Disaster Exercises Avoiding a Train Wreck

I didn't get to see the train plow into the yellow school bus, but hundreds of Argentines witnessed the crumpled bus tossed along the railroad tracks by the oncoming train engine. They looked delighted. It must have been quite a sight.

This was June 2000, and I had been invited to one of Buenos Aires' outlying neighborhoods to view an MCI exercise. The enthusiastic planners had crashed a train engine into a bus, liberally sprinkling the jumbled mess with an assortment of hysterical and bleeding "victims." By the time I arrived, the exercise scene was a flurry. There didn't seem to be an incident command system (ICS) in place, and I could discern absolutely no organization to the response.

The excitement of the train stunt had attracted hundreds of nearby residents who had to be kept at bay by law enforcement. There were at least as many "victims" as in any real train disaster and more responding agencies than I was able to count. None­theless, the entire exercise was completed before I got my bearings. When one of my smiling hosts asked me for an evaluation, I was speechless.

I asked diplomatically, "Who exactly was directing the incident?" No one could tell me. What struck me, however, was that virtually all the dozens of responders, regardless of their individual affiliations, knew and greeted each other by name. I wasn't accustomed to seeing that kind of comradery during any interagency activity, real or otherwise.

Though it is hard to talk about "orthodoxy" when the incident command system has only been around since the 1980s, to my eyes, the Argentine exercise appeared unconventional at best. Nevertheless, the moulaged victims had been quickly transported to appropriate facilities. It is hard to argue with the methods when the results surpass expectations.

The bane of every MCI or disaster, real or otherwise, can generally be reduced to one word: communications. My Argentine colleagues appeared to have overcome this conundrum effortlessly. In that mysterious economy of group effort, I suspected there was something useful to be discovered about multi-agency emergency response. It wasn't until much later, during my own participation in disaster-exercise planning, that I began to unravel the secret to that curious Argentine model.

Overcoming Sibling Rivalry

Interagency competition is particularly acute in the EMS arena, where fire services have increasingly taken on a nontraditional medical role. As is always the case in Argentina, doctors staffed the ambulance crews during the exercise I witnessed. These doctors choose to work on the street and enjoy rubbing elbows with fire department personnel and law enforcement. Other personnel, who had virtually no medical training, viewed the doctors as skilled professionals, not competitors. At the end of the exercise, the smiles I saw attested to the sense of shared accomplishment.

Outstanding examples of disaster response are rare, as evidenced by the attention they continue to receive years after their physical effects have been erased. Current FEMA training materials laud the response of Woodbury County public-safety personnel to the crash of United Airlines Flight 232 in Sioux City, IA, in 1989, where out of a total of 285 passengers and 11 crew, 174 passengers and 10 crew members survived. It is generally recognized that, were it not for the responders' exemplary preparation, the victims would likely have fared much worse. Gary Brown, director of Disaster and Emergency Services for Woodbury County, didn't sound at all surprised when I called him wanting to know his community's "secret."