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PREPAREDNESS:Plan, Respond and Recover

Following a disaster, vital services like power, communications andeven medical care may not be available for hours … or even days.

The time to prepare is NOW.Be ready to act on your own.

Do it for yourself and for those you love.

As published in the September 2008 issue of Indianapolis Woman magazine

P R E P A R E D N E S S : 2 Plan, Respond and Recover

TA special message from State Health Commissioner

Dr. Judy MonroeThe recent storm damage in our state brought home the urgent

need for families, businesses and communities to make plansbefore a disaster hits. The tornadoes and flooding caused extensiveproperty damage and seriously impacted the health, safety and well-being of thousands of Hoosiers.

As state health commissioner, I know how much hard work hasbeen done in Indiana on the state and local level to prepare foremergencies and natural disasters. We’ve come a long way since thetragedy of Sept. 11, and I am encouraged by the outstanding responsewe saw from our community and state partners.

The state disaster recovery centers, the sandbagging done by the Indiana National Guardand Columbus Regional Hospital’s mobile emergency room unit are just a few examples ofresponse efforts that could not have been possible without a great deal of planning andcoordination.

However, emergency preparedness planning is not just a task for state and local governments.Emotions run high during an emergency, which is why important decisions on how torespond cannot be made in the heat of the moment. Having a good emergency plan not onlywill help you stay calm during a major crisis, it could save your life!

September is the time when children prepare to go back to school. I challenge you to makeit the month you help make certain you and your loved ones are prepared for an emergency.Start by taking four important steps:

> Get a disaster kit> Make a plan> Be informed, and > Get involved You will find more details in this month’s health insert on how to accomplish these

steps. Hopefully, the following information and stories will inspire you to start gettingprepared today.

Judy Monroe, M.D.State Health Commissioner

Are You Ready?Reality hits fast and hard when experiencing a disaster (Answers on page 12.)

1. I don’t have to plan for an emergency because it probably won’thappen. True False

2. Planning for an emergency is the responsibility of our government.True False3. I don’t have to stockpile food because I just live right down the

street from a store. True False4. A family of three should have nine gallons of water stored as

part of a preparedness kit. True False5. There is nothing you can do to protect yourself from flu

pandemic. True False

6. A family communication plan should include a meeting locationand an out-of-town contact. True False

7. If you are a pet owner, planning for your pet is an importantpart of an emergency preparedness kit. True False

8. Storing large amounts of frozen food is advisable in anemergency preparedness plan. True False

9. It is important to keep extra medication on hand in case of anemergency. True False

10. It is important to share your emergency preparedness planwith your children. True False

Table of ContentsLetter from Dr. Judy Monroe 2Quiz 2Pre-9/11 3Always Prepared 3Man-made or Natural Disasters 4Makeshift Workspaces 4Prepare. Respond. Recover. 5Comunicating With Children 6Lessons From Katrina 6Emergency Preparedness and You 6Make a Plan 7Coping After a Disaster 8Understand Radiation 8Pandemic of 1918 9Pandemic Influenza 10Disaster Recovery 10Preparing Schools for Pandemic

Influenza 11Plan Ahead 11Emergency Food 12Answers to Quiz 12Food During Disasters 12What If ... 13Extending Healing Hands 14In The Wake of a Flood 14Continuing Care at Columbus

Regional Hospital 15Provisions of a Recovery Plan 15Resources 16Thank You to Our Sponsors 16


TTThere was a time in a simpler age when

preparedness began as a set of ideas puttogether to keep one living a safer,healthier life. It was born from the idea ofdoing things that promoted good healthand avoiding things that caused sicknessand disease.

As the risk to different things change, sodoes our message and our priorities changeabout preparedness — the foundation ofpublic health. Our goal is to meet the currentpublic health challenge by being one stepahead. That is preparedness.

Preparedness is more than just themanners we practice when we cover ourmouths to sneeze or cough. It can be assimple as the process of boiling water tosterilize it and make it safe to drink, orhandling and preparing food to keep itsafe to eat. As our knowledge grew aboutdifferent food products, we learned thateating certain things rich in nutrientsprotected us from ailments caused bycertain deficiencies and that storing foodat certain temperatures would keep us safefrom food poisoning. We also learned toenrich certain foods and fluoridate drinkingwater to promote good health.

Preparedness also extends to the controland elimination of infectious disease. Asviruses invaded the population, healthofficials stepped up to do everything theycould to protect people from illness. Thedevelopment of vaccines for diseases likesmallpox and polio greatly improved thoseefforts. These and other discoveries haveaided in the fight to combat some of thegreatest illnesses ever seen in public health,and vaccinations continue to be aneffective measure in preventing disease.

Preparedness has always been andalways will be at the foundation of whatwe do in public health. As new threats areidentified we will adapt and continue todo everything in our power to keep thepublic safe. j

Pre-9/11Preparedness, then and now

by Loren Robertson, M.S.,R.E.H.S., Assistant Commissioner,

Public Health and PreparednessCommission, Indiana State

Department of Health

There was something that always fascinatedme about my grandmother’s large purse.Grandma “S” never referred to it as a purse,but always called it her “pocketbook.” Typically,it was as big as Mary Poppins’ carpetbag, andit was full of everything you could possiblyimagine.

She carried the typical grandmother typethings: tissues, cough drops and thosepaper toilet seat covers for the publicbathrooms. She always had a rain bonnet foran unexpected shower, bandages, safety pinsand change for the bus. She even cameprepared for dinner out, carrying everythingfrom wet hand towelettes to a small supplyof zipper lock bags for leftovers.

We all can learn through my grandmother’sexample. Preparedness is about havingimportant things available when you needthem. In the case of a disaster, such as a fire,flood or health threat, that can mean accessto valuable records, supplies, expert help andvital resources.

Start in a simple way. Keep importantrecords in a specific place that is accessibleshould a disaster strike. Keep extra copies ofwallet-sized birth certificates, Social Security

Always PreparedStart simple, then add necessary resources to meet your

emergency needs by Laura Finch, Risk Communication Section Chief, Public Health Preparedness and

Emergency Response, Indiana State Department of Health

Laura Finch’s Grandma “S” always was preparedfor little emergencies and was quick to share herher wisdom with her granddaughters.

cards and shot recordsavailable in your wallet.

It’s also good to keep alist of medications,dosages and allergy infor-mation on hand withyour insurance cards incase of an emergency soyou can continue to get the medical careyou and your family need. Save all yourimportant phone numbers to your cellphone but keep a printed copy as well.

This is just a start. Read on to learn howto prepare you and your family for theunexpected. By taking time to make andfollow through on plans, you will have morecontrol in an emergency situation since youwill have the resources you need.

Preparedness is simply planning aheadeffectively. Start with the simple lessonslearned within your circle of influence: family,friends, colleagues and experts. Put into usethe plans, ideas and resources found in thispublication so you can effectively meet thechallenges that may someday pose a threatto your safety and welfare. j

Laura Finch

IMakeshift

WorkspacesJohnson County health workersband together with a “can do”

attitudeby Laura Finch, Risk

Communication Section ChiefPublic Health Preparedness and

Emergency Response, Indiana StateDepartment of Health


In the summer of 2008, we watched as severe storms and floodscaused devastation throughout Indiana. While people in communitiesrushed to avoid potential injury and disease, the damage thatremained was disturbing. The forces of nature serve as a clearreminder to all of us that we need to be prepared for a public healthemergency at all times.

