Louise K. Comfort

Coordination in Rapidly Evolving Disaster Response Systems: The Role of Information

Assessing the changing dynamic between the demand that is placed on a community by cumulative exposure to hazards and the capacity of the community to mitigate or respond to that risk represents a central problem in estimating the community’s resilience to disaster. The authors present an initial effort to simulate the dynamic between increasing demand and decreasing capacity in an actual disaster response system to determine the fragility of the system, or the point at which the system fails. The results show that access to core information enhances efficiency of response actions and increases coordination throughout the network of responding organizations.

Complex Systems in Crisis: Anticipation and Resilience in Dynamic Environments

Confronted with increasing risk and uncertainty from disruptive change, public managers seek methods to strengthen the capacity of their interdependent organizations to anticipate risk and demonstrate resilience in response to threat. The problem intensifies for public organizations that interact with private and nonprofit organizations to protect a community at risk from natural or technological disasters. It reflects the constraints placed upon human decision processes in complex environments by limited cognitive capacity, and illustrates the persistent difficulty in achieving coordination among multiple organizations with different responsibilities in different locations in serving the public interest. This article summarizes current research on the design and development of an interactive, intelligent, spatial information system (IISIS) for decision support in the mitigation of, and response to, risk from hazardous materials for a university community. Appropriate uses of the IISIS prototype are expected to increase both the technical and organizational capacity to manage timely, accurate information exchange within and among organizations, thus increasing coordination in action.

Cities at Risk: Hurricane Katrina and the Drowning of New Orleans

The impact of Hurricane Katrina on New Orleans revealed vulnerabilities caused by the interaction of the city’s fragile physical environment, aging infrastructure, and declining economic and social structure. The hurricane constituted a triggering event, but the severe destruction and heavy losses documented the extraordinary costs of inadequate plans and practice, given the city’s high exposure to risk. This condition and its sobering consequences are not limited to New Orleans, but constitute a silent threat for other cities in the United States and the world. The challenge for cities is to create a new vision of vital, resilient communities that are able to assess and manage their own risk in order to limit escalating damage from extreme events.

Communication, Coherence, and Collective Action: The Impact of Hurricane Katrina on Communications Infrastructure

Communications infrastructure is critical to managing the complex, dynamic operations that evolve in disaster environments. The impact of Hurricane Katrina destroyed the communications infrastructure within the New Orleans metropolitan region, leaving emergency response personnel and the public with little capacity to exchange information vital for coordinating response actions. The loss of communications proved especially damaging, given the size of the geographic region and the number of people affected. The authors used content analysis of news reports to identify the network of organizations that emerged in response to Hurricane Katrina, and network analysis to examine patterns of interaction among the organizations. The patterns reveal significant asymmetry in information among organizations at different levels of authority and responsibility in the disaster response system, a condition that contributed to the collapse of coordination in disaster operations. Conversely, well-designed communications and information infrastructure can contribute significantly to the resilience of communities exposed to recurring risk.

Coordination in complex systems: increasing efficiency in disaster mitigation and response

Coordination in multi-organisational settings is extraordinarily difficult to achieve. This article examines the problem of inter-organisational coordination in the context of public administration theory and practice. The authors present the concept of complex adaptive systems as a theoretical framework that explains the dynamic processes involved in achieving coordinated action among multiple organisations to manage complex technical operations in environments vulnerable to risk. They argue that coordination may be achieved more easily with the appropriate design of a socio-technical system, that is, a system that supports the exchange of critical information among technical and organisational entities to improve performance in both. The goal is to design a decision support system that uses information technology to enhance the capacity of multiple organisations to adapt their actions reciprocally to changing conditions of risk, enabling the set of organisations to manage risk more effectively and efficiently for the community as a whole. The authors present the design and initial findings from a trial demonstration to implement a prototype interactive, intelligent, spatial information system in the Pittsburgh Metropolitan Region.

Disaster reanimatology potentials : A structured interview study in Armenia : I. Methodology and preliminary results

In general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia. III. Results, Conclusions, and Recommendations

