University of Delaware Disaster Research Center PRELIMINARY PAPER #138 HOW INDIVIDUALS AND GROUPS REACT DURING DISASTERS:

PLANNING AND MANAGING IMPLICATIONS FOR EMS DELIVERY E. L. Quarantelli

*This is a longer written version of a paper presented under the title "How Individuals and Groups React During Catastrophic Events" at the National Disaster Medical System National Conference on June 28, l989 in Denver, Colorado.

Introduction We have been asked to summarize what social science research has generally concluded about individual and group behavior in extreme stress situations such as disasters. We will do so. But we first want to indicate why such knowledge from systematic study is important. It is important because no planning for disasters, no managing of them, can be any better than the assumptions which are made. In preparing and in responding there are necessarily assumptions being made about the behavior of the human beings and groups involved in the situation. It obviously follows that if valid assumptions are made, it raises the probability that the disaster planning and managing will be good; it also follows that if incorrect assumptions are made the opposite is likely to be true. Thus, in looking at the research derived knowledge that exists about human and social behavior in disasters we are in many respects saying something about the validity or invalidity of the assumptions made. As will be seen, some of the assumptions that underlie much disaster planning and managing are based on incorrect beliefs about how human beings and organizations behave in disaster situations. If there are inaccurate or mythological beliefs about the behavior that actually occurs in disasters, the preparedness and response cannot be efficient and effective. Correct knowledge alone allows valid assumptions which in turn will facilitate good disaster planning and managing. Our remarks will touch on a half dozen different topics. First, we will discuss what is systematically known about the reactions of individuals to disasters, especially their emergency time behavior. Our general point will be that human beings react remarkably well and that the locus and source of most problems are elsewhere, primarily in the organizations that typically are expected to respond in community disasters. Our second set of comments will be about the need for good planning by such community groups. Research indicates that it is possible ahead of time to evaluate the appropriateness of the preparedness undertaken. Third, we will however note that managing a disaster is not the same as planning for one. The difference is essentially one of a strategical versus a tactical approach to a threatening or dangerous situation. Fourth, we will talk about the tactical problems of emergency

oriented organizations in responding at the emergency time period of disasters. They revolve around problems of communication and information flow, authority and decision making, and coordination. In our fifth set of remarks we will very briefly highlight what some of the social science research has specifically observed about the delivery of emergency medical services (EMS)in disasters. Essentially we note that planning for a different kind of EMS system is needed at times of disasters. Finally, our sixth and concluding comments will suggest that those occasions which should be called catastrophes are not only quantatively but also qualitatively different from typical disasters in American society. As such they require a somewhat different planning and managing approach. Why can we feel confident about what we will say? Mostly because our remarks are drawn from a rather large body of research literature that has been developed over the last 35 years. Some of the findings come from the over 500 field studies that the Disaster Research Center alone has conducted on natural and technological disasters since 1963 (see Quarantelli, Dynes and Wenger, 1986). However, we also draw from the systematic work done elsewhere including that now being undertaken in over three dozen countries around the world from Japan to the Soviet Union, from Italy to India, from Columbia to China (for a view of the historical development of the field of disaster studies, see Quarantelli and Dynes, 1977; Quarantelli, 1987; for recent summaries of research findings, see Kreps, 1984, 1991; Drabek, 1986). For expositional purposes here, we will primarily focus on community type disasters--where there is a sudden and major disruption of the everyday routines of an urban locality, be it a town, city or metropolitan area as a result of some natural or technological disaster agent that threatens and/or impacts life and property. However, there are non-community type disasters such as most transportation accidents which seldom disrupt across-the-board the ongoing routines of an urbanized area (there are of course exceptions such as the massive evacuation of about 215,000 residents near Mississauga, a Toronto, Canada suburb as a result of a chemical threat from a train derailment; see Scanlon and Padgham, 1980). At the other extreme, there are also catastrophic occasions that extend far beyond temporarily disrupting the routines of a single community, and that we will discuss later in noting qualitative as well as quantitative differences between "disasters" and "catastrophes". Overall, however, our remarks will be mostly about individual and group behaviors in community disasters (for discussions of the concept and definition of disaster see Quarantelli, 1985c; 1987; also Britton, 1987).

Let us turn now to our first topic. 1. The Reactions of Individuals There is a prevailing popular image of how people will react in disasters. While obviously there are variations in the imagery, the general picture is that human beings do not respond too well in such stressful situations (Wenger, Faupel and James, 1985). It is generally assumed that individuals especially at the emergency time period are likely to panic and act irrationally, will be stunned and unable to take care of themselves, act in anti-social ways, be emotionally traumatized or psychologically incapacitated, and react selfishly and in self centered ways during and immediately after a disaster threat and impact. Clearly if it is assumed that these are the typical widespread reactions of individuals in disasters, certain kinds of planning and managing ought to be undertaken. However, the research studies indicate that the picture is an almost totally incorrect one in every respect. The popular image is a compound of myths and misunderstandings about how human beings actually behave in the emergency time periods of disasters (for a summary of research findings see Disaster Prevention and Mitigation, l986). Let us look at five rather widespread myths. l. The panic myth. If there is one word that tends to be associated with disaster behavior, it is the word "panic". Of course, the term can refer to many things. If the referent is to the probability that most human beings involved in disasters will be frightened and afraid, that is a correct perception. Almost all sane persons will feel anxiety and fear in the face of great personal dangers and threats. However, when the term panic is used in everyday speech, mass media accounts, or official statements in connection with disasters, usually far more is implied. It is assumed that in the face of great threat or danger that people will panic in the sense of wildly fleeing, aimlessly running around or breaking down hysterically. Even if the response is not viewed as intrinsically self destructive, the behavior is seen as nonadaptive and inappropriate for the situation and in a basic sense as being irrational. However, research has consistently shown that panic in these behavioral senses of the term, is extremely rare if not actually totally nonexistent in community disasters. Disaster victims do not flee wildly, they do not run around aimlessly, they do not hysterically break down. Instead of fleeing away, they will either remain where they are or converge upon impact sites to help in

whatever ways they can. Instead of irrationally running in (a favorite scene in disaster movies), victims will intentionally and deliberately to search for and find usually relatives and friends, that are important to them. of breaking down in hysterics, they try to do what they themselves and others in the immediate situation.

circles proceed others, Instead can for

Disaster victims may be very concerned and frightened, but that does not mean they will act without thinking, selfishly or impulsively. They do not become unreasoning animals. In fact, instead (one could argue) they tend to show more rationality under stress than they do normally, if by rationality is meant conscious weighing of alternative courses of action in a situation. None of us undertake much conscious weighing of optional courses of actions in performing the great majority of our daily routines. But those caught in the emergency time periods of disasters, when their very lives and those of others that are important to them may be at stake, become very conscious and aware of the behavioral choices they have and make. Panic flight behavior can occur in any extreme stress situation. But it is quite rare, usually engaged in by very small numbers of people, and typically of short duration and distance. Furthermore, the occurrence of panic requires an unusual combination of circumstances, mainly the perception of an extremely sudden and very direct threat to one's life in a very limited spatial area, that escape by one's own actions from a future dangerous situation is still possible, and that self can not be helped by others in the immediate vicinity. These are a set of conditions that on the whole are not usually present in any degree in almost all community disasters; they are more likely to be present in a spatially focused emergency occasion such as a nightclub or hotel fire, for instance (Quarantelli, 1981b). Overall, panic behavior is not a major feature of almost any kind of disaster. It is of very little practical or operational importance in the great majority of community disasters. It is something that can almost be ignored in disaster planning and managing, except for the keeping in mind that it is a myth and not something to be assumed. 2. The passivity myth. If danger and disaster do not generate panic, it is sometimes thought that they create just the opposite--paralysis of actions and reactions. Thus, it is believed that in the face of warnings of extreme threats, people will freeze and be unable to act. Another related widespread notion is that most victims are so stunned or shocked by the impact of a disaster, that they cannot react or cope at all with the crisis in which they find themselves.