At the state level, Gov. Mitch Daniels established the IndianaDepartment of Homeland Security in 2005 to improve the prepared-ness and response capabilities across the state. Combined with themulti-agency Counter-Terrorism and Security Council, which I chair, we have improvedour capacity to address potential emergencies and ensure the safety of our Hoosierfamilies.

Indiana’s model for homeland security combines the expertise of a variety of agencies.When a natural or manmade disaster strikes, we know it takes a coordinated effort byeveryone involved to respond appropriately. State response plans must be organized beforedisaster strikes — and the same goes for individuals and families.

Protecting your family from a public health emergency is possible when you plan inadvance with resources found in this insert. Become familiar with potential hazards. Makea plan should an emergency occur. Educate yourself on where to turn for help andresources. Share this information with your family — the more informed you are, the saferyou’ll be in an emergency.

Indiana is better prepared than ever before to handle public health emergencies. Wehave teams in place to deliver the best protection possible to our residents. However, thestorms of 2008 remind us all that the time to prepare and protect our families is before anemergency strikes.

By working together and becoming informed, we can protect ourselves and our lovedones from serious harm.

Becky SkillmanIndiana Lt. Gov.Chair of CTASC

Manmade or Natural DisastersIndiana’s state of preparedness: informed, coordinated and ready

Lt. Gov. Becky Skillman surveys erosion and

crop damage caused byextensive flooding at

Facemire Farm in Johnson County.

Each day, we come to our workplaces to face“business as usual.” Rarely do we encounter anevent that drastically alters the way we conductbusiness and our day-to-day operations. Wehave resources like technology, phones andmeeting rooms to help us get the job done.

But what do you do when your office hasbeen hit by a natural disaster and has sustaineda large amount of damage? How do youcontinue to operate and serve customerswhen flood waters stand a good distance fromthe floor, when utilities are unavailable andwhen your facility is no longer safe to be in?

Now imagine that you are a county healthdepartment, faced with a deluge of citizensseeking help from the recent flood oftendescribed as the “worst flooding incident inthe history of Indiana.”

Then envision trying to take care of aninflux of desperate Hoosiers though your officeand staff also has been hit hard by the flooding.

That is the situation the Johnson CountyHealth Department encountered after its officesat the courthouse annex were damaged inrecent flooding. The department was forced

In talking with an employee at Mariah Foods’warehouse, Lt. Gov. Skillman learns about thedamage done to $5 million worth of goods.

to set up a makeshift headquarters in an oldbank building along Main Street in Franklin,Ind. The move allowed staff members toassist county residents, provide services andeven conduct staff meetings outdoors via asetup of folding tables and chairs placedunder the former bank’s drive-through lanes.

Department officials also set up a temporaryoffice in the county’s north annex building,and another office in a spare room at adowntown law firm. Until rebuilding theground floor of the courthouse annex iscompleted, these are the areas the healthdepartment will call home.

Though the location is an unusual place toconduct operations, the health departmentwas still able to handle crisis managementafter the flood. More than 700 tetanus shotswere administered to people exposed tofloodwaters, inquiries were handled aboutmosquito problems in the area, and free wellwater testing kits were distributed.

While still operating in “emergency mode,”the health department also conductedinspections and issued food service permitsfor annual summer events such as festivalsin the Greenwood area and the JohnsonCounty 4-H & Agricultural Fair. Thechallenges of the department split betweenthree temporary sites didn’t interrupt thecontinuation of needed services to countybusinesses and residents.

With good planning and innovativethinking, staff members of the JohnsonCounty Health Department pulled togetherto continue routine operations and assistcounty citizens affected by the flood. Evenwithout a home office, the departmentdidn’t miss a beat. j


Prepare. Respond. Recover. Coordinate emergency efforts: Limit loss of life,

injury, illness and damageby Debbi Fletcher, Coordinator of Public Outreach and Engagement,

Indianapolis/Marion County Emergency Management

disasters affecting Marion County residents.The Indiana Department of Homeland

Security’s Division of Emergency Responseand Recovery provides resources and supportfor recovery from natural or manmade disastersthroughout Indiana.

The division assists residents, as well asemergency response leaders who manageemergencies or disasters.

For example, the Other Needs Assistanceprogram provides grants for home repair, rentalassistance, and personal property lost ordamaged during the disaster. For moreinformation, log on www.in.gov/dhs.

So what can you do to prepare? Becomeinformed. Log on www.ready.gov. Learnmore about the four steps to preparedness:

> Build a kit> Make a plan> Be informed> Get involved, possibly by training to

help your communityConsider being a member of the

Community Emergency Response Team.Log on www.indygov.org/ema to learn

more. j

IImagine one person preparing for an

emergency. Now, imagine all the steps acounty must take to keep residents safeduring an emergency. The Indianapolis/Marion County Emergency ManagementAgency does just that. After more than 50years, the agency’s goal continues to be toprotect life and property in the city ofIndianapolis and Marion County.

Coordinated response is key to handlingemergencies, so planning is a vital duty forthe Indianapolis/Marion County EMA.Through partnerships with governmentagencies, private and nonprofit organiza-tions, the agency addresses needs like publicworks, transportation, firefighting, masscare, medical services, search and rescue,hazardous materials, food and water, energy,law enforcement, business and industry,animal issues and other public concerns.

A written plan detailing city and countyresponses to all hazards is called theComprehensive Emergency ManagementPlan, which is continually updated.

First responders are coordinated andsupported by the Indianapolis/MarionCounty EMA. These first responders,such as police, firefighters, emergencymedical services and volunteer rescuers,are trained and prepared to help the public atshort notice. Decisions regarding responseand distribution of resources to address anemergency are made through the MarionCounty Emergency Operations Center.

Indianapolis/Marion County EMA also isresponsible for threat analysis, training,community outreach and education, grantsmanagement and homeland securityplanning. The agency plans for, mitigatesagainst and responds to emergencies and

Gov. Mitch Daniels and Lt. Gov. Becky Skillmanjoin Maj. Gen. R. Martin Umbarger to discuss thetornado damage at Camp Atterbury.

Debbi Fletcher (left) leads a response teamtraining session; the Regions Bank Building inIndianapolis after a tornado; and officials surveya robot designed to handle emergencies.

B


Believe it or not, the most importantthing to consider when speaking to yourchildren about disaster is your own reactionas a parent. Much of the research literaturesuggests children’s reactions to trauma —including disasters — is heavily influencedby parental response and interpretation.

When talking with your child in responseto a disaster, you must begin by gettingyourself in a mindset to discuss it in an even-tempered manner.

Regardless of your child’s age, your job asa parent is to foster a sense of security whilebeing a reliable source of information aboutthe surrounding world. Though it is importantto be truthful with your children, do notoffer too many details. Start with a basicdescription of the event, then allow yourchild to ask his or her own questions.

Other factors to keep in mind are yourchild’s developmental age and personalitystyle. Deliver news of a disaster in a sensitiveway, with the understanding that this, like allsituations in life, is an opportunity for yourchild to gain new skills to cope with events.

After all, your job as a parent is to support

your children in waysthat allow them eventual-ly to become strongeradults.

