Terrorism and All-hazards Preparedness and Response:

Basic Awareness

Prepared by the faculty and staff at theInstitute for Disaster and Emergency Preparedness (2011)

Course Competencies

SPECIAL NEEDSPOPULATIONS

DISASTER ROLES

INFECTION CONTROL

PUBLIC HEALTHPUBLIC HEALTH DISASTERDISASTER

EMERGENCY EMERGENCY RESPONSERESPONSE

PERSONAL AND PERSONAL AND WORKPLACE WORKPLACE

EMERGENCYEMERGENCY PLANS PLANS

HAZARD HAZARD COMMUNICATIONSCOMMUNICATIONS

EMERGENCY EMERGENCY OPERATIONSOPERATIONS

EMERGENCY STRUCTURE

HISTORY OF BIOTERRORISM

BASIC AWARENESS

Agenda•Module 1: Overview of All-hazards Preparedness▫ What is a disaster▫ Overview of Terrorism▫ What is CBRNE

•Module 2: Responding to an Emergency▫ Disaster Cycle▫ NIMS▫ State Emergency Management▫ Psychological Considerations

•Module 3: Vulnerable and Hard to Reach Populations

•Module 4: Personal and Workplace Emergency Preparedness and Response

Module 1: Introduction to All-hazards Preparedness

Objectives for Module 1• Describe the basic concepts of all hazards

emergency preparedness.• Identify various natural and man-made disasters,

including examples of terrorism.• Identify and describe the acronym CBRNE.• Identify four types of natural disasters,

differentiating between intentional and non-intentional man-made disasters.

• Define terrorism and list the common elements of a terrorist act.

• Define Pandemic Influenza and differentiate between annual influenza.

All –Hazards Defined….

•Homeland Security Presidential Directive Defines all-hazards preparedness as “being

ready for domestic terrorist attacks, major disasters, and other emergencies.”

•Preparedness refers to existence of plans, procedures, policies, training and equipment

•Development of personal preparedness plan

Module One: Bioterrorism and All-hazards Preparedness

Why is planning and preparing important?

All-Hazards Preparedness - RAIN

•RAIN▫Recognize the hazard/threat

(What do I see, hear, or smell?)▫Avoid the hazard/contamination/injury

(What do I stay away from?)▫Isolate the hazard area

(Whom do I protect?)▫Notify the appropriate support

(Whom do I call?)

Case Scenario: Hurricane Incident

•How do you stay informed?•What is your family’s disaster plan?•What is the disaster plan at your

workplace?•How is it activated?•What is your role?

All-hazards Preparedness

What Is a Disaster?

Mississippi Katrina 2005 Hurricane Rita Louisiana 2005

Biloxi Hurricane Katrina 2005Wildfire California

Disaster

Natural Disaster Man-Made Disaster

Intentional(Terrorism) Non-

Intentional

What is the difference between an intentional disaster and a non-intentional disaster?

What are some examples of disaster ?

Examples of Natural Disasters•Earthquakes•Extreme Heat•Landslide and

Debris Flow (or Mudslide)•Blizzards• Ice Storms•Hurricanes•Tsunamis•Fires •Floods

What Is a Man-made Disaster?

•Elements of human intent •Morbidity, mortality, and

economic damage•Preventable• Intentional and non-intentional

Non-intentional Disasters

▫Explosions ▫Spillage ▫Train derailments

Source: CNN.com (http://www.cnn.com/2005/US/01/26/train.derailment/)

Intentional Disasters

▫Enemy attack▫Sabotage▫Civil unrest▫Actions that impair

the orderly administration of the government

Case Scenario: Tornado Incident

•How do you stay informed?•What is your family’s disaster plan?•What is the disaster plan at your

workplace?•How is it activated?•What is your role?

Summary•Disasters:

Typically unexpected Unique Contain common elements Conducive to preparedness approach for

planning and mitigation.