There is a tendency to assume that disasters leave large numbers of people dazed, shocked and unable to cope with the new realities of the emergency. The assumption is that victims are so disoriented and demoralized that they will need outsiders to do the most elementary tasks for them such as being fed, housed and clothed. Essentially the image is one of passive dependency on others by those impacted by disasters, and that nothing will happen unless Big Brother in the form of helping outsiders, especially agencies or organizations, step in. Research has consistently shown that this image of helplessness is also quite incorrect. In the face of acceptable warning messages, people will seek safety and generally take actions that are adaptable for the situation (Perry and Mushkatel, 1984). Furthermore, those who experience disasters are not immobilized by even the most stressful of occasions. They are neither devoid of initiative nor passively expectant that others will take care of them and their needs. Usually before the full impact is over, search and rescue efforts are initiated by neighbors and those nearby (over 90 percent are typically rescued in this way). The injured are found and are transported by whatever means are available and as quickly as possible to hospitals. Temporary shelter is actively sought from and offered by kin and friends; the same is true of food and water. In fact, the evidence is substantial and consistent that far from even seeking and much less depending upon formal relief and welfare organizations, these are among the last sources that the vast majority of victims will turn to for help. In the immediate aftermath of a disaster, self- and kin-help and mutual informal initiative and assistance will dominate. Except for those severely injured, survivors respond quickly and initiate a variety of personal and social recovery actions. Helplessness and passively waiting for organizations to provide help is far from the norm (Quarantelli, 1981a). 3. The antisocial myth. To inexperienced officials and journalists, disasters are seen as offering opportunities for the surfacing of antisocial behavior. It is assumed that deviant behavior will emerge and dazed victims in the impacted area are easy targets for looting and other forms of criminal activity if they do not engage in widespread pillaging themselves. In fact, next to the supposed "panic" problem, is the supposed "looting" problem. The imagery is that as Mr. Hyde takes over from Dr. Jekyll, crime rates will rise and exploitative behavior will spread. This picture is often supported by mass media accounts and widely circulating stories or rumors. It is also supposed that at times there will be disorderly crowd behavior if not actual riots in the aftermath of a disaster.

According to research studies, this image is also basically incorrect and fundamentally mythical. Many stories of looting will typically circulate, but actual instances will be very rare and if they occur will be done by outsiders rather than the impacted population itself. Far more material will be freely donated and given away than could conceivably be looted. Crime rates almost always drop. Exploitative behavior is only likely to be seen in relatively rare instances of profiteering after the immediate emergency period is over. There is almost never any crowd or riot behavior that stems directly from the immediate impact of a disaster agent. In actuality, prosocial, rather than antisocial behavior is a dominant characteristic of the emergency time period of a disaster. If disasters unleash anything, it is not the criminal in us but the altruistic. Such crime as occurs will be far below that which would normally occur in the community on a normal everyday basis, the mythological belief to the contrary. 4. The traumatized myth. The traumatic stress of a disaster experience is widely thought to have both short and long run negative consequences for the mental health of the individuals involved. Thus, supposedly some people are driven "crazy", numerous others are so psychologically scared that they cannot function normally, and many seriously emotionally damaged victims are left behind. These pathological reactions are presumably manifested by almost all, or a majority of victims and may last indefinitely unless treatment is given. However, this image of disasters as inevitably creating many and serious mental health problems is another one of the prevailing major myths of disaster behavior. In reality community disasters at least very rarely, if ever, produce any new psychoses or severe mental illness. They neither appear at the time of impact nor emerge later in the recovery time period. (Even most preimpact hospitalized mentally ill persons react more or less in the emergency period in the same way as do other victims). Outpatient treatments by mental health clinics, visits to psychiatrists, admissions to mental health institutions, self reporting surveys of impacted populations, use of psychotherapy facilities, outreach programs to find people needing psychological counseling, etc. have consistently failed to show post impact rises which can be interpreted as signifying the appearance of serious mental health problems as a consequence of a disaster impact (Quarantelli, 1985a). (It should also never be forgotten that in any given community on any given day, there will be residents suffering from a variety of different kinds and severities of mental health and psychological problems; to argue that disasters bring about

problems requires showing frequencies over and above the normal everyday rates which research studies have consistently failed to do; at least l5% according to some recent epidemiological surveys-see Regier et al., l988). Disasters can generate many surface psychological reactions such as sleeplessness, loss of appetite, anxiety and irritability (see, e.g., Lystad, 1988). These tend to be subclinical, short lived and self remitting. While in some disasters most of the victims show many such symptoms, more typical is considerable variation in different disasters of the number of victims who exhibit them, and the kinds of post impact psychological reactions that appear. Most important, even those showing these kinds of reactions are rarely incapacitated in terms of their normal everyday behavior. That is, the experience of a disaster often does become part of the psychological makeup of victims (e.g., in memory) but it seldom is behaviorally dysfunctional for the work, school and household activities of those involved (Quarantelli, 1985). In fact, for a minority of victims, disasters can have favorable psychological consequences, strengthening positive self conceptions and social ties to others. Just as communities and groups are better off as a result of undergoing a disaster, so are some individuals and families. This is simply part of the fact that disasters are not totally bad in all their consequences; it is an empirical matter that sometimes there are good effects. 5. The self centered myth. It is frequently assumed that directly impacted disaster victims (those who have been injured and/or suffered personal and material losses) will dwell on their own losses. This self centeredness supposedly leads them to despair about the future. As a result of this they will have low morale which leave them reluctant to rebuild shattered businesses and homes. It is thought they will therefore move out of the impacted communities which collectively have little social solidarity in the aftermath of a disaster. Research studies indicate that this is a generally incorrect picture. Contrary to this popular image, morale is not destroyed. Right after impact collective morale is higher than usual. Such an attitude may seem implausible since disasters create to a greater or lesser degree those who had immediate losses--the death of a family member, injury to themselves, damage to their property, perhaps loss of work or destruction of businesses. However, in a typical community disaster, victims are always greatly outnumbered by non victims. Even in a community with a large number of "victims", their losses do not necessarily have a cumulative effect in lowering morale. Individual or family suffering is always experienced in reference to the plight of others. Suffering in the

disaster context is not an isolated experience and therefore it does not become an isolating experience. Even the victims judge themselves in terms of what happened to others. With only one exception, there are always other who are worse off. Too, the various deprivations within the community have not been occasioned by the victims themselves but instead have been brought about by outside, seemingly random forces. So not only is each victim a small part of a larger community of sufferers but even their losses are likely to be seen as "good fortune" compared to what might have happened. Thus the members of disaster stricken communities are seldom as bleak about their future as is believed. Morale is not low, but in part because of the community of sufferers, it is actually often high immediately after impact (it can and often does drop later in the post recovery period). The great majority of victims not only intend to but start rebuilding efforts as quickly as possible, and the research evidence is that population movement away from impacted communities is usually what it would have been if there had been no disaster at all. Thus, overall, disaster victims do not panic, they are not passive, they do not become caught up in antisocial behavior, they are not behaviorally traumatized, and their morale is not low. Beliefs to the contrary are myths. The research evidence indicates the opposites of the myths are what will predominate. We do not want to leave a romanticized picture that individuals by themselves or in conjunction with a few friends and neighbors can handle all community disaster related problems. People perform far better than false speculations or widespread mythologies about human behavior under stress would indicate. But there are some things which solitary individuals cannot do or do well. Neighbors can find victims in a search and rescue effort; they cannot perform major surgical operations or give blood transfusion. Similarly, major debris clearance, restoration of electric power, testing for water pollution, for example, are not tasks that private citizens or small groups of neighbors can perform very well. Furthermore, such matters as the issuance of warnings about threats, assigning community priorities for emergency preparedness actions, integrating the convergence of outside relief help, or making immediate policy decisions about agency responsibilities--to merely hint at the myriad possibilities involved--of necessity have to be organizational tasks and involve group actions; they cannot result from the initiative or be the acts of isolated individuals, separate persons, or in most cases, private citizens. Nonetheless, what social science research has concluded is that the source and locus of most problems in the emergency phase of disasters is not to be found in the victims, but in the

organizations attempting to help them (Dynes, 1974). Human beings cope fairly well. Thus, in the social sense of the term, disasters are primarily disruptions in the routine behavior of groups rather than interruptions of the everyday actions of individuals (Kreps, 1985). When all is said and done, disasters are public difficulties in collective social entities; they are not the personal problems some persons might have. In any community type disasters, certain emergency oriented organizations are almost inevitably involved. These typically would be police and fire departments, the local emergency management agency, the local Red Cross chapter, hospitals and emergency medical service groups, and the public utilities. Research studies show that the preparedness planning of these organizations for disasters varies considerably from one community to another. (In American society however this planning has generally gotten consistently better through the last two decades, see, for example the DRC research regarding local emergency management agencies see, Wenger, Quarantelli and Dynes 1986; for police and fire departments see Wenger, Quarantelli and Dynes, 1989). Actually it is the relatively rare situation where there is no planning at all; that is not the issue. Emergency oriented community agencies almost always have undertaken (or at least think they have) some preparations for disasters. Rather the important question is whether the planning is any good or not (Dynes, Quarantelli and Kreps, 1981). This brings us to our second major topic.

