Archive for March, 2010

Is the U.S. ready for a public/private aeromedical evacuation model?

Monday, March 29th, 2010

Author: Shelby Rushing, Emergency Management Planner, IEM

Since August 2008, when deployed to New Orleans to assist with the evacuation of transportation-dependent citizens during Hurricane Gustav, I have been involved in evacuation planning in one capacity or another. At the recent National Evacuation Conference in New Orleans, several IEM colleagues and I delivered presentations on our experiences with the planning and execution of evacuations by air and rail.

Also on the agenda was Annika Wallengren of the Swedish Transport Agency who discussed that country’s successful private/public aeromedical evacuation model – the Swedish National Air Medevac System.

The Swedish Transport Agency, in partnership with Scandinavian Airlines and the county council of Västerbotten, developed and operates this emergency aeromedical system, which uses a converted Boeing 737 jet to transport individuals to hospitals and other medical care locations. The commercial jet can be converted rather quickly – in approximately 6 hours – and can carry up to a dozen patients and an additional 20 “lightly” injured patients, relatives, or other passengers.

This service was first employed during the Mumbai terrorist attacks in December 2008 to evacuate injured Europeans from India to London. According to Annika, a similar system exists in Italy, but other countries have been slow to adopt this public/private aeromedical medical model.

Perhaps we should consider such collaboration in the U.S.

In this country, aeromedical missions are conducted by the Department of Defense using military cargo aircraft. The Swedish model appears to represent an alternative that deserves consideration, with DoD aircraft being reserved as a last resort contingency.

Signs of Rebuilding in Port-au-Prince, Haiti

Thursday, March 25th, 2010

Author: Chris Oxner, Market Analyst, IEM
Reports from the ground in Haiti

The mountains and hills of Port-au-Prince are surprising.  I didn’t expect to the find the city located in such beautiful environs.  And anytime I start thinking about the natural beauty of a place, I like to imagine what the first people to see it thought.  Like at the end of The Great Gatsby when Nick is thinking about Gatsby’s house and then he “gradually became aware of the old island here that flowered once for Dutch sailors’ eyes—a fresh, green breast of the new world.” Here, you might think of Columbus and his crews or later Spanish sailors.  But long before Europeans arrived there were people living on the island and beholding the splendors of hill, mountain, and ocean.  All over Port-au-Prince you’ll see the name Quisqueya – on schools and buildings and in the names of organizations.  It’s a very old word.  Older than the European explorers.  This is what the people already living here called the island before anyone else arrived.  People likely migrated across the sea to Quisqueya from the Yucatan and found it a paradise.  The word means “mother of all lands” or “mother of the earth.”

Haiti earthquake picture of damage in Port-au-Prince

Earthquake damage still visible in Port-au-Prince

Driving around Port-au-Prince today there is still a lot of destruction.  And some progress.  I saw a field of bricks baking in the sun.  New bricks being made for new construction.  Rubble has been moved into piles so that most streets are passable.  As far as I can tell there are no rules of the road for Haitians, so if the gap is wide enough between the car in front of you and the oncoming vehicle, you can just shoot the gap and hop in front of the car that was in front of you.  The presidential palace is a sad sight.  I could imagine how splendid and dignified it had looked before the earthquake; now it’s a complete wreck.  There are incredible sights of buildings leaning over to their seeming limit.  People everywhere selling goods on the streets – people lining every street.  I wondered where they get the goods in the first place, and I learned that for many of them – the women – these are microfinancing programs.  They go down to the port to buy wholesale some merchandise (shoes, soap, etc.) and then sell it on the streets for a meager profit.  This is their $1-a-day or $2-a-day income.  And sitting outside on the busy, noisy, hot streetside, coming early in the morning to set up and leaving at dusk with their goods bundled on their heads.

Supermarket fruit at Haitian market

Supermarket fruit at Haitian market

At the supermarket in Pétion-Ville—the tiniest neighborhood in Port-au-Prince—the food was outrageously priced.  All across Port-au-Prince, food prices have skyrocketed since the earthquake.  The food at the grocery store is twice as much as the same food (brands) at a U.S. store.  Only the top echelon can shop there.  The people on the streets eat food aid, if anything – or they eat cheap street food and inexpensive produce from the market.