TerrorismTERRORISM IS THE UNLAWFUL USE OF FORCE AGAINST PERSON OR PROPERTY TO INTIMIDATE OR COERCE A GOVERNMENT, THE CIVILIAN POPULATION, OR ANY SEGMENT THEREOF, IN THE FURTHERANCE OF POLITICAL OR SOCIAL OBJECTIVES

~ Federal Bureau of Investigation

What is terrorism?Man-made intentional disasters – used to

coerce• assassinations• bombings• cyber attacks• hijackings• kidnappings• CBRNE

Common elements of terrorism

Difference between terrorism and other man-made disasters:

• Acts of terrorism are intentional• Intent to coerce some population – often

utilizing the element of fear• Targets are planned and specific

September 11, 2001 Attacks

The September 11, 2001 attacks (often referred to as 9/11) were a series of coordinated terrorist attacks upon the United States of America carried out on Tuesday, September 11, 2001. Commercial airlines were used to crash into the World Trade Center in New York City and the Pentagon in Washington, D.C. Approximately 3,000 people died in these attacks.

The explosion resulting from the crashing of United Airlines Flight 175 into the South Tower. A huge plume of smoke and fire can be seen emerging from the North Tower.Source: Public Domain

September 11, 2001 Attacks

The Pentagon was severely damaged during the attack, and 125 lives were lost. Buildings surrounding the

World Trade Center were heavily damaged by the debris and massive force of the falling twin towers.

Suicide AttacksA suicide attack is an attack in which the attacker or attackers intend and expect to die. Such attacks are often carried out with the help of vehicles or explosive materials such as a bomb (a suicide bombing), or both (i.e. a vehicle loaded with explosives). If everything goes to plan, the attacker is killed upon impact or detonation. Chechen suicide bombing at

Rizhskaya station of the Moscow Metro on August 30, 2004 (above).

An injured man stands in front a building destroyed by of two suicide car bombs targeting a hotel used by foreigners in Baghdad (left)Source: Guardian Unlimited,

image.guardian.co.uk/.../2005/11/18/hamra372.jpg

London Subway Bombings

The 7 July 2005 London bombings were a series of coordinated suicide bombings that struck London's public transport system during the morning rush hour. Fifty-six people were killed in the attacks, including the four bombers, and about 700 injured.

A bomb damaged a subway train between Liverpool Street and Aldgate stations in London on July 7. Bombs also went off on two other subway trains and a bus. Police said the death toll was more than 50 from London's terrorist bombings.

Sources: Ft. Wayne News Sentinel

Weapon of Mass Destruction (WMD)“Any weapon that can be used to kill or

maim many persons at one time” (definition adapted from uslegal.com)

•Weapons of mass destruction have been used throughout history

•Expansion of the reach due to advanced technology

Bioterrorism

Bioterrorism involves the deliberate release of viruses, bacteria, or toxins.

Agents used are typically found in nature in order to cause illness or death.

Anthrax Attacks of 2001

In October 2001 anthrax attacks were conducted via five envelopes containing B. anthracis spores that were sent through the U.S. postal system. Twenty-two cases of anthrax resulted, and in all, five people died from inhalational anthrax.

Image (top) of envelope in which the letter containing Anthrax was sent to Senator Tom Daschle during the 2001 anthrax attacks

Source: Public Domain

Workers handled a suspected letter containing anthrax (left)

Source: Guardian Unlimitedhttp://image.guardian.co.uk/sys-images/Guardian/Pix/gallery/2001/12/19/anthrax.jpg

Bioterrorism Agents By CategoryBioterrorism Agents by Category

Characteristics Examples

A (High-priority organisms that pose a risk to national security)

• Easily disseminated or transmitted from person to person•High mortality rates

AnthraxBotulismPlagueSmall poxTularemiaViralHemorrhagic Fever

B (2nd highest priority) •Moderately easy to disseminate•Moderate morbidity rates and low mortality rates•Require CDC diagnostic capacity and enhanced disease surveillance

Ricin toxinBrucellosisFood safety threats (Salmonella and E. coli)

C (3rd highest priority emerging pathogens that could be engineered for future mass dissemination)

•Easily available•Easy to produce and disseminate•Potential for high morbidity and mortality rates and major health impact

Nipah VirusHanta Virus

US policy on terrorismThe old threat level awareness system with the five color-coded bars representing escalating threat levels has been replaced.

The new system has only two levels:Imminent – for credible, specific and impending threatsElevated – for credible threats (with a Sunset Provision to expire if no new information becomes available)

Do you think this new system is better?

Case Scenario: Anthrax Incident

Summary

• Disasters that can cause sudden mass casualties and poses a significant challenge to the health care system.

• Examples are prevalent throughout history.

• Heightened perception of terrorist attacks.

• Understanding is the first step in preparedness

What is CBRNE?