2. Research Findings and Disaster Planning To assess in any intelligent way, preparedness planning for disasters requires asking the question: what is good planning? It would be possible to advance some ideal version of what should be, but we prefer to root our answer to the question in the empirical studies undertaken. Part of this research is particularly strong on the community and organizational aspects of disaster planning, the strategic approach to the matter. Good community disaster planning criteria: we will suggest ten. is that which meets certain

Good organizational and community disaster planning should: 1. Recognize that disasters are qualitatively different from minor emergencies.

There is a widespread belief, to paraphrase some police officers, that a disaster is merely a very large scale traffic accident. This view is simply wrong. In a disaster there is a difference of kind not just degree compared to what goes on in an accident or minor emergency. There is not only a quantitative difference which is obvious but also a qualitative one which is not as obvious. A disaster involves not just more, but something which is qualitatively different. An accident cannot be perceived as a little disaster, nor can a disaster be viewed as a big accident. There are some fundamental differences between the two kinds of situations. During community disasters, organizations are faced with a new set of circumstances with which they must cope that are different from those involved in accidents or minor emergencies. Typically in disasters compared to everyday or minor emergencies, organizations have to: (1) quickly relate to far more and different groups; (e.g., business concerns with government units, local agencies with state and national organizations that they were not even aware of before the disaster occasion). (2) adjust to losing a part of their autonomy; (e.g., personnel, operations, resources and locations become partly controlled by certain public authorities). (3) apply different performance standards; (e.g., instead of speed of response, resources can become the norm). allocation of

(4) operate within a closer public and private sector interface; (e.g., boundaries between public and private personnel, goods and services become blurred), and (5) respond to being directly impacted themselves; (e.g., there can be direct and indirect loss personnel, resources, equipment, and facilities). of

Thus, disaster preparedness planning which does not recognize the qualitative as well as quantitative differences between emergencies and disasters cannot be good. It is very crucial that disaster planners recognize that they have to think about disasters in a rather different strategic way than they do for everyday accidents, disruptions, and minor emergencies. To paraphrase Hemingway, just as the rich are different from the poor in their behaviors, disasters as social crises are different in fundamental ways from everyday emergencies.

10

2. Be generic rather than agent specific. Much disaster planning is agent-specific rather than being primarily generic or general. There is a tendency to organized separate planning around specific disaster agents. Thus, one finds in many localities there often is separate planning for chemical threats, for nuclear plants, for fires, and so on. The planning is separate with sometimes different organizations for preparing and responding to the separately viewed dangers or impacts. This kind of agent specific planning might seem natural and obvious. Are not chemical threats different from earthquakes? Are not floods different from massive fires in high rise buildings? The answer, of course, is yes, but yes only up to a certain point. For very many of the human and organizational problems in preparing for and responding to disasters, the specific kind of disaster agent does not matter. For example, the same kind of warning messages and the same kind of warning system is needed and effective in getting people to evacuate irrespective of the specific disaster agent involved. It does not matter if the agent is a chemical spill, an hurricane, a tsunami or a radioactive fallout--what will motivate people to give credence to warning messages, what kinds of warning messages will be effective, what will limit the acceptance of a warning, and so on, will be the same in all cases. These human aspects of a disaster do not depend on the specific type of disaster agent involved. Similarly, if there is need for organized search and rescue the more important organizational aspects that have to be dealt with do not depend on the specific disaster agent involved. Research, for example has consistently shown that multiple agencies will attempt to undertake most of the later search and rescue, that the coordination of such groups is very difficult (see Drabek et al. 1981), that the handling of dead bodies especially if they are dismembered or disfigured is very psychologically disturbing and has mental health consequences for those who engage in such activities. The specific disaster agent involved does not matter very much. Disaster occasions do differ from one another. But it is not the difference between a chemical disaster and an earthquake disaster, for instance, which is most crucial. The differences that are important have to do with other matters such as predictability, controllability, speed of onset, length of possible forewarning, duration, scope of impact, destructive potential, and so on (Dynes, 1974). It is important for planning and response, for instance, if there is a warning time. It matters far much less if the agent involved is a natural one or is a technological one. Certain physically "dissimilar" disaster agents can have similar

11

consequences. Conversely, certain physically "similar" disaster agents can have rather dissimilar effects for the purposes of preparing for disasters. Given all this, it is not surprising that research studies have consistently shown that from a strategic perspective that disaster planning should primarily be first of all generic or general, and that there should be only one major organization responsible for coordinating the overall planning for all kinds of disasters, community or others. There should not be separate planning by different groups for different agent specific disasters. Of course, within overall planning, there can and might be special provisions for the particular aspects of certain specific kinds of disaster agents (e.g. radiation), but primary emphasis must be on the generic or general aspects involved in preparing for disasters We should also note that general disaster planning in contrast to specific agent planning is: (a) cost efficient in terms of expenditures of time, effort, money and resources; (b) a politically better strategy because it is possible to mobilize a wide range of groups interested in disaster preparation and response, in effect create a more powerful constituency for disaster planning; (c) a major way of avoiding duplication, conflict, overlaps and gaps in actual responses; and (d) a way of increasing efficiency as well as effectiveness in any organized response to a community disaster. 3. Be integrated rather than fragmented. Another weakness in planning is that too often it fails to take an overall community perspective on the process. It is of no use for an organization to plan well for itself or a handful of other organizations when potential or actual disasters precipitate a community mass assault on the problem. Studies by ourselves and other researchers have, in fact, consistently reported that local emergency personnel are often surprised at the number and diversity of responders, both from within and outside the community, which converge on the disaster site, the larger the disaster, the more the converging groups and their variety. In the United States, community disaster preparedness planning is frequently fragmented with different clusters of organizations involved. One of the clusters is around what has been called the social control sector. This planning is usually undertaken by representatives of local government and usually involves the local emergency management agencies (LEMAs), police and fire departments, public safety agencies and sometimes public works organizations. Another planning cluster tends to be around what might be called the medical and social service sectors. Hospitals, emergency medical groups and variety of other public and private social

12

service agencies such as the Red Cross chapter often engage in related planning for services for victims. Then in recent years, increasingly disaster planning is also being undertaken by institutions and organizations from the private sector--the nuclear power and the chemical industries being obvious cases. Too often their planning is separate from most other community groups. From an overall perspective, this is obviously a bad planning strategy. Good preparedness planning requires an integrated community effort. All relevant sectors of the community not only need to be involved, but their various actions need to be tied to one another. The DRC field research keeps finding localities where there is separate planning for evacuation and for on site command posts, for instance. To a considerable extent, this fragmentation reflects everyday conflicts and disputes over organizational territory and domain between police-fire departments, fire departments-hospitals, LEMAs-police departments, and so forth. But disasters do not impact only one sector or segment of a community; in fact, a disaster by most definitions is something which disrupts community life across-the-board. Therefore, from an organizational point of view good planning also has to be across-the-board. 4. Be based upon an emergent resource coordination and not a command and control model. There is a strong tendency to assume that disasters create a social void or vacuum that needs to be quickly filled. Thus, it is often visualized that the best model for disaster organizational preparedness is what has been called the command-and-control model. This is the notion taken from the structure of the military world, that a top-down, rigidly controlled, and highly centralized social organization ought to be developed for disaster purposes (Dynes, 1983, 1990). Let us leave aside the fact that the command and control model is more fiction than fact even in the military area. It is not the way armies, navies, or air forces actually operate, especially in conflict situations, stereotypes and group mythologies to the contrary. Direct studies in the disaster area not only have shown that command and control models seldom are organizationally viable in community life, but more important, would be poor models for disaster planning even if they could be implemented in the real world. As applied to disasters, the command and control model is based on several premises: massiveness of disaster impacts, weaknesses of human beings under extreme stress, fragility of impacted social systems, breakdown of social order, and the need for a single encompassing structure to replace supposedly nonfunctioning groups in disaster stricken communities. According to research, all these

13

premises are questionable. Even in major disasters far more remains intact than is disrupted, damaged or destroyed. Human beings react well to the challenges of the emergency period. Local social organizations do not cease functioning. There remains order and structure at both the personal and social levels. Disasters do not bring a descent into chaos and disorganization requiring firm leadership from outside the local area. The fact of the matter is that victims and local groups move to try to do what they can frequently improvising and innovating in their efforts. This is paralleled by massive convergence of aid from the outside. Thus, in good disaster planning, rather than attempting to centralize authority, it is more appropriate to develop mechanisms for integrating the emergent and the convergent activities. The issue is coordination not control (Kreps, forthcoming). From a strategic point of view, the objective is to try to facilitate adequate linkages among relevant groups so that community objectives in responding to a disaster can be accomplished. The goal is not to attempt to impose order from above, something which is both unnecessary and unachievable (Dynes and Aguirre, 1979).

