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Disaster Preparedness and Response in Israel

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Presentation on theme: "Disaster Preparedness and Response in Israel"— Presentation transcript:

1 Disaster Preparedness and Response in Israel
Six weeks of learning about the infrastructure, policy, and culture of preparedness in Israel Heidi Moline June/July 2009 Emory Preparedness and Emergency Response Research Center Visiting student with the the Ben Gurion University PReparED Center (research of Preparedness and Response to Emergencies and Disasters).

2 Field Experience Timetable
Week Work/Activities Location 1 Turning Point 3 National Drill Tel Aviv, Haifa, Ramla, Kiryat-Gat 2 ICS writing, Hospital Preparedness presentation Beer-Sheva, Tel Aviv 3 ICS writing, WHO training exercise Beer-Sheva, Netanya 4 Resilience writing, Visit to a community clinic Beer-Sheva, Dimona 5 Resilience writing, Resilience meeting Beer-Sheva, Jerusalem 6 Wrapping up, Hospital Radiologic Drill Beer-Sheva

3 Israel's National Emergency Exercise
Week 1 Turning Point 3 Israel's National Emergency Exercise

4 Turning Point 3 – NEMA Exercise
June 1-4, 2009 Emergency management Representatives from 30 countries Witnessed parts of the national drill for various emergencies, including: missile attacks collapsed buildings a terrorist with a car bomb The National Emergency Management Association (NEMA) sponsored Turning Point 3 exercise was an excellent opportunity to ‘jump into’ the world of emergency preparedness and response in Israel. With representatives from over 30 countries in attendance, it was an absolute privilege to be able to participate in the exercise. Most of the attendees were military representatives from their respective countries, with most working under their national disaster management agency. The first day of the drill included a preview of the week and a brief visit to the Magen David Adom headquarters in Tel Aviv. We were able to see the operations room, on the Ministry of Defense campus.

5 Turing Point 3 – Day 2 Missile siren @ 11:00
Elharizi Elementary School, Tel Aviv School drill procedures, 3 minutes to get all children in to shelters Scenario had the missile striking the building, Police, Fire, and MDA were on site The second day they took us to a school in Tel Aviv, where we were able to watch the school response to a missile siren. They had Police, Fire, and MDA on scene to show us their incident response for the second part of the drill. The siren was played throughout the country and depending on the distance from the hypothetical threat, residents had anywhere from 15 seconds, to 3 minutes to get into shelters. Where we were at the kids had 3 minutes to get from the classrooms to the shelters, which were concrete, underground shelters centrally located on the school campus. They conducted a first ‘wave’ where those who were able went into the shelters, and those who couldn’t make it in time found a safe room inside the school. Following the siren, approximately 5 minutes later, the students from inside the school made their way to the underground shelters. The second part of the scenario included a missile striking the building and trapping children inside on a top floor. The firefighters on scene leaned a ladder against the building and brought the teacher down. This was quite impressive, and I couldn’t imagine that happening in the US for a drill, if for no other than the insurance risk. Fire and MDA teams brought out children from inside and set up a triage outside in the school’s designated area. It was a wonderful opportunity to see how Police, Fire and MDA work together during emergencies, although I wasn’t able to tell who the incident commander was…I knew it was supposed to be the Police but I wouldn’t have been able to tell from just watching.

6 Turning Point 3 – Day 2 These kids were awesome! Just the best actors! They also gave some kids roles as leaders. These pre-identified leaders are in a class that teaches them how to respond in emergency situations and shows them how to become peer leaders in the event of an emergency.

7 Turning Point 3 – Day 2 Home Front Command headquarters in Ramla
Toured the: Emergency Operations Center Call Center Media Room Medical Coordination Later in the day they took us to the Home Front Command headquarters in Ramla, where we were able to see way in which the army responds to events. They gave us a tour of the Emergency Operations Center, Call Center, Media Room, and the Medical Coordination Center. It was a great opportunity to see how they develop messages to deliver to the public and communicate events during wartime. It was also quite impressive how the medical coordination team can see the number of beds each hospital has available, the routes of the ambulances, and just everything necessary to coordinate the response.

