2. Introduction

Authors:

Ciro Ugarte, MD

Jacobo A. Tieffenberg, MD, MS, MPH

Ribka Amsalu, MD, MSc

Lou E. Romig, MD, FAAP, FACEP

“Failure to plan is planning to fail.” This quote by Benjamin Franklin appropriately reflects the message of this module. Emergency preparedness planning is crucial to prevent or mitigate a disaster. As defined in Module 1, disasters occur when a natural or man-made event transforms a vulnerable human condition into a traumatic event causing needs to exceed the local capacity for response. Without adequate planning, the most common response to these types of incidents is confined to simply rescuing victims and transferring them promptly to a hospital facility (the “Scoop and Run” approach). This results in the transfer of the problem from the incident site to the hospital, overwhelming and disrupting the care capacity of the health facility.

Some events occur suddenly, with little or no warning. Others, such as flood and hurricanes, usually provide advanced warning or have a gradual onset that allows for additional preparations before the critical stage ensues. In any case, specific planning and preparedness are especially important to reduce the suffering caused by disasters, particularly for children. Children are among the most vulnerable populations in disasters because they have unique physiological, psychological, and developmental needs. Pediatricians and the local community have a special responsibility to assess how local, regional, and national preparedness plans and response systems will actually function to protect children. Failure to consider the needs of children in disaster planning, preparedness, and response at all levels potentially jeopardizes this vulnerable population. Pediatricians must advocate for the health, safety, and well-being of infants, children, adolescents, and young adults who cannot advocate for themselves. Increasing our understanding of how children were affected by past disasters will inform and strengthen our response.

The information provided in this module can assist in the design of an emergency preparedness plan that will increase coordination among the many disciplines involved in disaster response. Active participation of all relevant entities in plan development is crucial. Participation in planning among involved entities breaks down the silos that all too often isolate different disciplines, and promotes understanding and cooperation among them. The multidisciplinary, inclusive planning process is actually more important than the document itself. The planning process facilitates a collective understanding among all the key agencies and their personnel about the plan, which is indispensable for effective implementation of the plan when it is needed. Planning should include both short-term and more long-term ways of risk reduction from potential disasters, efforts to educate families and community organizations about preparedness, and methods of horizontal and vertical coordination involving multiple local entities as well as regional, national, and international assistance networks. Local planners need to have knowledge of the regional and national response systems and the means to coordinate local activities with these systems.

This module reviews the basic concepts for emergency planning and response preparedness, and discusses the various levels of planning which include the family, health professionals, community organizations, and health facilities. The final section of this module reviews how to organize community emergency services capable of responding to a mass casualty incident.