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Showing papers in "Journal of Homeland Security and Emergency Management in 2010"


Journal ArticleDOI
TL;DR: In this article, the authors provide a methodology and a set of indicators for measuring baseline characteristics of communities that foster resilience by establishing baseline conditions, it becomes possible to monitor changes in resilience over time in particular places and to compare one place to another.
Abstract: There is considerable federal interest in disaster resilience as a mechanism for mitigating the impacts to local communities, yet the identification of metrics and standards for measuring resilience remain a challenge This paper provides a methodology and a set of indicators for measuring baseline characteristics of communities that foster resilience By establishing baseline conditions, it becomes possible to monitor changes in resilience over time in particular places and to compare one place to another We apply our methodology to counties within the Southeastern United States as a proof of concept The results show that spatial variations in disaster resilience exist and are especially evident in the rural/urban divide, where metropolitan areas have higher levels of resilience than rural counties However, the individual drivers of the disaster resilience (or lack thereof)-social, economic, institutional, infrastructure, and community capacities-vary widely

1,294 citations


Journal ArticleDOI
TL;DR: In this paper, the authors simulate the effects of a hypothetical H1N1 epidemic in the U.S. using a quarterly CGE model and find potentially severe economic effects in the peak quarter.
Abstract: We simulate the effects of a hypothetical H1N1 epidemic in the U.S. using a quarterly CGE model. Quarterly periodicity allows us to capture the short-run nature of an epidemic. We find potentially severe economic effects in the peak quarter. Averaged over the epidemic year, the effects are considerably damped. Our results indicate that the macroeconomic consequences of an epidemic are more sensitive to demand-side effects, such as reductions in international tourism and leisure activities, than to supply-side effects, such as reductions in productivity. This suggests that demand stimulus policies might be an appropriate economic response to a serious epidemic.

103 citations


Journal ArticleDOI
TL;DR: The best available estimates of the value of small risk reductions, expressed as the value per statistical life (VSL), average about $6.5 million as mentioned in this paper, which may increase the VSL appropriate for terrorism risks, possibly doubling the value.
Abstract: Regulations designed to increase homeland security often require balancing large costs against highly uncertain benefits. An important component of these benefits is the reduced risk of fatalities from terrorist attacks. While the risk to an individual appears small, the benefits may be large when aggregated over the population. U.S. regulatory agencies have well-established approaches for valuing mortality risks, but address risks that differ in significant respects from those associated with terrorism. The best available estimates of the value of small risk reductions, expressed as the value per statistical life (VSL), average about $6.5 million. However, terrorism-related risks may be perceived as more dreaded and ambiguous, and less controllable and voluntary, than the workplace risks underlying many VSL estimates. These factors may increase the VSL appropriate for terrorism risks, possibly doubling the value.

66 citations


Journal ArticleDOI
TL;DR: In this paper, the authors examined four hurricane response operations drawing on content analyses of news and situation reports, revealing information about: (1) how critical actors interacted and coordinated, (2) subgroups under each network, and (3) each network as a system.
Abstract: The study addresses interorganizational learning and coordination as well as their impact on collaborative capacity building in disaster environments. Community coordination requires communication and planning to take necessary precautions in the face of severe threats of disasters. The historically unique case of the four Florida hurricanes of 2004 is used to assess coordinated response under conditions of repeated threats of hurricanes. The repeated threat scenario suggests that emergency managers must vigilantly work to keep the partnering public, private, and nonprofit agencies and citizens informed and apprised of the seriousness of the situation. The research examines four hurricane response operations drawing on content analyses of news and situation reports. Content analysis provides interorganizational interactions that are subject to network analysis revealing information about: (1) how critical actors interacted and coordinated, (2) sub-groups under each network, and (3) each network as a system. Using network analysis in analyzing disaster response systems is a new way of exploring the issues from another perspective and through a new methodology. The article showcases the potential use of network analysis in both organizational and emergency management research.

42 citations


Journal ArticleDOI
TL;DR: In this article, the authors emphasized the importance of local empowerment, organization and leadership, and planning for sustainability-providing potential lessons for US disaster management in disaster recovery efforts in other countries.
Abstract: Successful disaster recovery efforts in other countries emphasized local empowerment, organization and leadership, and planning for sustainability-providig potential lessons for US disaster management.

