Lessons learned from Katrina, 9/11, SARS, and other disasters
For the physicians in the audience, myself included, I apologize, but we're probably the least important - notwithstanding Ben's efforts on the top of a parking garage - because at the point of care in a critical situation, sometimes that's what you have to have. But without the infrastructure and command and control, and support mechanisms, you can't get to Ben, let alone evacuate the patient that he's taking care of. It becomes a non-sustainable mission.
So the point of command and control is that, yes, you do some things right in front of you in terms of delegate authority, but you're also looking ahead into the horizon, and your responsibility in command and control is to know the mission at least an echelon or so above you – what – in the case for us, it was what do the public health officials in Baton Rouge feel are the most important things for us to do and, as volunteers, where could we put our efforts after our initial boots-on-the-ground experience.
SHUTE: How would you improve that communication with the folks in Baton Rouge?
FRANZ: From the onset, I think always the most important thing is your first communication. We partnered. Our Minnesota lifeline effort was a coalition between the Mayo Clinic, the University of Minnesota, College of St. Katherine's, a Jewish relief organization called Nacama. And probably over all of that was the American Refugee Committee who had never done a domestic operation before. It's a non-governmental organization. And they had just come from tsunami relief and Darfur. They had the maturity to know, as they took a look at Katrina, that it was going to be more like an international, complex, humanitarian emergency than it was going to be a perhaps temporary relief operation. And as a result, the initial communication is most important, and by their rules of engagement, it's to go and find the most senior person in command, the most senior center of legitimacy, which was the senior public health official in Baton Rouge, and ask what can we do to help?
SHUTE: Dr. Low, what were the communications you saw when you were in the hospital, and how do you think those could be improved the next time around?
LOW: Well, the communications we had every day, we had a press conference that was held about 3:00, which included Toronto Public Health and representation from other public health units in the Greater Toronto Area. We had our chief medical officer of health, myself sort of representing the clinical side, and I think actually that worked pretty well. There was criticism about too many people, too many talking heads, and that it should have been one person that relayed the message and only one person, and that's what they did in Singapore. I would disagree with that. I think that people in Toronto were well informed. I think they felt a certain amount of reassurance that they were getting the facts. We didn't see people on the streets wearing masks. Tourism, of course, plummeted. But people who lived within the city really had, I think, a pretty good understanding of the disease and I think that's a direct effect of good communication, being available to the press, and just being accessible in sharing the information that you had at hand. And I felt that at the end of the day, I think that put us in good stead.
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