CBRNE is a Classification System for Man-made Disasters

CBRNE is a Classification System for CBRNE is a Classification System for ManMan--made Disaster Eventsmade Disaster Events

C = ChemicalC = Chemical

B = BiologicalB = Biological

R = RadiologicalR = Radiological

N = NuclearN = Nuclear

E = ExplosiveE = Explosive

The CBRNE framework

applies to both non-intentional and intentional

disasters.

The CBRNE framework

applies to both non-intentional and intentional

disasters.

Cyberterrorism is beyond the scope of this presentation, but its potential is acknowledged.

The accidental release of methyl isocyanate (MIC) in Bhopal, India on Dec 3rd, 1984, is an example of a non-intentional disaster involving a chemical agent.

The deliberate release of Sarin nerve gas into the Tokyo, Japan subway system in 1995 was an intentional or terrorist disaster involving a chemical agent.

Source: http://specials.rediff.com/news/2004/dec/01sld2.htm

Biological AgentsThe deliberate or unintentional release, or exposure to, certain biological agents.

Difficult to diagnose a response to the release of a biological agent

The deliberate exposure of persons to anthrax in the U.S. in September and October of 2001 represents an example of intentional use of a biological agent to do harm

Source: http://www.chemrest.com/DomesticPrep2/Biological%20Agents%20Page.htm http://news.yahoo.com/photos/ss/events/sc/013105birdflu/im:/060529/481/jak11005291251;_ylt=Av_aFX6371jlEF7jhUYtfp_lWMcF;_ylu=X3

As of now, the avian flu is not confirmed to be transmissible by human-to-human contact

Radiological and Nuclear Agents

Intentional and non-intentional exposure to harmful radioactive materials

The term ‘dirty bomb’ is most often used to refer to a Radiological Dispersal Device (RDD) with traditional explosives

The bombing of Hiroshima and Nagasaki during the closing days of World War II, was an intentional disaster.

The accident, which occurred on April 26, 1986 at the Chernobyl nuclear power plant in Pripyat, Ukraine, is an example of a non-intentional, man-made radiological disaster.

Source: http://news.bbc.co.uk/nol/shared/spl/hi/pop_ups/05/asia_pac_hiroshima_then_and_now/img/1.jpgwww.niauk.org/images/education/chernobyl.jpg

Explosive Agents Any substance or article designed to detonate by the rapid release of heat or

gas.

Madrid Train Station Bombing

At least 190 people were killed and 1,240 wounded as 10 bombs rocked three Madrid train stations during the height of the morning rush hour. The intentional attack took place just three days before Spain's general elections in March, 2004.

Bombing of the Atocha railway station, Madrid (above)

Source: MSNBC, msnbcmedia.msn.com/j/msnbc/Components/Photos/..

Madrid: Aftermath of train station bombing (left)Source: www.vituperation.com/.../September/peace07.jpg

Case Scenario: Chlorine Spill

Source: http://www.historylink.org/essays/output.cfm?file_id=2090

What is “pandemic influenza” and how do I prepare for it?What are the phases that a pandemic may go through?

What is “avian influenza”?

Preparing for the Next Pandemic

Key Differences Between Annual and Key Differences Between Annual and Pandemic FluPandemic Flu

Trust for America’s Health: www.healthyamericans.org

Parameter Annual Flu Pandemic Flu

When Annual, in winter 3-4x/century; no seasonality

Who 5-20% population 25-50% population

Deaths* 36,000-40,000 500,000 in 1918

Recovery 1-2 weeks Greater severity, morbidity

Vaccines Available May not be available

Antivirals Available Limited, efficacy unclear

*U.S. only

What a Pandemic Flu Could Mean

The normal winter flu season: 36,000-40,000 deaths 200,000 hospitalized Global economic

repercussionNo natural immunityStresses healthcare

systemCDC Quarantine rooms in

national airports

Infection Control in CHCs•Separate well and sick waiting rooms•Use of a facemask•Use of a respirator•Use of gowns and gloves•Use of eye protection or face shields•Dedicated equipment•Hand sanitation readily available•Home visits

Challenges•Staffing may be a problem•Communications•Hospitals are traditionally stand alone•Limited surge capabilities•Security•Appropriate staff training

Module 2: Understanding the System Response to a Disaster

Objectives for Module 2:•Describe the disaster cycle.•Describe a NIMS team approach. •Discuss the significance of incident and

unified command planning in disaster management.

•Define key agencies involved in state emergency operations.