5. Focus on general principles and not specific details. There is a tendency whether in developing written plans, conducting exercises, thinking about possible hazards, and so on, to elaborate considerably. In fact, there is a strong temptation to go into very specific details. This is the wrong way to proceed. There are several reasons why this is a poor path to follow. It is impossible to plan for everything. Situations are constantly changing and specifics quickly get outdated. Too many details leave the impression that everything is of equal importance when that is clearly not the case. Complex and detailed planning is generally forbidding to most potential uses and will end up being ignored. While disaster planning cannot totally ignore specifics, particularly at the organizational level, good preparedness planning should be based upon the use of general principles from which simple rather than complex plans can be developed. But even apart from written plans, all disaster planning should aim at general rather than specific details. For example, within the context of what was said earlier, good preparedness planning will consider the fact that during emergency occasions, organizations with response responsibilities will be working with new and more groups (both existing and emergent), and that the new and different kinds of relationships imposed by the crisis situations are unlike those that are required during periods of normalcy. However,

14

during the planning process, no attempt should be made to specify all of the possibilities and intricacies associated with the scope or degree of interorganizational contacts which might conceivably develop. Finally, good planning requires accepting the belief that there are principles of good planning. Few would explicitly deny this. However, implicitly, some officials think that every occasion is unique and that, in a real sense, general preparedness planning is impossible. That is not a valid view. Every human being is somewhat biologically different from other human beings. Nonetheless, the medical world, for example, has little difficulty in identifying general symptoms of illness and specifying uniform treatment procedures. Similarly, each disaster is different, but a general preparedness approach is possible. 6. Recognize that far more is involved than producing a document. A further impediment to developing good disaster planning involves the adoption of too narrow a view of what preparedness planning involves. To many, the writing of a disaster plan is seen as the essence of planning. Studies indicate this is not only incorrect but actually can be a very dysfunctional position to take. Officials sometime think they are well prepared merely because they have a formal written plan. Even worse, focus on a plan often leads organizations to ignore other critical activities that are absolutely necessary to developing good community disaster planning. Disaster preparedness is not synonymous with the formulation of a written disaster plans. A more useful perspective is to envision planning as a process rather than to perceive it as just the production of a tangible product. Viewed this way, preparedness planning involves all of those activities, practices, interactions, relationships, and so forth, which over the short term or long run are intended to improve the response pattern at times of disaster impact. As viewed within the aforementioned preparedness planning includes: perspective, disaster

(a) convening meetings for the purpose of sharing information; (b) holding disaster drills, rehearsals, and simulations; (c) developing techniques for training, knowledge transfer, and assessments; (d) formulating memoranda of understanding and mutual aid Agreements; (e) informing the public and others involved in the planning process; (f) obtaining, positioning, and maintaining relevant material

15

resources; (g) undertaking public educational activities; (h) establishing informal linkages between involved groups; (i) drawing up organizational disaster plans and integrating them with overall community mass emergency plans; (j) continually updating materials/strategies; and (k) thinking and communicating information about future dangers and hazards. Thus, while formal disaster plans are an element in disaster preparedness, they are best viewed as only one of numerous activities which should be undertaken to improve the efficiency and effectiveness of a community disaster response. Organizational problems cannot be achieved solely by writing a plan. For example, converting disaster victims into potential helping resources must involved public education, training techniques, group involvement and so forth. Similarly, reducing interorganizational conflicts requires having meetings, holding drills, securing agreements or memoranda of understanding, and taking other necessary actions as required. A range of activities have to be undertaken if the desirable preparedness objectives are to be achieved. 7. Strive to evoke appropriate actions by anticipating problems and possible different solutions. While in some instances planning can be oriented to prevention, most preparedness activities have to be directed towards altering or modifying what will happen. Planning should indicate the range of probable problems which will occur. Thus, good planning attempts to reduce uncertainties, but it is unwise to assume that everything of importance can be anticipated or that all the unknowns can be accurately predicted ahead of time. The various contingencies are too many to allow anticipation of all possibilities. However, good planning can indicate some of the major parameters of the crisis occasion. For example, the planning process can incorporate the perspective that disaster victims will take the initiative and will not be passive, or that helping organizations will have difficulties in mobilizing because of lack of clarity what the situation requires. Such a strategical approach reduces the unknown which have to be considered. It not only narrows the range of problems which need to be anticipated, but also lessens the number of alternative or optional solutions which have to be examined. If disaster victims do not markedly engage in or are not subject to looting, there is little need to plan for a variety of security measures or the mobilization of many law enforcing agencies. On the other hand, if there is always a degree of tension if not conflict between local and nonlocal helping organizations, whether in the public or private sector, this needs

16

to be recognized and addressed in preparedness planning. Research studies also indicate that good planning does not assume there is only one solution to a problem. Rather, realistic and major alternatives or possible options ought to be indicated. In this connection, good planning should be more like a road map than a blueprint. The latter says that this is the way that building must be built; the former suggests a variety of different ways of getting from one point to another. Furthermore, community disaster preparedness planning should strive to evoke appropriate actions. At times planning appears to be used primarily as mechanism for speeding up responses to crisis situations. It is true that good preparation might allow a quicker response to certain problems; however, quickness of response should be a by product not a major objective. Appropriateness is more important than speed. Accordingly, it is much more important to obtain relevant information about what is happening than it is to take immediate actions. Reacting to the immediate situation may seem the most natural and humane thing to do, but it is rarely the most efficient and effective response strategy. The immediate situation is rarely that important in terms of both short and long run consequences. Planning in fact should help to discourage impulsive reactions and to encourage the adoption of deliberative actions appropriate for the crisis occasion. For example, planning should be directed at slowing down the convergence of helping organizations at a disaster site, thus reducing coordination problems. 8. Be based on what is likely to happen and the real problems which will emerge. Much community planning for an emergency time situation is unrealistic in at least two related ways: a failure to be based on what is likely to happen and incorrect expectations about actual problems which are likely to surface. In general the tendency is to plan from the perspective of the organization doing the planning and to try to implement that which is most convenient from its point of view. Whether intended or not, this assumes that people and other groups will adjust to whatever is planned. For example, certain routes may be designated for evacuation because they are easy to control by the public authorities even though the roads are unfamiliar to potential evacuees. Generally, this is a poor strategy. It is far better to plan on the basis of how individuals usually react during crisis situations, than to expect them to change their behaviors

17

drastically during disasters. Thus, planners must adjust their planning to however people actually behave under stress, rather than to expect people to change their behaviors in order to conform with the planning. Thus in evacuating people will try to leave an area by streets with which they are familiar and are accustomed to traveling. The principle is equally applicable to organizations. The great majority of groups cannot be expected to act and/react much differently during a disaster than they would during periods of normalcy. For example, it is useless to assume that concerns over organizational domains or territories which prevail during normal times will suddenly disappear during a crisis occasion. Disaster planning must also be adaptable enough to include expected group behaviors, rather than to try forcing organizations to drastically alter their activities in order to meet the requirements of unrealistic planning. In addition, real rather than mythological problems must be the focus of planning. Thus, preparedness planning can be no better than the assumptions made about individual and group problems during disasters. Unfortunately, as we indicated in our earlier remarks, much planning often is based on common sense notions and/or on the most recent limited disaster or minor emergency experience of the organization or community. This would be appropriate if, for example, the common sense notions and assumptions made about emergency time disaster problems were valid. But they often are mythological rather than real. Thus, if planning assumes panic, disorder and passivity as significant problems which will appear at the height of a disaster occasion, an incorrect point for starting planning will have been taken. We shall also see that there can also be major misconceptions about organizational problems as well. As will be discussed later, if it is incorrectly assumed that communication problems of groups stem mostly from technological failures, that there is considerable breakdown of organizational authority, or that interagency coordination can be brought about by centralizing control, this too will be a bad starting point for planning purposes. As someone wrote a long time ago, more damage is done by what people incorrectly believe to be true than by lack of knowledge per se. Unfortunately, in the disaster area, false beliefs about human and group behaviors and problems in disasters abound among emergency planners and emergency officials. To the extent that this is the situation, they will be operating with a poor planning strategy. 9. Take into account the new elements that emerge in a disaster context.

