Towards a More Integrated Response to Emergencies and Disasters

The process of responding to emergency situations involves matching urgent needs with available resources in the most rapid and efficient way possible. Timely mobilisation and quick action can reduce the toll of lives lost, injuries sustained and damage experienced in disasters. It follows that professionalisation of response and management is the key to improvements in these processes [1]. In fact, in recent decades, advances in planning, training, technical competence, information management and the specifications of equipment have greatly improved the average level of performance of professional emergency responders and the managers who direct their efforts. At the same time, their work has become more broadly based, complex and challenging [2].

In recent decades there has been much discussion of ‘complex emergencies’. By common consensus, the term is now applied to particular situations in which governance, security, and the normal socio-economics of society have broken down under the duress of military instability. However, some commentators have argued that, rather than being a special category of disaster or crisis, by their very nature all emergencies are complex [3]. As a result they require a sophisticated response. Moreover, as the available tools become more powerful, particularly in telecommunications and information management, there is a further impetus to make the response to crisis a complex one. Complexity is inherent in the number and size of organisations that respond to disaster. Commonly, a major internationally-declared emergency may induce more than 70 nations to send personnel, expertise, equipment and donations: in the case of the January 2010 earthquake in Haiti, 129 countries participated [4].

In the modern world, responses to major disasters tend to be complex, not merely because of the size and scale of operations, nor only because of the number of countries and agencies that take part, but also because of the range of functions represented by these organisations. Full-scale emergency response involves people trained in at least 35 different disciplines and professions: from architecture to seismology, from psychology to civil engineering, from cartography to emergency medicine, the specialists must all work together [5]. One can liken emergency response to a symphony orchestra. The player of each different instrument has a particular sheet of music to read. Only the conductor has the full score, but the overall effect of playing different instruments is harmonious. Likewise, emergency managers must coordinate people from different organisations and specialities who are carrying out different tasks, and they must ensure maximum possible harmony and minimum discord.

The term ‘integrated emergency response’ implies a variety of different things. First, it signifies interoperability [6]. During the international response to the Haitian earthquake, under the aegis of European Union coordination, French and German field hospitals were set up in Port au Prince to treat injuries and provide the local population with basic health care. Personnel rapidly discovered that the procedures and equipment used were not interchangeable, which made it difficult for the field hospitals to give each other mutual support. Moreover, many of the NGOs present in Haiti lacked adequate roles, self-sufficiency and useful skills [7]. As international disasters are likely to become ever more common, imposing and complex, there is a need for compatibility beyond national borders. Concomitantly, there is a need for local and regional harmonisation of equipment, procedures, plans, protocols, training and exercising [8].

In reality, the processes of integrating emergency response go far beyond matters of interoperability. There is a need to provide a common language and culture to organisations that are likely to be highly diverse in their modus operandi and ways of approaching the problems that need to be faced during an emergency. In disasters, the ability to work together effectively and efficiently is paramount. This requires members of organisations to understand something about the work of other agencies. Indeed, in disasters it is almost as important to understand what other people are doing as to understand one’s own role, as this is the only means of successfully acting in concert. It is also necessary for emergency managers to acquire enough knowledge of the language and procedures used by specialists to be able to direct their work. To do this, they must interact effectively with the specialists and hence must appreciate their roles and potentials.

The increasing sophistication of modern emergency response makes the process of coordination a particularly challenging one [2]. The challenge is increasing in relation to the possibilities offered by the current growth in information and communications technology. Information technology tends to favour collaboration over command, cooperation over control [9]. Thus, it helps to flatten the chain of command. The transmission of digital images, maps, video clips, data-sets, situation reports, voice-over-Internet protocol messages and other information facilitates collaborative solutions to problems. It also ushers in a new age in which the comprehensive management of information is emphasised in order to provide problems with more holistic solutions than would have been possible in earlier times.

Traditional emergency management is a hierarchical process of command and control, of giving, receiving and acting upon orders. This is explained by its military origin [10]. One of the main deficiencies of this approach is its rigidity in the face of problems that can change with extreme rapidity and which require highly flexible solutions. Information and communications technology is one factor that enables this approach to be changed to one that is structured much more closely around the problems that need to be solved in emergency situations. If all participants act in good faith, and in concert, there is no reason why responding to emergencies need not be a collaborative effort, in which expertise is brought to bear collectively in order to solve multi-faceted problems (such as evacuation, the provision of shelter, public safety and the stabilisation of hazardous environments) which need the simultaneous input of different disciplines and professions [11]. The quality of interaction between the protagonists becomes much more significant than the quality of command, not least because, although professional emergency responders may be grateful to receive direction, they are often less happy to be commanded. The difference is subtle but it is one of culture and attitude: collaboration fosters creativity and autonomy in decision-making [12].