•Define psychological first aid and how mental health services can be integrated into disaster response.

The Disaster Cycle

We Are Here

It’s Not that Simple – The Challenges in Responding to a Disaster

•Staffing may be a problem

•Communications•Limited surge

capabilities•Security

RecoveryThis is a long and gradual process.

Mental issues become very important during this part of the disaster cycle (after the initial shock is over and the realization that “normalcy” is a long way off).

This is the most costly portion of the cycle“an ounce of prevention is worth a pound of cure.”

Local Emergency Management

• Warn citizens to take whatever action to minimize risk to family and to property

• Evacuate if necessary

• Initiate an emergency operations plan that spells out the specific local duties

Major Disaster DeclarationProcess follows specific steps

• Local government responds and must be overwhelmed

• State responds with state resources and must be overwhelmed

• Damage assessment by local, state and Federal organizations

• Major Disaster Declaration is requested by the governor

• FEMA makes an evaluation and recommendation to the President

• President makes the declaration

Agencies and Departments• Fire Department• Police Department• Health Department• Emergency Medical

Services• Medical Examiner• Emergency Preparedness

Office• Press Secretary/Public

Affairs Office

• City/County Attorney• Public Works Department• Local Emergency Planning

Committees (LEPCs)• Local Emergency

Operations Centers (EOCs)• Local Hazmat Teams• Community Emergency

Response Teams (CERTs)

Summary• The disaster cycle is an open-ended process,

cycling back after an event or incident.

• Effective planning is critical for more positive outcomes after a disaster.

• Disasters always start with the local government.

• The first 72 hours after a disaster are the most critical and focus on stabilization.

Overview of the National Incident Management System (NIMS)

Disasters are highly complex and often share a common set of problems and challenges that can be addressed during planning.

Understanding how the system responds is an important first step for anyone who might assist in a disaster.

How Does NIMS Work?How Does NIMS Work? How Does NIMS Work?

INCIDENT

LOCAL RESPONSE

FEDERAL RESPONSE and SUPPORT

STATE RESPONSE and SUPPORT

The Incident Command System

What is Incident Command Structure?

•What it IS… Organizational core of a

crisis management system

•What it is NOT…A complete, ready-to-

go, “disaster plan”

Early planning for transition to consequence management

Universal link with outside resources

Management system designed to integrate

resources from numerousorganizations into a single

response structure using common terminology

and processes

Unified Command(Fire, Police, EMS, Public Works)

Operations Planning Logistics Finance/Administration

Unified Command

More than one responding agency within the incident jurisdiction (e.g. police & fire)

Incident crosses political jurisdictions (e.g. county or state lines)The multiple agencies work together to establish a common set of

objectives, strategies, and actions into a single incident action plan

Area Command

Responsibilities of Area Command

Area Command

SETS OVERALL STRATEGYAND PRIORITIES

ENSURES ALL OBJECTIVESARE MET

ALLOCATES CRITICALRESOURCES

ENSURES STRATEGIES AREFOLLOWED

Established to oversee the management of multiple incidents

These incidents are generally geographically dispersed or may evolve over time (pandemic influenza)

Training RecommendationsIncident Command • Required for effective command, control, communication,

and coordination• Used by emergency management organizations • Introductory ICS courses:

IS-100.b – (ICS 100) Introduction to Incident Command System

http://training.fema.gov/emiweb/is/is100b.aspIS-700.a – National Incident Management System

(NIMS), An Introduction

http://training.fema.gov/emiweb/is/is700a.asp

Summary

• NIMS integrates emergency preparedness and response into a comprehensive framework for incident management

• It includes a unified approach to managing complex incidents often involving multiple response agencies and jurisdictions, incorporating standard command and management structures

National Response Framework (NRF)

The NRF is built on the following five principles:

1. Engaged partnerships2. Tiered response 3. Scalable, flexible and adaptable operational capabilities 4. Unity of effort through unified command5. Readiness to act

http://www.fema.gov/emergency/nrf/index.htm#

Response Partner Guides• Designed to provide a ready reference of key

roles and actions for local, tribal, State, Federal, and private-sector response partners.

• Local Government Partner Guide▫ http://www.fema.gov/pdf/emergency/nrf/PartnerGuideLocal.pdf

• Private-sector Partner Guide▫ http://www.fema.gov/pdf/emergency/nrf/

PartnerGuidePrivateSector.pdf

Florida Emergency Management• The State Emergency Operations Center is

activated when a disaster or potential disaster is first detected.