It is important tosend compassionatemessages acknowledgingthe pain and suffering inevitably involved insuch situations. However, your messagesultimately must convey a sense of hope andassurance your family will make it through. j

Resources to help childrendeal with trauma, includingdisasters, can be foundonline:

> National Child Traumatic StressNetwork helps to improve access to servicesfor children and their families. Log onwww.nctsn.org.

> FEMA for Kids is a Web site wherechildren can learn to be prepared for disas-ters. There are also resources for parentsand teachers. Log on www.fema.gov/kids.

Communicating with ChildrenYour response to disaster influences your child’s ability to copeby Suzanne Courtney, Psy.D., All Hazards Committee member for the state of Indiana,

adjunct professor University of Notre Dame

Lessons from Katrina

Tragedy highlights the importanceof family preparedness

by Leisa Prasser, RN, Public HealthPreparedness Aide to the State

Health Commissioner, Indiana StateDepartment of Health

Think survival.Think basics like

food, water, clean air and warmth.Developing a plan for dealing with

emergencies can seem daunting for a family,but it doesn’t have to be overwhelming orexpensive. Start by recognizing potential

Emergency Preparedness and YouCreate a plan to fit your family’s needsby Kristen Garcia, Field Public Information Officer, Indiana State Department of Health

disaster situations, identify your needs, makea plan then collect supplies to meet the needsidentified in your research.

Should you have to remain in your homefor an extended period of time or shouldshipments of food and other goods bediminished, determine the amount of

reserved goods you should have on hand.Inform each family member of the reasonsfor the stockpile and its location.

Begin by evaluating your family’s needs.Do you have small children? Pets? Parentsor extended family members you may takein if the emergency is big enough?

After Hurricane Katrina devastated partsof the Gulf Coast in 2005, thousands ofpeople were forced to live in shelters becausetheir homes no longer existed. In manycases, those who evacuated the area cameback to nothing.

Many people were left without important,even life-sustaining, medications theydepended upon.

Rarely, do any of us consider we mighthave to live in a shelter, but Hurricane Katrinaand the June 2008 floods throughoutIndiana proved it is possible for our circum-stances to change quickly because of anemergency or disaster. At any point, you andyour family could be left without a home,extra clothing and treasured possessions.

Influenza pandemic also could forceindividuals and families to be homeboundfor an extended period.

Though the prospect of facing a crisissounds very negative, there is one majorpositive: You can take steps now to improveyour circumstances should a crisis hit.Preparation not only empowers you to getthrough tough times, it allows you to provideyou and your family with a sense of safetyand security.

Suzanne Courtney

Kristen Garcia


Preparation is a smallmeasure that can yieldbig results when theunexpected happens.

To prepare for a disas-ter or a public healthemergency, includingnatural disasters andhealth pandemics, it’s important to learnfrom the lessons learned of those whoresponded to the needs of the people whosurvived Hurricane Katrina.

Make a Ready Kit. Don’t forget to includemedications for family members. Consideryour family’s day-to-day needs. For moreinformation, go to www.ready.gov for a listof supplies.

Teach children about preparedness andbeing ready for an emergency. This does nothave to be done in a manner that wouldscare them. Explain your plans factually,giving them steps that would allow them tobe proactive. Just as we teach fire safety athome and in schools, it’s important to educatechildren about floods, tornadoes, pandemicinfluenza and other emergencies.

Consider pets in your planning. If youhave to leave your home, is there a safeplace your pets can go? Pets are often a bigpart of our families; we want to care fortheir needs also.

Make sure your family is up-to-date onimmunizations, including adults. Many ofus fail to get a tetanus booster as we get older.In a clean-up situation, such as after ahurricane, tornado or flooding, exposure totetanus is possible through cuts, scrapes andopen wounds. If you have not had a tetanusbooster in the last 10 years, get one. j

Make a list of basic survival needs. Thenestimate the amount your family uses. Dothey go through a roll of toilet paper a day? Arethere medications someone needs?

You don’t have to buy supplies all at once.Buy a few inexpensive canned goods, bottledwater or toilet paper with each shopping tripand gradually build up your supplies.

In a worst-case scenario of pandemicinfluenza, stockpiling goods is not the onlything to consider in having a preparednessplan. Take into consideration that schools

and daycares could be closed for weeks.Would you be able to work? If you did work,who would take care of your children, agingparents and pets?

Should social distancing measures be takento stop the spread of viral infection, be awarebusinesses most likely will be closed. Considerhow you would live without a regular income.Make a plan to set aside an emergency savingsfund to help offset that loss.

How prepared is your family to treat anillness in case medical care is not immediately

available? Are there neighbors with specialhealth care skills who would be able to help?

All these things need to be part of a familydisaster plan but don’t have to be available andready immediately. Start with one aspect thatis manageable and build from there.

For resources, log on www.co.benton.mn.us/pubhealth/emergencyshoppingguide.html foran Emergency Preparedness Family ShoppingGuide. To create a Family Disaster Plan, log onwww.redcross.org/services/disaster/beprepared/fdpall.pdf. j

Personal Information Name:______________________________Address:_____________________________Phone:______________________________Cell phone: ________________________Birthdate:___________________________

Local Contacts Name:______________________________Relationship:_________________________Address:_____________________________Phone:______________________________Cell Phone:__________________________

Out-of-State Contacts (If a disastershould occur, call your out-of-state contact; itis often easier to call long distance.)Name:______________________________Relationship:_________________________Address:_____________________________Phone:______________________________Cell Phone:__________________________

Make a Plan Gather critical information and share it with your family

The following types of information can prove to be extremely helpful in an emergency. Usethe outline as a guide for making your own emergency contact plan. Store it in a place that iseasily accessible during a crisis.

Nearest Relatives Name:_____________________________Relationship:________________________Address:___________________________________________________________Phone:___________________________Cell Phone:_________________________

Pets Cared For ByName:____________________________Address:__________________________Phone:____________________________Cell Phone:_________________________

Meeting Places Outside your home:___________________Outside your neighborhood:____________

A specific plan should be created forchildren in childcare or school, older adultsand other immediate family members whoneed special assistance. j

Leisa Prasser

D


During a crisis, it may take emergencypersonnel up to three days to reach you.Therefore, it’s important your family prepared-ness kit is designed for three days.

Local officials and disaster relief workers willcome to help you and your family when disasterstrikes. But they can’t reach everyone right away.So it’s imperative to be prepared with theappropriate resources while waiting for assistance to reach you.

A preparedness kit is a stock of supplies to help you, and your family,survive an emergency until rescue personnel is able to reach you.Disaster kits must be tailored to your unique needs, taking into accountall of the people living in your home. Resources also need to beflexible enough to sustain your family through a wide range of possibleemergencies. Here are 10 essential items to collect and store:

1. A three-day supply of water: one gallon of water per person, per day2. Food that won’t spoil, such as canned or packaged items3. Manual can opener4. Clothing: one change of clothes, including shoes, per person5. Blankets and sleeping bags for all family members6. First-aid kit including antiseptic, bandages, family’s prescrip-

tion medications or extra glasses7. Battery-powered, hand-cranked or solar-powered radio and

flashlights with extra batteries8. Extra set of car keys and a credit card, cash or traveler’s checks9. Sanitation supplies such as soap, toilet paper, toothpaste and

toothbrushes10. Special items for infant, elderly or disabled family members The Indiana State Department of Health and Indiana Department

of Homeland Security encourage Hoosiers to be prepared for anydisaster that might take place. We have seen floods, earthquakes andtornadoes in just the last year, so we are all aware of the dangersaround us. Take some simple actions now, and ensure you and yourfamily are prepared for any emergency.