18

Disasters lead to the emergence of new demands and problems which in turn leads to new activities and collectivities. Put another way, the emergency time period of disasters, generate much emergent phenomena. This is true both at the individual and group levels (Drabek, 1987; Forrest, 1974). Disasters create radically new social environments for responding entities, individuals or groups. Among the more important aspects are the following: those responding have to operate with a great deal of uncertainty about the real demands and capabilities in the crisis situation and there is often both a feeling and a need for great urgency to act. This means that everyday and usual ways of acting, at both the individual and organizational levels, are not always appropriate for coping with the emergency time periods of disasters. One consequence of such a state of affairs is that a variety of organized behaviors emerge in disaster occasions. Some researchers think that by cross tabulating two dimensions--tasks and norms--a fourfold typology can be produced (see Quarantelli, 1966; Dynes, 1974; Stallings, 1978; Drabek, 1987). Tasks are either regular or nonregular, norms are either old or new. Thus, four types of organized behavioral responses are derived: (l) (2) (3) (4) established (regular, old); expanding (regular, new); extending (nonregular, old); and emergent (nonregular,new).

Planning which assumes that disaster problems can be handled primarily by established organizations only, are working with an incorrect view of the situation at the emergency time period of disasters. There are organizations which expand and those which extend; in addition, there are new groups which come into being. Realistic planning has to take this kind of strategic view of how disaster related problems might be handled. Improvisations of the kind indicated are at the heart of organized efforts to cope with the needs and uncertainties of the emergency time period of a disaster. 10. Use the best social scientific knowledge possible. It is not possible to adequately prepare for disasters solely on the basis of one or two personal experiences. There are dangerous limitations to such an approach. Organizational officials are unlikely to have direct personal experiences with very many disasters. Thus, any idiosyncratic features of a particular disaster may be mistaken as universally characteristic of all

19

disasters. There is also a tendency to make broad generalizations based upon personal experiences with one or a few disaster occasions and to apply observations made to the full spectrum of possible disasters. Additionally, due to the lack of a broad perspective, it is not always possible to derive meaningful lessons from personal experiences. For example, rather than recognizing a perceived absence of panic as a general human tendency, often it is attributed to one's own unique stable qualities or the sterling but exceptional characteristics of the impacted population. Finally, it is never easy for organizational officials to make an impartial evaluation of the actions of their own group. Too often, after action reports are post hoc defenses or justifications of the what the agency did, rather than a candid assessment of either the problems encountered or the mistakes made. A direct personal or organizational disaster experience is less useful for disaster planning purposes than is often recognized. Before such experiences can be utilized, they must be systematically analyzed and their limitations explicitly stated. It is therefore possible for some officials within emergency oriented groups to be involved in several disasters, yet demonstrate by their actions that they learned very little. In essence, the events to which they refer are not conducive for deriving general principles. Just as military "war stories" contribute nothing to military planning strategy, disaster "war stories" are also seldom useful in developing preparedness planning strategies. The most adequate knowledge base for planning purposes is grounded in as wide a range of as many disasters as possible, involves a systematic and objective examination of what occurs, and attempts to draw general principles and theoretical models from the information obtained. This is what social scientific research in the disaster area attempts. Until the last few decades, disaster planners could justifiably say that there were very few social scientific studies which could be used. This excuse is no longer legitimate.

3. Managing Disasters It is very easy to assume that if there has been community disaster planning there will be successful emergency time management. That would seem to be after all the ultimate purpose of planning ahead of time. Unfortunately, however, research has shown that is far from being the case (Quarantelli, 1988a). There often is a big gap between what was planned and what actually happens in a major disaster crisis. There is in fact only a partial correlation

20

between the undertaking of preparedness planning and the successful or good managing of community disasters. The reasons for this is twofold. One is that preparedness planning can be poor in the first place. Thus, if as indicated above, the planning is agent specific rather than generic, if planning is too segmented or segregated rather than involving all relevant social actors, or if the planning demands artificial or far-from-everyday activities, there will be implementation of that kind of poor planning in actual disaster situations. (Quarantelli, 1985b). Poor planning can only encourage poor management activities. This is the more obvious of the two major reasons why successful crisis management does not automatically follow from disaster preparedness planning. Given that, the other reason will be discussed, namely a failure to recognize that the principles of crisis management are different from the principles of disaster preparedness planning. Studies of disasters have demonstrated that organizational officials do not always distinguish between the two processes or activities with consequent negative results. Sometimes it seems to be assumed that because preparedness planning is in place, management of the disaster will only require implementation of the prior planning. But preparedness planning and emergency managing are not simply two sides of the same coin. Perhaps if a parallel is drawn, the last point can be made even more clearly. The military draws a distinction between strategy and tactics. In fact, they teach and try to implement in practice, the difference between the two. Strategy, in general, has reference to the overall approach to a problem or objective. But there are always situational factors or other contingencies which require particular adjustments to attain a specific goal if the overall objective is to be attained. This is the area of tactics. In somewhat parallel terms, good disaster preparedness planning involves the general strategies to be followed in readying for sudden community emergencies. In good crisis management, particular tactics are used to handle the specific situational contingencies which are present or which arise during the course of the emergency. Clearly it is usually impossible ahead of time to spell out in detail the particular tactics which have to be used because, almost by definition, they will be relatively specific to the actual situation encountered. Good crisis management, to a considerable extent, is the application of tactics which are specifically relevant to the situational contingencies of a given community disaster. However, just as the military finds it possible to advance tactical principles in addition to strategical principles, disaster researchers can point to some of problems that require tactical considerations for effective and efficient crisis

21

management. Let us therefore turn to the behavior of groups in disasters. 4. The Reactions of Groups Just as there are many mythologies about human behavior in disasters, there are also widespread misconceptions about organizational responses. In what follows we will summarize major mythological and real problems of organizations in the emergency time periods of disasters. For purposes of presentation we organized our remarks under problems in: l. 2. 3. 4. The mobilization of groups; Communication and the processing of information; The exercise of authority and decision making; and The development of coordination.

l. The mobilization of groups. It is sometimes thought that organizations cannot be mobilized and function well because of a possible conflict between the work role and the family role of officials. Thus it is sometimes assumed that important officials or key personnel will stay away or leave their jobs at the emergency times of disasters because of a concern for or a need to take care of their victimized families. There is a general belief that forced to choose, people will choose family over work responsibilities, and that this will hinder or impeded organizational mobilization for a crisis. Research however shows that this so-called role conflict does not result in the failure to carry out or the abandonment of major occupational responsibilities. At least it is not a major problem, especially in the higher echelons of organizations and particularly those that are seen as necessary in an emergency time response. Studies clearly indicate officials in such positions can be expected to do their jobs, although it does result in psychological strain and stress for those caught in such a role conflict (Dynes and Quarantelli, 1986; Rogers, 1986). It is also sometime thought that at least in major disasters local organizations cannot be mobilized quickly because they are overwhelmed by the nature of the occasion. Thus it is thought that apart from officials being concerned about themselves and their immediate family, community groups cannot respond because they do not have the organizational will to do so. Part of this is seen as stemming from the shock that groups undergo as a result of the experience (paralleling the shock that human beings supposedly undergo as we noted earlier), and part from the belief that

22

organizations are faced with a totally unfamiliar situation. Studies do not support this view of organizational paralysis. Groups move as quickly as possible to do what they are capable of doing; many tasks and responsibilities are the same as in normal times (for example, fire departments can continue to be concerned with fire problems, water department with water problems, lifeline organizations with various services, etc.). While often there may be a lag in group mobilization for a disaster, this stems mostly from the lack of appropriate information and adequate knowledge about the needs and demands of the occasion which are relevant to the operations of the organization. Learning what has happened in the immediate aftermath of a disaster impact is usually a major problem for all responding organizations; this is the problem rather than any kind of organizational shock (however, prior planning can make a difference in the speed of response, as we shall note later). There are also other organizational difficulties in mobilizing. Let us note two of them. Along one line, the problem often is that there is little of an appropriate nature around for a required task. For example, it is not always clear, who has the responsibility for suddenly performing new disaster-related tasks, such as undertaking large scale formal search and rescue, making up lists of missing persons, or processing large number of dead bodies. These are not the normal responsibility of any community agency, but these and similar tasks in a major disaster will have to be assumed by someone sooner or later. In the absence of prior planning, some group or groups will have to mobilize its personnel for the work and attempt to ascertain what has to be done and what will be needed for a rather unfamiliar type of work activity. So while a disaster does not generate an overall unfamiliar social setting, it can create specific new tasks that will hinder group mobilization. Along another line, the problem in mobilizing may be an overabundance of something that is not needed. For example, an almost always existing problem at emergency time of disasters is the use of volunteers. Many well motivated volunteers with a wide variety of skills are not necessarily an organizational resource. In fact, in the absence of very good prior planning of who will use volunteers, where they will be sent, how they will be supervised, when they will be used, and so on--in the absence of such detailed planning (which some local Red Cross chapters do have), the sheer presence of mass of individual volunteers will simply create another disaster related organizational problem. Often, vitally needed regular staff members will have to be used to get rid of the volunteers or to attempt some ad hoc planning and/or training of them for some hurriedly designed tasks. Consequently, volunteers often hinder rather than help in the mobilization of almost all organizations. (We leave aside here the complex question of what

