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7/29/2019 Emergency and Disaster Management Journal
1/4
DOMINO, NIKKI Y.
4ACN
EMERGENCY AND DISASTER MANAGEMENT JOURNAL
Two words, emergency, and disaster, are scary and send ripples down the spine
of everyone. Though emergency is a situation of grave risk to health, life, or
environment, and disaster is any phenomenon, natural or man made, that has
the potential to cause a lot of destruction of life and property, the mere mention
of either of these two words is enough to make people jittery. Yes, emergency
and disaster are closely interrelated but there are differences between the two
that will be highlighted in this article.
Emergency refers to any situation that is threatening and requires quick
response from you. When you see a risk to self, property, health or environment,
you act hurriedly to prevent any worsening of the situation. However, there are
situations that demand fleeing and no action on your part can help mitigatedanger to life and property. Emergencies are of all scales and may affect a single
individual to an entire population in area. For example, a person who has
suffered a stroke may have to be taken to a hospital in time to get him medical
care. This is a small-scale emergency as it involves a single individual and
perhaps his family. On the other hand, an earthquake or a tsunami that strikes
without prior warning is emergency that requires planning and preparedness to
save lives and properties. When it comes to defining emergencies, most experts
agree that all situations posing danger to human life are regarded as
emergencies, while those posing danger to environment, though serious, do not
require action as quickly and swiftly as an emergency. It is important to note that
some authorities do not consider it an emergency when there is an immediate
danger to the life of an animal population. On the other hand, fires, tornadoes,
hurricanes that have the potential to sweep across properties are included in
emergencies. There are agencies that are involved in management of
emergencies and their action is divided into four categories starting from a state
of preparedness to a quick response, recovery phase and then finally mitigation.
There is another emergency that is called as state of emergency, which is what
prompts governments to declare emergency in the state and curtail the rights of
individuals. This is an extraordinary step to deal with civil unrest as peoplespowers are usurped by the administration.
Disaster refers to any man made or natural hazard having potential to cause
widespread destruction of property and human lives is considered as a disaster.
To common people, a disaster is a phenomenon or event that leaves behind a
trail of destruction that also claims human lives. Landslides, earthquakes, fires,
explosions, volcanoes, and floods are some of the well-known disasters though of
late, terrorism and its related events have caused much more mayhem and
destruction than natural disasters. Though, the intensity of a natural disaster
may be the same, its after effects are felt more in developing countries than inadvanced, developed nations. This is because of both higher density of
populations and lesser preparedness in case of third world countries. An
earthquake in a developed country causes much less destruction than a similar
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DOMINO, NIKKI Y.
4ACN
one in a poor country with higher density of population and with houses that
have not been designed to face earthquakes.
Emergency Management Journal Synthesis
The Response to Hurricane Katrina by Donald P. Moynihan
Hurricane Katrina was the largest natural disaster in the United States in living
memory, affecting 92,000 square miles and destroying much of a major city. Over
1,800 people died and tens of thousands were left homeless and without basic
supplies.
Katrina evolved into a series of connected crises, with two basic causes. The
primary cause was the hurricane itself, but no less important was the collapse of
man-made levees meant to protect a city built below sea-level.
Any consideration of Katrina must acknowledge that the impact of Katrina was
great not primarily because of human failures, but because of the size and scope
of the task. Good management might modify disasters, but cannot eliminate
them. Nevertheless, it is clear that better coordination among the network of
responders, a greater sense of urgency, and more successful management of
related risk factors would have minimized some of the losses caused by Katrina.
The type of risk deficits identified by this paper are relatively broad, and are
likely to be relevant to many of the type of complex crises that Lagadec [2008]
identifies as increasingly common.
Many of the lessons that emerge from the case draw directly from the deficits
identified. But there are some additional lessons. Katrina also occurred in the
policy aftermath of 9/11, and illustrated how new policies and structures of
crisis response that occurred after that event not only failed, but may have made
the response to Katrina worse, causing confusion about roles and
responsibilities, and limiting the ability of leaders to make sense or non-terrorist
events.
The paper also suggests the benefits of considering the collective set of crisis
responders as a network, with varying degrees of connectivity [Moynihan, 2007;
2008]. Two additional observations arise from this perspective. The capacity ofthe overall network depends a great deal on the capacity of hub members. Since
hubs such as FEMA have mandated responsibilities, they cannot be easily
removed from the network if their performance falters. This implies that
attention should be given to maintaining the capacity of hubs consistent with
their disproportionate influence on the overall network. A network perspective
also underlines how more emergent actors, typically voluntary actors from the
private or non-profit sectors, are largely disconnected from network hubs, and
therefore struggle to coordinate with other responders. But these players
provide vital support and cannot be ignored. Crisis managers need to do more to
incorporate these actors into the network before the disaster occurs.
