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International events and issues

George W. Contreras, MPH, MS, CEMMini‐Summit Chair

Ali M. Gheith, MS, CEMDisaster Mental Health: A report from Chile

Nancy Zionts, MBALessons from Israel

Tami Rougeau, RN, MSDeployment‐

Do you know where you are really going?

6th

Annual National Emergency Management SummitSeptember 6, 2012

Disaster Mental Health Post Earthquake and Tsunami:

A Report from Chile

George W. Contreras, MPH, MS, CEMAli M. Gheith, MS, CEM

6th

Annual National Emergency Management SummitSeptember 6, 2012

Presenters

• Ali M. Gheith, MS, CEM– Program Director

– MCNY, Emergency and Disaster Management

• George W. Contreras, MPH, MS, CEM– Adjunct Professor, MCNY

– Director, Allied Health Sciences• Kingsborough Community College (CUNY)

National Emergency Management Summit

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Background

• Earthquake and subsequent tsunami

• Feb 27,2010• 8.8 Richter scale• Concepcion/ Constitution/ Talca/ Linares• Healthcare community severely affected


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5National Emergency Management Summit

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Magnitudes de Terremoto en Chile el 27 de febrero 2010


September 6, 2012

Background

• MCNY EDM Program traveled to Chile with 35 graduate students and 5 Professors (5/2011)

• Exchange of information between MCNY and Chilean government agencies such as Ministry of Health and Finance

• Historic event‐

Osama Bin Laden killed during our visit to Chile

– Our trip then became high‐profile throughout the country


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• Th


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• The


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Tsunami Tirúa


September 6, 2012


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Talca• Public hospital

– People were evacuated as best as possible– No plans prior to earthquake– No intention to prepare for earthquake since a new

hospital was being built• Private hospital (Maule)

– Staff demonstrated commitment to patients– Eg. Nurse stayed with pediatric patient in ICU– Shelter in place


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Talca• EMS

– SAMU– On duty crew shared experience– MCNY professor and students participated on ride

alongs on their calls

• Three people in ambulance– “reanimator”‐‐

lead person who is MD, RN,

midwife or physical therapist– “paramedic”‐‐

equivalent to U.S. EMT

– Driver‐‐

no medical training


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Linares• Public hospital

– Heard lessons learned from on duty staff

– Staff did as best they could with limited planning and resources

– Discussed several issues regarding post traumatic stress disorder among staff

– Requested assistance in Incident Command System


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Constitucion• Public hospital

– Restructured departments in hospital

– Hospital• On duty staff experiences

• Lessons learned– No re‐existing emergency operations plan

– Need to communicate better with field hospital

– No Incident Command System

– Need to conduct tabletops and drills with staffNational Emergency Management Summit

September 6, 2012

Lessons learned (as told by them)• Communication was unreliable

• Power was limited

• Decisions were made with very limited info

• Poor coordination among international aid

• Motivated to improve EOCs and obtain healthcare input in planning phases

• Hospitals will be built with more disaster management training for clinical and

administrative staffNational Emergency Management Summit

September 6, 201229

Lessons learned (as told by them)• Very limited knowledge of military field

hospitals

• Initial poor coordination between public health and other disaster agencies

• Poor response plans at the national and local levels especially regarding healthcare sector

• Severe damage to hospitals that took them out of service for extended period of time

post‐earthquake


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Lessons learned (as told by them)• Very extensive damage to infrastructure such

as housing, power plants, drinking water, basic sanitation

• Each one of the above had severe consequences to healthcare sector

• Motivated to improve emergency management focusing on the healthcare

sector including all phases of emergency management


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Next steps: Project 1

• Elaborate on the partnership between MCNY and UAC

– Post graduate certificate programs• Eg‐

five courses from current MPA program

• Eg‐

combination of online and onsite classes

• No need to create something new

• Can customize a certificate program for Chileans

• Memorandum of agreement signed


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Next steps: Project 2• Host and coordinate a visit of Chilean

delegation of leaders– Introduction to emergency management

– Take COOP course– Take ICS course– Take public health course– Field visit to NYC OEM, PA OEM, hospital EOC,

ground zero, etc

• March 2012‐

MCNY hosted a group from Chile


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Next steps: Project 3• Emergency Medical Services

– Coordinate week‐long training in Talca for SAMU counterparts

• BCLS, ACLS, PALS, trauma course, WMD

– Coordinate through UAC and MCNY

• November 2011– Conducted full scale exercise with FD, ONEMI,

UAC and SAMU with 75 simulated victims

• Next FS exercise –

November 2012


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Mutual benefits• UAC

– Partner with US university in a graduate program

– Develop certificate programs for their private and public sector organizations

– Become leaders for training in emergency management


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Mutual benefits• MCNY

– Assist professionals in emergency management (support from IAEM)

– Increase visibility, credibility and reputation at the national and international level as leaders in

emergency management (buy in from FEMA)

– Become a resource for Chilean private and public sector organizations (support from IAEM)

– Increase international collaborations


September 6, 2012

Final notes….• The healthcare sector needs more disaster

training for staff (administrative and clinical)

• Severe need for more disaster mental health training and services

• More interagency disaster drill planning and participation

• We can learn from each other


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SEGUIMOS

ADELANTE…….


September 6, 2012

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