And there are tent communities all around.  In fields, in parks, on sites where buildings were completely destroyed, up and down hills.  At the former campus of Quisqueya University,

Tent communities in Port-au-Prince

Tent communities in Port-au-Prince

there are 6,000 people sheltering and receiving medical care.  At the new campus location, on the site of a former president’s residence—the new location was just launched and it was the day of opening ceremonies that the earthquake struck—there are tents set up for students and teleconferencing equipment provided by an NGO for class instruction.

Haitians are working hard at rebuilding their homes, their businesses, their neighborhoods, and their country.  While the government is absent, the people of Haiti are taking action for themselves and for their neighbors.  There is graffiti all around.  And a word you’ll see often is Solidarité.

Home Grown! Haitian coffee. Haitian porridge. Haitian orange juice!

Wednesday, March 24th, 2010

Author: Chris Oxner, Market Analyst, IEM
Reports from the ground in Haiti

Haitian Orange Juice

Haitian Orange Juice

I haven’t yet mentioned the coffee in Haiti – it is fantastic. Locally grown. Haiti is the rare coffee-exporting country that has a local market for coffee. In fact, the Haitian farmers believe they are getting the better of the exporters, because they will export the larger beans, and keep the small beans to sell in the local market. But the smaller beans have much richer flavors. So, the orange juice and the coffee are great in the mornings. And Pascale made a huge pot of porridge, and I thought, I’m going for cereal. She saw me grab the box of cereal and hold it over my bowl and she was giving me a look and pointed at the porridge and said “tu ne l’aimes pas?” And I hesitated, not really wanting to eat it, but I dropped a few ladle-fulls in my bowl and sprinkled a little raw sugar, thinking, this should help it go down. But it was awesome. Haitian coffee. Haitian porridge. Haitian orange juice. Even Haitian raw sugar. Local, organic. No fossil fuels burned transporting these goods across an ocean.

Arrival in Haiti; Start of a Recovery Mission

Tuesday, March 23rd, 2010

Author: Chris Oxner, Market Analyst, IEM
Reports from the ground in Haiti

When I got off the airplane in Port-au-Prince, there was a band playing what sounded like New Orleans French Quarter music. That tells you something right there. And it is hot, even by Louisiana standards. I’ll tell you what was hotter – standing in a madhouse group of people trying to collect my checked bag. They just dump it on the floor and you have to scramble for it while fighting through all the other people. The streetside scene near the airport alternated between heavily fortified compounds (UN, US Embassy) and rubble.  Street vendors are everywhere, even selling in what seemed remote stretches of road.  The road itself was mostly gravel, deep ruts and large sections eroded.  I can imagine that come the rains in the next few weeks it will be mud and even more of the roads will be washed away.

Haiti street vendors

Haiti street vendors

The villa where we are staying is possibly the only property in the neighborhood without extensive damage from the earthquake. The outdoor pavilion does have some structural damage, so it has a yellow card (caution).  There are plans to fortify the damaged supports. There is a high wall around the compound, but from the upper rooftops there are fantastic views of Pétion-Ville, the mountains, more mountains, and many different communities.  The wind is blowing up here and hopefully we can tour downtown Port-au-Prince tomorrow.

Hospital Preparedness: A Critical Community Infrastructure

Thursday, March 11th, 2010

Author: Erin Downey MPH, ScD, Senior Health Systems Analyst, IEM

Hospitals are community symbols. Their ability to provide patient care is an indicator of a functioning society. During disasters their continued ability to provide patient care is essential, not only for disaster victims, but for their role in representing a resilient community that can withstand adversity.

Hospitals are also dependent upon critical infrastructures, e.g., power, water, information technology. The loss of their operational capacity during a disaster is devastating to a community and will call to question the confidence its members have in their jurisdictional leadership – at local, state or national levels. Many would argue that hospitals are critical community infrastructures in and of themselves.

