For Disaster Plans to be Effective, They Must be Dynamic

Disasters and infectious disease outbreaks over the last several years have demonstrated the importance of emergency preparedness for large-scale events affecting many people. The ability to respond effectively to events producing a massive influx of patients that disrupt daily operations requires surge capacity.

Surge capacity is the ability to obtain adequate staff, supplies and equipment, structures and systems to provide sufficient care to meet immediate needs of an influx of patients following a large-scale incident or disaster.

Disaster, be it in the form of natural, ‘man-made’ or a hybrid of those two, one way or another healthcare practitioners will be involved and have no choice but to learn, educate and strengthen ourselves in the art and science of disaster.

As healthcare personnel, we are now faced with mandates to find different ways to allocate scarce resources while providing care to an influx of casualties. For disaster plans to be effective, they must be dynamic, updated as well as common knowledge for staff. Plans that collect dust on the shelf and understood by only a few key staff will be of little use in the event of an actual disaster.

Hospital authorities should make every effort to be thoroughly informed about their organisation’s disaster plan and to advocate for disaster drills that include a cross-section of personnel on a variety of shifts.

Crucial planning of staff includes shared staffing and cross training maximise the number of trained staff available. Relevant critical staffs are put in nearby hostels to facilitate calling-in staff members, changing staff schedules, getting supplement staff support from other organisations and non-governmental agencies and volunteers.

Next comes planning for supplies and equipment, we need to allocate beds, ventilators and other supplies in a manner consistent with the goal of saving the most lives. We need to plan for means to supply alternate-care sites with oxygen, point-of-care testing equipment, walkers, wheelchairs, personal protective equipment and other supplies plus to ensure that the supply chain exists especially for pharmaceuticals. Health personnel must be flexible and be prepared to revert to perform manual blood pressures and reuse disposable equipment such as gloves, gowns and masks.

Equally important is planning for structure, early discharge of patients or moving patients to other units to free up beds in surge hospital. Hospital authority's should develop partnerships with nearby organisations such as schools, community or recreational centres, sports facilities or even hotels. Our recent experience with the Tsunami in Penang had taught us mobile and portable facilities can come in handy during disaster.

It is crucial to have alternate effective systems planning in place because during disaster, internal and external communication processes may be disrupted due to outages, circuit overload, cellular tower losses. Staff should be familiar with communication plans so that they can communicate effectively with outside entities such as EMS, public health offices and nursing homes.    

To avoid being unprepared when disaster strikes, there is a need to move from ‘reactive’ to ‘proactive’ mode of disaster surveillance healthcare personnel should anticipate, whereby a system that seeks to detect all the signs of impending disaster is in place so as to mitigate the extent of destruction. Latest technology and methods ranging from short messaging services to satellite monitoring needs to be developed. Careful risk assessment utilising updated methods need to be put in place.

Attention need to be given to post disaster diseases like cholera and leptospirosis. To complete our system, it is important to incorporate psychiatric and clinical psychology.

Training our healthcare personnel as local trainers in terms of weapons of mass destruction, chemical, biological, radiological, nuclear and explosion needs to be ongoing and even have regional training centre to cater for these needs.   

We need to liberate our preparedness program to the public for they too can play very important roles to in complementing health providers. There need to be healthy cooperation and coordination between government and non-government agencies- united with only one aim, that is the high spirit of helping mankind in the face of disaster.