The Good Samaritan: Integrating ordinary people into emergency response
By Joseph Scanlon
(Posted on September 29, 2011, on http://www.homeland1.com/disasterpreparedness/articles/1130306-The-Good-Samaritan-Integrating-ordinary-people-intoemergency-response/)
The real first responders in a widespread destructive incident are those who are
immediately on hand, including the survivors
In 1942, when fire raged through the Cocoanut Grove night club in Boston, there was an
urgent need for transportation of the injured and dead. Some were moved in taxis, and
many were transported in newspaper delivery vans.
AP Photo/Eric Draper
An earthquake victim salvages belongings
from the rubble of her home as a high rise
burns out of control in downtown Kobe,
Japan, January 19, 1995. The citizens
directly affected by emergencies are often
the real first responders.
In 1987, after a tornado tore apart large areas of Edmonton, Alberta, residents of a trailer
park used their undamaged cars to take injured survivors to hospital.
In 1995, survivors of the Kobe earthquake collected the bodies of the dead and took them
to temples and other public buildings.
In 1998, when Swissair 111 plunged into the Atlantic Ocean five miles offshore from
Halifax International Airport in Nova Scotia, the first response was by fishing boats from
nearby coastal communities.
In 2004, after the Indian Ocean tsunami struck Thailand and Sri Lanka, survivors picked
up bodies and took them to hospitals, temples and morgues.
These examples illustrate the well-documented fact that the real first responders in a
widespread destructive incident are those who are immediately on hand, including the
survivors. Police, firefighters and EMS personnel play little, if any, role in initial response.
The impact of civilians and survivors
What is not so well documented, and is less understood, is the impact of these Good
Samaritans' actions on emergency response.
For example, survivors are rarely equipped to do heavy search and rescue, so the people
they look after and take to medical centres are usually the least injured. The result is what
might be called "reverse triage": medical centres are inundated first by those least in need
of immediate medical attention.
Or to take another example, the fact that survivors leave the impact area with the injured
means that when emergency personnel do arrive, there is no one to tell them what has been
done and most important who has gone where with whom.
Occasionally, emergency personnel arrive in time to co-opt civilians and make them part of
the response.
For example, when an Air Ontario plane crashed in the bush near the airport of Dryden in
northern Ontario in 1989, most survivors walked out to a nearby road, where they stood
cold and wet and in some cases dripping of jet fuel.
An Ontario Provincial Police sergeant told drivers of civilian vehicles to load up with
victims and take them to hospital. He even loaded several slightly injured into a garbage
van.
In Edmonton in 1987, Royal Canadian Mounted Police told drivers to use their cars as
ambulances. One driver protested that the blood would stain his lovely white leather seats.
He was told to do it anyway.
In Nova Scotia in 1998, Royal Canadian Navy ships communicated with the fishing boats,
directed them into search lanes and asked them to bring any human or aircraft debris to
them, rather than take it to shore.
Sometimes emergency personnel even find imaginative ways to use people. After a building
collapse in my home city of Ottawa, Ontario, police used public works employees (who
wear distinctive gear) for perimeter security.
How to plan, not just react
While all these actions made sense, they were not part of any plan. Given the frequency of
involvement of ordinary citizens in emergency response, it would seem to make sense to
build that response into the plan or, to put it another way, to develop plans based on what
happens, not on what officials would like to happen.
Hospitals, for example, should assume that the first injured to arrive will be those least
injured and have plans to move them away from emergency. But hospitals should do
something else: they should have clerical staff assigned to take the names of Good
Samaritans so they will be able to inform personnel doing search and rescue who is safe.
But planning can go much further than this.
When the Ottawa Police Service asked what senior citizens could do in an emergency, I
suggested they be asked to keep track of who was at home and who was away and who was
rescued and who rescued them and, most important, who had not been rescued and
therefore might still be trapped in wreckage.
When Dr. Erik Auf der Heide and I studied the problems of dealing with chemically
contaminated victims, we realized two things: first, that some victims will reach hospital
before the hospital knows there has been an incident; and second, that the Good
Samaritans who assist contaminated victims may be disoriented by fumes as they drive
them to hospital.
This led to two suggestions.
One was that a hospital which receives contaminated victims should immediately alert all
other hospitals in its area so they can take preventative measures. The other was that as
soon as an incident becomes known, warning messages should go out over radio and
through Amber Alert systems so drivers will recognize the risks.
The issue, of course, is not whether these suggestions make sense, but whether planners
accept what will actually happen in emergencies and plan accordingly. From what I have
seen, that is often not the case.
Most emergency plans assume that an incident will be at a site, and that this site will soon
be controlled by police, and that firefighters will deal with fires, spills and heavy rescue,
and EMS personnel will triage the injured, sending them in an orderly way to the
appropriate medical center. There is also an assumption of command and control.
Such a plan may work at an air crash or train wreck, but it makes little sense after a
widespread destructive incident.
I say "may" work, because after an Air France Airbus A-340 ploughed off a runway at
Toronto International Airport in August 2005, civilians picked up passengers and in some
cases took them to where they had planned to go, even though the plane had never cleared
Customs.
Surely it's time emergency planners accepted that ordinary people will play a role in
disaster response and look for ways to work that into their plans and take advantage of
that activity. It no longer makes sense to have plans that state (like one I saw recently) that
under no circumstances must civilians be allowed to play any role in the response.
Perhaps that is in fact starting to happen.
Last December, I was asked to lecture in Amsterdam on the role of ordinary people in
emergency response. I was invited by local government and the Amsterdam fire
department, which not only takes an imaginative approach to emergency planning, but
considers it has a response to educate others. The invited audience came from all over The
Netherlands.
To avoid someone misinterpreting this column, let me make clear I am not suggesting that
emergency response be turned over to amateurs.
Firefighters will still be needed to do search and rescue. EMS personnel will still be needed
to assist and transport the more seriously injured. Police will still be needed to assist the
movement of personnel to and from an impact area.
Hospitals will still have to receive and treat the injured. Social service and voluntary
agencies will still be needed to assist persons locating displaced victims and providing
covering and clothing, sustenance and food, shelter and accommodation.
However, all these agencies should individually and together think how the actions of
ordinary people can be integrated into their planning and response.
Joe Scanlon is professor emeritus and director of the Emergency Communications Research
Unit at Carleton University in Ottawa, Canada.
For many years, he was an instructor of the Hostage Commanders Barricaded Persons course
at the Canadian Police College.