September 15, 2011

 

 From 9/11 to now: Disaster preparedness and response evolves

 
SAR dog receives IV treatment
A search-and-rescue dog receives an IV treatment to
combat exhaustion and overexertion while working at
 the Pentagon following the attack of 9/11.

Photos courtesy of FEMA
 

Training, collaboration key to mitigating future disasters
posted August 31, 2011

Sept. 11, 2001. Dr. Barry N. Kellogg sat tensely on his sofa with a packed bag at his side. He had on his AVMA Veterinary Medical Assistance Team clothes. A call to the higher-ups at the Federal Emergency Management Agency let them know he and his team were ready to deploy to New York City.

He was told to sit tight.

By that afternoon, the VMAT-1 commander and his team had finally made it to the World Trade Center. They had received no official direction, in part, because the federal government didn't know what to do with them.

"From the beginning, they didn't want us down there (at ground zero) because they didn't understand veterinarians as significant or important to the rescue mission," Dr. Kellogg said. "9/11 turned out to be the first real transition where federal agencies recognized that we had something to bring to the table."

Ten years later, animal-related disaster preparedness and response has changed dramatically.

State and federal laws now better recognize the importance of caring for animals in response efforts, and state and county animal response teams have been created to respond to local disasters. VMATs have evolved from a public-private partnership that responded to federally declared disasters to a private program that seeks to fill in any gaps in response and assist with training. And the federal government has increased the involvement of veterinarians in disaster planning and response plans.

Looking to the future, strong collaboration at all levels—whether through shared training or preparedness agreements—will take on even greater importance in this area, according to emergency officials.

From the beginning

Animal-related disaster preparedness and response began well before the WTC and Pentagon were hit and United Flight 93 crashed that day.

Hurricane Andrew, which hit Florida in August 1992, served as the catalyst for talks between the AVMA and the federal government. The hurricane destroyed the veterinary infrastructure in the region and left thousands of animals dead or displaced.

With the signing of a memorandum of understanding in May 1993, veterinary services became incorporated into the Federal Response Plan for disaster relief as part of the National Disaster Medical System. The agreement was signed by the AVMA and the Office of Emergency Preparedness of the U.S. Public Health Service.

It was then that the AVMA organized veterinary health professionals into VMATs. The system was developed to provide supplemental medical care to animal victims of catastrophic disasters in the event state and local resources are overwhelmed and federal assistance is required.

Though 9/11 wasn't the first major deployment for these teams, it proved to be one of the most indelible for them.

Pentagon SAR
Search-and-rescue teams operated at ground zero in New York City as well
as the Pentagon in Arlington, Va

FEMA initially dispatched VMAT-1, based out of Massachusetts, because it was nearest to New York City and could deploy the quickest, since all air travel had come to a halt.

After arriving in New York, Dr. Kellogg and his team soon established three canine triage stations at the World Trade Center to provide assistance to the search-and-rescue dogs working to locate survivors in the rubble.

Dr. Kellogg said on more than one occasion, the VMAT volunteers had to physically pull the dogs from service because they couldn't get the handlers to stop after 18 or 20 hours.

In all, 51 members from the four VMATs aided search-and-rescue efforts at ground zero from Sept. 11 until Oct. 31. The VMATs provided more than 900 treatments to about 300 SAR dogs that served at the disaster site.

"At first sight of the pile, I was struck with disbelief. My reaction was picked up by my dog, and she started to whine and search frantically. Shortly after, I got to work and we settled down and became the team we were trained to be."
—Sarah Atlas, deployed with Anna (now deceased) as part of New Jersey Task Force 1 to the World Trade Center


Dr. Kellogg said it was a difficult experience not only because of concerns that biological or chemical agents were present at the site but also because of how emotionally draining the experience was, due to the nature of what happened.

But some good came from the deployment, too.

"It was probably a real good thing for VMAT. That did elevate us in the federal eyes of what we could bring to the table. We were not just dismissed as animal lovers. We all know why we're doing it, but that's not a good enough reason to convince government managers. We're there to take care of animals so people don't put themselves at risk. This is how we got accepted," Dr. Kellogg said. 

The aftermath

Dr. Heather Case, director of the AVMA Scientific Activities Division and coordinator of emergency preparedness and response, said the event woke the general community up to the need to prepare for all hazards.
 

New federal entities were also part of that sea change. The Food, Agriculture, and Veterinary Defense Division of the Department of Homeland Security formed not long after the attack. The U.S. Northern Command, also created after 9/11 to provide command and control of Department of Defense homeland defense efforts, brought on veterinarians to help with its preparedness efforts.

In 2002, the Department of Homeland Security was created and started awarding grants aimed at safeguarding the country. Several states used grants to purchase equipment, such as emergency response trailers, and add staff positions so that animal health agencies could work toward building geographic information system maps.

That same year, FEMA announced it would distribute $225 million for state and local preparedness. Almost half that money was intended for updating plans for responding to all hazards, with an emphasis on the use of weapons of mass destruction, including bioterrorism. Other areas slated for funding included state emergency operations centers; mutual aid agreements between counties, cities, and states; and increased communications resources.

VMAT-1 mobile triage at the World Trade Center
On Sept. 11, 2001, at the World Trade Center, Veterinary Medical
Assistance Team-1 established a station in the Jacob Javits
Convention Center, where the canine units were being housed.
The VMAT also operated a mobile triage unit at ground zero and
had a mobile unit on an ATV that circulated through the pile.
 

