According to Barbera, who as a medical doctor has had the opportunity to serve on disaster response teams in both the U.S. and in foreign countries, it is important to understand that the healthcare organizations found in communities throughout the U.S. are not built for the extra surge in patients they are expected to serve after a disaster. They simply do not have the capacity and resources, including staff and funds, to do so. Furthermore, healthcare organizations that are directly or indirectly impacted by a variety of events, including terrorist attacks and natural disasters, can be expected to experience major recovery problems.
Barbera noted that this adverse situation is crucial because he, along with others in the medical profession, see healthcare recovery as a critical cornerstone to broader community disaster recovery. He suggested, for example, that the failure to restore the healthcare system in New Orleans since Katrina is a major factor hindering the economic and social revival of the community. Many former residents are hesitant to return to New Orleans because of concern about where they would get healthcare. Also, non-residents who would like to use their skills to help in restoration efforts may find the lack of adequate healthcare resources too daunting a problem to migrate to the city. On top of that the recovery capacity of the healthcare system, and therefore that of the city at large, is further eroded when medical personnel themselves choose to re-locate elsewhere due to slow healthcare system recovery along with degraded quality of life factors like compromised educational systems for their children. Barbera concluded by stressing the importance of government and community focusing upon restoration of the healthcare delivery system post-disaster, and that economic assistance to both public and private healthcare providers will likely provide major benefits in promoting rapid and complete community recovery.
Laurie Johnson, an independent urban planning consultant, began her joint presentation with fellow planner Robert Olshansky by discussing the evolution of pre-disaster planning for post-disaster recovery in the U.S. She concluded that an initial effort began in 1976 as a result of then mayor of Los Angeles, Thomas Bradley, appointing a task force to explore how the city might respond to a credible earthquake prediction. Recovery was one of the issues that the task force ultimately considered. Another important development that generated interest in preplanning for recovery was a project funded by NSF in the 1980s called Pre-Earthquake Planning for Post Earthquake Rebuilding (PEPPER). Johnson noted that a number of relevant actions in California followed this project, including a recovery and reconstruction plan for Los Angeles, drafted in 1988 and revised in 1993, and the development of recovery and reconstruction plans for California by its Office of Emergency Services. According to Johnson, FEMA entered the picture by funding the development of a post-disaster rebuilding exercise for local governments. This was followed by the agency’s collaboration with the American Planning Association to produce a planning guidebook in 1998 entitled Planning for Post-Disaster Recovery and Reconstruction, which was geared towards practicing planners.
Robert Olshansky discussed the state of Florida’s three-year post-disaster redevelopment planning initiative launched by the Florida Department of Community Affairs. He noted that funding for the initiative is provided by the National Oceanic and Atmospheric Administration (NOAA) through the Florida Coastal Management Program. All of Florida’s 203 coastal counties and municipalities are required to adopt recovery plans and inland communities are also encouraged to prepare them, according to Olshansky. He noted that many Florida communities already have plans for mitigation and response and that the new initiative is to ensure that long-term recovery strategies also further hazard mitigation and response goals. The Florida recovery planning initiative is being carried out in three phases. The first phase includes a review of existing recovery plans in the state and the development of new guidelines, followed by a test of the guidelines in a pilot community, and then an analysis of the pilot test and revision of the guidelines. The intended outcome of this process is to produce a model post-disaster redevelopment plan that would represent a consensus of relevant stakeholders, including local