In recent years, several county health departments have workedwith local retailers and drug stores to display suggested items thatshould be included in a preparedness kit. Check whether localbusinesses or organizations have kits available.

For more information about disaster preparedness, log onwww.prepare.org. j

Coping After a DisasterTake time to store 10 essential items that can

help during an emergencyby Kim Wilkerson, Field Public Information Officer, Indiana State

Department of Health

Understand RadiationLiving in the nuclear age

by Shirley A. Fry, M.D., MPH, former director forCenter for Epidemiologic Research and staff member,Radiation Emergency Assistance Training Site at OakRidge Associated Universities and R.J. Michael Fry, M.D.

We are continuously exposed toa variety of radiations throughoutlife. Most of them are from natu-ral sources, such as radon fromuranium in rocks and soil, cosmicrays — particles that enter ouratmosphere from outer space, andultraviolet rays from the sun.Some radiations are manmade bymachines, such as those designed to produce X-rays or microwaves.

In some situations, radiation is helpful; in others it may beharmful. Just as we need exposure to the sun’s UV rays to producevitamin D in our bodies for good health, overexposure to UV rayscan cause severe sunburn and increase our chances of developingskin cancer later in life. Uncontrolled exposure to X-rays orother radiations that act similarly in our bodies are rare but canput us at risk for radiation emergencies. Be aware of and preparedfor radiation emergencies by learning about radiation.

What is radiation?Radiation is a naturally occurring form of energy that also can

be manmade. For example, manmade radiations, such as X-raysand radioactive isotopes, are used in effective diagnosis and treatmentof disease. Although we cannot sense it, radiation can be detectedand measured by trained individuals using various instruments.

When considering radiation emergencies, it is important to beaware of two types of radiation –– ionizing radiations such as X-raysand naturally occurring gamma rays and alpha and beta particlesthat can result in radiation emergencies, and non-ionizing radiationssuch as visible light, UV rays and microwaves that do not.Uncontrolled releases of ionizing radiations can be accidental orthe result of acts of nature or terrorism.

Kim Wilkerson

R.J. Michael Fry, M.D. and Shirley A. Fry, M.D.

RRecent disasters have many of us wondering

about our ability to better survive future crisises.Who would care for my family while I try to

get resources or medical help? Do I know how tocare for someone with an infectious diseasewhile protecting myself and others? Would I beable to continue to work? Could I live without apaycheck for a few months?

If faced with a widespread health threat like influenza pandemic,there are questions for which you want solid answers to keep you and yourloved ones safe and protected. More and more Hoosiers are consideringhow they can be better prepared for future incidents, whether manmade,natural or health threats of epidemic proportions.

The hard-learned lessons of the pandemic of 1918 have set thestage for how public health officials respond to today’s health threats.To avoid another tragedy of this magnitude, greater awareness, moreeffective preparedness and improved coordinated response is required.

Snapshot of Indiana’s pandemic Not a soul could be found in schools, churches, theaters and other

public gathering places across Indiana on Oct. 9, 1918. Due tothe outbreak of the “Spanish flu” pandemic, the State Board of Healthhad issued a notice for everyone to vacate all public places. Incompliance with the advice of the U.S. Public Service, residents avoidedall community gathering places — making them resemble a ghosttown for nearly five weeks.

Today, daily life can be quickly disrupted by a pandemic influenza,just as it was nearly a century ago.

A virulent outbreak of pandemic influenza in 1918 killed anestimated 20 million to 25 million people worldwide. Indianasuffered significantly as well. The Vital Statistics Department of thestate of Indiana records the impact of the pandemic with these facts:

> Deaths between Sept. 1, 1918, to March 1, 1919: 10,994> 20 and 40 years old: 50 percent> Under 20 years old: 30 percent> 50 years and older: less than 10 percent > 10 percent more males died than femalesGetting accurate reports of infected people to the State Board of

Health was very difficult since physicians were busy treating patientsfor influenza. Though every effort was made to get daily reports fromas many health officers as possible, daily reports ceased on Feb. 1, 1919.According to these reports, 154,600 were reported official cases ofinfluenza. However, a more accurate count by health officers is estimatedat nearly 350,000 cases because there wasn’t time to document morethan half of the cases.

The state population was only 2,930,390, which is less than halfof the current population, so the number of Hoosiers affected wassignificant. j

Pandemic of 1918After hard-learned lessons, are you prepared

for a widespread health threat?by Shawn Richards, Respiratory Disease Epidemiologist,

Indiana State Department of Health

For More InformationMore detailed sources of information about

radiation emergency preparedness and responseinclude the following Web sites:

> Indiana State Department of Health:www.in.gov/isdh/17908.htm

> Centers for Disease Control and Prevention:www.bt.cdc.gov/radiation/

> Armed Forces Radiological ResearchInstitute, Medical Radiobiology Team:www.afrri.usuhs.mil

> Radiation Emergency Center/Training Site:www.orau.gov/reacts


Shawn Richards

What are the risks of radiation exposure? Accidental exposure to radiation and the potential for radiation

emergencies can occur anywhere sources of radiation are used orstored, such as in hospitals, research laboratories or while radioactivesubstances are in transit. However, such emergencies are rare andgenerally limited in scope with little or no threat to public health.

Deliberate releases of radioactive materials, or ionizing radiation, bymeans of a “dirty bomb” in crowded places are designed primarily tocause public fear and panic. In addition to blast injuries, explosions of“dirty bombs” and improvised or actual nuclear weapons can resultin immediate exposure to ionizing radiations and afterwards fromradioactive contaminants. Such exposures can damage our DNA,which may affect the body’s ability to build and repair itself andresult in early and delayed health effects.

What are the effects of radiation exposure?The degree of this DNA damage depends on the amount of

radiation exposure or dose, the dose-rate and the tissues affected.These factors also influence the time between exposure and the appear-ance and the severity of symptoms. A low dose is unlikely to cause ill-ness though a very high dose can result in severe, possibly fatal illness,occurring within hours or weeks. Delayed effects include an increase inour existing cancer risk. Medical treatment, including decontamina-tion, is effective in reducing the probability of health effects.

Protect yourself and your loved ones against potentiallyharmful radiation exposure:

> Become informed about radiation and generally prepared for adisaster. Avoid contributing to fear and panic should a radiationemergency occur:

> Move away from the explosion site> Take cover in a closed building to minimize exposure to radi-

ation and radioactive dusts that may be inhaled or swallowed > Remove clothing that may be contaminated and store it in

containers> Wash to remove contaminants from noncovered body areas> Follow official instructions for further actions.j

(Note: This brief summary is the result of discussions with fellow members of the

Indiana State Department of Health’s ad hoc Indiana Radiation Advisory Team.)

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Pandemic InfluenzaKnow enough to cope and protect those you love

by Janet Archer, RN, MSN, Chief Nurse Consultant, Public Health Preparedness and Emergency Response, Indiana State Department of Health

family project. TheIndiana State Departmentof Health recommendsyou stock up with a twoweeks’ supply of food andwater for all members ofthe household. Get thekids involved in thisproject. Older children can make out thegrocery lists, and the younger ones can pickup an item or two each week during the tripto the store.

