World Trade Centre and Port Arthur Incidents – A Comparison and Lessons Learned in Emergency Management
The World Trade Centre and Port Arthur massacre were both unparallel man-made disasters associated with terrorist acts. Commonalities in both Major Incidents were the unprecedented degree of violence directed at their victims and thorough inability of the local resources of either incident to manage the major medical incident (Byrnes 2002, p. 196-211; and Tasmanian Disaster Committee 1997, p.1-13).
The World Trade Centre had an enormous loss of life (a total of 2, 823 people), which included the responders to the tragedy, with the death of ‘72 law enforcement officers, and 344 firefighters’ (Byrnes 2002, p. 211). The planning stage of the incident became almost unparallel to any other man-made incident . One of the largest contributing factors in access to the scene and its victims were because of the collapse of two man-made structures and the subsequent secondary explosions of fuel and hazardous fumes, toxic gasses, and debris (Byrnes 2002, p.198-9). Although rendering an enormous amount of damage, the attack occurred within a relatively short period of time. However, due to the location of the incident there was a large contingent of emergency services readily available, including the Port Authority Police Department and the New York Police Department (Byrnes 2002, p. 82-3). Due to communication and physical barriers, such as the collapse of the twin towers, organisational isolation occurred and many teams of services were separated.
By contrast, the Port Arthur Massacre was perpetrated by a single gunman. The scale was relatively smaller and the isolation was caused by rural distances, while the difficulties encountered in responding related to the remote environment, such as a lack of medical resources, personnel and enormous transport distances to definitive treatment (Tasmanian State Disaster Committee 1997, p.2-3). The attack was more localized towards the local community and the hazards were more primary due to threatened gunfire with relatively less building and environmental damage. The planning stage was of a much smaller duration and the execution was more random. The police presence was initially non-existent (Tasmanian State Disaster Committee 1997, p.2-3).
Comparisons of the two incidents appear limited to the tragic and horrific nature of both events because of the diverse nature of the two incidents. Both involved the needless loss of human life and subsequent confusion that affected the ability of the coordinated responses to the major incident. The scale of the two incidents differ in the numbers of killed and injured; however, when comparing statistically, the smaller Port Arthur incident may even have a higher percentage of victims on a pro-rata community basis. There were thirty five killed in Port Arthur massacre compared to close to 3000 in the World Trade Centre (Byrnes 2002, p. 196-211; and Tasmanian Disaster Committee 1997, p.1-13).
The World Trade Centre incident involved a long term coordinated attack over many years whilst the Port Arthur massacre appears to be a more random response; although, even this was preplanned to some extent, as evident by the fact that the perpetrator carried a bag with numerous weapons and ammunition into the Café at Port Arthur, showing that he planned to kill more people than one weapon with one cartridge was capable of (Tasmanian Disaster Committee 1997, p.5). The terrain and access to casualties vary considerably. The access to the World Trade Centre victims was restricted because of the building collapse and fire whilst the Port Arthur victims had access restricted because of the threatened gunfire and rural location.
Due to the isolation of Port Arthur there were less available resources than the World Trade Centre had available, which was in the middle of the New York city, with all the resources available. According to Cato the ‘initial response to Port Arthur involved two local doctors and three ambulances’ (2002, p.70).
At the World Trade Centre there were approximately 400 rescue workers killed during the rescue attempt due to the hazards at the scene, as opposed to no rescue workers injured in the Port Arthur incident, because the only major hazard (the perpetrator) did not come back and kill the rescuers. However, much of this, was due to sheer luck on the rescuers part and the difference in circumstances, as the rescuers for both incidents continued their work without ensuring that the hazards were removed or reduced.
At the World Trade Centre there were tremendous transportation difficulties related to access and egress due to the substantial vehicle damage caused by the destruction of the World Trade Centre. According to Byrnes the ‘airports were closed thirty six minutes after the event and all bridges and tunnels were closed at a similar time interval following the airport closure’ (2002, p. 198-200). In contrast, there were no airport closures in the Port Arthur massacre; however, there were difficulties with access and egress based on the isolation of the incident. According to the Tasmanian State Disaster Committee, ‘the closest ambulance was fifteen minutes away in a small country town’ (1997, p.5).
There are obvious differences in the number of perpetrators of the two incidents with a single planner for the Port Arthur incident compared with many planners and terrorists involved in the World Trade Centre. According to Cato the ‘initial fatalities were those on the aircraft and the impact are where almost one hundred percent of those involved died’ (2002, p. 64). In contrast, the perpetrator killed those he could locate in various locations of Port Arthur. According to Cato ‘the killing spree was the worst ever in the world at that time’ (2002, p.70); similarly, the same can be said about World Trade Centre incident (Byrnes 2002, p.211).
The World Trade Centre incident was and still is regarded as an attack on the United States of America as a nation, whilst the Port Arthur massacre was the result of unclear motifs. It is unclear to what extent Bryant’s schizophrenic illness contributed to a delusional attack on his victims however it is clear the World Trade Centre attackers had clear and precise intentions.
There were much more police authorities at the World Trade Centre incident including the Port Police Authority and Police Department. The bi-state nature of policing may have affected the coordinated response. The police response at Port Arthur in comparison was achieved by an establishment of a Police Operations centre directing a forward command and a special response group. At the World Trade Centre incident there were by comparison numerous Federal law enforcement agencies and although the senior agency was the Port Authority Police Department there were problems with jurisdiction and coordination (Byrnes 2002, p.197). This broadening of jurisdiction lead to communication and response difficulties, because each agency communicated on different frequencies and systems.