National medical responses to catastrophic disasters have failed to incorporate a resuscitation component. Purpose: This study sought to determine the lifesaving potentials of modern resuscitation medicine as applied to a catastrophic disaster situation. Previous articles reported the preliminary results (I), and methodology (II) of a structured, retrospective interview study of the 1988 earthquake in Armenia. The present article (III) reports and discusses the definitive findings, formulates conclusions, and puts forth recommendations for future responses to catastrophic disasters anywhere in the world. Results: Observations include: 1) The lack of adequate construction materials and procedures in the Armenian region contributed significantly to injury and loss of life; 2) The uninjured, lay population together with medical teams including physicians in Armenia were capable of rapid response (within two hours); 3) Due to a lack of Advanced Trauma Life Support (ATLS) training for medical teams and of basic first-aid training of the lay public, and scarcity of supplies and equipment for extrication of casualties, they were unable to do much at the scene. As a result, an undetermined number of severely injured earthquake victims in Armenia died slowly without the benefit of appropriate and feasible resuscitation attempts. Recommendations: 1) Widespread adoption of seismic-resistant building codes for regions of high seismic risk; 2) The lay public living in these regions should be trained in life-supporting first-aid (LSFA) and basic rescue techniques; 3) Community-wide emergency medical services (EMS) systems should be developed world-wide (tai-lored to the emergency needs of each region) with ATLS capability for field resuscitation; 4) Such systems be prepared to extend coverage to mass casualties; 5) National disaster medical system (NDMS) plans should provide integration of existing trauma-EMS systems into regional systems linked with advanced (heavy) rescue (public works, fire, police); and 6) New techniques and devices for victim extrication should be developed to enable rapid extrication of earthquake casualties within 24 hours.

Integrating organizational action in emergency management; strategies for change

Creating effective organizational response under the complex, uncertain operating conditions of a major disaster poses a sobering challenge to public service agencies which bear the primary responsibility for emergency management. The emergency response process, initially designed in standard, hierarchical organizational format for reactive agency operations, demands careful reconsideration in the rapidly changing, increasingly interdependent social environment of the 1980s. The perceived responsibilities of national, state, and local agencies in disaster vary with political and economic conditions. Finding the optimal mix of shared responsibilities within the specific limitations of time, resources, and professional skills available in any given emergency, constitutes a continuing task for emergency service personnel. This article examines the role of information search processes within and between organizations as a means of integrating multiple agency and/or jurisdictional operations into effective emer-

Resilience, Entropy, and Efficiency in Crisis Management: The January 12, 2010, Haiti Earthquake

The transition from disaster to recovery represents a major challenge to decision makers who seek to build a stronger, sustainable future while they cope with losses and destruction from an extreme event. Decision makers encounter a dynamic environment in which they must balance the tensions between entropy and efficiency in their search for resilience as they seek to maintain sustainable operations in a region exposed to recurring risk. In communities that have experienced disaster, the initial response is a strong mobilization of resources and personnel focused on clear goals of saving lives, protecting property, and meeting immediate needs. The urgency of danger directs the priorities for action, and organizations and individuals voluntarily act cooperatively to meet immediate needs, representing a first step toward resilience. Yet, the resources and energy committed to a shared effort to meet immediate needs generated by the extreme event slowly give way to entropy, or the dissipation of attention, energy, and resources that leads to a consequent loss of efficiency in risk reduction. The deteriorating situation leads to new calls for efficiency to regain resilience. The evolving process represents a dynamic among resilience, entropy, and efficiency that shapes the communitys capacity to manage risk from exposure to recurring hazards. It is largely driven by interactions among organizations participating in disaster operations, their exchange of timely, valid information, and their capacity for learning and adaptation, as well as gaps in cognition and action. We explore the tensions among resilience, entropy, and efficiency in an analysis of interactions among local, regional, national, and international organizations operating in response to the January 12, 2010, Haiti Earthquake. Three types of data are used to analyze patterns of interaction among the organizations: 1) content analysis of newspapers; 2) documentary reports by professional organizations; and 3) semistructured interviews with policy makers operating in Haiti. In analyzing the networks of organizations operating in disaster operations, we document the response system that emerged during the first three weeks following the earthquake, January 12-February 3, 2010. We conclude that timely intervention in information flow can be used to minimize entropy, increase efficiency, and strengthen resilience in a disaster-stricken societys transition from response to recovery.

Disaster: Agent of Diplomacy or Change in International Affairs?

Disaster is presented as a process of transition which changes relations both within and among states engaged in mitigation and response. The article advances the concept of complex adaptive systems (CAS) as an analytical tool that captures the high degrees of complexity and dynamics characteristic of potential or actual disasters. Consequently, the three case studies in this special section of the Cambridge Review of International Affairs which analyse critically the argument for disaster diplomacy as an opportunity to increase cooperation among rival states are re‐examined in a CAS framework. Based on the application of CAS to the case studies, the article concludes that creative diplomacy for disaster reduction is most effective at the ‘edge of chaos’, that narrow region where there is sufficient structure to hold and exchange information, but also sufficient flexibility to adapt new alternatives to meet urgent needs.