Other tasks to consider:> Schools and daycares may be closed for

up to three months. Find an alternate planfor your children that will be safe.

> Elderly or disabled family or neighborswill need help preparing.

> Talk with your doctor about your family’schronic medical conditions and what specialthings you need to do.

> How is your workplace preparing? Canyou work from home? Do you have enoughsick days? Do you provide an essential servicefor your community?

> Wash your hands frequently for 20seconds. (Sing “Happy Birthday” twice!)

> When you cough or sneeze, cover yourmouth with a tissue or cough into yoursleeve to avoid getting germs on your handsand spreading them to others.

The key to coping with pandemicinfluenza is staying away from people withthe disease, and a few simple steps will helpyou accomplish that goal. j

Few businesses arecompletely preparedfor a successfulrecovery from a majordisruption such as apandemic flu or virusoutbreak. Knowingwhat to do before,during and after adisaster enables an organization to respondand continue when these types of scenariosoccur.

So why aren’t companies better preparedfor things such as pandemic flu? There arethree primary reasons:

Companies simply do not know how toplan.

Readiness means different things todifferent groups of people.

There are very few standards or acceptedcriteria that define what readiness means orhow to achieve it.

Of course, all companies should observetraditional hygiene practices for preventingthe spread of a virus. But, in order to truly tobe able to respond to, recover from andcontinue operating when a significantbusiness disruption occurs, like a pandemicvirus outbreak, companies must learn toembrace how to plan in general. Start bydiscussing a couple of fundamental questions:

> How ready is your organizationrequired to be? Do you have regulatoryrequirements to meet in order to ensure yourcompany can address the impact of not onlya pandemic but other types of scenarios thatmay have a similar impact?

> Is there a desire within your organiza-tion to be prepared? Is it your company’sintention to learn how to respond, recoverand continue operating when a potentiallysignificant business disruption occurs?

Your business can easily learn how to planfor business disruptions by creating a “game

DisasterRecovery

Business continuity –– providing peace of mind

by Belinda Wysner, CBCP, President, InCiteBCM, LLC

Belinda Wysner

Janet ArcherIInfluenza pandemic occurs when a new

virus invades the human population andcauses severe illness. There is no pre-existingimmunity; no vaccine will be available at thebeginning of the outbreak, and no medicineis guaranteed to stop the disease. It’s difficultto imagine how a quickly changing virus canturn lives upside down.

When was the last time you saw a“Quarantine” sign on a neighbor’s house?Have you witnessed a child become gravelyill or even die from a widespread disease?

Perhaps a grandparent or older neighborremembers these things. They recognize theimportance of “social distancing” and stayinghome due to an outbreak, such as smallpoxor measles.

Today, most of us would have to work hardto adapt to such a lifestyle disruption. For aslong as we can remember, vaccines have beenavailable for most major infectious illnesses.Smallpox has been eradicated; polio israre; we have scientists researching vaccinesfor infectious diseases, such as influenza, HIVand ebola. Until those vaccines are developed,being prepared is your best defense.

Most people don’t think twice aboutinsuring themselves and their loved onesagainst an accident or illness. So why shouldplanning for an emergency such as pandemicinfluenza be any different? Planning aheadwill not only help you when we are faced withan influenza pandemic, but you will also beprepared for other emergencies as well.

Preparing for influenza pandemic can be a


Preparing Schools for

Pandemic InfluenzaQ&A

by Phyllis Lewis, School Health ServicesCoordinator, Indiana Department of

Education

Q: How con-cerned should webe about potentialoutbreaks like pan-demic influenza?

A: The more than 1million school-agedchildren and youthenrolled in Indiana’s K-12 schools would bepredominately affected when pandemics,epidemics and localized outbreaks occur asshown historically.

Q: Who would decide to closeschools during an outbreak of aninfectious disease?

A: Both local and state health departmentshave the authority to close schools under statelaw, regardless of whether a disaster has beendeclared. The state health commissionerwould monitor the pandemic and notify andinstruct local health officers to close schoolswithin their jurisdictions and then communi-cate when it would be safe to re-open.

Q: How do schools prepare forinfluenza pandemic?

A: Pandemic influenza preparedness ispart of the emergency management plan allschool corporations are required to develop.The unique elements within the plan includesurveillance, isolation, evacuation, first aidand emergency care; managing employee andstudent absences and reporting requirements.These crisis plans include four phases:Mitigation/Prevention, Preparedness, Responseand Recovery.

Q: How would schools commu-nicate with parents about pandemicinfluenza?

A: At the local level, open schools woulduse their identified communication systemfor sharing information with local families. Ifthe schools are closed, information would be

distributed through Web sites, “telephone tree”contact lists, local TV and radio. The statehealth commissioner would disseminateinformation in coordination with the statesuperintendent of public instruction. TheIndiana Department of Education’s electronicmessaging system would keep principals andschool superintendents informed.

Q: How would schools continuethe learning process if they wereclosed for an extended time?

A: Continuing students’ education occursat the local level. Each school corporationwould establish a system for its community.To support local educators and families,the Indiana Department of Educationprovides learning resources online atwww.doe.in.gov/standards. These resourcesinclude learning activities.

Q: How might schools plan forrecovery?

A: Recovery plans would include assess-ment of educational and health needs ofstudents, a system for addressing grief and loss,documentation of all activities and providingcrisis intervention for staff and students. Toimprove future emergency response efforts,improvements would be made to the recoveryplan based on the results of a review. j

plan” for response, recovery and businesscontinuity based on a variety of potentialscenarios. Companies need to assess theirneeds and start this manageable process. Oneinternationally recognized method forreadiness planning is called BusinessContinuity Management, which encom-passes all aspects of disaster recovery andbusiness continuity.

This set of published best practicesdefines how to achieve a state of readinessorganization wide. By following theseproven practices, any organization canlearn to implement a management processthat will allow them to address anynumber of potential risk issues.

However, since businesses vary signifi-cantly, even within the same industry, it isimportant to seek out expert resources todetermine what each organization can andshould do in order to increase the odds ofa successful recovery effort. j

On The Web:To learn more about what you cando to prepare for a pandemic,visit the following Web sites:

> American Red Cross:www.redcross.org/news/ds/panflu/planahead.html

> Health and Human Services:www.hhs.gov/pandemicflu

> United States Pandemic Flu:www.pandemicflu.gov

> World Health Organization:www.who.int/csr/disease/avian_influenza/en/index.html

> Centers for Disease Controland Prevention (CDC):www.cdc.gov/flu/avian

> Indiana State Department ofHealth: www.in.gov/isdh

> Indiana Department ofEducation – School HealthServices: www.doe.in.gov/pandemicflu

onth

e

web

Phyllis Lewis

Plan Ahead Do your part to protect yourselfand your family in the event of apandemic:

> Stop the spread of germs bypracticing effective hand-washing

> Practice proper coughing andsneezing etiquette by using tissues or your sleeve

> Stay home when ill

> Share accurate informationwith friends, family and coworkers

> Educate yourself about thespread of disease

> Create personal pandemic flupreparedness kits containing atwo-week supply of water, food,medication, and other emergencysupplies (see checklists atwww.pandemicflu.gov)

W

Answers to Quiz(from page 2)

1. False –– No one would haveimagined that a tragedy like Sept. 11could happen here in the United States orthe level of devastation cause byHurricane Katrina could happen in ourcountry. A big lesson that we came awaywith is that we are not invulnerable, andplanning is essential to either protectingus or lessening the effects of a natural ormanmade disaster.