• Florida’s response is then initiated through the State Emergency Response Team (SERT)

• The SERT is comprised of Governor-appointed Emergency Coordination Officers.

• Florida Emergency Management websites by county: http://www.floridadisaster.org/fl_county_em.asp

Emergency Support Functions (ESFs)

FEMA designated 15 FSAs within the National Response Framework. There is some variation at the state level

with the naming & inclusion of additional ESFs. For example,

the Federal ESF 11: Agricultural and Natural

Resources is divided into ESF 11: Food and Water and ESF 17: Animal and Agricultural Issues within Florida’s FSA

structure.

The ESFs consolidate multiple agencies that perform similar or like functions into a single,

cohesive unit.

Role of Florida Division of Emergency Management

•Manages overall response and recovery efforts by integrating resources statewide.

•State’s liaison with federal and local agencies on emergencies of all kinds.

•Conducts damage assessment surveys and advises Governor.

•Maintains Emergency Operations Center

State Emergency ManagementState emergency legislation

allows the governor to declare a

“State of Emergency”

State emergency managers then step in

and assist in the coordination and

activation of resources for recovery efforts.

Regional & County Emergency Managers of Florida

Summary

• The federal government establishes the framework that is followed by states, regions and communities.

• A successful response requires the interaction of personnel and resources from multiple agencies.

• The funding tends to be from the top down, whereas the response tends to be from the bottom up.

What Is a Traumatic Incident?

• Horror• Helplessness• Serious injury or• Threat of serious injury

Five psychological needs disrupted by trauma

SAFETY

CONTROL

INTIMACYESTEEM

TRUST

Psychological first aid (PFA)

is a concept created to help sustain safe surroundings,

calm, connection to others, empowerment and hope in the immediate aftermath of a

disaster.

The Psychosocial Impact of Disasters

Disasters can cause serious disruption of the functioning of a

community.

Consider and plan for the conditions of the community, families, and special needs

populations.

Pre-disaster Phase

Warning Phase

• Impending disaster information is communicated.

Impact Phase•The larger the scope,

destruction, and personal losses, the greater the effects.

Rescue or Heroic Phase• Community and individual mobilization• Emergency personnel help victims• Evacuation and relocation• Family reunification• State of shock

Honeymoon Phase•Acceptance of

mental health personnelInventory Phase

•Required assistance vs. available assistance

Disillusionment Phase•Responders pull out•Physical and emotional responses may worsen; anger and blame may ensue.

Recovery Phase

•People and communities return to a “new normal,” however long-term health issues may begin to emerge.

It is important for health care professionals to understand the potential causes of stress and to recognize the signs of psychological trauma when assisting victims of a disaster.

Cognitive Symptoms• Inability to concentrate• Inability to process new information•Difficulty solving problems•Poor memory•Preoccupation with the disaster•Confusion• Inability to understand consequences

Emotional Symptoms•Fear•Anxiety•Depression•Feeling overwhelmed•Numbness•Helplessness•Guilt• Irritability•Anger•Grief•Mood swings

Behavioral Symptoms• Impulsiveness•Risk-taking•Excessive eating•Alcohol/drug use•Compensatory sexuality•Compensatory buying•Withdrawal•Family discord, divorce•Hypervigilance•Career burnout

Physical Symptoms• Excessive heart rate (tachycardia)• Slow heart rate (bradycardia)• Headaches• Hyperventilation• Muscle aches, spasms• Sleep changes• Appetite changes• Psychogenic sweating• Fatigue/exhaustion• Gastrointestinal (indigestion, nausea,

vomiting)

Spiritual Symptoms

•Anger at God•Crisis of faith•Withdrawal from faith-based community•Cessation of practice of faith•Religious hallucinations or delusions

Normal Reactions to Stressful Incidents

There are a wide range of responses, but most victims in disasters respond normally to

an abnormal situation.

Disaster Stress Response

•Age-specific •May evolve over a period of time•Need to gain a sense of control

Exercise Achieving PreparednessPreparedness is a multi- tiered approach

involving individual/family preparedness as well as organizational/business preparedness, among others.

Questions for your consideration:If faced with a disaster situation…• How prepared are you as an individual? • How prepared is your organization and/or business?

Module 3: Vulnerable and Hard-to-Reach Populations

Module 3 Objectives•Describe at least 4 vulnerable and hard to

reach populations who may be at risk during an emergency.

