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When Helping Hands Are Tied

The earthquake in Haiti on January 12, and the time it took to mobilize aid to that country, reactivated my cynicism about our ability to quickly respond to a disaster anywhere. In Haiti, an impoverished country about 3,000 miles from the Florida coast, the people struggled to rescue those buried in the rubble and waited for help to arrive—waited and waited for what must have seemed like an eternity to them.

As I watched the news coverage, I wondered what had happened to the lessons we allegedly learned from the Hurricane Katrina disaster in 2005. I wondered about our ability to respond to the concurrent storm threatening to unleash mudslides in Southern California. But what intrigued (more accurately, irked) me was that the news crews managed to arrive in Haiti, before anyone else, to report on the devastation.

Somehow, planes carrying the reporters were able to land when others could not. Size notwithstanding, those planes could surely have carried more than the crews and their equipment. Just as the buses that were sent to transport the people out of New Orleans could have been stocked with food and water, so too could those planes been filled.

Yet as the reporters surveyed the damage and commented on the unbelievable conditions, all the while looking hydrated and clean, they repeatedly pointed out the lack of supplies. One reporter noted with embarrassment the ability to get her to the disaster zone, but not people who could assist in the rescue or care for the injured; nor was advantage taken of their transport to carry water and medical supplies to those in need.

The frustration was audible in comments from the Haitians, who were tirelessly digging and searching in the rubble that was once their homes, businesses, and community. Some of the newly homeless—hungry and dehydrated—huddled in the remains of churches and other structures, waited, and prayed that help would soon arrive.

Meanwhile, poised to be that help were the teams of health professionals who had traveled from the United States to Haiti and were confronted with difficulty getting there. In the newspapers, reporters recorded the dismay of the US military officers at the fact that confusion or disagreement as to who was in charge contributed to the delay in getting aid into Haiti.

In the US, relief efforts are coordinated through the White House, yet the bottleneck at the US-controlled Haitian airport seemed a contradiction to coordination. Again, I am intrigued. Since the events of 9/11, control and coordination of rescue and relief efforts have been stressed repeatedly.

Most, if not all, who are involved in any type of disaster response have been trained on the Incident Control System (ICS), a structured approach to facilitate activities in five major functional areas: command, operations, planning, logistics, and finance/administration. It is a standardized, on-scene, all-hazards incident management approach that:

• Integrates facilities, equipment, personnel, procedures, and communications operating within a common organizational structure

• Enables a coordinated response among jurisdictions and functional agencies, both public and private

• Establishes common processes for planning and managing resources.1

This is not the first international disaster to which the US has responded. We know the importance of quickly identifying the complexities of an incident.

Yet, to my eye, it is clear that we have not been able to apply those lessons of quickly unraveling the complications of a natural disaster to this tragedy. The evidence is in the knowledge that equipment and supplies, such as the US military mobile field hospitals and health kits from the International Medical Corps, must be transported by the military, because of their weight.

Coordinating the delivery of supplies is also difficult and controversial. Relief teams from civilian organizations are delayed because military flights get precedence over civilian ones. So in some instances, the equipment and supplies are there, but there are not sufficient health care providers to utilize the tools that are available. Therefore, the ability to help is hampered once again, because there is no structure to enhance the ability of all responders to work together more effectively.

To the extent that they can, many nations respond to disasters such as the earthquake in Haiti. It seems illogical to me that despite the “history” of going beyond borders to help others, there does not seem to be an international version of ICS. If we have agencies such as the United Nations and the International Medical Corps, why isn’t there an international ICS? If there is one, why doesn’t it appear to be effective and efficient?

 

 

I will admit, as the years have passed and as the US has continued to provide to other countries while we struggle to recover from the financial tsunami and other devastating events that we have faced, I have been tempted to become more of an isolationist. Then I am reminded, by my conscience and my colleagues, that we reach out and extend the helping hand because despite our own looming problems—financial ruin, unemployment, and homelessness—we are resilient, and the world looks to us as the “safety net.” Good, bad, or indifferent, we help because we can.

Yet, I wonder, can we respond better? And if another natural disaster hits the US, have we learned what not to do from the Haiti tragedy? Will we be ready to help ourselves?

References

1. Federal Emergency Management Agency, National Incident Management System. Incident Command System. www.fema.gov/emergency/nims/IncidentCommandSystem.shtm. Accessed January 25, 2010.

