Ruth Bachmeier, MS, RN John R. Baird, MD, MPHDoug Murphy, MBA, BMSFargo Cass Public HealthFargo, North Dakota
Objectives• Identify role of
local public health during a major flood
• Recognize importance of collaboration and cooperation during a major flood disaster
• Evaluate the risk/benefits and decision making involved in evacuation of vulnerable populations
Red River at Fargo, NDRiver flows northVery flat land Wet autumn Record snow fallFlood stage: 18 ftMajor flood stage: 30 ft Record flood of 1997:
39.57 ftMarch 28: crested at
40.82 ft
FEMA photo
Role of Fargo Cass Public HealthHistorically
Tetanus shotsPost flood
environmental concerns
Minimal EOC
2009 Limited Tetanus shotsPre-post environmental
concernsFull EOC involvementEvacuation of
vulnerable populationsShelter coordination
and staffingSandbag supervisionPIO backup
Fargo Cass photo
Emergency OperationsDirector of public
health: city cabinet meets weekly
Weekly flood meetings : first part of March
EOC activation: city and county
Public health in both EOCs
Twice daily flood briefings
Bob Collins PhotoMinnesota Public Radio/mpr.org
Collaborating PartnersLocal hospitals, long-term care facilities,
congregate living sites for vulnerable populations
North Dakota Long Term Care Association
North Dakota Department of HealthNorth Dakota Department of Human
ServicesFM Ambulance and transportation
providers
Poll 1My jurisdiction has distinct geographic characteristics which should be taken into consideration in our PH emergency planning.
A Strongly Agree
B Agree
C Disagree
D Strongly Disagree
Click on the down arrow if you can’t see the response choices.
Poll 2Health facilities and facilities housing vulnerable populations in our jurisdiction have role and staff specific, up-to-date emergency plans in place, and have exercised those plans including mandatory or advised evacuation procedures.
A Strongly Agree
B Agree
C Disagree
D Strongly DisagreeClick on the down arrow if you can’t see the response choices.
Evacuation Planning Conflict between
protecting city and evacuation“Evacuation is not an
option”
Plan for vulnerable populations
Frequent partner meetingsTeleconference Interactive video
network
FEMA photos
Secured shelter sites
Evacuated 2500 hospital, long term care and other vulnerable population facilities
• Coordinated evacuation plans with nursing homes and group homes
• Formalized evacuation plans for four facilities
• Transportation arranged• More EMS resources requested
through EOC
Met with healthcare facilities
Timeline: Monday – Saturday 3/23 3/24 3/25 3/26 3/27 3/28
2nd
crest
TransportationCoordination vital
Limited resources in high demand
School buses, facility buses, planes, private companies, ambulance
Staff assist on evacuation vehicles
Federal transportation/evacuation team arrived shortly after mission over
Bus seat configuration
Daniel Reetz photo
Poll 3In our jurisdiction, we have a clear understanding of Red Cross services and terminology and what our role would be in partnering to set up an emergency shelter in the event of an evacuation.
A Strongly Agree
B Agree
C Disagree
D Strongly Disagree
Click on the down arrow if you can’t see the response choices.
SheltersPrimary site unavailable:
affected by flooding Shelters placed in small
community 20 miles west
of FargoTwo churches, two public
schools
Lots of resources, Red Cross, DMAT: not always clear who was in charge
Resources missing for provision of basic cares
Repatriation: Second CrestShelters for other
community’s evacueesEngineering
assessmentsPotential second
evacuation riskTransporting stretcher
patients delayFewer buses available
Fargo Forum photo
Lessons Learned Staff deep enough and soon enough
(sleep is a good thing)Incident command system works
for a public health emergencyCommunication: internal / external
need improvement Wording of evacuation order: voluntary
versus mandatory importantSpecific flood vulnerability assessments
important for each facility
More Lessons LearnedPH not an expert on
transportation (but we are now)
Patient identification: triage tags
Definition of shelters forspecial populations
Facilities evacuating to “sister” facilities worked well
FEMA Photo
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