• Identify specific vulnerabilities for each of the populations as well as basic responses to assist each of them.

•Describe approaches and/or resources used by each level of government to assist vulnerable populations in an emergency.

Special NeedsNational Response Framework

• The 2010 NRF definition of special needs is, “populations whose members may have additional needs before, during, and after an incident in functional areas, including but not limited to :

• Maintaining independence,

• Communication,• Transportation,• Supervision, and• Medical Care.”

Non-English Speaking ResidentsVulnerabilities Basic Responses

• Difficulty communicating• Difficulty understanding

directions• Difficulty communicating

needs• Inability to understand

critical information related to the disaster

• Lack of information in appropriate languages

• Accurate translation of teaching materials

• Accurate verbal communication

• Multilingual translators at key locations before/after disaster

• Public information broadcasted in multiple languages*Critical to recognize different cultural norms.

Rural PopulationsFlorida Rural Counties

BAKER - BRADFORD - CALHOUN

COLUMBIA - DESOTO - DIXIE FRANKLIN – GADSDEN - GILCHRIST

GLADES - GULF - HAMILTON HARDEE - HENDRY - HIGHLANDS HOLMES - JACKSON - JEFFERSON

LAFAYETTE - LEVY - LIBERTY MADISON – MONROE - NASSAU

OKEECHOBEE – PUTNAM – SUMTER SUWANNEE - TAYLOR - UNION

WAKULLA - WALTON - WASHINGTON

Rural Populations

• Housing stress• Reduced supplies• Insufficient resources• Limited information

and technology• Poverty • Lack of education• Transportation issues

Basic Responses for Rural Populations• Identify how to notify residents of an

anticipated all-hazards incident•Provide preparedness and response

information (radio, TV, door-to-door effort)• Inform residents of available services•Provide easily accessible transportation

with identification of safe evacuation routes

•Design an action plan to reduce barriers

Older Adults…

• Individuals over 65 years of age•Florida has largest proportion of people

over 65 years of age•More than 1.5 million are over the age of

75•Of Florida’s “over 65 population,” over

19% have 2 or more disabilities, almost 19% are home-bound, and more nearly 15% have Alzheimer's disease.

Older Adults Vulnerabilities Basic Responses

• Living alone (<5% in long-term care)

• Uncertain where to get information

• Living with a disability• Dependence on

medications or assistive devices

• Limited or no health insurance

• Identify where the older adults reside in the community

• Encourage older adults with disabilities to register with the emergency response database

• Establish a community alert process, accessible transportation, and evacuation teams

Older Adults: Basic Responses• Identify persons who will check on older

neighbors before/after crisis• Provide detailed resource information to

assisted living facilities, retirement communities, doctor’s offices, and clinics

• Encourage older population to have adequate prescription medication on-hand▫Medications that require refrigeration▫Updated list of medications (and/or copies of

prescriptions)▫Go-pack

Children

……are not small adults!

Children and Disasters

•Create separate kit for each child•Keep copy of immunizations in kit•Communicate with child in easy to

understand terms •Limit exposure to media•Reassure child that family is strong and

that people are here to help

Persons with DisabilitiesThe American with Disabilities Act

(ADA) defines an individual with a disability as “a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record or such an impairment, or a person who is perceived by others as having such an impairment.”

Why are Individuals with Disabilities Vulnerable?

Five main sub-populations

• Cognitive Impairments• Mental Illness

(including Substance Abuse)

• Developmental Delays• Physical Disabilities• Sensory Impairments

Vulnerabilities• May require a

caregiver and/or other designated person to assist, provide oversight, & make decisions

• May not be able to advocate for themselves (e.g., to make or follow an emergency plan)

• May have special transportation needs

• May have special medical needs

Basic Responses: Persons with Disabilities• Identify a caregiver for optimal functioning

and outcomes•Coordinate appropriate transportation and

accommodation• Identify special needs shelters that have

proper supervision and resources•Work with healthcare providers to create an emergency plan

Homeless

Source: www.post-gazette.com/images3/20050821dsrichjones0817_450.jpg

Homeless

• Lack of permanent, safe shelter

• Individuals often distrust the government & authority figures, which may impede outreach efforts.