The Hospital Preparedness Program (HPP), initiated by the Bush Administration and continued in the Obama Administration, is now in its eighth year of funding and represents an approximate $4 billion national investment. It is clear that strengthening hospitals’ resiliency is a priority, but given its competition with other national priorities, are preparedness levels improving fast enough? Will US hospitals be prepared not if, but when, our next disaster occurs?

We know that disaster frequency is increasing, both natural and manmade threats, nationally and internationally. Since HPP was started, the US has experienced over 475 federally declared disasters of over 20 disaster types.[1] Most recently, the Haitian and Chilean earthquakes reveal a painful truth: any community is at risk, at any time, for abrupt devastation. Hospitals as critical community infrastructures must be strengthened.

Mitigation investment strategies that ensure hospital operational status in post-disaster periods are essential. In addition to power, water, information technology, hospitals must be designed architecturally to withstand threats. Expenditures that consider hospital security during its formation represent approximately 4% of the construction costs—far less than those of rebuilding, or redesigning existing construction.[2]

Further, mitigation strategies must stem from quantitative, high quality research efforts that accurately reflect ground truths of disasters—not just US disasters, but global disasters. The World Association for Disaster Emergency Medicine promotes the standardization of disaster terminology and research design. The United Nations International Strategy for Disaster Reduction promotes research agendas in economically disadvantaged countries. In “Safe Hospitals” the Pan American Health Organization underscores that “Protecting critical health facilities, particularly hospitals, from the avoidable consequences of disasters, is not only essential to meeting the Millennium Development Goals, but also a social and political necessity.”

Given the devastation that is now seen in both Haiti and Chile, and given the ongoing impacts of disasters that are of higher probability and of lower catastrophic consequence (e.g., flash flooding and severe storms) ongoing research and mitigation strategies specific to hospitals must emphasize their role as a critical community infrastructure.

[1] Retrieved February 16, 2010 from

[2] Boroschek, Krauskopf R, Retamales Saavedra R. Guidelines for Vulnerability Reduction in the Design of New Health Facilities. Washington DC: Pan American Health Organization; 2004.

Become an Expert at Word: Tips from a Know-It-All

Monday, March 1st, 2010

Author: Jonathan Wiggins, Technical Writer, IEM

Before coming to IEM, I thought I was a master at Word. Up to that point, I had gotten everything I needed out of the program and didn’t think there was anything more I could learn. I was young and egotistical back then. Since coming to work here as an editor, however, I’ve learned many new things about the program—some out of necessity, some out of curiosity.

I am now older and impossibly more egotistical. My prowess with Word has astounded and amazed people at workshops across the country. After one workshop, a fire chief offered me a job on the spot. Were it not as his secretary, I might have been tempted. Although what I and other editors are capable of may look like magic to some, don’t be fooled. We’re simply making the most of the tools available to us. To that end, I was recently asked to include some Word tips in the newsletter.

Efficiency is often necessity for an editor. To be competitive in the marketplace, project budgets do not always allow enough time for thorough edits. As a result, we have to make do with the time we’re given. Keyboard shortcuts are one of the most effective weapons in our arsenal. Using keystrokes to accomplish something will generally always be faster than using your mouse to accomplish the same thing—especially while trying to learn Office 2007. For example, to save your document, hitting Ctrl + S takes less than a second; whereas moving your mouse to Office Button ® Save takes a bit more time. It’s not a huge savings, but it adds up.

The following keyboard shortcuts pertain to selecting text. Note: The shortcuts, as is the case with many keyboard shortcuts, are universal and can be used in other programs.

  • To select all text, press Ctrl + A.
  • To select one character at a time, press Shift + Left [ALR1]  or Shift + Right, as appropriate.
  • To select one whole word at a time, press Ctrl + Shift + Left or Ctrl + Shift +Right.
  • Press Shift + Home to select the text from your cursor’s current position to the beginning of the line. Press Shift + End to select the text from your cursor’s current position to the end of the line.
  • Press Ctrl + Shift + Home to select the text from your cursor’s current position to the beginning of the document. Press Ctrl + Shift + End +to select the text from your cursor’s current position to the end of the document.