Planning for the unexpected in a theater of operations.It has been said that the more you sweat in peace, the less you bleed in war. Just because a unit deploys to a combat zone does not mean that readiness training should stop. Training should never stop, nor should it become so focused that it results in only one or two response criteria being exercised in various types of scenarios. A unit should determine which characteristics and problems are predictable and recurrent and which are fluke occurrences.
Although major disasters are low-probability events, they must be planned for because even small-scale incidents can detract from detract from
verb 1. lessen, reduce, diminish, lower, take away from, derogate, devaluate << OPPOSITE enhance
verb 2. a maneuver commander's mission. The expense and effort of preparing for a potential crisis is an investment with little certainty of return. Often, the benefits of preparing for a disaster are invisible in the short term and are recognized only after an actual crisis occurs.
A common mistake in disaster planning disaster planning - disaster recovery is developing response criteria that are an extension of "routine" emergency measures. Actually, the reverse should be true. Adopting disaster-response criteria for all emergency planning could reduce training costs, permit agencies to become familiar with each other's personnel and response methods, and improve response to routine situations.
Crises generally do not render people stunned and unable to act. People will act on their own initiative and take what they believe to be appropriate actions. In fact, the public's willingness to help often overwhelms the responding agencies. Making this fact the focus of disaster planning helps to design response criteria based on what people most likely would do in a crisis situation.
What exactly is a disaster? According to the Federal Emergency Management Agency The Federal Emergency Management Agency (FEMA) is the federal agency responsible for coordinating emergency planning, preparedness, risk reduction, response, and recovery. The agency works closely with state and local governments by funding emergency programs and providing technical (FEMA), a disaster is an occurrence of a severity and magnitude that normally results in deaths, injuries, and property damage and that cannot be managed with routine procedures and Government resources. It usually develops suddenly and unexpectedly and requires immediate, coordinated, and effective response by multiple Government and private-sector organizations to meet human needs and speed recovery. It also requires the responding agencies to react to emergent situations in a nonroutine way under conditions of extreme urgency to maximize the sustainment of life, property, and resources. It is important to note that there are no size parameters in this definition. A disaster can be of any size and can occur at any time without warning.
Emergency Response Planning in Afghanistan
From July 2003 until April 2004, I served as the combat health support officer for the 1st Brigade, 10th Mountain Division (Light Infantry), from Fort Drum, New York This article is about the U.S. Army base in New York State. For other places with a similar name, see Fort Drum.
Fort Drum is a census-designated place and U.S. Army military reservation in Jefferson County, New York, United States. , while it was deployed to Kandahar, Afghanistan, for Operation Enduring Freedom. When our brigade arrived at Kandahar Airfield, we found that no written emergency response plan was in place. Some of the other deployed units, including Fort Drum's 10th Forward Support Battalion A Forward Support Battalion was an Army of Excellence unit designed to support a Brigade.
It was composed of:
Soon after I arrived, Kandahar Airfield was struck by two separate enemy rockets. Some people, including commanders, first sergeants, command sergeants major, and base defense personnel, rushed to the point of impact and stood around the crater talking about what should be done and who should be in charge, but no one knew what to do or which agency should be in charge of the scene. An on-scene chain of command had never been established. As a result, the commander of the Base Defense Operations Center A command and control facility established by the base commander to serve as the focal point for base security and defense. It plans, directs, integrates, coordinates, and controls all base defense efforts and coordinates and integrates into area security operations with the rear area (BDOC BDOC Biodegradable Dissolved Organic Carbon
BDOC Business Document
BDOC Base Defense Operations Center
BDOC Biodegradable Organic Carbon
BDOC Bed Days of Care ) assumed responsibility for cleaning up the mess and reporting findings to his chain of command.
Installation Force Protection Working Group
To guard against a repeat of this situation in the future, the BDOC commander established an Installation Force Protection Working Group made up of representatives of several different agencies. The group discussed base defense and perimeter security measures and how to employ them, but it never contemplated actions to be taken in an everyday, routine emergency.