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Marie-Eileen Onieal, PhD, CPNP, FAANP

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The earthquake in Haiti on January 12, and the time it took to mobilize aid to that country, reactivated my cynicism about our ability to quickly respond to a disaster anywhere. In Haiti, an impoverished country about 3,000 miles from the Florida coast, the people struggled to rescue those buried in the rubble and waited for help to arrive—waited and waited for what must have seemed like an eternity to them.

As I watched the news coverage, I wondered what had happened to the lessons we allegedly learned from the Hurricane Katrina disaster in 2005. I wondered about our ability to respond to the concurrent storm threatening to unleash mudslides in Southern California. But what intrigued (more accurately, irked) me was that the news crews managed to arrive in Haiti, before anyone else, to report on the devastation.

Somehow, planes carrying the reporters were able to land when others could not. Size notwithstanding, those planes could surely have carried more than the crews and their equipment. Just as the buses that were sent to transport the people out of New Orleans could have been stocked with food and water, so too could those planes been filled.

Yet as the reporters surveyed the damage and commented on the unbelievable conditions, all the while looking hydrated and clean, they repeatedly pointed out the lack of supplies. One reporter noted with embarrassment the ability to get her to the disaster zone, but not people who could assist in the rescue or care for the injured; nor was advantage taken of their transport to carry water and medical supplies to those in need.

The frustration was audible in comments from the Haitians, who were tirelessly digging and searching in the rubble that was once their homes, businesses, and community. Some of the newly homeless—hungry and dehydrated—huddled in the remains of churches and other structures, waited, and prayed that help would soon arrive.

Meanwhile, poised to be that help were the teams of health professionals who had traveled from the United States to Haiti and were confronted with difficulty getting there. In the newspapers, reporters recorded the dismay of the US military officers at the fact that confusion or disagreement as to who was in charge contributed to the delay in getting aid into Haiti.

In the US, relief efforts are coordinated through the White House, yet the bottleneck at the US-controlled Haitian airport seemed a contradiction to coordination. Again, I am intrigued. Since the events of 9/11, control and coordination of rescue and relief efforts have been stressed repeatedly.

Most, if not all, who are involved in any type of disaster response have been trained on the Incident Control System (ICS), a structured approach to facilitate activities in five major functional areas: command, operations, planning, logistics, and finance/administration. It is a standardized, on-scene, all-hazards incident management approach that:

• Integrates facilities, equipment, personnel, procedures, and communications operating within a common organizational structure

• Enables a coordinated response among jurisdictions and functional agencies, both public and private

• Establishes common processes for planning and managing resources.1

This is not the first international disaster to which the US has responded. We know the importance of quickly identifying the complexities of an incident.

Yet, to my eye, it is clear that we have not been able to apply those lessons of quickly unraveling the complications of a natural disaster to this tragedy. The evidence is in the knowledge that equipment and supplies, such as the US military mobile field hospitals and health kits from the International Medical Corps, must be transported by the military, because of their weight.

Coordinating the delivery of supplies is also difficult and controversial. Relief teams from civilian organizations are delayed because military flights get precedence over civilian ones. So in some instances, the equipment and supplies are there, but there are not sufficient health care providers to utilize the tools that are available. Therefore, the ability to help is hampered once again, because there is no structure to enhance the ability of all responders to work together more effectively.

To the extent that they can, many nations respond to disasters such as the earthquake in Haiti. It seems illogical to me that despite the “history” of going beyond borders to help others, there does not seem to be an international version of ICS. If we have agencies such as the United Nations and the International Medical Corps, why isn’t there an international ICS? If there is one, why doesn’t it appear to be effective and efficient?

 

 

I will admit, as the years have passed and as the US has continued to provide to other countries while we struggle to recover from the financial tsunami and other devastating events that we have faced, I have been tempted to become more of an isolationist. Then I am reminded, by my conscience and my colleagues, that we reach out and extend the helping hand because despite our own looming problems—financial ruin, unemployment, and homelessness—we are resilient, and the world looks to us as the “safety net.” Good, bad, or indifferent, we help because we can.

Yet, I wonder, can we respond better? And if another natural disaster hits the US, have we learned what not to do from the Haiti tragedy? Will we be ready to help ourselves?

The earthquake in Haiti on January 12, and the time it took to mobilize aid to that country, reactivated my cynicism about our ability to quickly respond to a disaster anywhere. In Haiti, an impoverished country about 3,000 miles from the Florida coast, the people struggled to rescue those buried in the rubble and waited for help to arrive—waited and waited for what must have seemed like an eternity to them.