39 citations


Journal ArticleDOI
TL;DR: The objective of this study was to examine the plans that public, university and private hospitals in Turkey have made in preparation for possible disasters, and to further investigate what types of measures have been taken as a way of focusing on plan characteristics and surge capacity.
Abstract: The objective of this study was to examine the plans that public, university and private hospitals in Turkey have made in preparation for possible disasters, and to further investigate what types of measures have been taken as a way of focusing on plan characteristics and surge capacity. The study involved 430 hospitals throughout Turkey, each of which had 100 or more beds according to statistical data issued by The Ministry of Health of Turkey. Of these 430 hospitals, 358 were public, 40 were university-affiliated, and 32 were private. The questionnaires developed for the study were sent to the hospitals by mail. Only 251 hospitals returned responses. The questionnaire response rate was 58.4%. A total of 32 questions were asked in the survey. Frequency distributions of the data for statistical analysis were made, and tables were created according to the type and capacity of the hospitals. This study found that 233 hospitals (92.8%) have written disaster plans. When analyzed according to the type of hospital, 204 public hospitals (93.2%), 19 university hospitals (86.4%) and 10 private hospitals (100%) were found to have written disaster plans. According to the study, 63.5% of the public hospitals, 80% of the private hospitals and 31.8% of the university hospitals perform an exercise on an annual basis, as stated in the disaster plan. Disasters occur at unexpected times and have the potential to seriously affect the demand for health services. Local hospitals are one of the most significant facilities for providing health services during disasters. In this study, the level of disaster preparation of the hospitals in Turkey was examined.

39 citations


Journal ArticleDOI
TL;DR: In this paper, the role of social networks (the public as participants) in the mechanisms of emergency communication is investigated, and a model of communication is proposed to represent emergency communication interactions via internet tools, cell phones and social networks; and to relate these dynamics with prior research.
Abstract: Emergency management efforts rely strongly on the clarity, coordination and efficiency of communication among emergency responders, disaster preparedness experts, emergency response agencies, the public, and other stakeholders. Though emergency communications systems have been researched, the research has often not taken into account the impacts of social networks, mass media, and new internet based technology. This research investigates the role of social networking (the public as participants) in the mechanisms of emergency communication. A model of communication (a four-channel model) is proposed to represent emergency communication interactions via internet tools, cell phones and social networks; and to relate these dynamics with prior research.

34 citations


Journal ArticleDOI
TL;DR: In this paper, the authors argue that an offensive-defense strategic framework must be adopted to think about and organize against cyber threats in the 21 century, and that the United States must set aside deterrence and adopt a full war-fighting posture.
Abstract: How should the United States organize itself to deal with the threat of cyberaggression? The initial effort of the Obama Administration, released in May 2009, focuses attention on the organizational and bureaucratic decisionmaking infrastructure necessary for cybersecurity and provides some general guidelines about goals and means. It does not address the more fundamental question of strategic approach. This article suggests the time has come to resolve the core issue of what organizing principle should drive national cybersecurity policy. Specifically, we argue that an offense-defense strategic framework must be adopted to think about and organize against cyber threats in the 21 century. This means that the United States must set aside deterrence—the dominant strategic anchor of the past fifty-plus years—and adopt a full war-fighting posture. What has worked in the nuclear realm, and remains relevant for homeland security against WMD terrorism, will not work in cyberspace.

33 citations


Journal ArticleDOI
TL;DR: The authors argued that resilience is much more than mitigation and recovery but combines those efforts with the investment of deliberate civic involvement, and proposed a new perspective on the topic of resilience, which offers another perspective on resilience.
Abstract: This opinion offers another perspective on the topic of resilience. The author contends that resilience is much more than mitigation and recovery but combines those efforts with the investment of deliberate civic involvement.

30 citations


Journal ArticleDOI
TL;DR: This article is the result of continuous scientific and research activities of several years of the authors, who are active in the positions of lecturers and research workers at the Faculty of Special Engineering of the University of ¬ilina in Žilina, Slovakia.
Abstract: This article is the result of continuous scientific and research activities of several years of the authors, who are active in the positions of lecturers and research workers at the Faculty of Special Engineering of the University of Žilina in Žilina, Slovakia. Scientific and research activities of the faculty are focused on solving the theoretical basis of crisis and security management, on optimizing the activity of the institutions of crisis and security management within the prevention and solution of crisis phenomena, improvement of complex systems intended for protection of persons as well as property, issues of protection against fires and other specific problems in the section of security of the society as well as of the individual citizens.

