California You Are Studying, Right? by Jim Augustine, MD
Monday, March 15, 2010 
Jim Augustine, MDAs I watch the Chilean earthquake response, and review the tapes of Haiti, I hope the emergency medicine colleagues in California are studying the damage and planning their response. One can’t help but think that California has a seismic action that will occur at some point, and that the damage in at least some areas will approximate that which occurred in Haiti and Chile.
Will California be prepared, and will the rest of the country be able to support the needs of the damaged communities?
In the early 1990’s, we undertook planning to evacuate California and its health care facilities after a big earthquake. This was the process that resulted in NDMS, and DMATs, and then USAR and DMORTs and DMVTs, and so on. The plans for medical evacuation systems were updated for the two Persian Gulf wars, and again after Katrina. The Haitian disaster has resulted in some medical evacuations to the United States, but nothing that would stress the regional health systems.
The Katrina evacuation, and then the damage to Haiti, are some of the saddest events you could ever witness. The Katrina evacuees arrived with all their belongings in small trash bags and sacks. That is all the worldly possessions of many of the evacuees. Many of the Haitians had only the clothes they wore, and little hope of housing and food. The medical reports were shocking. The health system was overwhelmed, and there are predictable losses of life and limbs, and now the spread of disease.
What would be different about a large California quake? Would the community reaction cause problems similar to New Orleans? Will hospitals stay open? Will nursing homes be damaged and evacuated? Will community emergency health centers be able to manage health needs? How will rescues be carried out, and will national resources be needed both for response and to manage evacuees? How will emergency medicine be prepared for the various medical effects?
We should be grateful if California preparedness leaders are doing a significant study of the earthquakes, and finding resources from around the country to assist in planning for mass response and evacuation. Because disaster preparation usually means you prepare a plan and then use it to respond to a different hazard then what you planned for, we will all benefit from the All Hazards approach used in the updating of a California response plan. Because the disaster challenges to the health system: tornadoes, hurricanes, tsunamis, blackouts, earthquakes, flu outbreaks, and wildland fires; are all very similar.
And for all you involved in responses to Haiti and Chile, bless you!
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