authors describe and comment on the public health system response to a catastrophic earthquake measuring 8 on the Richter scale that hit the Sichuan province in China on May 12, 2008. Drawing on the literature and field research, including a series of interviews with survivors, first responders and policy makers, the post-disaster analysis presented here describes and discusses the counter methods employed during the public health response to the disaster. It also presents a conceptual framework to describe the response, emphasizing pre existing preparedness level of the medical and public health systems, as well as social, economic and geo-political factors having an impact on mitigation efforts. The framework presented in this manuscript could be used by other researchers to describe and analyze the emergency response to other disasters.

Quarantelli established criteria for evaluating the effectiveness of disaster management. The objectives of this study were to analyze the response of the healthcare system to the Tsunami disaster according to the Quarantelli principles, and to validate these principles in a scenario of a disaster due to natural hazards. The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research team to study the response of the Thai medical system to the disaster.The analysis of the disaster management was based on Quarantelli’s 10 criteria for evaluating the management of community disasters.Data were collected through personal and group interviews. The three most important elements for effective disaster management were:(1) the flow of information;(2) overall coordination;and (3) leadership. Although pre-event preparedness was for different and smaller scenarios,medical teams repeatedly reported a better performance in hospitals that recently conducted drills. In order to increase effectiveness, disaster management response should focus on:(1) the flow of information;(2) overall coordination;and (3) leadership.