Emergency Incident Management Systems. Louis N. Molino, Sr.
even the most basic of disasters often leads to increased death tolls and severe devastation. These issues have amplified human suffering during many major incidents, and the country of Haiti is quite often reliant upon other countries for assistance when a disaster occurs. Because Haiti often relies on integrating outside resources, it is extremely important to have an IMS method. When the country decided to enact an IMS method as a basis for incident management, it was decided that the method used should be a system that was familiar to the countries, especially those most likely to respond to their request for assistance. Unfortunately, it would take a major disaster to move toward the standard use of an IMS method.
In January 2010, a 7.1 earthquake struck Haiti. While in the initial stages of the disaster, there was no estimate of deaths and injuries, but the country knew they needed outside assistance. It would later be realized that more than 222 500 killed, and the earthquake displaced over 300 000 people (United States Geological Survey, 2011). Haiti did not have an IMS method in place when the earthquake struck, which created additional challenges for those countries and agencies that came to assist them in their time of need. In the initial stages of the response, chaos, confusion, and uncertainty appeared to be the common theme, and it was ongoing for many days, even after outside resources arrived. The international response to this disaster was swift, and large contingencies of rescue workers began to arrive from a multitude of other nations within 24 hours.
With Haiti being a member of the Caribbean Disaster Emergency Management Agency (CDEMA), the first outside help to arrive was from neighboring Caribbean countries. In 2010, some of these countries were using an adapted form of the ICS method, but not all of them were on the same page. According to Fordyce, Sadiq, and Chikoto (2012), the country of Haiti had a new and inexperienced emergency management agency in place at the time that the earthquake struck. The fledgling agency was so new that it completely relied on help from regional and international countries for everything, even if it was the slightest disaster. As help arrived for the 2010 earthquake, it was quickly realized that incident management of such a large‐scale disaster would be daunting (Fordyce et al. 2012).
As international help arrived, an IMS method (very similar to ICS) was used by most countries to help manage the incident. While it did not take long for CDEMA and other international response partners to initiate an IMS method (to help the people of Haiti), it was still a fractured response. This was partially because no IMS method was in place in Haiti. It should be noted that even though an IMS method was not nationally used, managing an incident of this magnitude would be difficult for even the most seasoned and adept user of an IMS method. While it was a monumental task, most resources were coordinated and managed to provide a more efficient and coordinated response and recovery. Those that responded and used an IMS method included member countries of the United Nations, and peacekeeping troops from the United Nations, and a multitude of international nonprofits. Additionally, numerous countries offered assistance from their military and other resources that they could loan. Thousands of nongovernmental agencies (beyond nonprofits) also jumped into the response and recovery and helped. Perhaps one of the most beneficial nongovernmental agencies was a multitude of ham radio operators, who facilitated better communications (Fordyce et al. 2012).
In the response mode, most of the resources were managed by the United Nations. Unfortunately, they were not the only organization coordinating efforts, and those managing portions of the response did not always integrate with the UN Command Center. This lack of unity in coordination added to the chaos, confusion, and uncertainty faced on the ground (Fordyce et al. 2012).
When the earthquake struck, it did not only damage private residences and businesses. The earthquake was so strong, and Haitian building codes were so weak, that many government buildings and hospitals were destroyed or damaged. According to an article in the Academic Emergency Journal (2010), every hospital in Haiti was damaged or destroyed. The first hospital to somewhat recover was marginally functional in two days, about the time that emergency medical relief was arriving from the United States. This original functioning hospital, and rapidly set up field hospitals, were quickly overwhelmed with the estimated 333 000 people who were seriously injured. As time went on, more hospitals and field hospitals were opened, but even then, there was great difficulty in meeting the needs of the Haitian people. In the initial stages of the response, there was no framework in place for managing this disaster, or the hospitals (Hausweld et al. 2010).
While the Government of Haiti had been working on disaster resilience, they were in the infant stages of creating response protocols when the earthquake struck. This massive earthquake killed over 50% of the government employees, which complicated the response and recovery even more. The United Nations also had a large presence in Haiti prior to the quake. They had been acting in a peacekeeping role, and they were coordinating humanitarian aid well before the earthquake. When the earthquake struck, they too were devastated, losing nearly half of their staff members, including the UN leadership that was on the ground in Haiti (Hausweld et al. 2010).
Almost immediately, the US government activated the National Disaster Medical System (NDMS). Teams who were specialized in providing for disaster medical needs were soon organized and dispatched to Haiti. An article on lessons learned by Grimm (n.d.) describes how the Baptist Child and Family Services medical team was sent to a hospital in Carrefour. This 50‐bed hospital was credited seeing 300–400 patients per day for a period of several weeks directly after the earthquake struck. Grimm (n.d.) describes that when they arrived at Carrefour, the hospital was brutally overwhelmed, and was not capable of caring for all the patients in a timely manner. The hospital had no method of IMS to manage the incident, so this Strike Team that was sent to shore up this hospital provided a quick training on Hospital Incident Command System (HICS). Within a short period of time, the hospital began to be more efficient in treating patients with a high standard of care. With integration of resources, and through coordination and cooperation that was facilitated by using an IMS method, it was not long before a tent city was set up outside of the hospital for postoperative care (Grimm, n.d.). There is little doubt that the use of Hospital Incident Command System (HICS) was taught and utilized in many hospitals and field hospitals as more resources made their way into the country.
Much has changed in the way that disasters are managed in Haiti since the 2010 earthquake. While relatively little information could be found on the requirements of ICS when researching IMS methods in Haiti, there were several pieces of information that would lead almost every researcher to believe that the ICS method or IMS is in the late stages of implementation. It appears to have started when Community Emergency Response Team (CERT) trainers were sent to Haiti to help develop the private citizen into a basic responder in a disaster (Community Emergency Response Team, 2011). Even while individuals were still living in tent cities, they were learning what they could do to save lives in a disaster, including IMS principles. In the first training, over 400 Haitians, most of which were still living in a refugee camp, learned basic skills on how to manage and help in a disaster. Many even commented that if they had known these skills prior to the earthquake, they could have saved friends and family (Community Emergency Response Team, 2011).
Only two years after the earthquake, on 12 January 2012, a Mass Casualty Incident (MCI) occurred. A dump truck loaded with gravel apparently lost brakes in a crowded part of Port‐au‐Prince. Soon after the incident, the head of a local university hospital and the International Medical Corps, along with numerous nonprofits and local firefighters, began the process of creating an After‐Action Review (AAR). In this incident, 26–30 people were killed and 56–57 injured after a truck lost control on one of the city's busiest streets. The After‐Action Review states several times that there was a lack of knowledge and training related to the Incident Command System. The report called for the ICS method to be used nationwide (Donaldson, 2012).
A 2015 press release by the Office of US Foreign Disaster Assistance (USAID/OFDA) revealed that the Government of Haiti Directorate of Civil Protection (DCP) was in the process of introducing a new training program that will deliver ICS training to all first responders. The plan was focused on implementing a multiyear program with technical support from the US Forest Service and funding from USAID/OFDA (USAID Newsletter, 2015). While the ICS method was created in the United States, the Haitian government is adjusting the ICS method for their own specific use. The area that seems to have the most changes from