8 Turning Point 3 – Day 3 Resilience exercise in Haifa
Showed us the use of community resilience centers during events Individuals are provided coping and resilience activities and live there until they were able to return to their homes Haifa was a city that was under attack during the 2nd Lebanon War in During the war, they realized there was a need for resilience centers for citizens and they have developed a leading resilience center. Located in what normally acts as a high school, the resilience center is a central area where residents can come to while under attack and there will receive needed psychological care and other interventions that will help in promoting individual coping and resilience to the events.

9 Turning Point 3 – Day 3 Volunteers would come to the facility in the event the resilience center is opened. Most have some training in psychology and have worked with distressed individuals. The families would live at the center until they return to their home. Children are taught relaxation techniques and given light tasks around the center.

10 Turning Point 3 – Day 3 Destruction site rescue, near Beer-Sheva
The second half of the day we went to a destruction site in Kiryat-Gat. There the Army had planted dummies inside a building and demolished the structure. The exercise had them finding and rescuing the dummies trapped in the rubble. One really interesting aspect of the scene was that they were playing recorded sounds of sirens and machinery to give the exercise a life-like feel. Two guys with FEMA who were helped with the World Trade Center said that the sounds were enough to give them goose bumps and that the only thing it was missing was the smell. Pretty impressive if a drill can be that real! After talking to several German engineers who specialized in search and rescue research they brought up a great point: we weren’t able to really see the longitudinal aspects of the event. For instance, seeing what the rescue is like 2 days later, when removal get’s more tricky and what they do with the displaced rubble. I suppose that’s something that is difficult to present, but it is an interesting observation.

11 Turning Point 3 – Day 3

12 Turning Point 3 – Day 4 Building evacuation, 6,000 people in downtown Tel Aviv Scenario: a terrorist drives into downtown suspected of carrying a car bomb Police, fire and MDA work together for this event. The last event of the week was an evacuation of 8 buildings (6,000 people) in downtown Tel Aviv. They first blocked off the road and had a ‘fake’ terrorist drive a car into the area – they suspected he had a bomb in the car. The police then called for the evacuation of these buildings. As with the school event, the scenario had several people trapped in the upper floors of the building, and so the fire teams sent a bucket truck up to rescue the people. Everything happened much slower than I would have anticipated – probably from what I’m used to seeing in movies – especially the evacuation of the building. They later said it was a great evacuation, but as a spectator expecting people to come pouring out of the building, it seemed a little anti-climactic. Which I think actually shows how calm all the people were and how exaggerated my expectations were! I think this was the best chance we had to see the relationship between police, fire, and EMS services (more so than the school). All of the agencies had a specific role and seemed to be geographically distanced from each other. Again, I would not have known that the police were in command… except for the guns and security.

13 Turning Point 3 – Day 4

14 Hospital Preparedness Presentation
Week 2 Hospital Preparedness Presentation

15 Hospital Visit, Tel Aviv
Ministry of Health presentation on hospital preparedness Chief of ED talked about what really happens at the hospital when they get casualties from an MCE Hazard suits available to staff near ambulance by – with picture directions of how to put suits on! I think the best part about seeing the hospital preparedness procedures was being able to actually SEE all the things that set Israeli preparedness apart from most other countries and what I had read about before arriving in Israel: the decontamination showers, being able to move all patients underground in a matter of hours, and the efficiency in triage during emergency events. I attended a presentation by the Ministry of Health which provided an excellent supplement to the Turning Point drill and the very military-based aspects of preparedness I had been exposed to there. Learning about the logistical aspects of hospital preparedness (ie: the number of beds they have to be able to have ready in 5 minutes for an MCE, having backup generators and water supply, and who takes control of the the situation in the ED. These are things that I found just fascinating, and I wish I could attend a similar presentation at the main hospital in Atlanta to really see how they compare.