28 citations


Journal ArticleDOI
TL;DR: The National Incident Management System (NIMS) framework is the nationally accepted model for emergency public information for emergencies and disasters as discussed by the authors, which does not accommodate the need and structure of social media outlets which have quickly become an integral component of public communication during an event with emergent information and details.
Abstract: The National Incident Management System (NIMS) framework is the nationally-accepted model for emergency public information for emergencies and disasters. NIMS mandates that all released public information are approved by the Incident Commander prior to distribution. Unfortunately, this does not accommodate the need and structure of social media outlets which have quickly become an integral component of public communication during an event with emergent information and details. These two communication mechanisms must be reconciled to ensure successful emergency public information during future emergencies or disasters.

Journal ArticleDOI
TL;DR: In this article, the authors conducted seven focus groups and 10 individual interviews to gather data on what happens in the first critical moments of a mine emergency, including explosions, fires, and inundations.
Abstract: Researchers at the National Institute for Occupational Safety and Health (NIOSH) conducted seven focus groups and 10 individual interviews to gather data on what happens in the first cru­ cial moments of a mine emergency. The goal of the project was to learn about responses on-site during the initial phases of a mine emergency to further improve response. The subjects repre­ sented underground coal and salt mines in the southern, western, mid-western, and eastern parts of the United States. They included on-site responders, mine rescue team members, and experts in mine emergency response with extensive experience in managing mine disasters. The types of disasters the subjects experienced were diverse, including explosions, fires, and inundations (sud­ den floods of water or inrushes of dangerous gases). This study was unique in its focus on the first moments in an emergency response, in studying underground coal mine emergencies and in utilizing a focus group methodology. Results indicated that there were common themes in initial response, which included the importance of mine emergency planning and training, quantity and The authors acknowledge the dedicated miners, mine rescue teams and their trainers, medical mine rescue teams, mine safety training professionals, and mine management across the country. Thanks to Melissa Silva, HUCAU Student Intern, Pittsburgh Research Laboratory and Michael Meighen, former NIOSH employee. quality of communication providing information for decision-making, leadership and trust, plus individual personal issues. Previous relevant studies are presented and the researchers discuss the data providing specific examples. The article concludes with recommendations to enhance initial response in the first critical moments of an emergency.

Journal ArticleDOI
TL;DR: A two-factor hierarchical system of scoring is proposed, details candidate measures, and economic conditions for selecting appropriate measures are explored, and conditions for market adoption of information security scoring are discussed.
Abstract: This paper explores approaches for scoring information security risk that could lead to investment drivers and drive appropriate levels of security. Our approach is grounded on two important factors that determine cyber risk: (1) the information security resources (e.g., technologies, skills, and policies) that reduce the likelihood and consequences of successful information exploits; and (2) the security processes and capabilities that drive a continuous improvement of the security resources in use. The quality of a cyber defense system is the result of the integration of these two factors. This manuscript proposes such a two-factor hierarchical system of scoring, details candidate measures, and explores economic conditions for selecting appropriate measures. We review several scoring systems available that contain elements from this proposed system and discuss conditions for market adoption of information security scoring.

Journal ArticleDOI
TL;DR: This article covers the origin and evolution of CDXs, and it describes the design, goals and lessons learned from BCS 2010.
Abstract: In May 2010, the Cooperative Cyber Defence Centre of Excellence and the Swedish National Defence College hosted the Baltic Cyber Shield (BCS) international cyber defense exercise (CDX). For two days, six Blue Teams from northern European government, military and academic institutions defended simulated power generation companies against a Red Team of 20 hostile computer hackers. The scenario described a volatile geopolitical environment in which a hired-gun Rapid Response Team of network security personnel defended Critical Information Infrastructure (CII) from cyber attacks sponsored by a non-state terrorist group. This article covers the origin and evolution of CDXs, and it describes the design, goals and lessons learned from BCS 2010.

