DISАSТЕR МАNАGЕМЕNТ LЕАDЕRSНIР FОR РАRАМЕDIСS 1
Disаstеr Маnаgеmеnt Lеаdеrshiр fоr Раrаmеdiсs
A disaster is a significant occurrence that affects the lives of a community. A disaster has an impact on the environmental, economic, and material spheres of the society, and the disruption overwhelms the affected community to the extent that the available resources cannot cope. The main type of disaster is the natural disaster that includes earthquakes, volcanic eruptions, floods, and hurricanes. The disaster has immediate and secondary effects such as tsunamis and fires that further disrupt essential services such as transport, health services, and communication. Disasters require the deployment of immediate emergency services so as to mitigate the immediate and long-term effects of the people affected (Hartwell, 2014).
A tsunami is defined as a series of prolonged full depth waves moving across the ocean. The impact along the coastline is a secondary natural disaster mostly caused by under- sea earthquakes, volcanic eruptions, and rapid changes in the atmospheric pressure. A tsunami is considered a disaster because it is more destructive than the average waves, and since they cause vast floods that rush onto land for extended periods of time compared to regular waves (Australian Institute for Disaster Resilience, 2010). Additionally, there is widespread damage to property, and extensive numbers of people are affected in the manner of displacement and even fatalities. Tsunami is considered a disaster because the recorded tsunamis in the Asian countries have resulted in a lot of fatalities and very high localized economic costs (Jayasuriya, McCawley & Asian Development Bank Institute, 2010).
Paramedics and other emergency services agencies are responsible for immediate response and disaster management. The local authorities together with the paramedics use the available resources and scale the effects and complexity of the disaster. A catastrophic level of disaster calls for a coordinated assistance on a national level. Therefore paramedic leaders must have the skills to work with others (Australian Institute for Disaster Resilience, 2009)
Leadership during Disaster
The Tsunami disaster placed much scrutiny on the Asian leaders because the whole world expected immediate response. The magnitude and impact of the disaster triggered the world into action delivering relief and offering direct assistance. The governments worked fast and deployed military forces to help with the rescue missions, delivering relief, security, and inter-agencies communication. The established task forces were adequately funded and the citizens assured that the governments were doing everything possible to rescue the victims and provide aid. Further, the Asian governments appealed for help and welcomed the assistance that was rapidly being offered from all over the world. The actions taken by the governments in Asia after the tsunami disaster showed the need for leaders to have certain qualities that allows them to make critical decisions and establish a reporting framework that is functional and serves all the parties, including the victims and the assisting agencies (Aitken et al. 2012).
The trait theory refers to the characteristics of an efficient leader in any situation. The assumption made under this theory is that the leadership capabilities are based on the characteristics of the person. An effective leader must possess personality traits such as self-efficacy, out-spoken and open, intelligent, and so forth (Connor, 2014). The ability and willingness of the leaders from the tsunami-struck areas to ask for help shows that they empathized with the victims and they were willing to do whatever it takes for the citizens. On the other hand, the Japanese government had initially refused to welcome international aid and this also shows the characteristics of those in authority. The initial reactions of the Japanese government can also explain the functional theory. The actions of the authority would have put the country in more danger as the victims would not have received any international aid (Kapucu&Özerdem, 2013). The situational theory requires awareness of the situation, and that involves being aware of all that is going on as well as what might take place next. The Asian governments immediately issued press releases on the tsunami and warned all the citizens, various efforts were undertaken to evacuate those in danger. A firm grasp on the situation means collecting information, processing and assessing the relevance of information and helping those in danger as the Asian governments did in the situation (Norri-Sederholm et al., 2014).
In times of crisis, there are mass casualties from the disaster such as a tsunami. As a result, there is a need for a triage algorithm to guide the paramedics on how to maximally allocate the limited resources to produce the greatest outcome for the largest group of people. Therefore amass-casualty triage allows care for those who seem likely to survive rather than the critically injured. Immediate intervention is only given to those who will benefit from care and not those who will die despite the medical intervention. In Australia, the use of triage is vital because it helps save lives and the medics in the fields are fully utilized. There is an increased quality the treatment offered because there is no wasted time on dead persons rather more time is availed to rescue the injured with the potential to survive (Rauner, Schaffhauser-Linzatti & Niessner, 2012).
