If New York City faces another catastrophe on the scale of September 11, city residents now are more prepared for the aftermath. The question is: Are our primary care health centers, churches, businesses and other community institutions charged with taking care of us?
On June 2, that question brought together a spirited group of 36 community leaders and professionals living, working in or representing Manhattan's Community District 5, which roughly encompasses the area south of Central Park between Lexington Avenue and 8th Ave from Columbus Circle to Union Square. During a six-hour meeting, the group drafted a plan--one of only five district-level plans that have been crafted in the city-- to enhance the area's emergency preparedness by coordinating the sharing of medicines, health professionals and other resources.
"There should be criteria to access the resources so no one can hoard [them]" a middle-aged woman told the group, which sat clustered around her in a nearly empty auditorium. "There should be criteria for how you access what you need and organizations should be held accountable for the resources that they use."
A man who sat nearby – David Fortino, the Region II program manager of Citizen Corps, a division of the Federal Emergency Management Agency (FEMA) that coordinates volunteer emergency response teams – raised an additional issue. "During certain circumstances, you might want to suspend the law requiring hospitals to stabilize all patients," he said. "In the case of an emergency, a hospital might not be able to see everybody." Some patients getting treated at hospitals during an emergency aren't critically ill and can be redirected to local clinics, he said.
The day's emergency preparedness efforts were being led by the Primary Care Development Corporation (PCDC), a non-profit that received $600,000 in funding from the City Council to facilitate the process of developing district-level plans citywide and train health centers to respond to emergencies.
"You've got health facilities all over the city, they have their own businesses. They have their own patients; people tend to be proprietary," says Daniel Lowenstein, PCDC's director of external affairs. "Unless there's some type of coordinated communication and planning prior to an emergency, there will be problems," says Jean Paul Roggiero, a PCDC program manager.
PCDC's emergency planning assistance covers all disasters – man-made and natural, including disease outbreaks. The organization is helping community institutions train volunteers and install telecommunications systems that can survive a catastrophe, such as the Government Emergency Telecommunications Service, a White House-directed emergency phone service that permits calls when normal phone lines are congested.
PCDC is also teaching primary care health centers new ways to dispense vaccines during a pandemic, to use phone trees to mobilize their off-duty health care professionals and to create systems that alert and update other centers to disasters.
"The sharing of information during an emergency is critical," says Roggiero. "During the landing [of Flight 1549] on the Hudson, facilities nearby weren't sure whether it was a bomb or a plane. But one facility that was near the plane sent a team to help. At the same time they were able to contact the primary care emergency preparedness network."
About one-third of the people invited to District 5's planning session did not attend. "Generally people are not thinking about emergency preparedness," said Lowenstein. "You've got sanitation issues. You've got the parks. Getting people to sit down with this is a challenge."
The District 5 group made progress at its meeting, developing a list of 10 initiatives to be carried out over the next year. They plan, among other things, to conduct training and drills at their respective institutions and to encourage their neighboring institutions to adopt and adapt the incident command system that the police and fire departments use in a disaster. That system defines the key roles and responsibilities of an emergency response team.
Zandra Myers, a Far Rockaway community organizer who started an emergency preparedness group in her neighborhood, ended the meeting by delivering a speech underscoring the importance of their efforts. "Emergency preparedness is top heavy," Myers said. "You have Homeland Security and FEMA, you have the Office of Emergency Management. And then you have the community, wondering 'Where do we go? What do we do?'"