Preparing for Terrorism and Disasters in the New Age of Health Care - Research Paper Example

Terrorism and Disasters Terrorism and Disasters Introduction Terrorism may arise from ideological, religious or political grounds. However, although it may not have a single definition that is binding legally, it can accurately be used in reference to violence that aims at creating fear, especially targeting non-combatant governments and societies (Richardson, 2006). Disasters, on the hand, are devastating man-made or natural calamities or sudden accidents. Essentially, disasters disrupt a society’s or community’s normal functioning on a large scale (Beck, 2006). Both terrorism and disasters are terrifyingly similar in their occurrences that pay no regard to national borders and, therefore, no country or community is immune from terrorism and disasters, not even the perpetrators of terrorism themselves. However, depending on the levels and type of preparedness of governments, communities and individuals, vulnerability to terrorism and disasters vary on a wide scale (UNGA, 2012). The most obvious consequences of terrorism and disasters are the setbacks impacted on economic and social development, disruption of water and electricity supply and the crippling of communications and transportation systems. Agreeably, some countries in the developed world are sufficiently prepared to recover from these disruptions, even though the costs in terms of time and finances are considerably high. However, terrorism and disasters also present constant threats to public health, especially among older adults with conditions and disabilities that call for extra assistance, those with chronic diseases and to families with children who have special needs. More importantly, the effects are of magnitudes that surpass the affected communities’ capability to manage with their own resources (UNGA, 2012). It is critical for authorities and communities to plan how they will respond to these vulnerable groups when stricken with terrorism or disasters. Among the preparedness measures is taking care of medication and equipment, notifying health professionals and moving to special shelters. This paper will research and discuss on the topic of preparing for terrorism and disasters in the new age of health care. Vulnerability to Health Risk Factors The presence of threats to public health cannot be doubted, as is manifested in nuclear, natural, terrorist, biological, radiological and chemical incidents. Apart from the traditional causes of health problems which are mainly diseases, terrorist attacks and disasters compound the effects of the complexity of the threats. The impacts these events have on a nation’s well-being are more pronounced in their aftermath, most notably the 2001 terrorist attacks, the SARS (severe acute respiratory syndrome) 2003 outbreak and the 2005 Hurricane Katrina. Evidently, from the consequences that followed these events, the level of preparedness in terms of preventing, responding to and recovering from emergencies in public health will protect the safety and health of the public as well as emergency responders. The larger parts of marginalised regions and developing countries have not accomplished the Millennium Development Goals (MDG) as proposed by the United Nations (UN). They have not implemented next-generation health surveillance and monitoring systems required to provide critical information to decision making agencies in times of emergencies. Minimizing these general vulnerabilities are challenging in themselves to most nations. Further, there are more specific challenges that need to be addressed. Some authorities are characterised by the lack of epidemiology and assessment sciences, which can enhance studies into the medical supplies necessary to eliminate infectious agents (Ziskin & Harris, 2007). They do not have sufficient guidelines for screening health practitioners, and the lack of effective protective gear for emergency responders complicates the situation. It is conventional practice for most responses by public health sectors to focus on food and water safety and the safe disposal of sewage in the event of terrorism attacks of disasters. This is usually at the expense of the impacts of such events on chronic conditions, and the persons who depend on medication and devices on a daily basis for their lives (Ziskin & Harris, 2007). The social, economic, emotional and physical environmental conditions that follow acts of terrorism and disasters can aggravate chronic illnesses due to exposure to stress and infection, aside from extreme weather conditions and lack of water and food. Terrorism and Disaster Preparedness in the Perspective of Health Care It is imperative to have a minimal degree of preparedness across the international, national, regional and local levels which address recovery, relief and prevention. In this context, preparedness activities and procedures are designed to generally minimise injury, protect against the worsening of health conditions and minimise loss of life (Quarantelli, 2000). However, preparedness should extend far beyond the drafting or proposing of a plan. Prevention should target permanent, or long-term at the least, protection from terrorism and disasters. It is both logical and practical to acknowledge that not all terrorism and disasters are preventable in their entirety, but through sound evacuation strategies, design standards and environmental planning, the exposure to vulnerabilities that further endanger health can be mitigated. An effective starting point would be to understand that although the prevention of disease and disability as well as management of chronic conditions and special needs usually come in the relief stage, preparedness can and must be done much earlier. That is the best way to ensure that the recovery stage is not complicated by aspects that might have been overlooked long before the terrorism or disastrous event. Health care leaders and their respective authorities must ensure that their health institutions offer continuous training to their staff implement appropriate programs that will