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9/11: How did it affect EMS/medical disaster response in your area?


Bernhard

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Sorry for the long post, it's a topic that is really interesting for me - if you want to skip the whole story behind my interest, just jump to the end of this posting, where the real question is...

As most of the people on the world I still remember very well, what I did when the terrorist attacks on the USA happened. Even beeing here in Germany, we had a lot of media coverage of this horrible events. Now, ten years later, a lot of this memories came back (with the media coverage...) - and I tried to recall, what has changed for me since then. First of all it was the thought "I never could stand on top of the tower any more" (beeing in NYC in 1997 including a visit to the top of the WTC) and "Those pictures I have from the skyline of New York wouldn't be the same today".

But it even had an influence of my engagement in EMS and disaster response. Beeing a medic, I thought of the fellow responders immedeately when I saw the flames there - and I understood what it meant when I saw the towers falling. What would I have done? A question, that hopefully never needs an answer.

The German EMS/disaster response community was horrified as well. Since over ten years there almost was only a basic awareness of disasters. In the cold war, Germany had a very sophisticated civil protection and disaster response structure, with defined civil medical platoons all over the land, equipped by federal funds and staffed with trained volunteers (I started there). In the 1980ies the equipment and structure of this platoons were laughed at by the "real" EMS folks, since EMS developed a professional attitude and noone saw any use for the disaster response - in a war we would have been nuked anyway, so why bother?

A highly influencing incident then was the 1988's disaster at Ramstein Air Force Base with at least 450 (hospital treated) or up to over 1000 (ambulatory treatment on scene included) injured people (and 70 death). This leads to local establishment of medical response groups to assist EMS, but this still was very unstructured and just based on the engagement of some "silly" individuals.

The large structured and federal funded platoons still were laughed at by "modern" EMS folks, since they were considered slow and lacking modern equipment. However, they were the standard structures in German disaster response, since the east-west (cold war) conflict was at a height.

With the more or less unexpected drop down of the eastern block this argument was gone and so noone really missed all the federal structures in disaster response going away soon. German EMS finally really grew up to a modern system with highly educated professionals and a dense net of responders. The unification of Germany following the break down of the east German Democratic Republic needed a lot of tax money which wasn't spent on disaster response.

Some incidents with around 100 injured/100 deaths (i.e. derailment of a high velocity train in Eschede and else similiar events) lead to a slighlty more structured attempt to build up volunteer response groups for assisting EMS in multi victims situations. German Red Cross proposed a unifying structure for medical groups, some german federal states regulated their own disaster response (often inherited a lot from the Red Cross' suggestion). That was OK for the "usual", we thought of that time...

Then September 11th, 2001 stroke. German (and european) EMS and disaster response experts were stunned. What would we do? All concepts were completely reduced to some 10-20 victims, barely able to handle 100 or so. Now we were talking about thousands!

Things calmed a bit, discussion about 9/11quickly turned into debates about military involvement, not about EMS and disaster response. But the EMS/disaster experts pushed the topic forward and tried to alert politicians. The overall topic was: "How would we handle a 1000-victim-disaster, needing large distance response". The ones arguing that would be simply not very probable became silent, when a "100-year" natural disaster hit: the flooding of the Elbe River in August 2002 affected several cities, one of them Dresden. More than 30'000 people had to be evacuated. A lot of things have to be improvised, political leaders don't came out very good. Therefore a respected member of the German parliament, a former german army General, was appointed to analyse the response and propose improvements.

This report (and a lot of discussions in the aftermath of the flooding) lead to a new understanding of inter-state mutual aid in Germany. It resulted in a new federal concept of disaster response units and - more surprising to me - into the awareness of the EMS community on maybe beeing a part of even larger multi victim incidents.

The forthcoming world soccer championship 2006 in Germany, including several terrorist threads (if real or just suspected) sped up the process a lot.

Now in Germany we have:

  • a federal agency for civil protection and disaster response (we had one before the cold war ended, but this died with the iron curtain)
  • several modern communication media implementations (internet...) and information connecting points (federal disaster situation center with laws/regulations about the information flow and inter-authority work)
  • concepts of civil medical task forces covering whole Germany on federal funds with modern equipment
  • most of the larger states actually implementing these concepts, sometimes even with additional own ideas (however, some other states still waiting for the federal funds flowing)
  • a strong understanding of EMS beeing part of disaster response
  • some kind of awareness of EMS providers maybe beeing attacked by terrorists
  • some awareness of CBRN issues including federal funding for protective wear for EMS providers / disaster responders (actually including the development of a complete new set of equipment, not bad at all).
  • a more and more scientific approach to EMS/disaster response topics
  • large state/federal wide disaster exercises (however, mostly table top but with some real elements)
  • a network system of mutual help in/outside the European Union (http://ec.europa.eu/...l/prote/mic.htm)
  • and some details (equipment, training, ...) else - feel free to ask, if you want to know more

All in all this was a more or less direct result of the terrorist attacks on USA at 9/11, which clearly served as the initial wakeup call for the disaster response community in Germany. I think, we're pretty good prepared now, compared to the 1990ies (however, I could think of more). Thankfully, it has not to be proved yet.

I personally grew up in a lot of this recent german EMS/disaster response history, starting as young volunteer in the cold war civil protection system, seeing the GDR and eastern block collapse from the point of view of a Red Cross volunteer organizing refugee camps at the soon-to-be-former border, seeing the professionalisation of german EMS, then beeing part of Bavarian response force to the Dresden flooding and now am active in a planning/leading group of statewide disaster response.

From this point of view, I'm just curious: How did 9/11 affect YOUR countrie's/area's disaster response concepts? Did it anyway (or other large incidents, like the New Orleans flooding) or would you do things today as have generations before? Any personal experiences?

Again, sorry for the long post (I was inactive a while, so I had some letters/words in spare). I hope you at least enjoyed the reading about german disaster preparedness history. :)

Just a plea: keep it on a technical level, any political/religious/ideological debate would fit better in the Non-EMS discussion board. Thank you!

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