Later, an Emergency Response Plan (ERP (Enterprise Resource Planning) An integrated information system that serves all departments within an enterprise. Evolving out of the manufacturing industry, ERP implies the use of packaged software rather than proprietary software written by or for one customer. ) Working Group was established to discuss interagency response to situations outside the purview The part of a statute or a law that delineates its purpose and scope.
Purview refers to the enacting part of a statute. It generally begins with the words be it enacted and continues as far as the repealing clause. of base defense. The group included the base fire chief, a healthcare planner, military police, and base operations and contract facility management personnel.
During the first few weeks of its existence, the ERP Working Group discussed various types of incidents that would provoke a community-wide response. Baseline planning included introduction of potential scenarios and appropriate response measures. These scenarios ranged from aircraft incidents on the airfield to emergencies at the ammunition storage point. Catastrophic scenarios, such as building collapses, structure fires, hazardous material incidents, and prisoner escapes from the installation's confinement facility, were assessed. The group also reviewed combat-related scenarios, such as indirect-fire, improvised explosive device Noun 1. improvised explosive device - an explosive device that is improvised
explosive device - device that bursts with sudden violence from internal energy , and nuclear-biological-chemical contamination incidents.
The focus of the ERP Working Group was not prevention of or defense against attacks but follow-on mitigation of further loss of life and property after an attack occurs, including consequence management. Within these parameters, the group focused on route planning and the response by various agency personnel to an incident. The group also decided that all incidents required an on-scene incident commander.
Incident Commander Responsibilities
The incident commander serves as the information source for the chains of command of the various responding agencies at the scene of an incident. The need for an incident command system (ICS (1) (Internet Connection Sharing) A Windows feature that enables two or more computers to share one Internet connection. First introduced in Windows 98 Second Edition, sharing is accomplished with network address translation (NAT), which is the common method. ) was first identified in the 1970s during a series of wildfires that swept through California. Because of the haphazard response of agencies to the fires, it was determined that any incident involving multiple agencies required a single point of command, control, and coordination. The ICS provided a means for coordinating the collaborative efforts of individual agencies as they worked toward stabilizing an incident and protecting life, property, and the environment.
The ERP Working Group decided that the senior responding fire chief would be the on-scene incident commander because most of the scenarios developed by the group likely would involve a fire service response. In situations that did not require an interagency response, the primary respondent to the scene would become the incident commander.
The key to successful disaster planning is identifying the situations that do not require all agencies to respond. For example, Federal law mandates that, for any situation involving hazardous materials (HAZMAT), an |CS must be established. This was critical at Kandahar Airfield since a HAZMAT incident was always possible because of the variety of fuel and chemicals used at an operational airfield.
An ICS also facilitates effective response by agencies to planned events, such as dignitary visits, parades, and concerts; natural hazards, such as large fires; incidents involving multiple casualties, such as air, rail, water, or ground transportation accidents; and wide-area search and rescue operations. The system prevents the response by agencies that are not required, and it potentially could preclude resources from being employed inefficiently. As an example, a prisoner escape typically does not require a fire service or explosive ordnance detachment response.
Interagency Communication Requirements
The next step in the ERP development process was identifying the requirement for interagency communication capabilities. Before development of the ERE each agency had its own radios and frequencies. New radios were purchased so each agency could carry one radio that was equipped with multiple channels to permit cross communication among the supervisory staffs of the responding agencies. The ERP Working Group decided that the BDOC would be the base Emergency Operations Center The Emergency Operations Center, or EOC, is a central command and control facility responsible for carrying out the principles of emergency preparedness and emergency management, or disaster management functions at a strategic level in an emergency situation, and ensuring (EOC EOC Emergency Operations Center
EOC Equal Opportunities Commission (UK)
EOC Educational Opportunity Center
EOC End Of Course
EOC Epithelial Ovarian Cancer
EOC Environment of Care (JCAHO) ), and, as the plan developed, more emergency management responsibilities were given to the BDOC commander. For more effective interagency response in a disaster, the BDOC would serve as the focal point focal point
See focus. for receiving information and disseminating messages to responding organizations.