facilitate rapid responses to threats of disasters and actual disasters (Ziskin & Harris, 2007). For preparedness that will serve its purpose, health care organizations and all concerned practitioners need to first identify where their facilities and themselves fit in the overall systems of preparedness their communities have in place (McGlown, 2004). A system of hierarchy then needs to be established and communicated to all stakeholders and, in the perspective of health care, the entire community including political leaders, policy makers, carers and patients are stakeholders. The significance of this step is to avoid conflict that usually arises in the wake of confusion that follows immediately after disaster strikes. Roles must be clearly outlined, with everyone only concerning themselves with what is expected of them (McGlown, 2004). For instance, at the institutional, agency or government levels, it is critical to understand ethical and legal issues that surround terrorism and disaster preparedness and planning. First responders have always cited the challenges presented by the bureaucratic integration of military and civilian responses as significant factors that contribute to aggravating injuries and health conditions after disastrous event take place (McGlown, 2004). What should happen, on the contrary, is that national health policies with regard to disasters must be refined. Such refinement must encompass restating of national and local goals of programs. Statutes addressing powers in times of emergencies must also be explicitly addressed, and the training and education of public health workers must be prioritised to specifically prepare the health care system to handle terrorism and disasters (Ziskin & Harris, 2007). Health Care System Preparation for Disasters The United States can serve as a practical example in this area of research (Richardson, 2006). Prior to the 9/11 terror attack, nonmilitary health institutions, emergency rooms and medical responders had insignificant to no association at all with the federal government. Volunteers were the most prominent individuals and bodies that managed emergency response systems locally, while some institutions were licensed by certain states to function as hospitals. Most of the individuals who practiced as paramedics and medical technicians in emergencies were also certified by their respective states. However, after the 9/11 event, attention was necessarily shifted to such previously overlooked resources that are inherently crucial in the type of reactions and responses required after terrorism acts and disasters (Richardson, 2006). The National Response Plan incorporated the National Incident Management System in its design to ensure that emergency responders will in future operate under one plan, undergo regular training and use the same work categorization. It became a statutory requirement for first responders, made up of personnel in emergency rooms, emergency medical responders, firefighters and police officers to have basic knowledge in caring for terrorism and disaster victims while also protecting themselves. Prophylactic medicines and current vaccinations were among the measures put in place to protect the first responders. In cases of virulent diseases such as, for example, pandemic influenza, or even biological terrorism acts, any nation’s health care system must exhibit preparedness by having the appropriate vaccines, anti-virals, prophylactic drugs and antibiotics (Gostin, 2006). These should be made readily available and easily accessible as preventive and restorative countermeasures. Apart from these interventions, health care institutions and the respective authorities need to have non-pharmaceutical countermeasures well designed to be easily and safely executable, such as quarantine and isolation. Further, some aspects of particular concern to hospitals include bed capacity and availability of emergency personnel as well as issues of liability. Health institutions, health practitioners, emergency responders and national and local governments that have strategically designed their prevention and response plans to seamlessly incorporate non-pharmaceutical and pharmaceutical interventions have better chances of mitigating health consequences of disasters in their communities. Another way, in which the United States serves as the perfect example of preparedness, or the lack thereof, is in the communication system’s vulnerability as the 9/11 and Hurricane Katrina events demonstrated. The negative effects and dangers of failures in telephone systems and electrical power blackouts were experienced at a time when the services were needed the most (Gostin, 2006). Basically, that could be blamed on the lack of preparedness and having sufficient alternatives in place. It becomes evident that health departments, hospitals, agencies or centres commanding incidents and emergency management offices must design, implement, and continuously test and upgrade back-ups to their communication systems. Just in the same way that these entities have back-up storage systems for their data and information, it is of equal importance to have back-up plans for real-time communication incase of failure of the primary one. Preparing for Disasters by Specific Groups Vulnerable Older Adults and Children with Special Needs Although not the entire older-adult population is more vulnerable to a disaster’s negative impacts than the younger population, just like children with special needs, older adults are affected disproportionately by disasters (McGlown, 2004). The most affected are those with disabilities and chronic diseases. For example, Hurricane Katrina’s impact on the population nursing chronic diseases proved that the treatment of chronic diseases must be prioritised by the health care industry, authorities and the public after a disaster. A preparedness strategy targeting the disability and older community should include reaching out to that population and learning from them their most immediate needs should a disaster strike. This will also facilitate the designing and implementation of geographical