Tue, Apr 26, 2011 page8

• Toward a quick-response system

  • By King Chwan-chuen and Frank Shih Solomon Chen 金傳春，石富元， 陳志成
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  The March 11 disaster was Japan’s largest catastrophe since the atomic bombings of Hiroshima and Nagasaki during World War II. Its impact was much greater than that of the 1995 Hanshin earthquake. Even the Japanese government, having used the best disaster response model, is struggling in the face of this crisis. Governments around the world have been obliged to re-evaluate their own disaster preparedness. We believe that Taiwan can also learn from the Japanese disaster in at least five aspects.

  First, Japan conducts several earthquake drills throughout the country every year. This time, it also had the benefit of an advanced tsunami early-warning system. The number of casualties was thus much lower than that of the 2004 tsunami in South Asia. In addition, the Japanese public was aware of what needs to be done in a disaster and were able to conduct themselves in a calm manner.

  Second, the compound nature of the disaster decimated the effectiveness of the response. The traditional management system is designed to respond to specific disasters, to be directed by different departments individually and was not designed for a more integrated response. As a result, Japan was caught off guard. This highlights the importance of an integrated disaster response mechanism and inter-departmental integration.

  Third, the risk of radiation from the stricken Fukushima Dai-ichi nuclear power plant has exacerbated the situation, complicating relief efforts and necessitating the emergency evacuation of huge numbers of people from the disaster areas. Consequently, there was the risk of a secondary crisis, with insufficient supplies of fuel, food, water, everyday necessities and medical supplies. The mobilization of the Japan Self-Defense Forces has allowed the authorities have the situation under control, but too many essential tasks still need to be done. The importance of logistical management is thus self-evident.

  Fourth, the international tsunami warning mechanism worked well and Japan’s neighbors were immediately informed. The response to the nuclear crisis, however, has been more problematic. It is of utmost importance to react to critical moments quickly during an unfolding crisis, as the windows of opportunity that present themselves are often fleeting. A great deal of expert advice from overseas was not implemented in time, clearly showing that international coordination at the right time and in the right place is crucial.

  These days, the effect of a national disaster is not confined to only one country and an understanding of other countries and a sensitivity to other cultures can only be of benefit to relief efforts.

  Fifth, when the disaster broke out, the management at the Fukushima Dai-ichi plant failed to assess the potential risks in time, or at least to inform the public of them, damaging the public’s trust in the authorities’ ability to deal with the situation. In the immediate aftermath, when the Japanese media were keeping the public informed of breaking news at frequent intervals, it actually had the effect of reassuring the public, who felt they at least knew what was going on, thus minimizing possible social panic. This shows the importance of risk communication, crisis-handling coordination, effective command chains and integrated leadership.

  In addition, Japan has maintained comprehensive records detailing medical and disaster relief efforts going back for more than a century, useful as references for future relief efforts. Our own preparedness pales by comparison. In Taiwan there are no systematic, long-term educational programs in place to cultivate future leaders of disaster prevention and crisis management with the expert knowledge and experience to deal with these events.

  It is true that 13 colleges and universities have public health departments, but there have been few courses and little research available in the way of disaster prevention, and most courses that do exist tend to focus on knowledge and theory without practical drills.

  Other crucial elements, such as the integration of critical components available in different systems, forward-planning, the gathering and timely analysis of data and cutting-edge knowledge on, and hands-on experience of, cooperation and leadership tend to be ignored.

  During the 2009 influenza A(H1N1) pandemic, the governments of Hong Kong and Singapore authorized infectious disease specialist teams to lead the research investigations, applying those evidence-based results immediately to public health prevention efforts. When faced with unexpected events, scientists are able to find the best strategy to solve problem. The process produced a number of young leaders, now equipped with valuable experience in epidemic control, who were immediately recruited by the WHO.

  Taiwan is more vulnerable to a range of threats, including earthquakes, typhoons and the spread of infectious diseases, than Japan, and then, of course, there are the nuclear power plants. Therefore, we must take advantage of the opportunities offered by disasters to cultivate future leaders capable of predicting and handling disasters in local communities whenever the need arises.

  We sincerely recommend the government do the following. First, Taiwan should actively participate in international organizations related to disaster prevention to get the latest ideas, information and documents available. Second, it should establish a real-time disaster surveillance system and make it available online to keep the public and decisionmakers informed. Third, public-health education and practical training should include disaster relief components. Fourth, the media should be responsible for keeping the public informed about what to do in the event a disaster happens, something that is all the more pressing for those who live in vulnerable areas.

  King Chwan-chuen is an adviser to the Taiwan Association for Promoting Public Health, Frank Shih is chairman of the Disaster Relief Committee of the Taiwan Society of Emergency Medicine and Solomon Chen is a pediatrician at Pingtung Christian Hospital.

  TRANSLATED BY EDDY CHANG
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