Emergency response consists of a mixture of planning and action. Plans need to be made in advance of crises in order to ensure that the most rational use is made of available resources. Failure to foresee needs and cater for them when they can be identified in advance is tantamount to negligence. However, the planning process needs to be present throughout the strategic, tactical and operational roles in an emergency situation, as it must ensure that actions are adapted to circumstances which may be changing rapidly or abruptly from day to day, or even hour to hour.

In a full-scale major emergency, it may be necessary to activate various different plans. Diverse organisations need planning instruments if they are to cope well with a crisis. Hence, there is a need to integrate plans in the following ways:

• hierarchically, with respect to different levels of government (typically local, regional and national)

• organisationally, with respect to different emergency services and categories of responder

• geographically, with respect to neighbouring jurisdictions and other territories

• functionally, with respect to sectors of public administration (health, employment, education, public works and infrastructure, public security, etc.).

If, for example, a major incident occurs at a municipal airport, it may require the activation of the emergency plans for the airport as a separate facility, as well as the plans of local and regional authorities, health services and perhaps other sectors or bodies.

Integration is, as they say, “not rocket science”: in other words, it is far from being an abstruse issue that only highly specialised experts can understand. Indeed, much emergency planning is little more than “systematic, codified common sense”. A comparative reading of plans and procedures should ensure that there are no evident barriers to interoperability, no glaring incompatibilities and no great contradictions in the provisions of the documents. The result should be a ‘nested hierarchy’ of plans, in which the overall scheme apportions tasks and responsibilities according to the roles and capabilities of the participating organisations. However, it is one thing to share out the work: it is another thing to ensure that harmony prevails when a crisis occurs. That requires considerable sensitivity to the modus operandi of the various participating organisations.

A further form of integration is that which should occur between the emergency phase and the other parts of the ‘disaster cycle’. Of course, not all disasters are cyclical, and some are not even recurrent [13]. However, the model has proved robust, as there is commonly a progression through mitigation, preparation, emergency response, recovery and reconstruction—with the proviso that the phases may overlap rather than be entirely sequential.

It is a well-known axiom that shifting resources from reacting to disasters to preventing them should reduce the need for emergency response and should reduce their impact in relation to the strength of prior preparedness. It is striking how seldom this policy has been pursued since its effectiveness was first clearly demonstrated decades ago [14]. Many researchers, politicians, public administrators and other commentators have talked about preparedness, mitigation and the need to create resilience [15]. However, most obdurately, the lion's share of resources still goes into reaction, not preventative action. In part this is because one cannot avoid responding to disaster when it occurs. In part it is because the problem of mitigation is enormous and very complex. Moreover, increases in population, pressure on land in hazardous areas, poverty and marginalisation, and forms of speculation and exploitation all conspire to ensure that vulnerability remains unacceptably high. However, it is sad to reflect that political kudos still comes more easily from response, which has an air of charity about it, than from preparedness. Electorates are seldom very impressed by prudence, yet they always demand a prompt response to disaster when it occurs.

As a result of this, there are many more opportunities to integrate preparedness with response than examples of such initiatives. One reason for this is that it is seldom fully appreciated that the starting point for disaster risk reduction is at the community level. All disasters are essentially local affairs, for the theatre of operations, like the scene of damage, is always local, no matter how large the event [16]. Careful analysis of local needs in disaster should also indicate where local coping capacity can be strengthened in order to reduce the response needs [17]. This is therefore one way of demonstrating the need for integration between emergency response and various other aspects of resilience. Moreover, it underlines the fact that emergencies are best tackled in times of “peace” not merely during the crisis itself. Indeed, devising a reaction during the disaster implies that the response is improvised. Whereas each disaster contains some final and irreducible elements of uniqueness, such that improvisation cannot be completely eliminated, a response that is heavily improvised suggests that many elements which could have been sorted out beforehand were overlooked. Improvisation in place of prior planning represents inefficiency, and that can signify avoidable damage and casualties.

In synthesis, there is a demonstrable need for greater integration in the response to emergencies and the processes of disaster risk reduction. Integration must take account of the technological challenges of a world in which society is more interconnected than ever before. It must more successfully link up agencies, organisations, services and institutions that participate in disaster risk reduction. It must bridge the gap between academic studies and practical action [18]. It must more firmly integrate the response phase of the ‘disaster cycle’ with the preparedness, recovery and mitigation phases. Finally, it must integrate training and professional qualification with response activities, and do so in such a way as to encourage multi-disciplinary, holistic, problem-based approaches.