Home Health Best practices for environmental health : environmental pollution, protection, quality and sustainability
DISASTER SITE MANAGEMENT, COMMAND-AND-CONTROL PROBLEMS FOR EMERGENCY, AND OTHER PERSONNEL, SUPPLIES, EQUIPMENT, AND ENFORCEMENT
(See endnotes 36, 40, 41)
When a disaster occurs, there is an almost instantaneous response from the media and therefore information, accurate as well as inaccurate, is transmitted extremely rapidly throughout the community, the country, and the world. Large numbers of people, substantial quantities of equipment, and huge amounts of supplies start to flow initially and over the early days into the area. A vast number of governmental, voluntary, and private organizations and other people may respond in order to get help to the seriously injured and protect property. As an example, during the aftermath of Hurricane Andrew there were so many semitrucks with supplies and clothing going to South Florida that the roads were clogged and there was no place to put it all. Also there was difficulty in distributing that which had arrived. Further, how do you house, feed, and provide medical care for the governmental workers from the local, state, and federal programs as well as the private sector and other volunteers.
Each group arriving to help in the aftermath of the disaster may be bringing its own personal protective equipment, which may not be effective in the particular disaster situation. The standards for equipment as well as the performance of tasks may vary substantially or may be lacking entirely. Alarms and devices used by the guest first responders and construction crews needed to track or identify the location of individuals may malfunction or be so bulky that they interfere with the actions of the first responders and therefore are turned off or discarded in the hurry to save lives
This chaotic response may interfere with a well-thought-out and regulated team effort controlled by a unified command under a single controlling authority which can make decisions and issue orders to the experts in the unified command and then have them transmit the needs and orders to actual working groups trying to resolve problems caused by the disaster. However, typically even this command structure is lacking and in fact this was one of the most serious problems encountered by first responders when the World Trade Center was destroyed. Part of the problem was the loss of key leaders during the building collapse and the lack of a plan to respond in the event certain leaders were disabled or killed during the disaster. In addition, there was a lack of awareness of the extent, nature, and dangers of the incident, a serious breakdown in communications between various entities, a lack of clarity regarding the most significant risk factors and tasks to be performed, and a lack of training for a disaster of this size and scope.
On-scene incident commanders complain that orders and responses may be unclear, repeated numerous times and conflicting leading to uncooperative workers who are at times totally dysfunctional. People in fact ask who is in charge and why was this order issued. Since there are various agencies responding to the disaster at the local, state, and federal level, time after time in emergency and disaster situations each agency follows its own plan, causing confusion and duplication of effort and conflicts between the agencies, which often diminishes the effect of work being done by the field professionals.
The destruction of physical facilities including communication systems, without contingency back-up provisions, is a major challenge during large disasters. Emergency responders and citizens have difficulty coordinating because of the lack of a reliable communication system and everyone tends to go his/her own way.
Evacuation planning typically does not account for large numbers of people moving out of a given area into a safer area. Roads get clogged and in fact become parking lots, while the impending severe conditions continued to increase in scope. Provisions may have not been made for the poor who may not have access to transportation, the elderly, the handicapped, and the very young. Where will you put all these people and who will provide the necessary emergency housing, food, water, bathroom facilities, and safety of person and personal effects? Since major disasters involve multiple jurisdictions, typically these governmental bodies have not considered the broad picture of large area evacuation of people and what to do with them.
There seems to be a problem with poor public relations, since the governmental agencies depend primarily on the news media to get the messages out and the information released may be incomplete because of lack of time allowed by the media. Individuals may have difficulty in understanding directions and not observe the instructions from governmental units. There may be a substantial problem with understanding the language used, especially in areas where there are large immigrant populations.
For a large-scale, long-duration situation, there is an inordinate demand on resources including personnel, equipment, supplies, housing, etc. Who is going to authorize and pay for all of these resources on an emergency basis thereby avoiding the usual bidding process? How quickly will everything arrive because the need is for immediate delivery? How will the resources be managed and the materiel be stored and accounted for? Who will determine if the materiel is usable for the particular incident? Who will control the use of donated resources? How will unusable materiel be transported away from the scene and properly disposed of? Who will supervise various groups of volunteers and how will they be coordinated with the professionals working at the site? Who will verify the credentials of the volunteer specialists arriving at the scene?
When it is not apparent that a disaster has occurred, who determines that a routine fire is actually a far greater problem and a different level of response and command-and-control is necessary in the ongoing situation because of the potential level of unknown risk involved. Risk evaluation procedures, the training of risk evaluation specialists, and risk reduction behaviors may be inconsistent, lacking, or totally absent because of the variety of first responders coming from different parts of the country. Poor communications between various groups causes innumerable misunderstandings and interferes with the progress of the work needed at the disaster site. Further, the actual communication systems of the various groups working on the disaster may be incompatible and therefore, as an example, the police may not be able to speak to the fire officials or rescue officials, and so valuable time may be lost in resolving problems and protecting life. Further, who has the authority to decide if the site of the disaster now includes biohazards, chemical hazards, or severe physical hazards and determines the types of personal protective equipment including appropriate respiratory devices needed by the first responders to protect themselves while appropriately completing their work.
At what point do you transition from a rescue effort to a recovery effort, and therefore utilize different techniques and different work assignments and allowable time periods for a given task. A delayed, improper, or untimely transition may create unnecessary risks taken by the workers and may cause immediate or long-term health hazards to them.
How and when do you establish external perimeter or scene control of the area and thereby remove unauthorized people while isolating the area of the disaster? Who identifies and enforces the distribution of people within the various levels of risk within the disaster site?
Ultimately, there is a necessity for learning from actual situations that have occurred during various disasters that tend to repeat themselves. Unfortunately, there is no universally accepted means of developing reports concerning what happened and therefore it is difficult to compare one agency to another agency and one approach to another approach when they are dealing with the same problem. Various groups tend to write their own reports without consulting the others. Candor may be lacking because of the stakes or because inaccuracies have occurred but no one wants to own up to them. The level of detail may be so insufficient as to make the information unusable. Typically reports focus on what has gone wrong rather than what was right. Information on both is important, but something which goes right may become a Best Practice and be utilized by others in the same type of situation. When determinations are made as to a Best Practice, it is then necessary to continuously test the situation and upgrade the knowledge and practices as needed.
Best Practices to Resolve Problems for Disaster Site Management Command-And-Control for
Emergency and Other Personnel, Supplies, Equipment, and Enforcement
Note: This is a very complex topic well beyond the scope of this book. The Best Practices listed
will be but a small number of the actual recommendations to correct the problems found in management and command-and-control. (See endnote 41 for in-depth information.)
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