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ogy yields data that demonstrate correlation and indicate areas of further study and surveillance is the process of monitoring areas at risk for public health changes. Disaster medicine has identified specific disease entities that are characteristically seen in times of medical disaster response. These include: 1) Crush syndrome 2) Earthquake Asphyxiation Syndromes, 3) Hazardous Materials Exposures, and 4) Post-traumatic Stress Disorder (PTSD). There are numerous articles on these subjects and the scientific basis for these diseases have been fairly well established. Other topics relevant to disaster medicine, such as response (mobilization), incident command system, and logistics have been based on other professional organizations, such as from firefighters and the scientific basis has been less well established. Disaster medicine organizations will need to determine an approach to assimilate this information. Disaster medicine organizations have recognized the importance of defining the subspecialty core content and the American College of Emergency Physicians (ACEP) made the first effort of identifying this information in April 1990. This publication is currently undergoing revision by the cooperative efforts of a sister organization, the Society for Academic Emergency Medicine (SAEM) to be published in May 1995. Disaster researchers have identified critical components of disaster response and have begun research in the following directions 1) Disaster Assessment, 2) Information Management, 3) Training and Consultation, and 4) Disaster Research. One of the first major tools mobilized for disaster medicine research has been Epidemiology. Epidemiology is merely a research tool and a means towards effecting research in the particular critical component areas of disaster response mentioned earlier. Epidemiology has been used to identify and quantitate the type and scope of human pathology in times of disaster. Epidemiological tools have been employed to delineate public health problems and to indicate relative improvement or degradation of public health within an area. Epdemiological methodology ensures representative sampling, resulting in analysis with results that can be extrapolatable. Epidemiological data may provide a gold standard to decision-making officials as to the progress of disaster response and recovery. Finally, epidemiological data may indicate areas of interest that may require further surveillance. One of the first results of this initial research is that there was a great separate need for disaster assessment efforts. Thus, began the concept that an assessment team Volume 15, Number 4, 1995
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should deploy to a disaster area in an early time frame and that epidemiology data-gatherers should follow disaster response units to collect relevant data while it is still easily available. Emergency medicine followed the following steps in becoming a medical specialty 1 ) Definition of content, 2) Graduate Training Programs, 3) Medical School Role/ Development of EM Departments, 4) Standards/Boards, 5) Continuing Medical Education Standards Maintenance, and 6) Research/Format on a Body of Knowledge (leading to reiteration of step 1).
SUMMARY
Disaster medicine literature, which has been predominantly anecdotes and case studies, has now begun directing research using a combination of drill CQI, epidemiological tools and surveillance to begin data acquisition and analysis in earnest.
REFERENCES Famine-Affected, Refugee, and Displaced Populations: Recommendations for Public Health Issues Morbidity and Mortality Report, CDC July 24, 1992, Vol 41, No RR-13. Rapid Health Needs Assessment Following Hurricane Andrew-Florida and Louisiana, 1992 Mortality Report, CDC Sept 18, 1992, Vol 41, No. 37:685-688. Liliibridge SR, Noji EK, Burkle FM Jr: Disaster Assessment: The Emergency Health Evaluation of a Population Affected by a Disaster. Ann Emerg Med November 1993;22:1715-1720. Lillibridge SR, Noji EK, Burkle FM Jr: Disaster Mitigation and Humanitarian Assistance Training for Uniformed Service Personnel Military Med. May 1994;159 397-403. Henderson AK, Lillibridge SR, Salinas C, Graves RW, Roth PB, Noji EK: Disaster medical assistance teams: Providing health care to a community struck by Hurricane Iniki. Ann Emerg Med April 1994,23:726-730.