As I watched the news coverage, I wondered what had happened to the lessons we allegedly learned from the Hurricane Katrina disaster in 2005. I wondered about our ability to respond to the concurrent storm threatening to unleash mudslides in Southern California. But what intrigued (more accurately, irked) me was that the news crews managed to arrive in Haiti, before anyone else, to report on the devastation.

Somehow, planes carrying the reporters were able to land when others could not. Size notwithstanding, those planes could surely have carried more than the crews and their equipment. Just as the buses that were sent to transport the people out of New Orleans could have been stocked with food and water, so too could those planes been filled.

Yet as the reporters surveyed the damage and commented on the unbelievable conditions, all the while looking hydrated and clean, they repeatedly pointed out the lack of supplies. One reporter noted with embarrassment the ability to get her to the disaster zone, but not people who could assist in the rescue or care for the injured; nor was advantage taken of their transport to carry water and medical supplies to those in need.

The frustration was audible in comments from the Haitians, who were tirelessly digging and searching in the rubble that was once their homes, businesses, and community. Some of the newly homeless—hungry and dehydrated—huddled in the remains of churches and other structures, waited, and prayed that help would soon arrive.

Meanwhile, poised to be that help were the teams of health professionals who had traveled from the United States to Haiti and were confronted with difficulty getting there. In the newspapers, reporters recorded the dismay of the US military officers at the fact that confusion or disagreement as to who was in charge contributed to the delay in getting aid into Haiti.

In the US, relief efforts are coordinated through the White House, yet the bottleneck at the US-controlled Haitian airport seemed a contradiction to coordination. Again, I am intrigued. Since the events of 9/11, control and coordination of rescue and relief efforts have been stressed repeatedly.

Most, if not all, who are involved in any type of disaster response have been trained on the Incident Control System (ICS), a structured approach to facilitate activities in five major functional areas: command, operations, planning, logistics, and finance/administration. It is a standardized, on-scene, all-hazards incident management approach that:

• Integrates facilities, equipment, personnel, procedures, and communications operating within a common organizational structure

• Enables a coordinated response among jurisdictions and functional agencies, both public and private

• Establishes common processes for planning and managing resources.1

This is not the first international disaster to which the US has responded. We know the importance of quickly identifying the complexities of an incident.

Yet, to my eye, it is clear that we have not been able to apply those lessons of quickly unraveling the complications of a natural disaster to this tragedy. The evidence is in the knowledge that equipment and supplies, such as the US military mobile field hospitals and health kits from the International Medical Corps, must be transported by the military, because of their weight.

Coordinating the delivery of supplies is also difficult and controversial. Relief teams from civilian organizations are delayed because military flights get precedence over civilian ones. So in some instances, the equipment and supplies are there, but there are not sufficient health care providers to utilize the tools that are available. Therefore, the ability to help is hampered once again, because there is no structure to enhance the ability of all responders to work together more effectively.

To the extent that they can, many nations respond to disasters such as the earthquake in Haiti. It seems illogical to me that despite the “history” of going beyond borders to help others, there does not seem to be an international version of ICS. If we have agencies such as the United Nations and the International Medical Corps, why isn’t there an international ICS? If there is one, why doesn’t it appear to be effective and efficient?

 

 

I will admit, as the years have passed and as the US has continued to provide to other countries while we struggle to recover from the financial tsunami and other devastating events that we have faced, I have been tempted to become more of an isolationist. Then I am reminded, by my conscience and my colleagues, that we reach out and extend the helping hand because despite our own looming problems—financial ruin, unemployment, and homelessness—we are resilient, and the world looks to us as the “safety net.” Good, bad, or indifferent, we help because we can.

Yet, I wonder, can we respond better? And if another natural disaster hits the US, have we learned what not to do from the Haiti tragedy? Will we be ready to help ourselves?

References

1. Federal Emergency Management Agency, National Incident Management System. Incident Command System. www.fema.gov/emergency/nims/IncidentCommandSystem.shtm. Accessed January 25, 2010.

References

1. Federal Emergency Management Agency, National Incident Management System. Incident Command System. www.fema.gov/emergency/nims/IncidentCommandSystem.shtm. Accessed January 25, 2010.

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Clinician Reviews - 20(2)
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When Helping Hands Are Tied
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