Article
from
The Boston Globe
BOSTON, MA: Immediately after Tuesday''s horrific terrorist attack on the
World Trade Center, New York City firefighters raced to the scene - and
some gave their lives trying to save others. Local hospitals and health
care workers bore the brunt of emergency care. City police officers and
the state''s National Guard are keeping order in Lower Manhattan. City and
state agencies will oversee the months of cleanup and years of
reconstruction yet ahead.
These are grim reminders that local and state institutions - and not the
federal government - are the main players in disaster response.
New York''s emergency mobilization has been exemplary, but its
performance under extreme stress is not the result of heroism and
extraordinary effort alone. During the 1990s, under Mayor Rudolph W.
Giuliani''s active leadership, the city seriously committed itself to
developing a strong emergency management system. It invested dollars,
recruited talented managers, planned extensively, and provided
systematic training to response personnel. Terrorism was one of New
York''s key concerns - the 1993 bombing of the World Trade Center was a
wake-up call - but the city correctly sought to prepare for all kinds of
disasters, not just terrorism.
Few other cities in the United States could have responded to the World
Trade Center attack last week as well as New York City has. Yet they,
too, need to be ready.
What needs to be done?
The answer doesn''t lie in a dedicated system designed for terrorism,
although some may urge us to focus on that threat alone. Instead, we
need to significantly strengthen the general-purpose (or ''''all-hazard'''')
emergency management systems that already exist in Boston and
Massachusetts and most big US cities and states.
Although some specialized capacity is needed to combat terrorism, it
makes no sense to separate terrorism from emergency preparedness for
hurricanes, floods, blizzards, earthquakes, industrial explosions, and
accidental airline crashes. Many of the needed resources - emergency
medical services, rescue workers, law enforcement, for example - are
similar, no matter what the emergency. And even specialized resources
often can be applied to a wide range of contingencies, including but not
limited to terrorism.
We often neglect and underinvest in such services, however, because
they are invisible in ordinary times, called on infrequently, and have
relatively weak political constituencies compared with many other public
services.
Taking the threat and reality of terrorism as a spur to improve emergency
management makes good sense, even though catastrophic terrorism is
unlikely ever to occur in a particular locale. But we don''t know what
places might be targeted. Before Tuesday, we might have guessed New
York and Washington but probably not Oklahoma City. It is prudent for all
areas to take account of the threat.
And an ''''all-hazard'''' approach is more likely than a ''''terrorism-only'''' system
to get sufficient financing for personnel, equipment, training, and
exercises, and to effectively sustain the readiness of the resources over
time.
We need improved emergency planning not because we can predict or
prepare for every disaster that might arise - we know that is impossible -
but because the more contingencies we consider and probe, the more
angles we can be ready for. Just as the military must develop general
skills to fight wars and battles whose exact dimensions cannot be known
in advance, emergency managers must develop equally flexible plans and
implementation capabilities.
Where to begin?
First, we must improve the way that we direct and coordinate the diverse
agencies and professional groups that come together from many locales
and levels of government in a crisis. Within hours of the crisis in New York
City, as in Oklahoma City 61/2 years ago, multiple fire crews, police
officers, ambulances, and rescue workers converged, not only from all
over the city, but from neighboring jurisdictions on Long Island, and in
New Jersey and Connecticut.
Such teams, which have never worked together and have no common
operational method, must be productively coordinated. Otherwise they
may be doomed to ineffectiveness or however inadvertently to endanger
one another''s lives. The ''''incident management system,'''' developed initially
by the fire service in California to deal with this problem, needs to be
made standard practice.
Second, we need more health care ''''surge capacity.'''' Over the past
decade, health care has become leaner: fewer empty hospital beds, more
intensively used equipment, just-in-time restocking of pharmaceuticals
and supplies, and tighter medical staffing at all levels. But squeezing the
fat out of the health care system has left it with far less residual capacity
to respond to disasters and other emergencies.
To make up for the reduced capacity, we need to develop specific plans
for unconventional health care resources that can be quickly developed if
disaster strikes. These might include additional facilities for emergency
care in school gyms, sports arenas, convention centers; mobile equipment
and supplies; and registries of trained health care personnel who are
currently retired or doing other jobs but could be called on in an
emergency.
Third, we need improved communications systems, including widely
accepted ''''interoperability'''' standards so that telephones, radios, and
walkie-talkie systems used by emergency agencies can talk to each other.
Finally, we must invest in training emergency workers adequately and
regularly test their skills in simulated operations.
The threat of terrorism will probably be with us for many years. We must
be better prepared for attacks, but the way to assure that we have
appropriate response capability is to build a stronger all-hazard emergency
management system that is ready for - but not dedicated to - terrorism
alone.
Arnold Howitt is executive director of the Taubman Center for State and
Local Government and director of the executive session on domestic
preparedness at Harvard University''s John F. Kennedy School of
Government.
This story ran on page D8 of the Boston Globe on 9/17/2001.
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