HORSE RESCUE COMMUNITY PLANS IN S O U T H E R N C A L I F O R N I A
Timothy B. Collins
At this time, in California, there is no recognized statewide horse disaster rescue group. However, there are several organizations developing such a program. Author's address: 3333 Braemar Drive, Santa Barbara, CA 93109. 195
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One group is the California Veterinary Medical Association, which is preparing veterinarians to coordinate an animal disaster management system within each county. The veterinarians directing this program are Dr. Kerry Marshall, Dr. Don Gandolfi and Dr. Melissa Nixon. The program is intended to have one veterinarian responsible for large animals and one for small. The job of the individual coordinator will be to first determine what is presently available in the way of volunteer groups and become involved. If a group does not already exist, the coordinator is expected to organize one and act as a networking link with other California Veterinary Medical Association Disaster coordinators throughout the state. Each county will be responsible for determining the potential threats in their locale and for developing the needed training and resources to be self sufficient. When acting under the authority of the California Veterinary Medical Association, the volunteers are covered by the association's liability insurance. The counties in California are very large with different geographic and topographical conditions within them. In an actual emergency those on the scene must act quickly with sufficient expertise, equipment and resources to save animals. Consequently, the boundaries for an animal rescue group must be within a manageable area to allow for a quick coordinated response. The intensity of the January 1995 storm in Santa Barbara caught the community by surprise. Having a local group, we were able to respond. The horse owners in this case were able to get their own horses out and our Equine Evac team was prepared with billeting arrangements. The limitations of using county lines as boundaries is recognized and being addressed. Another California organization interested in horse rescue is the California State Horseman's Association. This organization has had an "Equestrian Trails Patrol" since 1947 with individual chapters throughout the state. Traditionally this volunteer patrol has been involved in monitoring trails for deterioration and safety. They donate their time and money for the upkeep of trails throughout the state. The Equestrian Trails Patrol already trains its members to respond to a medical emergency for both humans and horses. Steve Sharp of Mira Loma, California, a member of California State Horseman's Association went to its Board of Directors and presented a proposal for the Equestrian Trails Patrol to take further steps into horse rescue. As a result, the Board has directed Mr. Sharp to expand activities to include horse evacuation and rescue. The Mira Loma chapter of the California State Horseman's Associa196
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tion volunteered and rescued many horses during their 1989 fire. At that time the horses that were rescued were taken to homes of the various members that had space available. Now they have established a rapport with ranchers in the area and are prepared with a more organized billeting system. Although Mr. Sharp's offers to government agencies often falls on deaf ears, he said that the California Division of Forestry in the county of Riverside has recognized the group and has given them accreditation to cross fire lines, when safe, to rescue horses. The California Division of Forestry is responsible for fire protection in Mira Loma and uses volunteer reserves. Mr. Sharp found that agencies that already utilize volunteers are much more receptive to calling on a volunteer group that can present themselves as an organized valuable resource. The Equestrian Trails Patrol trains their members in CPR, search and rescue, Red Cross first aid and now horse first aid. Each member wears a recognizable uniform and has a numbered badge. This and the fact that California State Horseman' s Association has their own liability insurance adds to their accountability with the California Division of Forestry. The Mira Loma chapter of the California State Horseman's Association has been involved in several fire and flood rescues and I expect that it is only a matter of time when other government agencies will acknowledge the value of such a group. Two years ago when I spoke at our conference, as far as I know the San Diego and Santa Barbara groups were the only organized volunteer horse rescue teams in operation. Both groups have continued to progress and at least eleven other communities have already started or are planning to start a volunteer horse rescue program. San Diego has had a volunteer group involved in the rescue of horses and other species for quite some time. At our last conference Mike Conant informed us of their activities and since then they have been expanding their operation. They now have a reserve unit of about 75 individuals headed by a paid staff member of the San Diego Humane Society. According to Captain Baker, supervisor of the program, this is a significant step of progress. It opens a channel of communication between the volunteers and professionals allowing for a more coordinated response when an emergency arises. It also helps legitimize requests for training and equipment. This has improved the morale and safety of the individual volunteer. They are developing a 16-hour training program which among other things will include such essential skills as fire protection, and the handling and rescue of horses and a JOURNAL OF EQUINE VETERINARY SCIENCE
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variety of other large species including llamas, buffalo, and ostriches. Because the commander in San Diego is a California Humane officer with the official responsibility of enforcing the law, the unit acts within an official capacity as a support group during investigations beyond horse rescue. An example of this was supplying transportation for the birds when a cock fight operation was raided. Also in San Diego County is a group in Ramona. Although the team is newly organized, many members of the Ramona Emergency Animal Rescue unit have had a number of years experience in animal rescue. While this group does respond to calls regarding all animals, they do have an equine team. A duty officer carries a pager and will activate the needed volunteers for any life-threatening situation for animals. Ramona Emergency Animal Rescue is a non-profit organization which carries its own liability insurance. It is financed through private donations. The members supply their own uniform consisting of a khaki shirt, red T-shirt with Emergency Animal Rescue printed on the back and a red ball cap. They have monthly training meetings that active members attend. Reserve members must attend 4 specific training meetings on fire and safety, horse loading and handling, small animal first aid, and large animal first aid. Although the active members are certified volunteers for "United Animal Nations" and were called to assist during the earthquake in Northridge and the floods in Texas, it has been a challenge to become recognized by local government agencies. However, because of their experience and quickness to respond they are now on the rolodex of the Sheriff and County Animal Control Offices and are working towards their goal of becoming a part of the California Civil Defense and receiving I.D. cards from the Office of Disaster Preparedness as pre-approved volunteers. Since our last conference the Humane Society of Pomona has organized a volunteer horse rescue unit. Today there are 7-10 individuals who comprise a core unit that has been prepared to respond to emergencies. In addition to this there are other volunteers who attend the training sessions held twice a year which focuses on such things as trailering procedures, first aid and the handling of other livestock. In Pomona, besides working with horses, this group is prepared to assist with livestock such as goats, sheep and pigs. This month their clinic will introduce the volunteers to methods of calming animal victims through massage and learning about stress points. The Pomona Equine Rescue Team is now included in the Chino Valley Fire Department's Methods of Operation in Auxiliary Volume 15, Number 4, 1995