23

constitutes a volunteer, for a typology see Dynes and Quarantelli, 1980). 2. Communication and the processing of information. It is often assumed that communications are a problem in disasters; even many after action reports or retrospective looking back will allude to the communi-cation difficulties that existed at the emergency time period. Research however indicates this is a partially incorrect reading of the nature of the problem. Very often poor communication is equated with not having enough communication channels or means. But it is the rare disaster situation where not enough means of communication are available. It is only in the most unusual or catastrophic of disasters that communication technologies will be destroyed or disrupted, or that there will not exist enough physical ways of communicating because radios, telephones and computers are inoperative or not usable. Substitute means such as ham or citizen band radios and runners or foot messengers will often quickly emerge as substitute means of communication. On occasions there may be some scarcity of equipment for the given emergency demands, but this usually reflects the preimpact situation rather than a consequence of disaster agent impact. The major difficulties are in the processing of information through the available communication channels. Given the usual physical presence of means of communication, the real problems in this area are in poor, incomplete or inefficient information flow. Thus, in the great majority of instances, a major organizational problem that develops at the emergency time of disasters is in what is communicated, not in how it is communicated Furthermore, the information processing difficulties are typically multiple. There can be information flow problems within organizations or intraorganizationally, between organizations or interorganizationally, from certain groups to the public generally, and from selected elements of the public to groups. Intraorganizational problems. Research shows that there are often three kinds of information flow problems during emergency time periods. Organizations may use extra shift personnel and/or volunteers who will have to be linked into the message system of the group. If they are not, the intraorganizational information flow will be seriously impaired. Also, the communication channel used may be unusual with information, for example, entering the group at atypical entry points such as the head nurse in the emergency room of a hospital. Many groups assume information will come into the organization at particular points and be transmitted to particular officials; this does not always occur at emergency

24

time periods of disasters. Also not infrequently important information will be collected at different points in an organization and will never reach all relevant officials. The problem in many disasters is not the absence of organizational information of knowledge, but its existence and flow in the "wrong" places in the group structure. Interorganizational problems. Research shows that in the typical emergency time period of disasters, groups have to interact with organizations with which they are unfamiliar. Public agencies may have to deal with previously unknown private concerns. Local organizations may be in contact with extra community groups, many of whom might not even have known of one another's existence prior to the disaster. During an emergency time period, informal channels of communication might be used between organizations that ordinarily use formal links. And of course the substantive content of the information exchanged could be radically different from what it is on an everyday basis. These and other changes in the information flow frequently create problems in the interaction between responding organizations. This is particularly likely to be a major source of difficulty in the early stages of a disaster. In addition, studies suggest that the more formal and bureaucratic organizations are in preimpact times, the more difficult it is for them to shift or alter their interorganizational information flow patterns at times of disasters. Organizations to public problems. Often organizations suddenly have to communicate with the public generally at the emergency time period of a disaster. Most groups are not accustomed to doing this and even emergency oriented groups such as police and fire departments have less experience in doing this than is realized. It is often unclear too what information different parts of the public need and it is almost never known if citizens are being reached because no feedback can be quickly obtained. There is also a tendency to frame messages or requests in terms of organizational expectations and requirements, and a failure to couch them from the perspectives of the often heterogenous population that needs to be informed. This last reflects a typical bureaucratic inclination to do things on the basis of the need and convenience of the organization rather than from the viewpoint of the citizens or public presumably being serviced. Public to organizations problems. The converse of the just mentioned problem is that it is also very difficult for interested segments of the public to communicate well with organizations during the emergency time periods of disasters. Part of this has to do with uncertainly about which groups should be contacted. Not all organizations, including emergency oriented ones, are fully trusted and seen as legitimate sources of information by all

25

segments of the citizenry. People generally will familiar organizations, but these are not necessarily have the information being requested. One almost consequence is an overload of inquires and questions groups.

call upon those who inevitable for a few

Generally problems in organizational information flow are the most serious ones. If difficulties in this area are not solved or at least mitigated, there is no great need to worry about other kinds of problems. Rapid and accurate information flow are essential core ingredients of any effective and efficient organizational response at the emergency time periods of disasters. Any weaknesses in good information flow will simply magnify the difficulties or in some cases make it impossible to adequately deal with other organizational problems. 3. The exercise of authority and decision making. Disasters require that some agencies assume responsibilities and that some officials make decisions. If the exercise of authority is weak during non-stressful times, it will prove even weaker at a time of a disaster. If authority is very weak in the first place as is true, for example, in many county governments in the United States, it can completely disappear when disasters strike. However, even if we assume that the exercise of authority among agencies during periods of normalcy are operating properly within a community, there will still be problems during the emergency phases of disasters. Moreover, the difficulties which surface are often not those commonly anticipated, and have more to do with decision making than the exercise of authority. Thus, the organizational chain-of-command and line-of-authority very seldom breaks down in established groups. Even if there is inadequate information flow during a disaster, officials usually continue to exercise their formal authority and fulfill their normal official duties and responsibilities. If higher echelon personnel are not present or cannot be reached, officials at middle and even lower echelons often will make decisions they do not normally make. Even rigid bureaucracies will show some flexibility on this matter when faced with clear cut crises that require an immediate organization decision or response; in fact, decentralized group decision making is a common feature of disasters. Likewise, there are not many problems arising from questions concerning which organizations have the authority for performing traditional tasks during periods of disasters. Thus, there are seldom conflicts or disputes concerning decisions on who fights fires, repairs telephones, performs major surgical operations, or other specialized but everyday routine tasks. Such matter are the traditional responsibility of certain local community groups and a

26

disaster is unlikely to alter the normal pattern. However, research indicates there are at least three major problem areas regrading organizational decision making during the emergency time periods of disasters. First, there is the problem of personnel burnout which stems from the strong tendency of key officials to continue to work too long. Such personnel who remain on the job around-the-clock will eventually collapse from exhaustion or become inefficient in their decision making and other areas of responsibility. More important, when such officials are eventually succeeded by others, their successors will often lack vital information, because crucial data is seldom recorded at the height of emergencies. Good decision making requires relevant knowledge. Officials with the appropriate information will not always be physically capable of working beyond a certain point. If such officials occupy key decision making positions, the disaster response capability of the organization can be seriously impaired. Authority and decision making problems sometime arise also because of conflicts over organizational domains. Frequently this becomes an issue between established local agencies and outside or emergent groups and usually has to do with a traditional task. For example, for the most part, the security of an area is considered a traditional local police function. Conflicts can arise if state police or military personnel move into an impacted locality and also attempt to provide security, Such actions are often viewed by the local police as an attempt to usurp their authority. This issue is sometimes manifested in disputes over who has the right to set up roadblocks or to issue passes allowing entry into a restricted impacted zone. The problem is even more complex when the competing organization is an extra-community group or an emergent group (e.g., when non local relief or welfare agencies provide service). Though such "outsiders" may be exercising their mandated or usual function of providing standard services, such organizations are frequently viewed as intruders into the domain of local agencies while performing such functions. If the outside or local relief group is a new organization, established local agencies undertaking the same disaster task(s) are almost certain to raise questions about its legitimacy and authority. Finally, community disasters frequently cut across jurisdictional boundaries of local organizations. This creates a great potential for intergroup or agency conflict. During non crisis times, most vague, unclear or overlapping formal authority and responsibility matters can often be ignored. During the emergency periods of disasters, with decisions having to be made, this is frequently not possible. This is one of the more difficult organizational problems in disasters since the source of the problem is in the preimpact situation and can also have consequences for the post-