• Preference to remain living on streets

• Hidden in plain sight

Vulnerabilities Specific to the Homeless•Lack of permanent shelter, which makes it

difficult to:•Provide information about all-hazards

preparedness and response•Find the individuals and bring them to safe

shelter• Identify any communicating barriers•Determine special needs relating to any

disabilities

Migrant and Seasonal Farm Workers (MSFW)

Migrant and Seasonal Farm Workers

• Housing is often substandard • Overcrowding • Poverty, frequent mobility, low

literacy, language, cultural and logistic barriers

• Communication • Lack of trust • Live in rural communities

Basic Responses: MSFWs

• Identification• Create a database documenting farm

workers and their place of residence• Collaborate with county officials to establish

local emergency response teams•Translation

• Use interpreters to help with providing information

Seasonal Residents and Tourists

Source: www.evergladesgateway.com/miccosukeetribe/

Seasonal Residents and Tourists

• Arrivals and departures • Mobile homes• Older adults• No permanent phone• No family assistance • Non-English speaking• Move frequently• Lack of knowledge about local

health care facilities• Lack experience with Florida’s

natural disaster

Basic Reponses for Seasonal Residents/Tourists•Establish incoming visitor database for

persons arriving by plan• Include length of stay and location of

residence•Provide all-hazards preparedness

brochures that include resource numbers and websites for assistance.

•Availability of information at sites frequented by tourists

Summary

• Individuals with special needs or those that are hard-to-reach often have unique requirements that call for more detailed planning in the event of a disaster

• The number of vulnerable and hard-to-reach populations in Florida creates unique challenges in preparing for and responding to all-hazards disasters

• Provides a start for some basic responses

Local, State, and Federal Approaches

Summary

• Importance of the local government as a first responder

• At the top of the pyramid is the federal government, which can provide resources to augment state and local efforts.

Module 4: Family, Workplace and Community Emergency Plans

Objectives for Module 4

•Describe home, workplace, and community pre-and post-emergency plans and be able to explain the importance of the plans.

•Describe ways to plan for, be safe during, and recover from a variety of disasters.

Preparedness• Disasters strike quickly and without warning

• It is important to be prepared with plans in place beforehand

• Make one universal plan that can be implemented for any type of disaster

NO need to make separate plans for all the different possible types of disasters

STEP 1: Be Informed about What Might Happen

Does your neighborhood have an emergency coordinator or leader?

STEP 2: Make a Plan for What You Will Do in an Emergency

Depending on your circumstances and the nature of the disaster, the first important decision is whether to shelter-in-place or evacuate.

STEP 3: Have Emergency Supplies

• NOAA weather radio • Medications• Plastic bags• Important documents• Extra glasses• Cash• Flashlights• Rope• First Aid Kit• Waterproof matches

Personal Preparedness Plan and Kit

Criteria

Mobility Durability Longevity Adaptability

Focus

Multipurpose uses Easy to use for you

and others Self-reliance

RecommendationsYou need 7 days worth of supplies, at the minimum!

•1 gallon of water per person, per day•OTC medications for fever, pain, allergies•Pet supplies•Essential medications and prescriptions

http://www.ready.gov/america/about/_flash/movie15.html

Preparedness Kit

•Clothing▫Layer clothing appropriate to climate i.e. cold

weather gear may not be appropriate for Florida

▫What kind of clothing is needed in this climate? Rain gear, moisture wicking, heat dissipating

•Bail Out Bag (BOB)▫Single piece of equipment ▫Large enough to carry majority of equipment▫Single strap vs dual straps e.g. messenger bag

or backpack?▫More than one bag? When?

Emergency Supplies• Mess kit• Extra batteries• Multi-tool• Plastic sheeting• Duct tape• Compass - Lensatic• Signal flare or flare gun• Waterproofing • Basic First Aid kit• Wind up radio• Watch• Pen, pencil, chalk• Food (MRE, energy

bars)

• Soap• Personal Hygiene items• Plastic bucket with tight lid• Disinfectant• Sturdy shoes• Blankets/sleeping bags• Work gloves• Water filtration and

storage• Large cutting tool• Sunglasses• Sun screen• Bandana

Important Items & Documents•Store money, deeds, titles, passports,

financial info, birth certificates, insurance policies and other important documents in re-sealable bags and take them with you.

•These are important to reestablish your life post-incident.

•Have some sort of ID on your person for easy identification by authorities.