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Agency Operations Manual. Since they began in Pomona, they have been contacted by three surrounding communities, asking for information to help them start horse rescue programs in their communities. One more sign of being recognized as a valuable resource. For more information about Pomona's team contact Officer Marsha Wyatt. A group that began after the 1993 fire in Malibu, is represented by Stephanie Abronson. This group has been formed by a homeowner's association in Monte Nido, California. They not only have been focused on preparing themselves through a neighborhood watch and inventory, but they have put together a booklet to share with others valuable ideas for disaster preparation. The Monte Nido group asks each homeowner to draft a site plan for their property so others will know where to find important entries, valves, and what buildings contain animals or dangerous items. Due to the dangers of fires blocking escape routes, they are trying to get consent from the state for the association to use a state park close to the residences as a safe zone during an emergency. In 1993, those individuals who were at home were caught with no escape route after the first crucial minutes and those not home had no way of getting to their animals. Fortunately there were no human fatalities. It has been difficult to find a government official willing to say "yes," you can use that space for evacuating your horses. But they are still working at it. Grass Valley, a community within Nevada County had volunteers rescuing horses during their 1988 fire. Dr. Melissa Nixon a veterinarian was very active in the rescues. Since the California Veterinary Medical Association became interested in animal rescue, the Grass Valley volunteers have been operating under its auspices with Dr. Nixon as the official disaster coordinator. Some of the specific problems being addressed by them are: 1. Topographical challenges: Because of the mountain terrain, safe accessible billeting sights are difficult to come by and response time is slowed down. 2. The logging in of animals: They have devised a plan which assigns each rig a number and each animal a letter. This identification is marked on the rump of each animal with a livestock crayon. 3. Donations: Requests for food and bedding specify that only low protein food be donated and that shavings rather than straw be used as bedding. 4. Lost animals: In order to track down lost animals during a disaster, an information and lost and found hot line is set up. 197
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5. Injuries to humans: first aid is being taught to all of the volunteers. The size of the Grass Valley group is kept to about 50 volunteers who attend monthly training meetings or view a video of those they are not able to attend. Members take turns being on alert and having their trailers hooked up for a week at a time. There are several people listening to scanners who report any incidents involving animals to Dr. Nixon who then takes appropriate action. A local horse group "Horse Owners, Riders, Sellers, and Enthusiasts" with the acronym (HORSE) acts as an auxiliary group to the California Veterinary Medical Association Disaster coordinator in Nevada County. Now let me tell you the progress that we've made in Santa Barbara. As you might recall the Santa Barbara Equine Assistance and Evacuation Team (also referred to as Equine Evac) has been in existence since 1986. Prior to our last conference we were developing a mobile command post, we had acquired a rescue sling along with other equipment. We had begun holding annual general meetings for all horse enthusiasts in the area. These meetings have continued. Today the command post is equipped with a HAM radio and Citizen Band Radios and in an emergency we have an agreement with two cellular telephone companies who donate their services as well as equipment. In the command post we have a map that pinpoints the location of horses in the community. This map was developed in cooperation with the local veterinarians and farriers. In the fall of 1993 two major fires occurred south of us. One in Ventura, and one in Malibu. They occurred within ten days of each other. The Ventura fire, the first one, was our first opportunity to participate in mutual aid to another county. Within three hours of being activated, we had over twenty rigs at our Mobile Command Post in Ventura, 35 miles away. There was one thing missing. Ventura did not know what to do with us. We had not properly informed them of our capabilities. One week later Malibu, 75 miles away and more isolated, had a major fire. This time we activated only four rigs and the command post, but our reputation had gone ahead of us. They respected our abilities and we were put to good use. As a result of these experiences we learned about the protocol used in the state of California for all emergencies. The fire department directs everything from an "Incident Command Post." Each agency from the Sheriff's Department to the Red Cross works through a representative located at the Incident Command Post. Consequently, last year twenty Equine Evac members including the steering committee attended Incident Com198
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mand System training. We also have participated in a mock disaster sponsored by several Amateur Radio Emergency Services and are pursuing the possibility of being included when the local fire departments host mock disasters. In our local clinics we practice using our equipment. Obstacle courses are set up for drivers to better understand the limitations of their individual rigs. Another exercise is to line up a number of trailers and using a number of horses, each trailering crew is instructed to load different horses into different trailers thus familiarizing themselves with different trailers and the reaction of horses to these differences. As we practiced using the sling, horse ear plugs, a blindfold, etc., we discovered how many people were needed to use this equipment effectively, for both preparing the animal for rescue and removing the equipment. Within the last two years the Santa Barbara Equine Evac Team has responded to a number of requests for speakers or information from groups getting started. Consequently, to be of more assistance we are developing a packet of information. The most important maxim for each of us to follow is: Plan ahead and prepare to protect our own animals. Know the roads and the lay of the land and where safety lies. Educate ourselves and act.
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