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DOMINO, NIKKI Y.
4ACN
Disaster Management Journal Synthesis
Disaster and Mass Casualty Management: A Commentary on the American
College of Surgeons Position Statement by Eric R Frykberg, MD, FACS
On September 11, 2001, the United States was dealt a body blow from which weare still recovering. Beyond the ruthlessness and evil of the attacks on the World
Trade Center and the Pentagon, and the tragic loss of innocent lives, was our
realization of how nave and unprepared we were for the consequences ofterrorism that much of the rest of the world experiences regularly. We had
developed complacency as to our invulnerability to such attacks, feeling that
terrorist activity only affects others in faraway places. We felt no motivation to
plan for such attacks or their prevention, as much of the rest of the world does
with greater effectiveness.
Certainly the American medical community recognized its disturbing lack of
preparedness and experience in caring for the victims of mass casualty disasters
after 9/11, as it did following the Oklahoma City bombing 6 years before and the
World Trade Center bombing 8 years before. It is clear that managing large
numbers of acutely injured victims who present all at once involves principles
quite different from our everyday management of injured patients. These must
be learned as a new and distinct skill set through an intense educational effort if
we are to reach the proper levels of medical preparedness for terrorist events.
The American College of Surgeons has adopted the accompanying position
statement, as drafted by the Committee on Trauma, to emphasize and justify the
importance of surgical involvement in all disaster efforts, and to assert itscommitment to achieving this goal. The statement also makes the point that
surgeons must work as part of a large multidisciplinary team if we are to
succeed in disaster management. The College, through the Disaster and Mass
Casualty subcommittee of the Committee on Trauma, has already made great
headway in developing liaisons with a number of important organizations
involved in disaster planning and management, including the National Disaster
Medical System, the Centers for Disease Control and Prevention, the Oklahoma
State Injury Prevention Office, the American Public Health Association, the
American College of Emergency Physicians, the National Association of EMS
Physicians, the U.S. military, and the Department of Homeland Security. Several
educational products and programs arising from these relationships have
already been developed or are in development, and are being made available
through the American College of Surgeons Web site.
We in the surgical community have a lot of catching up to do, but progress is
being made. All surgeons are encouraged to become active in their own
community disaster planning programs, and we invite all interested surgeons to
participate in the Colleges activities to foster widespread understanding of
disaster management.
Mass casualties after disasters are characterized by such numbers, severity, anddiversity of injuries that they can overwhelm the ability of local medical
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resources to de- liver comprehensive and definitive medical care to all victims.
Surgeons traditionally have played an important role in disaster response. The
training and skills of surgeons, and the resources and infrastructure of trauma
centers and trauma systems, are especially suited to the logistical demands and
rapid decision-making required by large casualty burdens following both natural
disasters and man-made (biologic, nuclear, incendiary, chemical, and explosive[BNICE]) disasters. The American College of Surgeons believes that the surgical
community has an obligation to participate actively in the multidisciplinary
planning, triage, and medical management of mass casualties after all disasters.
Surgeons should provide leadership at the community, regional, and national
levels in disasters involving physical trauma to casualties that will likely require
surgical intervention and management (ie, explosions, structural collapses,
shootings, fires, and large-scale vehicular accidents). Disaster management poses
challenges that are distinct from normal surgical practice. It requires a paradigm
change from the application of unlimited re- sources for the greatest good of
each individual patient, to the allocation of limited resources for the greatest
good of the greatest number of casualties. This is achieved most effectively by
planning and training for disasters, through both internal hospital drills and
regional exercises involving all community resources. Res- cue, decontamination,
triage, stabilization, evacuation, and definitive treatment of casualties all require
the smooth integration of multidisciplinary local, state, and federal assets. This
would include (but not be limited to) prehospital services, the media, emergency
management and public health agencies, transportation and communication
resources, the military, and health care delivery facilities and personnel. The
medical management of mass casualties is only one of many critical functions
involved in the overall response to a disaster. It is incumbent on all surgeons to
attain an appropriate level of education and training in the unique principles andpractices of disaster and mass casualty management, and to serve as role models
in this field. The American College of Surgeons is committed to providing the
leadership and resources necessary to achieve this goal.