mapping from census data. From these data, water, food and medication distribution centres can then be set up in regions where such vulnerable populations are. For the elderly and frail population, evacuations procedures from nursing homes should be made less disrupting and executed in the shortest time possible (Beck, 2006). There should be personnel dedicated to moving medication and medical records of such citizens and the identified host facilities must always be ready to take up the influx of patients. Essentially, there nursing programs, supply of basic needs and medication should be interrupted minimally. In the same sense, children with special needs can generally be categorised alongside persons requiring specialised health care. Planning for disasters is already difficult enough even without having the extra requirement of preparing for specifically vulnerable populations due to their special needs. It calls for additional attention to needs and details, which usually are not faced by ordinary families. According to the Florida Institute for Family Involvement (FIFI), three core areas can be viewed in terms of preemptive thinking, planning and preparing for the disaster and the response and recovery procedures (FIFI, 2014). Preemptive thinking will always keep a family alert and aware that a disaster can strike at a time when its members are scattered at work, in the home, at school or in transportation systems. In such circumstances, they may not be in a position to immediately determine if their children with special needs are safe, especially when communication systems are affected, which is often the case. A family that always thinks ahead of disasters will have a provisional structure of what to prepare for, especially for the inhabitants of areas prone to both natural and man-made disasters. They need to prepare for dry months that are sometimes accompanied by wild fires, floods in the rainy seasons or coastal damages that result from Atlantic and Gulf storms. Disease epidemics are also not a rare aftermath of such disasters, and they usually limit the accessibility of health care and its facilities. Due to the quarantines that are imposed on some of the areas that suffer disease epidemics, the families should have plans for continued sanitation measures during their prolonged stays in such areas. For the sake of special-need children, it is imperative to have supplies that will last a minimum of two weeks. They include prescription and non-prescription medications, power supplies (batteries or generators) for electrically operated medical equipment, special diets and disposables like dressing materials (FIFI, 2014). Care plans should be updated and kept current as well as the schedule of medication special-need children need as prescribed by physicians. Forms providing emergency information on the children should also be filled and made easily retrievable. Most importantly, neighbours and the appropriate teams that manage local emergencies must be made aware of the presence of children with special needs, and also be furnished with the details of the needs (FIFI, 2014). Then, the families themselves must have their own kits of supplies for times of disaster so as not to endanger themselves while attending to their children. Another logical move as practiced by organizations and should be extended to homes, is to designate and share with family and friends an emergency convergence point for times of disaster. The home itself should also be made free of substances and materials that in themselves present a hazard in the event of a disaster. Each family member must be familiar with the operations of utilities, especially aspects such as turning off electricity and gas supplies. However, great care should be taken in the case of familiarizing children with such features, including, if necessary, not letting them handle them at all. Conclusion In conclusion, this research paper has shown that the negative effects of acts of terrorism and disasters go beyond the economical and social perspective. Health is also adversely affected in terms of preventing epidemics, protecting and providing care to vulnerable populations, and continuation of medication to those who were already undergoing treatment. However, technological advances have enabled the health care fraternity to advance in its practices, which means that they can also prepare adequately to handle health matters under emergencies presented by disasters. Preparedness has been seen to be the most reliable countermeasure, and it follows that well-designed and executed preventive, curative and restorative measures are the best supporting means. The health care fraternity of any nation could easily have the largest portion of stakeholders compared to any other industry. Therefore, the coordination of its activities before and while responding to disasters is a key determining factor of how well the nation will do in terms of maintaining optimum health. This is mainly because no single stakeholder, save for some governments in the developed world, have the capacity to handle the aftermath of a disaster entirely on its own (UNGA, 2012). References Beck, U. (2006). Risk society, towards a new modernity. Buenos Aires: Paidos. Florida Institute for Family Involvement (FIFI). (2014). Disaster preparedness for families of children with special needs. Florida: Author. Gostin, L. (2006). Medical countermeasures for pandemic influenza: Ethics and the law. Journal of American Medical Association, 295, 554-556. McGlown, J. (2004). Terrorism and disaster management: Preparing healthcare leaders for the new reality. New York: Health Administration Press. Quarantelli, E. (2000). Where we have been and where we might go. London: Routledge. Richardson, R. (2006). What terrorists want: Understanding the terrorist threat. London: John Murray. United Nations General Assembly (UNGA). (2012). Resolution adopted by the General Assembly on 29 June 2012. New York: Author. Ziskin, L., & Harris, D. (2007). State health policy for terrorism preparedness. American Journal of Public Health, 97(9), 1583-1588. Read More