Excerpt from Disaster Planning

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A disaster occurs somewhere in the world almost daily; however, to most people, disasters of the type discussed in this article are unusual events. A recent group of disasters, starting with the September 11th terrorist attacks and continuing through the tsunami affecting countries throughout the Indian Ocean, the South Asia earthquake in Pakistan, and the 2005 and 2008 Gulf Coast hurricanes have focused people's attention upon this topic.

Despite the increase in general awareness with recent events, the relative infrequency of major catastrophes affecting defined populations, leads to a certain degree of complacency and underestimation of the impact of such an event. The result of complacency is relative reluctance to devote the necessary resources for adequate disaster preparedness. Indeed, several authors note that the best time to propose major changes for disaster preparedness, including its funding, is immediately following a major disaster, even if the event has occurred in a remote location.

In the United States, large multiple-casualty events are exceptionally rare by world standards. Only 10 disasters in US history have resulted in more than 1000 fatalities (see Table 1). The vast majority of major events have resulted in fewer than 40 fatalities. According to data from the Centers for Disease Control and Prevention, the September 11th attacks caused 2819 deaths. Compared with 44,065 deaths from motor vehicle accidents in 2002, this number is small. However, the dramatic nature of disasters, with a relatively large death toll and psychological impact for a short time period can overwhelm an unprepared health and response system.

Table 1. US Disasters With Greater Than 1000 Casualties*

*Exact death tolls can be difficult to calculate, and some of these numbers are estimates.
**Even in modern times, death tolls can be difficult to establish. Debate still exists about the actual number of people who died during Hurricane Katrina and its aftermath. An article by Brunkard et al published in Disaster Medicine and Public Health Preparedness in August 2008, puts the Louisiana death toll at 971 plus another 15 deaths among evacuees.¹ An Associated Press article from 2006 claims the total number of bodies recovered from Louisiana and Mississippi was more than 1300.² There is also ongoing investigation into the possibility that the storm caused deaths during subsequent months and years due to myriad causes (eg, inadequate medical care, relocation stresses).

When a disaster strikes, the general population expects public service agencies and other branches of the local, state, or federal government to rapidly mobilize to help the injured and the community in general. Preservation of life and health are of paramount importance to those individuals injured in the disasters. For this reason, medical professionals must be included in all phases of disaster planning, as well as in the immediate response to these events. Adequate preparation has become particularly important following the problematic response seen during Hurricane Katrina.

For more information, see Medscape's Disaster Preparedness and Aftermath Resource Center.

Please click here to view the full topic text: Disaster Planning