In his remarks on June 21, 2011 to the National Press Club, former FEMA head Michael Brown stated that Americans should not expect FEMA to save them. The purpose of his speech was to inform Americans that they must prepare to be without government assistance immediately after disasters. He rightly stated that Americans should prepare to help their neighbors during the 96 hour lag of federal response.
In fact, given our current national capability to respond to national disasters, expectations should go beyond 96 hours. Most Americans have no clue that the planned initial federal response to emergencies is 96 hours. 96 hours is beyond the golden hours of emergency response, those 72 hours when many victims can potentially be saved. 96 hours after the levees broke in New Orleans, the city was under siege. By 96 hours, most Haitians had died under the rubble. After 96 hours, otherwise savable victims of Japan’s tsunami had perished.
While Mr. Brown was correct that FEMA is not the agency that will save Americans during the golden hours after an emergency hits, FEMA is however one of the group of agencies that make up the National Disaster Medical System, NDMS, that does respond to federal emergencies. Current NDMS planning calls for initial response at 96 hours, 24 hours after golden hours of response have expired and NDMS can no longer have a material impact on a community’s golden hour survival. Thus NDMS was designed with a fatal flaw.
NDMS was created in 1984 to respond to cold war mass evacuations, when our emergency medical response systems were just two decades old and at a time when our country expected less from our federal government. Since 1984, America’s emergency medical response capacity has grown significantly, technology has dramatically improved, and Americans’ awareness has accelerated. As a result, the 96 hour NDMS response time is simply no longer acceptable.
While Mr. Brown praised Director Fugate during his speech for “doing a fantastic job lowering America’s expectations “of what FEMA can do, his praise was misplaced. America should instead raise its expectations of what more FEMA can do to significantly improve FEMA’s role within NDMS, and What NDMS can do to significantly reduce its response time to support local agencies who are charged with saving lives during the golden hours.
After interviewing emergency managers of 2,500 hospitals, my company, EPI-Center, found that even America’s hospitals, institutions that are considered critical to our communities’ emergency medical response, are vulnerable to significant loss of life after 24 hours if left unassisted. That is why we built a commercial medical evacuation capability to evacuate an entire hospital in just 24 hours, called HELP (read about HELP at http://www.epi-center.us). The system was successfully tested in 2008 during Hurricanes Gustav and Ike and demonstrated that 96 hours is much too great a response impediment.
The concepts we operationalized can quickly and cost effectively be recreated within NDMS to build a national rapid response capability. Our country’s ambulance companies can double the effective capacity of NDMS and can be organized to much more effectively support local agencies during the golden hours of emergency response. NDMS can be reengineered to respond much more quickly to national disasters.
America has placed an immense responsibility for saving victims of national crises in the hands of agencies such as FEMA. Mr. Brown is correct that more will be done by individuals to help their neighbors in the coming American crises than should be expected from our federal government. Nonetheless, if NDMS will now commit to significantly reducing its 96 hour premise, its mitigation of this federal impediment will directly improve our states’ and local communities’ response capabilities, and will go far in underpinning America’s trust in FEMA.