Then, the Medical Reserve Corps was founded to supplement community resources for emergency response and public health. This national network, under the Department of Health and Human Services, now has more than 1,800 veterinarians enrolled. Of the 952 units, 385 report having at least one veterinarian, and 23 have 10 or more veterinarians, mostly on SART teams.  

More changes

Further changes to animal-related disaster response and preparedness came after Hurricane Katrina struck in August 2005. 
 

In the past, many states weren't capable of mounting a veterinary or animal health response on the natural disaster side, Dr. Case said. Hurricane Katrina highlighted the need to do so after some people stayed behind with their pets because most evacuation vehicles did not allow animals at the time.

Congress passed the Pet Evacuation and Transportation Standards Act in 2006, granting FEMA the authority to help state and local governments develop emergency and evacuation plans that take pets and service animals into account.

"My thoughts were just on how to maximize the use of my dog and to hopefully locate a survivor."
—Penny Sullivan, deployed with Quest (now deceased) as part of New Jersey Urban Task Force One to the World Trade Center

Incidentally, around the time Hurricane Katrina hit, changes in federal government policy led to the creation of two separate yet complementary Veterinary Disaster Response Team programs: the federal National Veterinary Response Team and the AVMA VMAT program.

The NVRT, which evolved from the long-standing AVMA program, operates entirely under government oversight to provide veterinary emergency preparedness and response services. It serves as a temporary supplement to the local, state, and tribal response teams by providing specialized veterinary medical capability consisting of providers, supplies, and equipment. Many volunteers serve on both a VMAT and the NVRT.

The change left VMATs to officially relaunch in 2009 to respond to requests for assistance from state governments—and to offer training in disaster response (see JAVMA, June 15, 2009, page 1488), thanks to funding from the American Veterinary Medical Foundation. Specifically, the VMAT program offers three main areas of help: training, early assessment of veterinary conditions and infrastructure, and basic treatment to augment overwhelmed local capabilities. So far, the program has memorandums of understanding with more than a dozen states, and more are in the works.

Present situation  

So, what is the state of animal-related disaster preparedness and response now, 10 years after 9/11? For one, there's a lot of synergy and cross-training, Dr. Case said, thanks to volunteers active at the local, state, and national levels. 
 

"The reality is all emergencies are local. A veterinary volunteer is usually a member of their county animal response team or their state animal response team, or, ideally, both. They're going to respond first at the county level. If the response escalates and additional assistance is required, then the county responder can deploy as a state resource and still be able to help," Dr. Case said.

Though the large, national catastrophes often grab the headlines, small and local events are more the norm, particularly house fires.

"So every veterinarian, ideally, would be involved in their state or local reserve corps and be prepared to assist if they need to shelter animals in an emergency situation or provide care for animals affected by a disaster," Dr. Case said. Short of that, she said veterinarians have a role in educating the public to be sure they've read disaster-preparedness brochures, have IDs for their animals, keep their pets' prescriptions up to date, and have made arrangements to take their pets with them in an emergency.

For the VMAT program, training is now a big part of its mission. The nearly 200 VMAT volunteers—from state wildlife veterinarians to board-certified equine surgeons, all engaged in disaster preparedness and response—work to help train teams and build capacity.

"Our primary role has begun to shift to education and training to assist the states in building up their response," Dr. Case said. "We're in the process of further creating our training component, because it's been clear there's a need to educate veterinarians on these activities."

Since their relaunch in 2009, the VMATs have received and fulfilled many training requests. Requests are filled on a first-come, first-served basis. Most often, this involves providing a single speaker for a one-hour lecture at an event created by the requester. But, the teams have also provided assistance at state and regional training events.

VMAT teams will celebrate 20 years of service in 2013. As part of that, there will be an event at the AVMA Annual Convention in Chicago.  

Planning ahead

Training and cooperation will be high priorities for the federal government as well now that Dr. Ty J. Vannieuwenhoven has been named as chief veterinary officer of the National Disaster Medical System. He was appointed the first week of June. He oversees the NVRT, but more broadly, his role will be to coordinate veterinary services in Emergency Support Function 8 of the national response framework. 
 

"A lot of it is not just being in charge of it, but also linking it together. So that means talking to Medical Reserve Corps Director Rob Tosatto about how we could use the MRC veterinarians or talking to Capt. Hugh Mainzer (chief veterinary officer of the U.S. Public Health Service Commissioned Corps) about how those 88 veterinarians could be used in what role as well," Dr. Vannieuwenhoven said.

"It was the most tense, the worst environment, the most emotionally draining, ever."
—Bob Deeds, deployed with Kinsey (now deceased) as part of Texas Task Force 1 to the World Trade Center

He also hopes for his office to better engage with state and local responders—largely state veterinarians' offices or state emergency response offices—so they understand what capabilities the federal government has and how to access them.

A long-term goal he has is for the NVRT, which holds field training exercises annually, to facilitate a more coordinated training effort among all veterinary medical responders, including VMATs, the MRC, and other entities.

"I'm hoping we work together so we're all training responders on whatever the current doctrine is, so they're not all developing different protocols," he said.

One collaborative training opportunity happening in the near future will be at next year's Integrated Medical, Public Health, Preparedness and Response Training Summit, hosted by the DHHS. The summit, May 23-25, 2012, will for the first time include a 1-1/2- to 2-day veterinary program.

Dr. Vannieuwenhoven also is in the process of working out an agreement with FEMA whereby urban search-and-rescue teams deployed by the agency would automatically engage the NVRT to provide the veterinary support for the SAR dogs. As it is now, the USAR teams set up contracts with local veterinary medical providers on a case-by-case basis.

 See more photos of the SAR dogs of 9/11 at www.avma.org by clicking on JAVMA News Photo Galleries.