The plan looked great on paper, but would it stand the test of an exercise involving a multiple agency response?
Based on guidance from FEMA and current policies, we conducted a tabletop exercise that included the critical disaster response agencies. Using the "crawl-walk-run" method, the scenario involved receipt of a suspicious package in a mailroom. Over the course of 2 hours, the "who, what, when, where, and how" of the incident were discussed. The overarching concern was how well information would flow among agencies and back to the respective chains of command.
Based on the findings of this exercise, it was determined that the BDOC would serve as the communications coordinator throughout an incident. Ultimately, the BDOC would be the clearinghouse for all information about an incident. The BDOC would notify the military police, fire, and other emergency services emergency services Emergency care '…services …necessary to prevent death or serious impairment of health and, because of the danger to life or health, require the use of the most accessible hospital available and equipped to furnish those services' personnel when additional assets were needed and when their services were no longer needed. All follow-up reporting would be channeled through the BDOC, and, in turn, the BDOC would notify the agency chains of command concerning actions during an incident.
The Real Test
Following the tabletop exercise, the ERP planners developed an actual exercise using FEMA's "8-Step Model for Exercise Design." Those eight steps are--
* Conduct a needs assessment for the drill.
* Define the scope of the rehearsal.
* Draft a statement of purpose.
* Identify the exercise objectives.
* Write a narrative of the exercise.
* List major events and details of the events.
* Assess expected actions.
* Identify messages associated with each event.
For 2 months, the ERP planners held weekly meetings to design an exercise. The chosen scenario involved a motor vehicle accident motor vehicle accident Public health A morbid condition that kills 45,000/yr–US; 60% are < age 35; MVAs account for 500,000 hospitalizations and most 20,000 spinal cord injuries, at a cost of $75 billion/yr with multiple occupants trapped inside a burning car. The scenario was designed to be as realistic as possible and yield the maximum benefit for all personnel involved. The goal was to provide a viable, multiple-agency response to an incident involving several casualties and a disruption in the daily routine of the base.
Since this would be the first exercise of this type at Kandahar Airfield, the location was critical. Planners were not sure how the agencies would interact with one another since no previous situation had provoked such a response. A site at the far end of the runway, approximately 1 mile from the center of the installation, was selected for the exercise to prevent disruption of pedestrian and vehicular traffic.
The base operations staff approved a request for the purchase of a wrecked vehicle for the exercise. This vehicle had its engine removed but still had glass and tires on it. Three days before the event, the fire chief, military police, and the medical planner drove to the site of the exercise and conducted a training exercise without troops (TEWT TEWT Tactical Exercise Without Troops ) in which they reviewed the key aspects of the exercise and the anticipated response methods. Using a synchronization matrix as a guideline for the events, the key leaders "walked" through the exercise from start to finish, making sure that it would meet the planners' design and intent. Other key players with supporting roles in the exercise were identified.
Tuesday, 2 March 2004, began like any other day at Kandahar Airfield. Soldiers participated in physical training, went to work, and ate at the dining facility. Meanwhile, the stage was being set for the first experience of its kind at Kandahar Airfield. Six "casualties," with simulated injuries applied by two nurses from the forward surgical team using a moulage moulage /mou·lage/ (moo-lahzh´) [Fr.] the making of molds or models in wax or plaster; also, a mold or model so produced.
n a model of a part or a lesion (e.g. kit, were taken to the site and placed inside the wreckage. They were given last-minute instructions about what was going to take place, and then the exercise began.
At approximately 1100, the BDOC received a phone call about a vehicle accident. The caller reported that several people were still inside the vehicle. The BDOC obtained critical emergency information from the caller and then passed the information to the fire service alarm center. At approximately 1105, a call went out over the radio with the details of the incident. The fire service was the first agency to acknowledge receipt of the information and respond to the scene.
