Volunteering In Times Of Disaster, The Time Is Now!

Physicians come to their profession with a highdeployment of MRC volunteers outside of their
sense of personal honor and a high sense oflocal jurisdiction.
personal duty. It is these two characteristics thatDuring the 2005 hurricane season, the MRC
spur physicians to contribute time, energy, talentstrengthened its partnership with the ARC. Prior
and resources in times of local, regional or evento Hurricane Katrina's landfall, the ARC disaster
national disaster.operations staff requested MRC support for their
Whether hurricane Andrew, hurricane Charlie,sheltering operations. Policies and processes were
hurricane Katrina, hurricane Rita, hurricane Wilma,developed to identify, assign, and activate MRC
the terrorist attacks on the Murrah federalmembers willing, able, and authorized to respond.
building, the World Trade Centers or theARC provided transportation, logistical support,
Pentagon, whether forest fires or largeand supervision for the deployed MRC members
automobile accidents whenever the healthcarewho supported ARC health services and mental
system appears to be overwhelmed physicianshealth and shelter operations.
and other health care professionals findMRC members also participated in response
themselves spurred to action. Unfortunately theyactivities outside of their local/state jurisdiction
also find themselves spurred.through a mission to support HHS response and
It seems senseless whether the time ofrecovery efforts.
tremendous need physicians would be turnedThe first Federal activation of MRC volunteers
away from such places as Louisiana, Gulfportoccurred on September 15, 2005, when HHS
Mississippi, Port Charlotte, Florida, Oklahoma City,needed staffing support for three special needs
New York City and Washington D.C. Yet a smallshelters in Louisiana. Subsequent mission
understanding of how disaster response systemsassignments allowed MRC members to fill positions
work explains this phenomenon.in Community Health Centers and health clinics on
The first and most important thing that physicianscruise ships housing evacuees in Mississippi and to
and other health care providers must know isperform health assessments in Texas.
that if you are not part of a disaster plan, youFor more information about the Medical Reserve
are not part of a disaster response. Even thoughCorps or to become a member, please visit the
it may seem chaotic when disaster reliefMRC website at, or contact the Medical Reserve
professionals are working side by side withCorps at:
volunteers and bystanders to save lives andMRC Program Office
livelihoods, what you are actually witnessing is aOffice of the U.S. Surgeon General U.S.
wellchoreographed dance. Long before theDepartment of Health and Human Services
disaster struck plans were established on how5600 Fishers Lane, Room 18C-14
best to respond in the event of a disaster. It is inRockville, MD 20857
this planning phase that the use of volunteersTel: (301) 443-4951
whether lay persons or health care professionalsFax: (301) 480-1163
is anticipated and integrated.E-mail:
Therefore if you wish to be part of a response, ifThe National Disaster Medical System - NDMS the
you wish your valuable skills to be used to helpNation's Medical Ready Force
stave off disaster and prevent catastrophe theThe National Disaster Medical System (NDMS) is a
time to volunteer is now.federally coordinated system that augments the
What Is The Disaster Life Cycle?Nation's medical response capability. The overall
Disasters come in four phases:purpose of the NDMS is to establish a single
* Interphaseintegrated National medical response capability for
* Adverse Eventassisting state and local authorities in dealing with
* Response Phasethe medical impacts of major peacetime disasters
* Recovery Phaseand to provide support to the military and the
With respect to most disasters we hope thatDepartment of Veterans Affairs medical systems
interphase, that period between disasters, is thein caring for casualties evacuated back to the U.S.
longest period of time. It is during interphase thatfrom overseas armed conventional conflicts.
plans are reviewed, practiced, refined andThe National Response Plan utilizes the National
practiced again. It is during this period of time thatDisaster Medical System (NDMS), as part of the
it is most optimal for health care professionals toDepartment of Health and Human Services, Office
join the ranks of volunteers to be called uponof Preparedness and Response, under Emergency
when the disaster strikes.Support Function #8 (ESF #8), Health and Medical
The Adverse Event is that brief moment in timeCare, to support Federal agencies in the
when the disaster actually occurs. When the levymanagement and coordination of the federal
actually breaks, the hurricane passes directlymedical response to major emergencies and
overhead or the bomb blasts. This discretefederally declared disasters.
moment is defined by the event itself. There isMuch like Army Reservists, NDMS members are
little that responders can do except survive tovolunteers who become government employees
lend aid when the event has past. Adversewhen they are deployed and must commit to
Events cannot be prevented, but can betwo weeks service if called. NDMS teams are
mitigated. They will happen with little regard toessentially designed to be a rapid-response
what planning has or has not occurred.element that deploys to disaster sites with
Occasionally man made events can be preventivesufficient supplies and equipment to sustain
but by and large the event phase is inevitable.themselves and care for patients for a period of
Immediately following the event begins the72 hours. In mass casualty incidents, their
response phase. It is this acute period thatresponsibilities include triaging patients, providing
determines whether an event becomes aaustere medical care, and preparing patients for
disaster. Disaster is defined as need exceedingevacuation.
resource. If during the interphase weaknesses inIn other types of situations, NDMS teams may
resource management, procedures or processesprovide primary health care and/or may serve to
are identified such that needs never exceedaugment local health care staffs. Should disaster
resources, the event never becomes a disaster.victims need to be evacuated to a different locale
Unfortunately, this occurs in precious few events.to receive more definitive medical care, NDMS
It is in the response phase that defines whether ateams may also be activated to support patient
disaster goes on to be a catastrophe. While apackaging, transport, reception and disposition.