2. True –– Though the governmenthas plans to protect its citizens, it is stillessential for individuals and families tohave their own plans. You need to knowhow to protect yourselves and what to doduring crisis events, such as tornadoes,fires, flooding and other emergencies.

3. False — In the event of anemergency such as influenza pandemic,people will be encouraged to practice socialdistancing and asked to stay home and avoidpublic places. This includes going to thegrocery store. At the same time, it is possiblethat during a crisis, most businesses eitherwould be closed or operating on a limitedcapacity. It is good to be prepared shouldsuch a circumstance occur.

4. True –– We should be prepared tocare for our families, without emergencyhelp, for three days. Each family memberwill need one gallon of water each day.

5. False — The same steps thatindividuals can take to protect themselvesfrom seasonal outbreaks of influenza alsowill be critical during a pandemic. Thosesteps include frequent and thorough handwashing and various “respiratory hygiene”practices, such as covering your mouth whenyou sneeze or cough. It also is important for

When you are prepared for life’s surprises,you will be able to protect and care foryour family. Disasters and emergencies occurindependent of our plans as many Hoosiershave experienced recently through floods andtornados.

The time to act is now. Create a disastersurvival kit that accommodates your family’slifestyle. Pay particular attention to those withspecial needs. With educated planning, you willbe able to strategically use your resources.

Food and water are major components ofany emergency kit. Stock your kit for a mini-mum of three days. Store at least of one gallonof water per person, per day. Include food yourfamily enjoys, such as ready-to-eat meats,canned fruits and vegetables, peanut butter andjuices. Properly stored, high-energy snacks ofnuts, seeds and dried fruits go a long waytoward providing needed energy. Add sugar/sweetener, salt and pepper and other staples.

Store survival items in a container thatis mobile and accessed easily. Create aninventory list with expiration dates andcheck food every six months. Replace items

Emergency FoodA moveable “feast” redefined –– be ready to feed your family

after a disasterby Sue Dumm, MS, RD, CD, Nutrition Consultant, Indiana State Department of Health

close to expiration. Remember to include resources to meet

special needs in your family. For example,store specific foods for those with foodallergies and special diets. Stock a three- toseven-day supply of prescriptions. If yourfamily includes infants or expectant mothers,pack emergency formula.

If an emergency arises, use survival supplieswisely. Even with power outages, food inrefrigerators and freezers will keep for a whileif doors are opened infrequently. In the caseof flooding, food in a refrigerator must bediscarded, as it likely will be contaminated.Once temperatures rise above 40

oF, food is

unsafe and must be discarded. Use food fromthese storage units prior to supplies in thesurvival kit. Charcoal and gas grills can beused to cook food.

The best way to cope with an emergencyor disaster is to plan ahead then use availableresources strategically.

For sample checklists and plans, visitthe American Red Cross Web site atwww.prepare.org. j

Disasters happen quickly, sometimes withlittle warning. When power is lost and water orfire destroys your home, salvaging yourfood and other belongings is critical. After amanmade or natural disaster, keeping yourfamily fed will go a long way toward helpingthem deal with the hard work of recovery.

Protect your family from food poisoning

caused by contaminated food products.Become aware of the precautions you musttake with your food and pantry items after afire or flood. Learn and practice food safety.

Food salvaged from a flood must be care-fully assessed according to how it is packaged.Any food that has come in contact withfloodwater, with the exception of undamaged

canned goods andunopened commercialglass jars, is unsafe foreating. Food that shouldbe discarded includes:

> Meat, poultry, fishand eggs

> Fresh produce> Unopened jars with waxed cardboard

seals (mayonnaise and salad dressing)> All food in cardboard boxes, paper, foil,

cellophane or cloth> Spices, seasonings and extracts

Food During DisastersEnsure recovered food safety — when in doubt, throw it out by Andrew Miller, Food Defense Coordinator, Indiana State Department of Health

Andrew Miller


Wpeople to stay home from work or schoolwhile ill and seek medical care as needed.

6. True –– During a disaster, thereshould be a mutual meeting location foryour family in case everyone is separated.An out-of-state contact is importantbecause during a disaster, everyone livingnear you could be affected as well. Yourcontact out of state should be out of thedisaster zone. Out-of-state calls mightbe easier to make if local circuits areoverwhelmed and busy.

7. True –– In the event of an emer-gency, you will need to make provisionsfor your pets. During a disaster, sheltersgenerally will not accept animals.

8. False –– It is recommended tostockpile nonperishable food, such ascanned or packaged items. During a naturaldisaster or other type of emergency,electricity may not be available to keepfreezers and refrigerators running. Alsohave food on hand that is easy to prepareand requires little to no cooking in caseovens or stoves aren’t operational. Be sureto keep a manual can opener handy.

9. True –– If you take prescriptionmedication regularly, it is important toplan ahead. In the event of an emergency,you will want to have extra medication onhand so you won’t run out in case youdon’t have access to a store or pharmacy.You may want to discuss this issue furtherwith your physician.

10. True –– It is very important thatyou talk with your children about what todo should a natural disaster, terrorist event ormajor public health emergency happen.Not only should you share your plan withthem but practice your emergency plan sothey will become familiar with it andknow what to do. j

What if an agency’s critical informationsystems fail? What if customers’ confidentialinformation gets stolen? Businesses shouldprepare so that answers are readily availablefor the “what if ” questions that arise.

Emergency response planning for a largecorporate enterprise is often an enormoustask. Literally every scenario imaginable canbe conjured up. But being prepared andhaving a plan to respond to an event helpsmanagement rest easier. As a result, executiveschoose to write plans for the worst-casescenarios so that they can customize theirresponse according to the actual situation.

Things to consider while planning:> Identify what kinds of emergencies

might affect your company> Assess how the company functions,

internally and externally> Create an emergency plan that protects

employees, shareholders and the business’reputation

> Identify/plan for necessary emergencysupplies

> Plan for “shelter in place,” as well asevacuation options

> Consider emergency medical needs andobtain provisions

> Consider alternate communication andtechnology needs should the company’sinfrastructure be disabled

> Network with community emergencyresponse resources

Planning today willhelp support employees,customers and theeconomy. A commitmentto disaster prepared-ness is like having aninsurance policy — itprotects your business with a strongerpeace of mind.

Every year, new elements should be addedto the organization’s emergency responseplan to improve preparations. This will allowthe plan to expand as the company grows oras risks change.

The key to a good plan is to test it regularly.For example, create a tabletop scenario thatinvolves multiple emergency response teamswith certain key players being unavailable.The goal of such an exercise is to illustrategaps in the current plans.

Once a company has an emergency planin place, mentoring other businesses in itssphere of influence makes good businesssense. This enables the business, communityand the economy to remain as stable aspossible during a large community disaster.