To facilitate realistic training, the doors of the vehicle had been smashed to prevent them from being opened with the handle. The glass was broken out of one of the side windows of the car, and orange traffic cones were placed on the hood and trunk to simulate flames. As soon as the first fire truck was seen coming toward the scene of the accident, smoke grenades were deployed to give a realistic appearance of smoke coming from under the vehicle.
The military police were the next agency to respond to the scene. With blue lights on, police patrol vehicles rushed toward the scene as if the accident were real. This was exactly the response the planners had hoped for. The fire service arrived, and firefighters immediately began to "pull hose" and assume positions to suppress the fire. With streams of water directed at the car, the firefighters advanced on the vehicle and knocked over the cones, which simulated putting out the fire.
When the fire was out, firemen moved to the vehicle and assessed the scene and the condition of the "casualties." The five victims inside the car had various injuries. One was conscious, and four were unconscious. A sixth casualty had been ejected from the wreckage and was lying on the ground in front of the vehicle. The conscious victim added to the realism of the exercise by screaming at the firemen to get him out of the car because he was afraid of being burned alive.
The firefighters extricated ex·tri·cate
tr.v. ex·tri·cat·ed, ex·tri·cat·ing, ex·tri·cates
1. To release from an entanglement or difficulty; disengage.
2. Archaic To distinguish from something related. the casualties and determined the nature of their injuries. As the extent of the various injuries was determined, the incident commander relayed information to the BDOC on the radio and requested assistance from emergency services personnel. The BDOC acknowledged receipt of the information and contacted the Kandahar Airfield health clinic. Within moments of the initial call, ambulances were en route to assist with the victims at the scene. As soon as the victims were placed inside the ambulances for transport to the emergency room, the exercise was terminated.
The final step was an informal after-action review at the scene of the incident while the events were still fresh in everyone's mind. The personnel involved gave great reviews. One airman stated that when he saw the smoke from a distance he couldn't tell if the incident was real or an exercise. That was the greatest compliment the exercise designers could have received.
The importance of the exercise was realized a few days later when the BDOC received a late-night telephone report of a fire and explosion inside the ammunition supply point See: distribution point. . The fire service was there in a matter of minutes A Matter of Minutes is an episode from the television series The New Twilight Zone. Cast
The value of the exercise never might have been realized had a real-life scenario not occurred so quickly following it. Several members of various agencies reported to the ERP Working Group that, had they not rehearsed their response to an incident of this nature, their success with the real fire might have been severely hampered. Success was an understatement in this situation, and the dividends far outweighed the expense of the disaster training.
CAPTAIN JERRY D. VANVACTOR 15 A MEDICAL SERVICE CORPS OFFICER WHO SERVED AS THE COMBAT HEALTH SUPPORT OFFICER FOR THE 1ST BRIGADE, 10TH MOUNTAIN DIVISION (LIGHT INFANTRY), WHILE DEPLOYED TO KANDAHAR, AFGHANISTAN, DURING OPERATION ENDURING FREEDOM. HE HAS A BACHELOR'S DEGREE IN HEALTH SCIENCE FROM ATHENS STATE UNIVERSITY Athens State University, located in Athens, Alabama, USA, is a two-year upper level university. Athens State is the only two-year upper level university in the state of Alabama. Thirty-three different majors are offered to junior and senior students. AND A MASTER'S DEGREE IN HEALTHCARE MANAGEMENT FROM TOURO UNIVERSITY INTERNATIONAL Touro University International (TUI), located in Cypress, California, is a for-profit virtual university owned by Summit Partners. All courses are delivered on the internet using advanced interactive teaching methods. . HE IS A GRADUATE OF THE ARMY MEDICAL DEPARTMENT (AMEDD AMEDD Army Medical Department (US Army) ) OFFICER BASIC COURSE, THE AMEDD OFFICER ADVANCED COURSE (PHASE I), THE MEDICAL LOGISTICS MANAGEMENT COURSE, AND THE SUPPORT OPERATIONS OFFICER COURSE (PHASE I).