Journal ArticleDOI
TL;DR: In this article, the authors present early observations from the experiences of two early adapters of a new generation of national security strategies, the Netherlands and the United Kingdom, and illustrate common themes and challenges that other countries might consider, ranging from fundamentally understanding the importance of a national security strategy as an effective frame of reference for national security decisions to administrative actions to keep the strategy ''evergreen, whether through a formal or informal assessment process.
Abstract: This article presents early observations from the experiences of two early adapters of a new generation of national security strategies, the Netherlands and the United Kingdom. The new strategies are broader in scope in addressing security challenges and are “whole of government,\" even increasingly “whole of society\" in nature. The strategy development process takes advantage of new mechanisms whereby governments can sense and prioritize quickly changing security challenges, adaptively plan for those challenges, and anchor the strategies in regular policy and budget cycles. The national security strategy experiences of both countries illustrate common themes and challenges that other countries might consider, ranging from fundamentally understanding the importance of a national security strategy as an effective frame of reference for national security decisions to the importance of administrative actions to keep the strategy “evergreen,\" whether through a formal or informal assessment process.

Journal ArticleDOI
TL;DR: The role of academia is not to await government guidance on homeland security curriculum content, but rather to define that discipline and its supportive education via the triad of teaching, research, and service as discussed by the authors.
Abstract: In response to Robert McCreight and Linda Kiltz, the authors propose that the role of academia is not to await government guidance on homeland security curriculum content, but rather to define that discipline and its supportive education via the triad of teaching, research, and service. This article contends that a sizable cadre of civic-minded individuals is already present, and that academia’s focus must be to develop and promulgate new knowledge across the cross-section of new students and experienced professionals. This new knowledge must include practical skills applicable to the broad scope of emergency preparedness and should leverage educational technology

Journal ArticleDOI
TL;DR: This article provided a background on community oriented policing (COP) strategies and tactics and examined their suitability for use in homeland security strategies and examined the effect of various homeland security and COP strategies on relationships between law enforcement and Middle Eastern communities; potential obstacles to maintaining positive relationships; and civil rights and profiling issues.
Abstract: The attacks of September 11, 2001, significantly changed the way local police agencies relate to the communities that they serve. Agencies that had previously embraced community oriented policing (COP) to address traditional crime problems were suddenly thrust into the front lines of the war against terror. Local police departments assumed new roles and responsibilities for protecting the homeland. In some cases, this has resulted in the reduction or elimination of community policing methodologies and degraded relationships between the police and the community. This paper will provide a background on COP strategies and tactics and examine their suitability for use in homeland security strategies. It will also examine the effect of various homeland security and COP strategies on relationships between law enforcement and Middle Eastern communities; potential obstacles to maintaining positive relationships; and civil rights and profiling issues. To date, research is showing that community policing strategies and tactics can be used to enhance homeland security efforts while continuing to improve relationships with these often estranged immigrant groups.


Journal ArticleDOI
TL;DR: This study summarizes data gathered from expert practitioners regarding the importance of creating and maintaining an informal, unofficial network of contacts and suggests for building and maintaining informal networking partnerships.
Abstract: Developing and maintaining informal networks is vitally important for emergency managers. Informal networks foster trust, which is critically important during emergency management operations. Information can be exchanged and decision making can be enhanced through tapping the power of informal networks as well. There is little empirical data that reflects how EM practitioners actually feel about the importance of experienced and inexperienced as well as governmental and private professional networks. This study summarizes data gathered from expert practitioners regarding the importance of creating and maintaining an informal, unofficial network of contacts. Suggestions are offered for building and maintaining informal networking partnerships.

Journal ArticleDOI
TL;DR: In this paper, the authors surveyed 145 private sector organizations to identify factors that motivate business and non-profits to adopt measures for emergency preparedness and continuity of operations planning, and found that participation in a collaborative partnership had as strong a correlation with motivation to prepare as did the other two factors.
Abstract: This study surveyed 145 private sector organizations to identify factors that motivate business and non-profits to adopt measures for emergency preparedness and continuity of operations planning. Consistent with previous research and anecdotal evidence, it identified the size and capability of the organization and previous disaster experience as principal motivators. It further identified that participation in a collaborative partnership had as strong a correlation with motivation to prepare as did the other two factors. This finding points the way for further research into policies and initiatives that could have a positive impact on preparedness in the private sector with implications for building resilience at the community and regional levels.

