Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

need under the 12 Emergency Services Functions (ESFs). Each ESF is headed by a
primary agency that has authorities, resources, and capabilities in the particular functional
area. Other agencies have been designated as support agencies for one or more ESFs
based on their resources and capabilities to support the functional area. The FRP is also
important in that most States use it as a base for the structure and some content of their
emergency operations plans. In turn, local emergency operations plans are based on the
State plans. (See Chapter 2, Systems Issues, for more information.)
One of the major functions physicians will be involved with and should become familiar
with is Emergency Services Function Number 8 (ESF #8), the Health and Medical
Services Function. ESF #8 provides assistance to supplement State and local resources
for public health and medical care needs during a disaster. In a federally declared
disaster, the U.S. Public Health Service (USPHS), a component of the U.S. Department
of Health and Human Services (DHHS), forms a Crisis Action Team and activates the
National Disaster Medical System (NDMS) as needed to provide health and medical care
assistance. A Disaster Medical Assistance Team (DMAT) is a deployable unit of 35
physicians, nurses, technicians, equipment, and supplies for austere medical care. A
Management Support Unit (MSU) manages field health and medical resources of
deployed DMATs. A Disaster Mortuary Assistance Team (DMORT) provides a
temporary morgue facility, victim identification, processing, preparation, and disposal of
remains. A Metro Medical Strike Team (MMST) provides assistance in the medical
treatment/management of chemical, biological, or radiological incidents resulting from
deliberate or accidental acts. In some cities, there are Metropolitan Medical Response
Teams that provide additional medical response capability. The parent agency of all of
these groups is the United States USPHS, with assistance from the Department of
Homeland Security (DHS).
Public Health Preparedness
On a larger scale, we should also recognize the need for public health preparedness. This
requires the existence of a strong public health system. To allow for rapid and efficient
response, we need both central organization as specified by Federal planning and State
implementation and decentralization of some resources, such as diagnostic capabilities.
It is important for pediatricians to understand the importance of public health and their
relationship to departments of health. This includes their role in public health, reporting
requirements and mechanisms, and mechanisms for receiving and soliciting information
from departments of health.
Advocating for Children and Families in Preparedness
Planning
To ensure that children are included in government and community planning and
preparedness activities, informed and motivated pediatricians should advocate for
children at all levels. This advocacy can take several forms. Grassroots advocacy can
include efforts to ensure legislation and funding to support an emphasis on children in
disaster planning at every level. Pediatricians can also serve as expert advisors to local,
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