Fortunately, the end of times failed to occur on May 21, 2011, as predicted by the American Christian radio host Harold Camping, but many residents of Joplin, Missouri surely felt like the end was near when the wrath of Mother Nature struck the following day. At 5:41 pm CDT a devastating EF5 multiple-vortex tornado struck this town of 50,000 people killing 153 (as of June 13th) and leaving a trail of widespread and catastrophic destruction that included severe damage to St. John's Regional Medical Center, two city fire stations, and the local high school. The tornado cut a swath one-mile wide by four-miles long. Six patients died at the hospital and over 180 were evacuated to other medical facilities in the area.
Natural Disasters Increasing
According to the NOAA's National Weather Service, as of June 16th, there have been over 1,500 tornadoes reported in the US in 2011 with an estimated 537 deaths, as compared to 561 US deaths from tornadoes in the past ten years. The accumulated impact of these tornadoes pales in comparison to the 9.0 magnitude undersea mega thrust earthquake that occurred on March 11th off the coast of Japan that was followed by a Tsunami that killed over 15,000 people, damaged or destroyed over 125,000 homes and buildings, and closed down 11 nuclear reactors leaving millions without electricity and clean water. The economic impact to Japan is expected to exceed 300 billion US dollars.
Natural disasters are on the increase. Rising populations in disaster-prone areas, climate change, and environmental degradation are major factors that contribute to the growth of these events, according to the Centre for Research on the Epidemiology of Disasters (2005). They are also becoming more costly and deadly. In 2010, natural disasters cost insurers about $218 billion, up from $110 billion in 2009. The U.S. has sustained 99 weather-related disasters from 1980-2010 (National Climatic Data Center) in which overall damages and costs reached or exceeded $1 billion at the time of the event.
Although one may never completely understand why these disasters occur, one thing is certain; Mother Nature equalizes the playing field when considering the need to invest in emergency preparedness. Natural disasters are no longer a problem isolated to coastal areas and the gulf. Every area in the world has either suffered from, or will suffer from, a natural disaster. Whether it is tornadoes and drought in the Midwest, flooding and ice storms in the Northeast, or earthquakes and mudslides along the west coast, Mother Nature has the upper hand.
Natural disasters are not random. Earthquakes occur along the fault lines between two tectonic plates on land or the ocean floor. Areas subject to seasonal flooding, droughts (and accompanying wild fires), or tropical storms are well known and increasing as a result of global warming. Awareness of one’s vulnerability and taking actions to mitigate their impact are keys to reducing the negative consequences of these types of events. Hospitals and health facilities are in the frontline when floods, hurricanes, tornadoes, blizzards and earthquakes strike and many are adversely impacted because safety measures were not adequately incorporated in their design, construction and functionality, and emergency management was never truly integrated into their operational soul.
All-Hazards Preparedness Planning
The need for preparedness cannot be overemphasized. Expanding local capacity, creating public/private initiatives to share resources, and enhancing regional partnerships are cost effective ways to improve the quality of the local response. Hospital emergency preparedness is primarily a matter of building internal awareness, capacity and capabilities, developing and implementing an operational plan that is practical, scalable, and sustainable, and institutionalizing an incident command structure that is well understood, practiced, and tested. Preparedness activities should include:
- Identifying vulnerabilities, through group participation, and dedicating appropriate mitigation and preparedness resources and materiel to address them
- Developing and exercising realistic scenarios tied to these vulnerabilities and enhance response capabilities accordingly
- Ensuring participation of hospital leadership in all planning and training activities with special focus on roles and responsibilities, identifying possible overlaps or gaps, and building consensus
- Maintaining close collaboration with local, regional and state partners
- Providing ongoing training and exercises in order to create realistic opportunities for leadership and staff to better understand and prepare for the special challenges associated with responding to disasters
In an all-hazards emergency preparedness environment, the underlying cause of the event (Rapture, Mother Nature, or Zombies) takes on less importance then the impact. The healthcare sector often bears a significant portion of the economic burden from disasters, both directly (damage to infrastructure, equipment, and supplies) and indirectly (reduced delivery of services with associated loss of revenue). Awareness of one’s vulnerability to disasters (natural or technological) and planning accordingly is the key to reducing the impact of these events.