Ruth Bachmeier, MS, RN John R. Baird, MD, MPHDoug Murphy, MBA, BMSFargo Cass Public HealthFargo, North Dakota

Objectives• Identify role of

local public health during a major flood

• Recognize importance of collaboration and cooperation during a major flood disaster

• Evaluate the risk/benefits and decision making involved in evacuation of vulnerable populations

Red River at Fargo, NDRiver flows northVery flat land Wet autumn Record snow fallFlood stage: 18 ftMajor flood stage: 30 ft Record flood of 1997:

39.57 ftMarch 28: crested at

40.82 ft

FEMA photo

Role of Fargo Cass Public HealthHistorically

Tetanus shotsPost flood

environmental concerns

Minimal EOC

2009 Limited Tetanus shotsPre-post environmental

concernsFull EOC involvementEvacuation of

vulnerable populationsShelter coordination

and staffingSandbag supervisionPIO backup

Fargo Cass photo

Emergency OperationsDirector of public

health: city cabinet meets weekly

Weekly flood meetings : first part of March

EOC activation: city and county

Public health in both EOCs

Twice daily flood briefings

Bob Collins PhotoMinnesota Public Radio/mpr.org

Collaborating PartnersLocal hospitals, long-term care facilities,

congregate living sites for vulnerable populations

North Dakota Long Term Care Association

North Dakota Department of HealthNorth Dakota Department of Human

ServicesFM Ambulance and transportation

providers

Poll 1My jurisdiction has distinct geographic characteristics which should be taken into consideration in our PH emergency planning.

A Strongly Agree

B Agree

C Disagree

D Strongly Disagree

Click on the down arrow if you can’t see the response choices.

Speed of River’s Rise

Crest Predictions

Poll 2Health facilities and facilities housing vulnerable populations in our jurisdiction have role and staff specific, up-to-date emergency plans in place, and have exercised those plans including mandatory or advised evacuation procedures.

A Strongly Agree

B Agree

C Disagree

D Strongly DisagreeClick on the down arrow if you can’t see the response choices.

Evacuation Planning Conflict between

protecting city and evacuation“Evacuation is not an

option”

Plan for vulnerable populations

Frequent partner meetingsTeleconference Interactive video

network

FEMA photos

Secured shelter sites

Evacuated 2500 hospital, long term care and other vulnerable population facilities

• Coordinated evacuation plans with nursing homes and group homes

• Formalized evacuation plans for four facilities

• Transportation arranged• More EMS resources requested

through EOC

Met with healthcare facilities

Timeline: Monday – Saturday 3/23 3/24 3/25 3/26 3/27 3/28

2nd

crest

TransportationCoordination vital

Limited resources in high demand

School buses, facility buses, planes, private companies, ambulance

Staff assist on evacuation vehicles

Federal transportation/evacuation team arrived shortly after mission over

Bus seat configuration

Daniel Reetz photo

Poll 3In our jurisdiction, we have a clear understanding of Red Cross services and terminology and what our role would be in partnering to set up an emergency shelter in the event of an evacuation.

A Strongly Agree

B Agree

C Disagree

D Strongly Disagree

Click on the down arrow if you can’t see the response choices.

SheltersPrimary site unavailable:

affected by flooding Shelters placed in small

community 20 miles west

of FargoTwo churches, two public

schools

Lots of resources, Red Cross, DMAT: not always clear who was in charge

Resources missing for provision of basic cares

Blizzard

Fargo Forum photos

DetailsTracking peopleListsSpreadsheetsTransport hotlineSingle point dispatch

Repatriation: Second CrestShelters for other

community’s evacueesEngineering

assessmentsPotential second

evacuation riskTransporting stretcher

patients delayFewer buses available

Fargo Forum photo

Lessons Learned Staff deep enough and soon enough

(sleep is a good thing)Incident command system works

for a public health emergencyCommunication: internal / external

need improvement Wording of evacuation order: voluntary

versus mandatory importantSpecific flood vulnerability assessments

important for each facility

More Lessons LearnedPH not an expert on

transportation (but we are now)

Patient identification: triage tags

Definition of shelters forspecial populations

Facilities evacuating to “sister” facilities worked well

FEMA Photo

Resources Fargo flood Web site

www.ndsu.nodak.edu/fargoflood USGS

http://nd.water.usgs.gov/floodtracking/charts Fargo Forum www.in-forum.com/ Fargo Cass Public Health

www.cityoffargo.com/CityInfo/Departments/Health/