The local paramedics were the first health response team as other national health professionals and NGOs reacted immediately. The paramedics focused on the potential health threat and risks that faced the survivors as a result of diseases. The team established its primary objective as protecting the health of the survivors and supporting a collective response among the agencies that responded. The paramedics provided important information on water-borne diseases and food poisoning to protect the survivors from the getting sick. The paramedics immediately activated the disaster management plan to effectively deal with the large-scale disaster. Patients with minor injuries were treated in the field, while those with severe injuries were rushed to the hospitals. The effectiveness of the paramedic’s efforts was also due to the application of the WHO guidelines that saved on cost and time because only the necessary mass vaccinations were conducted, and untrained volunteers in the field were avoided at all cost. The use of multiple agencies was important to fasten the rescue efforts and optimize the care given to the victims. Authority and responsibilities were divided among the team leaders like the paramedics, the WHO, the military forces, and so on. The different approaches taken were important in returning the situation to normalcy. Interdisciplinary efforts require a well-constructed structure and hierarchy to fuel the confidence and the ability of the integrated teams (Devitt & Borodzicz, 2008).
The paramedics were mostly concerned with the vulnerable population made up of children, pregnant and lactating women, old people, and persons with chronic diseases. More priority was given to supporting the health sector response including only admitting patients with severe injuries while the others were treated in the field so as not to overwhelm the hospitals. The WHO guidelines were used by the paramedics to guide when dealing with the vulnerable population and mass disposal of dead bodies to avoid spread of diseases. The triage algorithm was also used to immediately evacuate and transport prioritized patients for better medical care in a hospital setting (Jenkins et al. 2008). The paramedics worked on children first, and they were also tasked with reuniting them with their families. Different health professionals from other agencies who are more qualified to deal with children, like the WHO, were used to take care of their needs and to assist them with family
reunification (Burke et al. 2010).
The joint agencies had a mission of saving lives and providing information to the victims’ families. Paramedics would pass out questionnaires at the hospital to the patients or those accompanying the patients to gather more information about their families and how to contact them. There were established teams that were tasked with communicating information to families, and different embassies as soon as it was received. The paramedics set up these stations at the different hospitals where the patients were taken. Detailed patients lists that were regularly updated helped in providing critical information to the awaiting families. The coordination efforts between the hospitals and paramedics are essential to ensure an effective emergency crisis management is a joint activity that is focused on saving lives, and communication is an essential part of the action (Reddy, 2009).
Efforts from the ministry of Public Health included deploying personnel and resources to help the paramedics meet local healthcare needs and to establish a central command and control centre in Bangkok. The control center was used by the paramedics to provide information to the media regarding the patients, and to appeal for more professional help in dealing with the victims. The main concern was to provide the public with the information through all the available channels from notice-boards to the internet so that families and friends could visit the health facilities and claim their loved ones.
Lessons from Crisis Management
According to Perry (2007), the response to a natural disaster must be viewed as a whole when planning for disaster management. The author is of the opinion that the holistic approach should let the local emergency teams lead in the crisis mitigation. All the other teams are then included into action and thus, form the whole picture of disaster management and coping solutions.
Drennan and McConnell (2007) hold the view that a disaster provides an opportunity for bringing about some changes in the organization, opens up debate on management issues, exposes efficient and weak leaders, and advocates for policy changes. A crisis is an experience through which the public is made aware of the management and leadership situation of the country. Therefore, it is a learning opportunity and a break for a change.
Crisis management also teaches that the healthcare sector should focus on training the paramedics on sensitivity and how to deal with customer care complaints. Paramedics must have the necessary training and equipment to deal with the general population. The focus and preparation apply to both individual and mass- casualty setting (Risavi, Buzzard & Heile, 2013).
The Council of Ambulance Authorities in Australia outlines the roles of ambulances in disaster management. The ambulances are used by paramedics to offer patients pre-hospital care, and transport them to the appropriate healthcare facilities (The Council of Ambulance Authorities, 2013).
Disaster management is different based on the cause of the disaster. The paramedics must be aware of the cause before responding to the emergency call. Bio-hazardous materials require special handling, and in some instances, the paramedics are not equipped to provide care or handle the dead persons because of the harmful effects this may have on their health. Therefore, the cause of any disaster must be communicated as early as possible to minimize exposure and for fast decision-making (Baker et al, 2009).
Crisis management after a tsunami falls immediately on the paramedics who are the first responders in any disaster. A tsunami causes massive destruction of property and displacement of people. Hence, the work of the paramedics is to care for the victim’s physical and psychological needs. A great leader in a disaster situation must have the ability mobilize their team into action through leading by example as this will motivate the subordinates. Leadership in a disaster situations means that the head can coordinate with other team leaders because multiple agencies are involved in the operation. Therefore, an open channel of communication is essential to ensure a smooth flowing process. Paramedics must make sure that they prioritize when providing help in a mass-casualty setting, and this is done through a triage which is vital in maximizing the resources available and making sure that care goes to those who are in dire need and are likely to respond to such management. Managing a crisis requires excellent leadership skills for maximum performance and to keep other responders motivated. Thus, the lesson learned from the text is that the quality of leadership profoundly affects the outcome in a disaster.
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