Cell phones and other electronics• Yes, bring your phone and charger▫ But don’t rely on it; cell towers may be busy or destroyed▫ Calling cards

• GPS?▫ Use maps and road signs instead

• iPods, Xboxes, PS3s, DVDs▫ Take photos of them for records and insurance▫ LEAVE THEM AT HOME▫ Bring a book for entertainment

• KISS – Keep It Simple, Stupid!

How Do You Decide to Stay or Evacuate?

You might want to evacuate just for the peace of mind in being safe.

Follow local authority advice.

Elderly couple, La. Hurricane Katrina

Evacuation Plan• Err on the side of caution▫ Evacuate early and calmly; DON’T PANIC

• If you are separated from your family▫ Pre-determine a highly visible and safe landmark or

location along evacuation route to meet▫ Meet somewhere outside of major cities; city area may

be crowded and chaotic This may change based on evacuation procedures and aid

stations

• Traditional methods of travel▫ May not be viable i.e. roads are destroyed, cars not

accessible▫ Don’t get “jammed up” in traffic jams ▫Be prepared to walk!

Evacuation PlanCOMMUNICATE and PRACTICE your plan with your family

Pay attention to public announcements on the radio and television

Cooperation between family members, neighbors and community members can solidify preparedness

Family Readiness

• Talk to your children's schools and to your employer about emergency plans.

• Stay together. • Choose several destinations in

different directions so you have options.

Children• Accurate strategies to

identify children need to be implemented. Some are:▫ Talk to your children's schools,

daycare, and your employer about emergency plans and how they will communicate with families during an emergency.

▫ Inquire about disaster plans in these facilities and who will be responsible for the security of the children through the duration of the incident until reunited with family.

▫ Inquire about a preplanned arrangement with local EMS and recovery teams.

Preparedness and Children•Reassure children that “everything will be okay.”• Include favorite toys, books or activities to keep

children occupied.•Communicate with schools about preparedness

and contacting families during an emergency.•Make sure children know emergency procedures

(dialing 911, evacuation routes, meeting locations).

• Include children in the preparedness process.

Pet Preparedness•http://gopetfriendly.com/ for pet

friendly venues (hotels, parks, campgrounds)

•Food (wet), water, medications, bedding•Pet carrier, leash, muzzle and

immunization records•Make sure pet ID tags are up to date and

include your phone number and address▫ ID is your pet’s ticket home!▫Picture of your pet for easy identification

•FDOH recommends contacting local animal shelter for advice

Links for consideration• Survivalist Boards▫ www.survivalistboards.com/

• County Comm▫ www.countycomm.com

• Simpler Life▫ www.simplerlife.com

• GoRuck▫ www.goruck.com

• Zombie Squad▫ www.zombiehunters.org/forum/

• Pack Light, Go Fast▫ www.packlite.tumblr.com/

• Amazon.com, local stores (Target, Walmart, etc), sporting goods stores

Is your workplace required to operate during an emergency?

Hospital ER in the wake of Katrina

Disaster Planning at Work

Preparedness at Work•Communication is key! ▫Newsletter, e-mail, meetings on

preparedness and evacuation plans•Calling tree and voicemail recordings help

communication efforts•Out-of-town number to report in or get info• Involve all employees, from management

to maintenance, in preparedness. All can be essential to the effort.

Do you have a plan?

Determine a post-incident assessment plan and mode of communication.

How will you communicate with employees?

Louisiana High School, Hurricane Rita

Do you have a webpage and email on a server outside of the state?

Storage for Business Records

Have you made arrangements to backup files?

Workers with Disabilities

•Ensure they are included in preparedness plans.

•Enlist the help of others to help disabled coworkers. Potentially may have to lift, carry or assist those who are disabled.

•Develop a plan to assist those that are deaf or blind.

Recovery Hazards: More people are injured or killed during recovery and the clean up phase than the actual disaster.• Take precautions for

extreme heat• Electrical circuits and

electrical equipment • Power lines• Chainsaw and ladder

injuries

Lessons Learned

• Public is not prepared• May be worse than expected• Response is NOT right around the corner• Concerns over family affect responders • Communications and logistics • Impact affects healthcare, infrastructure,

and economics

FEMA Training

• IS-100.b – Introduction to Incident Command System (ICS)▫http://training.fema.gov/emiweb/is/

is100b.asp

• IS-700 – Introduction to National Incident Management System (NIMS)▫http://training.fema.gov/EMIWeb/is/

is700a.asp

is a continuing exercise for every citizen.

Disaster Preparedness