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Dr. Auf der Heide has taken on a monumental task. In this book he shows the recurrent problems that exist with the delivery of disaster care. He rightly points out that most failures of disaster management are system problems. I could not agree more.
Over the past twenty years I have been extensively involved in the medical aspects of disaster planning. I am a past chairman of the California Medical Association Disaster Committee and served as chairman of the Office of Emergency Services Disaster Medical Committee. During those years I learned that the public sector is charged, usually by law, to effect disaster planning; yet most of the resources are in the private sector. Seldom is there effective communication between the private and public sector. I also learned that public agencies rarely communicate effectively with each other in regard to disaster planning, compounding errors. It is my strong conviction that there will never be effective disaster medical care until it is incorporated into day-to-day EMS activities. This includes communication, access to transportation, and knowing the hospital resources and how to properly distribute patients. Cooperation between the private sector and the public sector on a daily basis is required before a profound impact on effective disaster response is realized.
Dr. Auf der Heide has addressed these issues in this book and has offered solutions. I believe this is an excellent resource. It should serve to focus our efforts on how to best achieve superior disaster care.
Donald D. Trunkey, M.D.
Chairman, Department of Surgery
Oregon Health Sciences University