27

disaster period, often fueling or adding to the everyday community organizational conflicts. 4. The development of coordination. Coordination is sometimes confused with control. Emergency oriented organizations which operate with a "command and control" image of how a disaster response should be handled are particularly vulnerable to this mistaken notion. Drawing from an inappropriate military model as we noted earlier, the incorrect assumption is made that an integration of the community response can best be made by imposing an authoritarian and centralized structure on the crisis situation. Research studies shows that this is not a good way of bringing about effective and efficient coordination to a civilian disaster. Coordination cannot be imposed. It has to be created. Development of organizational coordination is problem plagued, of which we shall mention three kinds. First, there is often lack of consensus on what is meant by coordination. It is actually unusual to find any organization which does not agree in principle that coordination is needed during disasters. The problem however is that "coordination" is neither self explanatory nor a matter of much consensus. At one extreme, some organizations view coordination, at best, as informing other groups of what they will be doing in the disaster. At the other extreme, some organizational officials see coordination as the centralization of decision making in a particular agency or among a few key officials. Given such diverse views surrounding the meaning of coordination, it is not surprising that even when a formal predisaster agreement to coordinate the disaster response exists, there can occur mutual accusations that one or both parties have failed to honor the agreement. But prior agreement or not, in the absence of an explicit understanding of what coordination means in operational terms, there will be serious organizational coordination problems. Studies show that it is rare to find such an explicit understanding in community disaster planning. Second, there are problems in coordinating organizations from the public and private sector. Public and private groups often have different interests, tasks and goals. For example, public agencies, by law and by tradition have to consider a disaster situation and the demands is creates from the perspective of the community at large. Private sector organizations necessarily have a much narrower perspective, assessing their involvement primarily as they see the disaster generally impinging on their operation and profitability and have much less flexibility in using their resources than do public groups.

28

Third, coordination (i.e., mutually agreed linking of activities of two or more groups) between organizations working on common but new tasks is also difficult. Even local agencies that are accustomed to working together, such as police and fire departments, may encounter difficulties when they suddenly try to integrate their activities to accomplish a novel disaster tasks, such as the handling of mass casualties. While police and fire departments may be accustomed to recovering a few bodies resulting from traffic accidents or fires, the large number of deaths resulting from a major disaster will pose a coordination problem. It is partly the newness of many disaster tasks which create strained relationships among organizations which had previously worked together in harmony. Also, in daily operations there can be a gradual development, frequently on a trail and error basis, of a working relationship between two groups concerned with the accomplishment of a common goal. Such leisurely developments of cooperative relationships are generally an impossibility given the immediate demands during the emergency phase of a community disaster. 5. Specific Observations on Emergency Medical Services (EMS) There are a series of problems with planning for as well as managing the injured that result from community disasters. In this discussion we will primarily focus on organizational response problems (planning issues are discussed in Tierney, 1985). Also in the time available we can only present some very general observations that studies have reported about the delivery of emergency medical services (EMS) in disasters (mostly taken from Quarantelli, 1983, but see also Butman, 1982 and Auf der Heide, 1989). For purposes of exposition we will discuss research findings about the characteristics of the phenomena at the emergency time periods of disasters without making a sharp distinction between the EMS system per se and the hospital operations that are associated with it. Thus, we will talk about search and rescue, the transportation of victims, treatment attempted, medical and hospital components involved, and the modes of integration of the various activities undertaken, without drawing a fine line between the EMS system and the hospital system.

Delivery of EMS

29

Search and Rescue. Almost irrespective of what other organizational personnel are present soon after disaster impact, the ore systematic and greatest amount of search and rescue is performed by members of fire departments. However, it should never be forgotten that as noted earlier the vast majority of search and rescue is undertaken by individual citizens. Even when medically trained personnel are among the first responders, they will not usually be in charge of the search and rescue or in control of the disaster site. In fact, the more the Incident Command System is being used, the less likely such persons will have the major responsibility (see Wenger, Quarantelli and Dynes, 1989). Search and rescue by formal organizations usually takes place in loosely structured situations with uncertain exercises of authority. Put another way, much of the activity is of an emergent nature. There typically is little communication from the disaster site or the locale of search and rescue to hospitals or any central EMS system point. Even when there is some, it is seldom medically informative. Estimates of casualties are almost always on the high side during search and rescue operations. Initial assessments will usually overestimate the number of dead and injured at given impacted sites. Invariably, little actual triage occurs in connection with search and rescue in disasters. Often what is said to be triage is not of a systematic nature. Transportation. Disaster victims typically arrive at hospitals by a variety of means. Essentially this means that any EMS system loses control over entry into the system. Disaster victim transportation is more likely to be by public rather than by private agencies. However, ambulances are not necessarily the major means used. The larger the disaster, the more likely transporters are from outside the local impacted community. This is part of the convergence assault we have mentioned several times. Potential transporters unsystematically converge on disaster sites

30

relatively quickly. This often leaves the rest of the surrounding area unprepared to handle any other sudden need for transporters. There are usually more transporting vehicles at the disaster site than are used for moving victims. This is part of an overresponse that is a problem associated with the Incident Command System (see Wenger, Quarantelli and Dynes, 1989). Speed of response appears to be the dominant concern in transporting victims to hospitals in almost all disasters. This in many cases is most dysfunctional than functional in situations of large numbers of mass casualties. Although there are some patterns to the transporting of disaster victims to hospitals, they typically are not the result of following either pre impact plans or impact time directives. For example, familiar hospitals tend to be where transporters take victims. Treatment. First aid activity is just as likely to occur as not at the time of the aftermath of a disaster, but is often not provided at the time of initial search and rescue. To the extent it occurs, first aid is not a dominant feature of the early search and rescue. There is a pattern to the volume of casualties flowing through hospital emergency rooms. For example, first casualties typically arrive within the first half hour after disaster impact, and most victims arrive over a relatively short time period. The less severely injured in disasters tend to be treated first at hospitals. This in part is related to the earlier mentioned loss of control over entry into the EMS system. On the whole, the very large majority of victims given hospital medical treatment in a disaster do not need extensive or intensive medical care. Put another way, most EMS delivered at times of disasters is of the simpler kind requiring no great amount of facilities or specialized equipment. There is a considerable range and an emergent quality to much of what is done in hospital processing and treatment of disaster victims. Situational contingencies often determine what is or is not done irrespective of prior planning. Very poor records are usually made of the medical processing and treatment of disaster victims especially when a hospital receives a large number of them. This has all sorts of implications ranging from problems of cost billings and insurance collection to the

31

difficulty of making any serious evaluation of the quality of the medical care given and the possible efficacy of abbreviated treatment procedures. Components involved. New groups are typically part of EMS delivery system in disasters. Conversely, many established EMS components are not involved in disaster EMS. In disasters there is a marked underutilization of hospital components available in any given geographic area. There is in fact a marked inequity in the distribution of victims to hospitals. The hospital which is the focus of victim convergence tends to exhibit a distinctive flow and casualty pattern. For example, one hospital typically receives not only the largest number of casualties, but the most severely injured as well. Loss of hospital capability seldom occurs in disasters. hospitals run out of any needed resources. Rarely do

A hospital, in its response to a disaster, will be both differentially involved and have some of its subcomponets carry out different tasks than they do in normal times. Again, there is much emergent phenomena. Modes of integration. Centrally coordinated EMS responses in disasters are very rare. This is especially true in metropolitan areas. There is typically little attempt or actual exercise of authority or control over the EMS response in disasters. There seldom is any control structure or unit present which has the authority or responsibility, or willingness to coordinate, collectively or individually, the organizations conducting rescue, transportation and treatment. Most coordination of actual disaster EMS is not planned. Such overall EMS coordination as occurs tends to exhibit a network rather than system form. Only limited integration of EMS subtask areas exists in most disasters. Part of this stems from a lack of information flow and exchange.