disaster is when needs exceed resources, aThe units are supported by a cadre of
catastrophe is when needs excess all ability toadministrative, logistical, and communications
respond. When the response phase fails or thepersonnel whose roles are vital to successful
planning phase is found lacking catastrophedeployment. Medical members are required to
includes.maintain appropriate certifications and licensure
Medical Reserve Corps - Your Chance to Servewithin their discipline. When members are
The Medical Reserve Corps (MRC) program wasactivated as intermittent Federal employees,
launched officially as a national, community-basedlicensure and certification is recognized by all
movement in July 2002. It was formed inStates.
response to President Bush's call for all AmericansIn contrast to MRC members, as Federal
to offer volunteer service in their communities.employees, all NDMS team members are paid
The objective of the MRC program is towhile serving.
strengthen communities by establishing a systemNDMS medical personnel includes many disciplines
for medical and public health volunteers to offerfrom physicians to pharmacists, ARNP's and PA's.
their expertise throughout the year and duringThe NDMS teams are also replete with an
times of community need. More than just a corpsexperienced pool of healthcare talent with diverse
of available healthcare professionals, the MRC is amedical backgrounds, ranging from RN's and LPN's
full partner of the White House's USA Freedomto Nurses Assistants. Paramedics and EMT's, with
Corps and the Department of Homelandyears of training and daily emergency experience
Security's Citizen Corps.are also an integral part of the teams. Respiratory
Volunteerism for America's healthcare providerstherapists bring yet another medical specialty to
has faced many obstacles in the days before thehelp round out the deep medical resources of an
MRC. Issues of liability insurance, malpractice,NDMS team.
worker's compensation, injury insurance and manyAdministrative, Logistical and Communications
other serious concerns have plagued the medialexperts round out an NDMS team and ensure
volunteer effort in the United States for the pastthat a fully self sufficient group of professionals is
2 decades. If insurance issues did not stand in theready to deploy at a moment's notice when
way of medical volunteers, licensure andrequested by federal disaster declaration.
accreditation issues stymied efforts to provideMost NDMS teams are also state disaster medical
much needed disaster medicine services followingresponse teams providing reservist style medical
disasters.support for their local communities as a
The adoption of Emergency Medical Assistancesupplement to MRC assets in an area.
Compacts (EMAC) across all 50 states and allFor more information about the National Disaster
United States territories was designed to addressMedical System or to become a member, please
the majority of these concerns, but recentvisit the NDMS website at oep-ndms.dhhs.gov.
legislation introduced in congress shows that theSo How Do I Participate?
EMAC's are far from resolving the key insuranceFirst, get educated. The sad truth is that few
issues facing medical volunteers. Legislation isphysicians have spent even eight hours learning
pending before both the U.S. House ofhow to keep themselves, their families and their
Representative and the U.S. Senate to resolvepatients alive in the event of a disaster. Take a
the interstate worker's compensation issue forBasic Disaster Life Support Course or similar
healthcare providers who volunteer their servicesHealthcare First Receiver training. You are of no
in time of disaster. In the near future, similaruse to anyone if you fail to go home alive at the
legislation will be proposed to resolve malpracticeend of the day.
coverage issues for healthcare volunteers inNext, get involved. Of the over 5000 hospitals in
disaster.the United States, only a very small fraction have
Membership in the Medical Reserve Corpsphysicians on the hospital disaster planning
resolves all these problems now and without thecommittee. Of greater concern is that few if any
need for special legislation. Medical Reserve Corpsof those physicians who do participate in hospital
volunteers are credentialed and their membershipdisaster planning have any formal training or
in the MRC provides Eminent Domain coveragecertification in disaster medicine or disaster
for malpractice as well as volunteer injurymanagement.
coverage in the event of an on duty mishap.Once you are educated and involved, become a
Who Can Volunteer for the Medical Reserveresource. The 2006 Institute of Medicine reports
Corps?on the state of emergency medicine in the United
MRC volunteers may include medical and publicStates soundly rebuked hospitals and healthcare in
health professionals including:general for poor and ineffective planning,
* Physicianspreparedness, training and practice. Throughout
* Nursesthe evolution of healthcare disaster preparedness,
* Pharmacistsphysicians have been conspicuously absent from
* Emergency medical techniciansthe table. It is well past time that those who have
* Dentiststhe ultimate responsibility for patient care and well
* Veterinariansbeing take responsibility for their role in disaster
* Epidemiologistsplanning and preparation.
* Infectious disease specialists.Finally once you have become educated, involved
In addition, volunteer interpreters, chaplains,and a resource, volunteer. If you are fortunate
amateur radio operators, logistics experts, legalenough to have a career which allows you the
advisors, and others may fill key support positions.freedom to deploy for weeks at a time to
Most MRC response and recovery assignmentslocations far from home, consider becoming a
are secured through local and state channels.member of an NDMS team. If your career needs
However, opportunities for MRC volunteers toand practice responsibilities require that you stay
assist outside their local jurisdiction do arise. Duringcloser to home, join an MRC team in your area.
the 2004 hurricane season, MRC volunteers wereEither way you will serve your community, your
asked to support the American Red Cross (ARC)nation and your fellow man in a way not possible
response activities in Florida. This was the firstanywhere else in medicine.