Journal ArticleDOI
TL;DR: This article examined the development of regional governance structures in response to the Urban Area Security Initiative (UASI) and highlighted potential barriers to collaboration including missing partners and unequal distribution of decision-making power in these networks.
Abstract: Despite its relevance in terrorism and disaster preparedness and response, few studies have looked at how federal guidance has influenced regional collaboration in urban areas. This study, which is based on field work and in-depth interviews in five U.S. urban areas, examines the development of regional governance structures in response to the Urban Area Security Initiative (UASI). Factors, such as federal initiatives, guidance, and funding, have acted as catalysts in fostering cross-jurisdictional collaboration among different kinds of preparedness and response organizations and sectors, as have local politics and power dynamics. Common structural components across urban areas allow for the comparison of inter-organizational administrative arrangements. Although this approach to collaboration has integrated key personnel likely to be involved in a large-scale regional disaster response, it also highlights potential barriers to collaboration including missing partners and the unequal distribution of decision-making power in these networks.

Journal ArticleDOI
TL;DR: The method proposed can be viewed as a more frugal decision analysis method, decreasing the efforts needed in elicitation of input statements which often is a cumbersome threshold for the use of decision analysis techniques.
Abstract: This paper focuses on the decision evaluation of different response strategies in emergency management utilizing decision analysis with imprecise information. A method for the selection of response strategies in emergency management, as well as a model for the representation of catastrophic consequences, are proposed. In emergency management decision problems, the available estimates of probabilities, utilities, costs, and priority weights are often subject to large degrees of uncertainty and imprecision. When uncertainty prevails in the input data and large societal values are at stake, coping with this lack of precision becomes very important in decision making processes. The method employs representation of imprecision in probabilities, utilities, and weights on attributes in the form of interval statements and comparisons together with a formal, comprehensive, and comprehensible description of a catastrophic consequence facilitating the use of preferential statements between catastrophic consequences. The method proposed can be viewed as a more frugal decision analysis method, decreasing the efforts needed in elicitation of input statements which often is a cumbersome threshold for the use of decision analysis techniques. It is suggested as a complement to cost/benefit approaches and other approaches relying on inaccessible probabilistic data either when probability assessments regarding catastrophic events are too uncertain or when pure monetary scales are deemed inadequate.

Journal ArticleDOI
TL;DR: In this article, the authors used the State of Colorado as a case study in how individual states are adapting and applying federal capabilities-based planning models to their homeland security programs, and the authors' findings lead to conclusions about Colorado's beginning phase of transforming deficient homeland security strategy, incoherent organization, and fragmented planning processes into sound strategy, focused structure, and organized methods.
Abstract: This article utilizes the State of Colorado as a case study in how individual states are adapting and applying federal capabilities-based planning models to their homeland security programs. The article reviews the corrective change in direction taken by Colorado in implementation of homeland security organizational strategies, structures, policies and procedures. The authors' findings lead to conclusions about Colorado's beginning phase of transforming deficient homeland security strategy, incoherent organization, and fragmented planning processes into sound strategy, focused structure, and organized methods. In November 2008, the Center for Homeland Security (CHS) at the University of Colorado at Colorado Springs began a research and mutual support effort with the Colorado Governor's Office of Homeland Security for the purpose of immersing in the state's revitalized homeland security planning cycle. The intent was to gain insight into the state's creation of a new homeland security organization, the application of a new homeland security strategy, and the efficacy of implementing federal capabilities-based planning processes from a strategic and operational perspective, rather than a federal grant application focus. Colorado's shift to a capabilities-based planning process was largely in response to criticism from both the Department of Homeland Security and Colorado state auditors on the use of federal homeland security funds. Audits described the state's strategy as disorganized and its homeland security structure as fractured with poor accountability and little meaningful oversight. This article examines the initial findings of the CHS immersion experience.

Journal ArticleDOI
TL;DR: A review of the literature provides an overview of disaster studies and anecdotal articles that reveal some of the difficulties and lessons learned over time and recommend research topics for future studies as mentioned in this paper, which is a good starting point for future research.
Abstract: Every year the world experiences numerous disaster events, both human-made and naturally occurring. These calamitous occurrences are of concern to health care providers for many reasons, not the least of which the reality that their incidence is increasing. Mounting event frequency and magnitude, coupled with increasing world population, results in human impacts that are devastating. Frequently these events call for the deployment of military force, to restore order and secure devastated neighborhoods, or to provide other forms of aid, including healthcare. These military forces often work in concert with community-based, civilian volunteers who participate in disaster response as part of non-governmental agencies. Thus, for health professionals both civilian and military, disaster events are of great concern. This review of the literature provides an overview of disaster studies and anecdotal articles that reveal some of the difficulties and lessons learned over time and recommend research topics for future studies.