32

6. Catastrophes and Disasters Earlier we emphasized that disasters are qualitatively as well as quantitatively different from everyday and minor emergencies. We think the same can be said about catastrophes and disasters. There is a qualitative as well as a quantitative difference between these two kinds of collective stress situations. Since we do not have time to examine this matter comprehensively and systematically we will simply provide two brief examples, one of a difference at the individual behavior level and another at the organizational level. First, in catastrophes the disruptive consequences are much more widespread making it difficult for certain otherwise social mechanisms to come into play. For example, disaster victims typically go to relatives and friends for sheltering. In a catastrophic situation, the nearby relatives and friends may also be displaced from their homes. What in a disaster can often be easily absorbed by that part of the community that is directly unaffected by impact, will be absent in a catastrophe. Second, the larger the scope or magnitude of impact and the greater the number of responders, the less is the likelihood of success of any overall organizational coordination. In fact, efforts to attain such coordination underlie the imposition of martial law or the designation of national military forces as the decision makers during massive disasters or catastrophes. Historically neither event has ever occurred in the United States, although both are relatively common response measures undertaken during catastrophes in both developed and developing countries. These steps do not always produce overall coordination. This is understandable. In almost any society, a major community disaster and certainly a catastrophe will precipitate a mass convergence of nonlocal organizations upon the disaster site. The numbers involved, the different levels of the social structure which they represent, the heterogeneous mix of public and private organizations involved and so on, virtually assure the impossibility of achieving any overall coordination during the emergency phase. Good planning may effectively reduce the convergence of such organizations and thus allow a relative degree of overall coordination. But such coordination remains relative at best and is frequently never achieved--either by prior planning or by the use of ad hoc efforts-during the emergency period. The magnitude and increased frequency of new tasks to be performed coupled with the need to integrate too many established and emergent groups and organizations minimizes the effectiveness of organizational

33

coordination during catastrophes. However, it is to be noted that the evaluation criteria used to judge the consequences of not achieving total organizational coordination determine to a large extend the significance of coordination in promulgating an effective community response to a catastrophe. If efficiency of response is rated highly, lack of coordination can be deemed a serious problem. If instead, effectiveness of response is judged more important, it is possible to tolerate a much lower degree of overall coordination. Coordination is sometimes discussed as if it were an absolute good. This is not true. There can be relatively effective organizational response in catastrophes without a high degree of coordination. Finally, we should note that the issue of whether preparations should be for a catastrophe rather than a disaster has been obscured in American society by the fact that unlike many other countries in the world we have not had any catastrophes, just major disasters. But even under the best of circumstances, we can expect more and worse disasters in the future than we have had in the past, and some of them may take catastrophic form (Quarantelli, 1988b). If, for example, we have the projected massive California earthquake, we will have an occasion with thousands of dead, tens of thousands injured, hundreds of thousands of buildings damaged or destroyed, and millions of lives disrupted as the shaking and rupture would sever the "lifelines" of power, fuel, water, transportation, sewage and communication that undergird the social fabric of a very wide area, embracing dozens of communities.

34

Bibliography Auf der Heide, Erik 1989 Disaster Response: Principles of Preparation and Coordination. St. Louis, MO.: C. V. Mosby Company. Britton, Neil 1987 Toward a reconceptualization of disaster for the enhancement of social preparation. In Russell Dynes, Bruna De Marchi and Carlo Pelanda (eds.) Sociology of Disasters: Contributions of Sociology to Disaster Research. Milan: Franco Angeli: 31-55.

Butman, Alexander 1982 Responding to the Mass Casualty Inciden5t. A Guide for EMS Personnel. Westport, CN.: Emergency Training Institute. (no author) l986 Disaster Prevention and Mitigation: A Compendium of Current Knowledge. Social and Sociological Aspects. New York: United Nations.

Drabek, Thomas 1987 Emergent structures. In R. Dynes, B. De Marchi and C. Pelanda. Sociology of Disasters: Contributions of Sociology to Disaster Research. Milan: Franco Angeli: 259-290. Drabek, Thomas. 1986 Human System Responses to Disaster: An Inventory of Sociological Findings. New York: Springer Verlag. Drabek, Thomas et al. 1981 Managing Multiorganizational Emergency Responses: Emergent Search and Rescue Networks in Natural Disasters and Remote Area Sensing. Boulder, CO.: Institute of Behavioral Science, University of Colorado. Dynes, Russell R. 1974 Organized Behavior in Disasters. Newark, DE.: Disaster Research Center, University of Delaware.

35

Dynes, Russell R. 1983 Problems in emergency planning.

Energy 8: 633-660.

Dynes, Russell R. 1990 Community emergency planning: False assumptions and inappropriate analogies. Preliminary Paper # 145. Newark, DE.: Disaster Research Center, University of Delaware. Dynes, Russell R. and B. Aguirre 1979 Organizational adaptation to crises: mechanisms of coordination and structural change. Disasters 3: 71-74. Dynes, Russell and E. L. Quarantelli 1980 Helping behavior in large scale disaster. In David Smith and Jacqueline Macaulay (eds.) Participation in Social and Political Activities. San Francisco: Jossey Bass: 339-354. Dynes, Russell and E. L. Quarantelli 1986 Role simplification in disaster. In Role Stressors and Support for Emergency Workers. Washington, D.C.: U.S. Government Printing Office: 23-37. Dynes, Russell R., E. L. Quarantelli and Gary Kreps 1981 A Perspective on Disaster Planning. Newark, DE.: Disaster Research Center, University of Delaware. Forrest, Thomas 1974 Structural Differentiation in Emergent Groups. Newark, DE.: Disaster Research Center, University of Delaware. Kreps, Gary 1984 Kreps, Gary 1985 Kreps, Gary 1991 Sociological inquiry and disaster research. Review of Sociology 10: 309-330. Disaster and the social order. 3: 49-65. Annual

Sociological Theory

Organizing for emergency management. In Thomas E. Drabek and Gerard J. Hoetmer (eds.) Emergency Management: Principles and Practice for Local Government. Washington, DC.: International City Management Association: 30-54.

Lystad, Mary (ed.)

36

1988

Mental Health Response to Mass Emergencies: Theory and Practice. NY.: Brunner/Mazel.

Perry, Ronald and Alvin Mushkatel 1984 Disaster Management: Warning Response and Community Relocation. Westport, CN.: Quorum Books.

Quarantelli, E. L. 1966 Organizations under stress. In Robert C. Brictson (ed.) Symposium on Emergency Operations. Santa Barbara, CA.: System Development Corporation: 319. Quarantelli, E. L. 1981aDisaster planning: Small and large--past, present and future. Proceedings American Red Cross EFO Division Conference. Alexandria, VA.: Eastern Field Office, American Red Cross: 1-26. Quarantelli, E. L. 1981bPanic behavior in fire situations: Findings and a model from the English language research literature. In Proceedings of the 4th Joint Panel Meeting, the U.J.N.R. Panel on Fire Research and Safety. Tokyo, Japan: Building Research Institute: 405-428. Quarantelli, E. L. 1983 Delivery of Emergency Medical Services in Disasters: Assumptions and Realities. Newark, DE.: Disaster Research Center, University of Delaware. Quarantelli, E. L. 1985aAn assessment of conflicting views on mental health: The consequences of traumatic events. In Charles R. Figley (ed.) Trauma and Its Wake: The Treatment of Post-Traumatic Stress Disorder. New York: Brunner/Mazel: 173-215. Quarantelli, E. L. 1985bOrganizational Behavior in Disasters and Implications for Disaster Planning. Newark, DE.: Disaster Research Center, University of Delaware. Quarantelli, E. L. 1985cWhat is a disaster? The need for clarification in definition and conceptualization in research. In Barbara Sowder (ed.) Disasters and Mental Health

37

Selected Contemporary Perspectives. Washington, D.C.: U. S. Government Printing Office: 41-73. Quarantelli, E. L. 1987 What should we study? Questions and suggestions for researchers about the concept of disasters. International Journal of Mass Emergencies and Disasters 5: 7-32. Quarantelli, E. L. 1988aDisaster crisis management: A summary of research findings. Journal of Management Studies 25: 373385. Quarantelli, E. L. 1988bFuture disasters in the United States: More and worse. Preliminary Paper # 125. Newark, DE. : Disaster Research Center, University of Delaware. Quarantelli, E. L. and Russell Dynes 1977 Response to social crisis and disaster. Review of Sociology 2: 23-49. Annual

Quarantelli, E. L., Russell Dynes and Dennis Wenger 1986 The Disaster Research Center: Its History and Activities. Newark, DE.: Disaster Research Center, University of Delaware. Regier, Darrel A. et al. 1988 One-month prevalence of mental disorders in the United States. Archives of General Psychiatry 45: 977-986. Rogers, George O. 1986 Role conflict in crises of limited forewarning. Journal of Applied Sociology 3: 33-49. Scanlon, Joseph and Massey Padgham 1980 The Peel Regional Police Force and the Mississauga Evacuation. Ottawa: Canadian Police College. Tierney, Kathleen J. 1985 Emergency medical preparedness and response in disaster: The need for interorganizational coordination. Public Administration Review 45: 7784. Wenger, Dennis, T. James and C. Faupel 1985 Disaster Beliefs and Emergency Planning. Irvington. New York:

38

Wenger, Dennis, E. L. Quarantelli and Russell Dynes 1986 Disaster Analysis: Emergency Management Offices and Arrangements. Newark, DE.: Disaster Research Center, University of Delaware. Wenger, Dennis, E. L. Quarantelli and Russell Dynes 1989 Disaster Analysis: Police and Fire Departments. Newark, DE.: Disaster Research Center, University of Delaware.

39