16 Hospital Preparedness

17 Incident Command Systems: Comparing Israel and Atlanta
Weeks 2 & 3 Incident Command Systems: Comparing Israel and Atlanta

18 Comparing Incident Command Systems
Comparing the incident command response to similar a similar blast in Atlanta and Israel, specifically: Who takes command Communication between agencies Speed of recovery Population characteristics Atlanta metro area was chosen because of similar population size to Israel

19 Comparing Incident Command Systems
Findings: Responses are similar Geographic scope and population differences affect the application of Israeli methods in the US Practice, practice, practice… with practice comes efficiency

20 Examining aspects of Community Resilience
Weeks 4 & 5 Examining aspects of Community Resilience

21 Resilience Work (cont)
Definition Psychological aspect Role in disaster preparedness Personal vs Community How can it be measured? Israel actively tries to improve resilience: Public education Resilience centers Would this work in the US?

22 Resilience Work (cont)
The more I worked on resilience, the more confused I became – meeting with the clinical psychologist really did shake what I had come to believe about resilience I’m starting to think there is just one general type of community resilience (based largely on social capital), and then event-specific preparedness (which after-the-fact would give the appearance of event-specific resilience)

23 Hospital Radiologic Exercise
Week 6 Hospital Radiologic Exercise

24 Hospital Radiologic Exercise
A Ministry of Health evaluation of Radiological Event procedures at Soroka Medical Center First of this type of drill at the BGU teaching Hospital 3 hour event Began preparing 5 months before I think ending my time here with a drill was the perfect end to my time here! It really makes things feel as thought my experience has come full circle. Upon walking up to the ambulance bay I could immediately sense who was in charge: a very serious woman (whom I later learned was the ED head nurse) with a blow horn who did not appreciate unwelcome onlookers getting in the way. Once I had a ‘Visitor’ pin I was OK, but it was definitely a reminder that as much fun as I’m having watching these drills, this is an evaluation exercise for an incredibly serious event. Here I was able to witness the decontamination showers in action! They used a hose to spray off the people who weren’t able to walk on their own, and sent those who could walk around the corner to be showered. It was really excellent to see the staff using the radioisotope detectors. I was also fascinated by the triage – those severely injured were sent directly inside without decontamination, where they were taken to a separate section of the ED. It was really cool to see that a little ambulance speed bump act as the decontamination line.

25 Hospital Radiologic Drill

26 Summary of Experience Beginning my stay here with the Turning Point exercise was a perfect introduction to disaster response in Israel It also allowed me to see the role of the military during disasters – I don’t think I really understood how intertwined and essential it is in disasters It provided a context for my research – the size of the country and type of infrastructure cannot be overlooked when comparing the US to Israel

27 Summary of Experience My experience was greatly enhanced by being apart of a close student community where we had very honest discussions about: What it’s like to live in Israel How the war affected their lives The role of religion and regional history Cultural norms

28 Summary of Experience I find the level of national pride to be just amazing. Seeing Israeli flags flying off balconies is a reminder of how connected the population is to the country. I was later told that the flags were just left there from old Independence days because people were lazy, but either way, it’s cool to see I felt like I was able to get a feel of the culture

29 Summary of Experience I did not expect the structure of the government and healthcare systems to be such a hindrance in adapting preparedness measures for the US The government role in hospital operations The role of the military in response I underestimated the importance of the size difference between the countries I’m beginning to think that the our geographic size and population, US preparedness and response isn’t too bad

30 Summary of Experience I wish I had attended a FEMA drill or hospital drill in the US before I came – I think this way I would have a better understanding of how to compare what I saw I wish I would have had a more specific and defined research goal and deliverable before I arrived I really can’t imagine having the opportunity to do everything I did in Israel in the US – just a truly amazing experience!

31 The End.


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