Journal ArticleDOI
TL;DR: In this paper, the analysis of proactive approaches to the governance of risk from natural hazards, including emergency and environmental management, community development, and spatial planning, is discussed, and the central role of emergency management in risk policy is reviewed.
Abstract: Some of the many issues of interest to risk scholars addressed in this work include: the analysis of proactive approaches to the governance of risk from natural hazards; approaches to broaden the scope of public policies related to the management of risks from natural hazards, including emergency and environmental management, community development and spatial planning. The texts further explore how spatial planning can contribute to risk governance by influencing the occupation of hazard-prone areas, and review the central role of emergency management in risk policy.

Journal ArticleDOI
TL;DR: In Emergency Response to Domestic Terrorism: How Bureaucracies Reacted to the 1995 Oklahoma City Bombing, Alethia Cook suggests that the success or failure of a disaster response situation is established in the first 12 hours.
Abstract: In Emergency Response to Domestic Terrorism: How Bureaucracies Reacted to the 1995 Oklahoma City Bombing, Alethia Cook suggests that the success or failure of a disaster response situation is established in the first 12 hours. Cook suggests that if lessons learned extracted from an intensive analytical review of these initial response hours, within the context of theoretical management structure, were adopted by the disaster response community, the likelihood of failure will be minimized. Cook presents such a study via an interview process of responders who arrived at the Oklahoma City bombing site within the first 12 hours.

Journal ArticleDOI
TL;DR: Results indicate that preparedness funds from the Centers for Disease Control and Prevention have an indirect positive impact on preparedness activities, a positive direct impact on local epidemiology programs, and no significant relationship to other measures of public health activity, casting doubt on the existence of broad improvements to the public health system.
Abstract: Advocates of federal bioterrorism preparedness programs have argued that the resulting infusion of resources into the public health system will result in improvement in the overall capacity of the public health system. This study tests that theory by modeling the impact of federal preparedness funds on local public health activities, controlling for local leadership, jurisdiction, and other resources. The study utilizes data from 850 local health departments responding to the 2005 National Association of City and County Health Officers (NACCHO) Survey of Local Health Departments. Results indicate that preparedness funds from the Centers for Disease Control and Prevention (CDC) have an indirect positive impact on preparedness activities, a positive direct impact on local epidemiology programs, and no significant relationship to other measures of public health activity, casting doubt on the existence of broad improvements to the public health system. Findings indicate that local factors play a varied but minor role in determining local health department activities.

Journal ArticleDOI
TL;DR: In this article, the three main components that were identified as contributors to confidence of county law enforcement when dealing with terrorist events were satisfaction with funding for training, adequacy of equipment and funding for prevention and reaction.
Abstract: Domestic terrorism continues to be a major concern for the United States. Despite the fact that County Sheriffs will have a critical role in dealing with public safety during and after a terrorist event, little is known regarding their confidence levels. The three main components that were identified as contributors to confidence of county law enforcement when dealing with terrorist events were satisfaction with funding for training, adequacy of equipment and funding for prevention and reaction. The results of this quantitative and descriptive study may become an important factor for law enforcement preparedness and for funding distribution in the future.


Journal ArticleDOI
TL;DR: In this paper, the authors provide lessons observed during a response and re-covery scenario resultant of a snow avalanche that occurred in Afghanistan north of Kabul, and observe the adherence by clinical teams to a single source of supply, equipment and supply accountability, and the development of appropriate pre-constructed push packs to support future scenarios such as the one experienced on February 9, 2010.
Abstract: Logistics operations are interwoven among the very fabric of emergency management and noaspect of a health care organization’s business processes goes untouched by tenable supply chainmanagement. The purpose of this work is to provide lessons observed during a response and re-covery scenario resultant of a snow avalanche that occurred in Afghanistan north of Kabul. Thelessons documented throughout this work are specific to how Soldiers, while deployed in supportof Operation Enduring Freedom, were faced with one of the most unlikely of scenarios conceiv-able – responding to a natural disaster. In this work are observations, relayed by organization-levelleadership during a deliberate After Action Review (AAR) related to communications, prepared-ness, warehouse security, the development of cross-functional teams, the adherence by clinicalteams to a single source of supply, equipment and supply accountability, and the development ofappropriate pre-configured push packs to support future scenarios such as the one experienced onFebruary 9, 2010.KEYWORDS: health care, logistics, disaster management, contingency operations