Passing on the lessons learned at workmakes sense at a personal level too. Discussingpotential hazards that could happen at workor at home may spark needed discussionsaround the dinner table. These conversationscan make a key difference in how familiesrespond in times of disaster as well. j

> Home-canned food> Opened containers and packages> Flour, sugar and other staples in canistersIn a few steps, you can sanitize canned

goods and commercial glass jars of recoveredfood to make it safe to eat. Remove paper labelsfrom the items; floodwater that has penetratedthe label can harbor dangerous bacteria.Relabel food items with an indelible marker.Wash jars with a scrub brush in a strongdetergent solution, and then immerse cansand jars for 15 minutes in tepid rinse ofwater made of two teaspoons of chlorine

bleach to every quart of water. Allow itemsto thoroughly air dry.

Sanitize dishes and cookware using thesame method. Boil metal pans and cookingutensils for 10 minutes. Discard and replaceany wooden or plastic utensils and babyitems such as bottles, nipples and pacifiers.

Food safety after a fire has similar concerns,but special consideration must be taken toassess food for safety. Food salvaged from afire is affected by heat, smoke and chemicalsused to extinguish the flames.

Food items, such as flour, bakery products,

rice and other grains must be destroyed due tothe uncertainty of the packaging or inabilityto disinfect the container. Also, remember towash your hands thoroughly and often whilerecovering food after a disaster.

If you have additional questions or needmore information on food safety after aflood or fire, please contact your county’sCooperative Extension Office or log onthe INShape Indiana Web site atwww.in.gov/inshape/2271.htm.

Click on Nutrition Resources to talk to adietitian about your nutrition questions. j

Shelly Hogan

What If …Pondering and then preparing for emergency response

by Shelly Hogan, MBCP, CISA, FLMI, IT Risk Management Consultant, American UnitedLife Insurance Company®, a OneAmerica® company


Wthat will be integratedinto ESAR-VHP. MRCunits utilize publichealth, medical andother volunteers tosupport existing localagencies with publichealth activities through-out the year and with preparedness andresponse activities in times of need.

Volunteers are dedicated to serving ourcommunities.

“It’s my professional responsibility to usemy skills to give back to my communityand state by volunteering in the event of adisaster or medical emergency,” says RodneyP. Wann, Medical Reserve Corps unit leader,Clinton County. “That’s what makesHoosiers so great. Why should health andmedical professionals be any different?”

Indiana is home to several other volunteerorganizations, including the American RedCross, the Citizen Corps, CommunityEmergency Response Teams, Salvation Army,United Way and faith-based organizations.These organizations are always looking forgood people, medical and nonmedical, to vol-unteer.

Make sure you do your part to keepyourself, your family and your communitysafer and more prepared. j

Extending Healing HandsA dedicated corps of health volunteers willingly reaches out

with care and hope by Rachel Miller, Emergency System for the Advanced Registration of Volunteer Health

Professionals Program Director, Medical Reserve Corps Coordinator, Indiana State Department of Health

White open-sided tents dot the ColumbusRegional Hospital campus in the aftermathof the June 7, 2008, flood. The entire hospitalfacility is rendered temporarily uninhabitableby the floodwaters of nearby Haw Creek, sostaff members work in tents, outlying build-ings and in offices throughout the community.

The scene is a mixture of summertimereverie and health care business as usual. A14-bed mobile Med-1 unit has taken upresidence in front of the main hospital buildingto provide area residents the security of fullemergency department services 24/7. Undera white tent gently moving in the breeze,meals are served to hospital staff and visitorsseated around tables and on benches.

In the background, the din of heavyequipment disrupts conversations to remindobservers of the scope of cleanup effortsunderway. Along the back of the hospital, atan montage of mud-caked computers, foodservice equipment and office furniture hasbeen discarded in heaps. Despite all the flooddamage, the promise of renewal permeates thehospital campus. Plans are already underwayto reopen the entire facility by mid-fall,following extensive restoration.

Staff members smile as they chat, and thebusiness of health care services continue.

A seemingly devastating disaster has beenaverted by preparedness, effective communityresponse and hard work. In an unprecedentedtotal evacuation of the hospital, hundreds ofcommunity members stop by to lend a hand.The National Guard — the Marines who hadbeen training at Camp Atterbury — and othervolunteers arrive to help relocate hospitalpatients to safe alternate health care settings.

Martha Myers, manager of Risk andSafety Services at Columbus Regional,discussed the potential evacuation with thehospital’s CEO, Jim Bickel. The usuallyshallow Haw Creek waters had edged up asteep embankment, threatening to damagepatients’ and employees’ cars.

In the Wake of a Flood

Columbus Regional Hospitalstaff members step up to thechallenge of helping evacuees

by Deb Wezensky

MMajor emergencies can overwhelm the

capabilities of first responders. Healthvolunteers can provide an important surgecapacity, as well as augment medical staffshortages at local medical and emergencyfacilities. Communities often need medicallytrained individuals and others to fill in the gapsof their emergency response plans and toimprove their overall response capabilities.

The Emergency System for the AdvancedRegistration of Volunteer Health Professionalsis a national effort to pre-register healthprofessionals who are willing to volunteerfollowing a disaster. The Indiana StateDepartment of Health is working to develop aregistry and database that will offer Internet-based registration for health care professionals.

The database includes doctors, nurses, fivebehavioral health occupations, pharmacists,respiratory therapists and others and is expectedto incorporate other health professions inthe future. ESAR-VHP collects informationregarding volunteer identity, licensure status,credentials or accreditation and foreignlanguage proficiency, as well as other skillsand abilities. Licensed health professionalsmay elect to volunteer when renewing theirprofessional license electronically with theIndiana Professional Licensing Agency.

The Medical Reserve Corps is a nationalnetwork of community-based volunteer units

Rachel Miller


“Within about 20 minutes, it looked likea tsunami,” Myers says.

Conditions deteriorated quickly at thehospital. While contacting other hospitalsabout arrangements to move patients to safety,staff members heard a knocking sound frombelow. Upon opening a basement door,floodwaters already lapped at the top step.

Within 15 minutes of the basementflooding, the hospital facility lost power.Emergency generators then failed. Phoneservice and technology support were rendereduseless. The hospital grounds took on theappearance of a war zone with incessant airtraffic and a constant train of transportvehicles arriving to evacuate 157 patients.

“All of us were wading in knee high water,”Myers recalls. “However, members of thesurrounding communities — the mayor’s wife,Kathi Armstrong and Theresa Henderson, thefire chief ’s wife … hundreds of volunteers —all made sure that patients made it to safety.”

Another hospital staff member helpedevacuate critical patients to safety. JoTabler, emergency department manager,was challenged to orchestrate more than oneaircraft into and out of the hospital groundswith no direct air to ground communications.

Using her cell phone, she was able toestablish communication with Sam Mathis,communications director at PHI Air Medical.

Since the hospital’s technology system wasinoperable, a staff member established wirelesscommunications via a laptop to monitor themovement of patients being relocated.

Working with the intensive care nursesand staff, Tabler helped determine who wouldbe moved, in what order and which medicalneeds were involved. “I would go outside andcommunicate with the flight crew memberfrom the next aircraft that landed and relay thatinformation to them. Patients were transportedon stretchers or backboards to the aircraftstanding ready with flight crews,” she recalls.

Although the entire facility was affectedby the flood, the hospital’s emergency planworked. “We practice disasters, and then weactually experienced one. It went off like itwas supposed to,” Myers says.

