The September 11, 2001 (9/11) terrorist attacks revealed the weaknesses present in the US national infrastructure for public health. Response efforts lacked the unified command and integrated communications required for large-scale response (Khan, 2011). Moreover, information that was necessary and important for decision making was not amicably shared among the public health agencies. The first responders from the public health agencies lacked the appropriate training and knowledge on disaster management. Additionally, equipment required in their roles was inadequate, and extremely in low supply. According to Centers for Disease Control and Prevention (CDC), rescue workers coming from New York City experienced high rates of illness in their respiratory systems one year after the bizarre attacks, and this could have resulted from inadequate use of personal protective equipment (Khan, 2011). These terrorist attacks, and the bioterrorist attacks that followed in October and November, 2011, raised the awareness of the vulnerability of the nations’ public health agencies and the need for them to be prepared for emergencies. It also revealed the necessity for a public health infrastructure that is sustainable and flexible, and why it is crucial to create linkages between health outcomes and environmental exposures.
The federal, local and state public health organizations had varying roles in the handling of the 9/11 terrorist attack event. The federal public health organizations had the role of acting because the health threats emanating from the terrorist attack spanned more than a single state. The bizarre terrorist attack involved terrorists crashing a plane in a field in Pennsylvania, one in the Pentagon (Washington D.C), and two into the World Trade Center in New York City (Robert Wood Johnson Foundation, 2011). Moreover, the federal public health organizations were tasked with assisting the affected states to shore up the expertise and resources necessary for an effective response to the disastrous occurrence. The magnitude of the effects of the attack was huge, considering three thousand people perished and thousands more were injured. Additionally, the federal public health organizations were tasked with contributing financial and operational resources necessary to enable evacuation of those who were injured and for them to be rushed to health centers for medical care. Their role also included ensuring all the levels of government had the capacity to attend to and provide the most essential of public health services to the victims of the heinous attacks.
On the hand, the state and local public health organizations had the primary responsibility of ensuring safe evacuation, bleeding containment, and successful healthcare attention for the victims of the terrorist attacks (Davis, et al, 2006). The state organizations were tasked with screening of conditions of those who had died and those who were injured, technical training and assistance to those who were to be involved in search of bodies in the resulting rubble. Moreover, the state public health organizations were to monitor the progress of those injured and who had been admitted in hospitals, to prepare for referral procedures for those whose condition was deteriorating, and to provide laboratory services for health facilities involved in determining the dead and mapping the best medical care for the injured.
Local health organizations also had a crucial role to play. Both local and state public health organizations are endowed with the primary responsibility for the provision of health care services as enshrined in the US constitution. The terrorist attacks called upon state and local public health organizations to spring to action and prevent further injuries to the victims, assist the affected communities in recovery from the psychological impact of the attack, and assure the quality and easy accessibility of health services for the injured (Marmagas, et al, 2003). The decentralized local public health organizations were majorly involved in making financial decisions regarding the amount of money to be allocated and disbursed to expedite the disaster response activities.
The federal, state, and local public organizations provided various services during the terrorist attacks. The local public organizations were majorly involved in linking the injured people to the health care services they needed, and they worked extra hard to give healthcare assurance to the injured. The state public care organizations evaluated the health care services that were needed, mobilized communities to come on board and volunteer their time and resources, and diagnosed the extent of injuries and complications suffered by the victims and came up with ways of reducing the impact on their overall health. The federal public health organizations monitored the health status of the victims, informed the citizens on the progress on the public health front, mobilized people to donate blood which was collected and banked for use on the victims, and developed plans on safe evacuation and retrieval of bodies (Robert Wood Johnson Foundation, 2011).
In my opinion, the public health organizations performed miserably in responding to the terrorist attack. The response of the organizations lacked an integrated communication leading to haphazard and uncoordinated response (Khan, 2011). A central communication center to guide the response activities of teams involved was required. Moreover, the public health organizations were not commanded uniformly leading to duplication of duties and disorganization in the response activities. Additionally, the responders had poor training and lacked the skills necessary to deal with disaster of such a magnitude. Of note also, the necessary equipment for the role of emergency response and disaster management was not enough which was an indication of unpreparedness in terms of stocking of disaster rescue equipment.
All the public health organizations at the federal, state, and local levels performed dismally in responding to the September 11, 2001 terrorist attack. Most of them prior to the attack were dismally equipped and lacked ability to respond effectively to emergencies (Khan, 2011). Most states did not have the ability to activate their staff and their emergency operation centers. The nations’ public health system did not get the necessary recognition of its importance in contributing to national security thus there was minimal investment in the sector. The public health organizations worked in isolation. They failed to work in tandem with fire departments and emergency medical service providers when responding to incidents or disasters (Marmagas et al., 2003).
The public health departments have a central role to play in preventing terrorist attacks like that of September 11, 2001. The organizations at the federal, state, and local levels can build stockpiles to support prophylaxis of people by starting a forward placement of lifesaving antidotes that counter terrorist attacks (Khan, 2011).
Several lessons were learned from the event. It was noted that it was important to make enough investments in public health preparedness to enhance the capacity of the organizations in terms of ascertaining health security in the event of epidemics or disasters (Davis, Mariano et al, 2006). After the poor response patterns witnessed in the 9/11 terrorist attack event, several policies should be developed. Firstly, the public health organizations have to integrate with fire departments and law enforcement agencies when responding to disasters (Homeland Security, 2008). Working in tandem with these agencies will ensure coordinated and organized response. After this attack, the contribution of public health departments in national security was realized. Subsequently, substantial investments have been made in transforming and bettering the infrastructure, capability and planning of these departments to help them ensure security of healthcare in large-scale disaster events.
References
Khan, A. (2011, January 1). Public health preparedness and response in the USA since 9/11: A national health security imperative. Retrieved November 17, 2014, from http://www.cdc.gov/phpr/documents/lancet_article_sept2011.pdf
Davis, L., Mariano, L., Pace, J., Cotton, S., & Steiberg, P. (2006). When It Comes to Terrorism, How Prepared Are Local and State Agencies? Retrieved November 17, 2014, from http://www.rand.org/pubs/research_briefs/RB9209/index1.html
Marmagas, S., King, L., & Chuck, M. (2003, August 1). Public Health’s Response to a Changed World: September 11, Biological Terrorism, and the Development of an Environmental Health Tracking Network. Retrieved November 17, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447942/
Homeland Security (2008, January 1). National Response Framework. Retrieved November 17, 2014, from http://www.fema.gov/pdf/emergency/nrf/nrf-core.pdf
Robert Wood Johnson Foundation (2011, January 1). Remembering 9 / 1 1 and Anthrax: Public health’s vital role in national defense. Retrieved November 17, 2014, from http://healthyamericans.org/assets/files/TFAH911Anthrax10YrAnnvFINAL.pdf
