AMA offers solid, useful resources for disaster response

A message to all physicians from Robert M. Wah, MD, chair of the AMA Board of Trustees.

By Robert M. Wah, MDis a reproductive endocrinologist and ob-gyn in McLean, Va. He was chair of the AMA Board of Trustees during 2011-12 and is currently AMA president-elect. Posted Oct. 17, 2011.

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The end of October often brings a collective sigh of relief for people who live along the Atlantic and Gulf coasts: It's the official end of hurricane season.

This has been a bad year for storms in the U.S. In April and May, tornadoes killed more than 500 people and caused billions of dollars in damage across the South and Midwest.

In August, we had Hurricane Irene. That storm proved less devastating than originally feared, in part because the region was prepared. The storm was 1,000 miles wide as it moved up the Eastern Seaboard. In anticipation of its arrival, public officials cleared coastal areas and put everyone on high alert.

Tropical storm Lee, on the other hand, caught us off guard -- and caused far more damage. Lee produced winds that stoked wildfires in Texas, tornadoes in the Southeast and significant flooding from Louisiana to New York -- including the area near my home in McLean, Va. In all, Lee dropped nearly 29 trillion gallons of water -- twice as much as Hurricane Irene. A dozen people lost their lives due to the disastrous storm.

Predicting natural disasters is far from an exact science. Being prepared for them, however, is something that we can do. Through our Center for Public Health Preparedness and Disaster Response, the AMA has become a leader in offering solid, useful resources to medical personnel who may find themselves responding to disasters -- natural or otherwise.

Working in concert with the National Disaster Life Support Education Consortium and a number of other groups, the AMA and the National Disaster Life Support Foundation Inc. co-sponsor the National Disaster Life Support -- NDLS -- education and training programs.

We currently offer NDLS courses at 75 training sites in the U.S. and a number of sites elsewhere in the world. Since 2003, the first year the first course was offered, more than 90,000 responders have been trained. In Tokyo alone, 1,000 responders completed the training before the devastating earthquake in March.

Serendipitously, an updated version of one of the NDLS courses was piloted by the training site in Reno, Nev., on Sept. 8-9. Just days later, instructors from the class were among the responders when a World War II fighter plane crashed into the grandstands at the National Championship Air Races, killing 11 people, including the pilot, and injuring more than 50.

Clearly, disaster courses cannot always be scheduled immediately before a disaster occurs. However, a week after the Haiti earthquake in 2010 and last spring's Japan earthquake and tsunami, the AMA convened "just-in-time" training webinars that were well-received by physicians and other health care professionals.

Over the years, the AMA also has worked with the Federation of Medicine to establish disaster volunteer registries to facilitate and coordinate deployment of physicians seeking to volunteer with federal or private sector volunteer response organizations.

Another AMA offering is CitizenReady, a series of short prepared presentations physicians can take to local civic groups and schools to talk about citizen readiness for disasters and public health emergencies (link).

In addition to training, the AMA currently is implementing a research project funded by the Centers for Disease Control and Prevention to test a Health Security Card, a smart card with basic medical and personal information that could be accessed by medical and other response personnel in emergencies (link).

The concept for this card came out of Hurricane Katrina, when so many people arrived at shelters or other relief locations without documentation of their health conditions or prescription medications.

Back in 2005, I worked with other health IT experts from around the country to create KatrinaHealth.org, where medication history for 1.5 million people displaced by the hurricane was made available on a secure website.

The pilot website went live in eight days and launched nationally 10 days later. We used AMA Physician Masterfile information to verify physicians needing to access the site to care for patients.

To further support the nation's preparedness efforts, the AMA publishes the Disaster Medicine and Public Health Preparedness journal (link). This past spring, in the wake of the deadly tornadoes, the AMA made a number of the journal's tornado-relevant articles available to civilian and military providers.

With Veterans Day on Nov. 11, now is a good time to remember the military professionals who work not just in disaster relief, but at all levels to protect the freedom and safeguard the health of our nation.

Members of the military traditionally have been among the first responders in any large-scale disaster. This was true after 9/11 when the U.S. Navy sent a hospital ship to New York Harbor to handle victims of the World Trade Center collapses. It was also true after the 2004 tsunami in Indonesia, the Haiti earthquake, Hurricane Katrina, and this year's earthquake and tsunami in Japan.

Having served more than 23 years on active duty as a captain in the U.S. Navy Medical Corps, I am proud of the tremendous dedication and sacrifices made by so many of my former and current shipmates, soldiers, airmen and Marines.

I am also fortunate to have participated on both the military and civilian sides of our nation's disaster preparation and response efforts.

When I was still in uniform and chair of the AMA Section Council on Federal and Military Medicine, we worked with the Council on Scientific Affairs in raising awareness of the need for civilian preparedness.

Back in 1999, the two councils co-sponsored an educational session on bioterrorism preparedness that was presented at the AMA Annual Meeting. This was two years before 9/11 occurred.

This past July, the AMA Board of Trustees had an opportunity to visit the U.S.N.S. Mercy, one of the country's two hospital ships. Navy Capt. Jeffery Paulson, MD, then the Mercy's commanding officer, is an AMA member. Dr. Paulson gave us a full briefing about the ship's recent humanitarian visits to the Pacific, where they performed hundreds of surgeries and patient visits.

Board members had an opportunity to tour this amazing vessel, which has a 1,000-bed capacity, and full OR, radiology, laboratory, dental and pharmacy capabilities.

Most impressive for me were the dedicated young enlisted hospital corpsmen who staff the ship and deliver excellent care with demonstrated skill and training.

And the need for this kind of skill and preparation is only growing. Between 2000 and 2009, there were 385 major natural disasters in the world, an increase of 65% from the previous decade. This year, roughly 263 million people are believed to have been impacted directly by natural disasters. That number is anticipated to be 375 million by 2015. And that is only natural disasters.

There will always be individuals ready and willing to offer aid to those in need. Worldwide, all Navy medicine facilities fly the signal flags saying, "Charlie Golf One," which means "Standing by to Assist."

This motto applies to the AMA as well. With my years of service in the military and as a physician, I am honored to be part of two groups known for their humanitarian efforts. I am also proud of the AMA's important and necessary role in providing training and resources to our nation's amazing first responders.

Robert M. Wah, MD is a reproductive endocrinologist and ob-gyn in McLean, Va. He was chair of the AMA Board of Trustees during 2011-12 and is currently AMA president-elect.

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