By 4 a.m. June 8, the waters of HawCreek subsided and deposited a four-footstatue of St. Christopher, the patron saint oftravel, on the hospital’s lawn. This scarredand battered flood refugee may very wellbecome a token part of the reclaimedColumbus Regional Hospital facility. j

A mobile emergency department unit,Med-1, arrived from North Carolina toprovide continued emergency services toColumbus and surrounding counties.“Getting the emergency department up andrunning was done for our community,” saysEmergency Department Manager Jo Tabler.

“We have met a big challenge to continueproviding emergency services,” Tabler says.“The whole leadership staff has been tremen-dously supportive in this whole process.Whether it’s been Gov. Mitch Daniels; Dr.Tom Sonderman, Chief Medical Officer; ourCEO Jim Bickel; or Cheri Goll, interimchief nursing officer, leadership has helpedput all the pieces of this project together.

“With Med-1 here, we provide a sense ofsecurity since our doctors are able to continuecaring for our patients,” she adds.

Patient and careful planning has resultedin continued effective and timely emergencycare, Tabler says.

Some companies never resume businessfollowing a disaster. Others fail within a fewyears. But with the help of a business recoveryplan, others will continue to prosper.

An organization needs an emergencyplan to keep business losses to a minimumshould a manmade or natural disaster occur.Some basic steps for creating a disaster recoveryplan for businesses include performing acomplete needs assessment, effective planning,implementation, practice and continuedimprovements of the plan.

There are Web resources available to starta disaster recovery plan. Experts offer adviceand other tools, as well as individualizedplanning solutions, to fit the unique needsof each business.

Commercial resources, such as data

protection/recovery experts like Double-Take Software, can be of service to yourbusiness to ensure your organization’soperations continue as seamlessly as possible.There are products that protect and recoverbusiness-critical data and applications tosupport disaster recovery.

Because each business is unique, profes-sional services and partner programs canhelp to assess, design, plan and implementdisaster recovery solutions for any size business.

Resources and Web sites to start creatinga business disaster recovery plan include:

> Ready Business, U.S. HomelandSecurity, www.ready.gov/business/index.html

> United States Small BusinessAdministration, www.sba.gov/services/disasterassistance/index.html. j

Provisions of a Recovery PlanContinuity of business operations is critical following a disaster


“Any diagnosis andtreatment capabilitiesdone in the originalemergency department canbe treated in this temporary 14-bed unit:X-ray, EKG, MRI, CT, ultrasound, cardiacarrests, broken arms, respiratory arrests,” sheexplains. “There is a totally functioninglaboratory as well.”

As emergency department manager, Tablerhelps keep the emergency staff continuallyeducated and managed.

Columbus Regional Hospital alreadyhad plans to redesign its emergency depart-ment prior to the flood. The timing of thedisaster has pushed the project up on thehospital’s timeline and is a part of the facility’snecessary renovations.

“One goal is to improve the way ourpatients flow through the department,”Tabler says. “We are making the best of thissituation.” j

Continuing Care at Columbus Regional Hospital

Martha Myers (left) stands amid flood-damagedequipment removed from Columbus Regional during

renovations. Myers joins JoTabler and Jim Bickel (right)

at Haw Creek’s embank-ments, which overflowed

— causing the historicevacuation of CRHpatients and staff.

Amateur Radio Disaster Communi-cations (“Ham”) Team, IndianaDepartment Homeland Security supportsauxiliary communications through the RACESprogram using amateur radio frequenciesand any other means necessary. Log onwww.in.gov/dhs/2686.htm.

American Academy of Experts inTraumatic Stress provides planninginformation for disaster/emergency manage-ment and business continuity programs. Call(631) 543-2217 or log on www.aaets.org.

American Red Cross provides disasterservices, preparedness information and otherhealth and safety resources and information.Log on www.redcross.org.

Centers for Disease Control andPrevention provide timely resources andinformation to increase ability to prepare forand respond to public health emergencies. Logon www.emergency.cdc.gov.

Chemical Biological RadiologicalNuclear Installation Protection ProgramPortal provides relevant information, resourcesand services to help people who live or work onmilitary installations prepare for a CBRNincident. Log on www.cbrn-online.com.

Chemical Education Foundation is anational nonprofit organization that promoteschemical safety. Call (703) 527-6223 or log onwww.chemed.org/html-index.html.

Disaster Help provides information ondisaster recovery and business continuityplanning. Log on www.disasterhelp.gov.

Resources to help you plan, respond and recoverDisaster Preparedness and

Emergency Response Association linksprofessionals, volunters and organizationsactive in disaster preparedness. Call (303) 809-4412 or log on www.disasters.org/dera/dera.htm.

Federal Emergency ManagementAgency provides resources for disaster responseand recovery from all hazards. Log onwww.fema.gov.

Humane Society of the UnitedStates provides information to prepare yourfamily — including your pets — for disasters. Logon www.hsus.org/disaster.

InCite BCM Inc. is a resource for anyoneseeking help with any aspect of disasterrecovery and business continuity planningincluding preparing for pandemic outbreaks.Log on www.incitebcm.com.

Indiana Department of HomelandSecurity provides resources to help prevent,protect against, respond to and recover frommanmade or natural threats. Log onwww.in.gov/dhs/index.htm.

Indiana State Department of Health’sPublic Health Preparedness providesresources and information on preparednessincluding biological and chemical agents.Log on www.in.gov/isdh/17855.htm.

National Center for Post-TraumaticStress Disorder provides research andeducation on the prevention and treatment ofPTSD. Call (802) 296-6300 or log onwww.ncptsd.org/index.html.

National Emergency ManagementAssociation is a professional network for stateemergency management directors. Call (859)244-8000 or log on www.nemaweb.org.

National Fire Protection Associationaims to reduce the burden of fire and otherhazards on the quality of life. Call (800) 344-3555 or log on www.nfpa.org.

National Governor’s AssociationCenter for Best Practices, EmergencyManagement Site provides various resources.Call (202) 624-5300 or log on www.nga.org

National Institute for ChemicalStudies helps communities manage risksassociated with chemicals. Call (304) 346-6264 or log on www.nicsinfo.org.

Pandemic Flu.gov provides resources toprepare and deal with the pandemic flu at thelocal, state and national levels. Log onwww.pandemicflu.gov.

Ready Business is a U.S. Department ofHomeland Security resource for creating abusiness disaster recovery plan. Log onwww.ready.gov/business/index.html.

U.S. Department of HomelandSecurity’s Ready Campaign educates andempowers Americans to prepare for and respondto all kinds of emergencies. It is a partnershipwith The Advertising Council. Log onwww.ready.gov.

U.S. Small Business Administrationprovides small-business owners tips on creatinga disaster recovery plan. Log on www.sba.gov/services/ disasterassistance/index.html.

Reprints of Preparedness: Plan, Respond, Recover are available by calling 317.585.5858 or by mail:Weiss Communications, 6610 N. Shadeland Ave., Suite 100, Indianapolis, IN 46220.

Thank you to our Sponsors:

This publication was supported by Grant/Cooperative Agreement Number U59/CCU525032-03 from Centers for Disease Control and Prevention (CDC).Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.

This project is funded by the CDC PHHS Block Grant award number B01DP009019-08.

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