There were considerably more agencies involved at the World Trade Centre; by comparison, the agencies involved at Port Arthur are considerably less and therefore the communication difficulties, duplication of orders and confusion at Port Arthur were similarly less also.
Both incidents have had far reaching ramifications. For example, according to Dutton, ‘gun laws in Australia were changed on a national level virtually overnight’ (1998, p. 225) and at the World Trade Centre the ‘President and Congress are seeking to increase the nations’ preparedness through a massive reorganization of homeland security agencies (Byrnes 2002, p. 90).
The World Trade Centre involved substantial material and property damage with the collapse of the twin towers. In contrast no such material destruction occurred at Port Arthur. The comparison of the two incidents is subjective as no two people’s perception will be the same of each incident. Comparisons need to be made for a constructive purpose such as analyzing the respective responses. This information may assist in developing a framework to develop policies and resources should a further incident occur.
In conclusion, comparisons can best be determined by analyzing the incident into varying components. Access was restricted in the World Trade Centre because o building collapse whilst access to victims in the Port Arthur incident was restricted because of potential gunfire. Isolation at Port Arthur was due to geographical distances whilst isolation a the World Trade Centre was due to physical barriers such as building collapse causing fire and noxious gases and communications difficulties.
Evaluate the medical management response to the World Trade Centre and the Port Arthur incidents (approx 1000 words).
Medical management response was chaotic at the World Trade Centre; largely due to difficulties with communications and brought to notice their total unprepared ability to cope with a disaster of this magnitude. There was medical assistance available but the execution of service delivery was ineffective due to poor coordination and also compromised because of physical barriers (Fire Department of New York 2004, p.3).
Medical management response at Port Arthur was compromised due to rural isolation and the lack of police presence during the first few hours of the incident response. This Major Incident also highlighted the lack of resources such as paramedic equipment and the difficulties encountered in transporting these resources to the scenes.
Unintentionally the first rule of first aid was neglected at the World Trade Centre. According to Hogetts and Mackway-Jones, ‘the first, most important consideration for pre-hospital care workers is whether or not it is physically safe for you to proceed’ (2002, p.45). Communication difficulties are enormous due to ‘channel congestion with many emergency responders operating on the wrong channel’ (Fire Department of New York 2004, p.8). We are further advised that the emergency dispatchers were overwhelmed with the situation. It is further seen that information flow to the incident commanders was limited due to this poor communication. Impinging on emergency response was the reconvening of a command structure after the second collapse of the World Trade Centre, despite command being restored, the communication problems continued. There were enormous problems with the dispatching of ambulances as some officers had responded without sanction (Byrnes 2002, p.199-200). Furthermore, the dispatching system broke down due to the enormity of the disaster with the coordinators loosing control of the tracking of their vehicles. Patient paperwork was discarded in an attempt to minimize transport and turn around times therefore reducing the ability of the system to track patient’s status and whereabouts.
Perhaps the greatest difficulty in medical management arose because of the inability of the responders to access the majority of the victims. Not only did the responders to the World Trade Centre have to contend with the twin towers collapse, but two neighboring buildings and a hotel also collapsed. What followed was an overwhelming inability to control the situation. Many ambulances, fire trucks and police vehicles were destroyed by the falling debris (Fire Department New York 2004, p.6).
The Port Arthur incident appears to be managed well considering the limited resources as listed in (Tasmanian State Disaster Committee 1997, p.14). However, it was clear that they were hampered by limited information being dispatched about the scene. There is a similar response to the World Trade Centre in that some responders failed to adhere to prior training and attended the scene without due safety considerations. The difference being that the responders at Port Arthur were luckier than their counterparts at the World Trade Centre, with no responder loss of life. Communication problems existed at Port Arthur as seen by the recommendation to improve mobile communications equipment at remote locations in the future. The responders to Port Arthur massacre were initially fragmented due to the geographical isolation of Port Arthur. There were also problems in Tasmania with inadequate oxygen supplies (Morgan 2004, p 35).
Both incidents overwhelmed the available medical resources thereby reducing the effectiveness of the medical management. The medical management was largely affected at the World Trade Centre by communication difficulties affecting information flow, whilst Port Arthur suffered because of geographical isolation and insufficient localized resources, which had not been geared to cover such an unforeseen contingency. There was also deficient information originating from the critical incident, which create difficulties in formulating an adequate response. Even if there had been foresight of an impending disaster it would have been difficult to justify the expense on economic grounds to prepare for such an emergency (Tasmanian State Disaster Committee 1997, p. 37).
At the World Trade Centre the command system failed as they were inadequately prepared for such a disaster. The communication system became inadequate for the scale of the disaster. In contrast, the Port Arthur massacre communication system was hindered because of poor mobile communications within the area (Tasmanian State Disaster Committee 1997, p. 15).
Hazards including fire, collapsed buildings and noxious gases hindered the rescue attempts and prevented effective medical management at the World Trade Centre. This was exacerbated by the confusion levels, which contributed to the emergency tracking of their resources becoming severely jeopardized.
Medically the Port Arthur incident had been fortunate in that there had been recent code brown training and there had been a recent Critical Incident course held at Hobart from which volunteers were dispatched to the scene. There was also a fortunate occurrence in that there was additional helicopter support which may not have been available had the critical incident happened the next day (Morgan 1997, p.32). There was also a recent External Disaster Course, which had been held at the Royal Hobart Hospital. Medical management was exceptionally difficult because at Port Arthur there were no police present in the first couple of hours.
Both incidents reflect the need for adequate medical pre-planning prior to the incidents even with adequate pre-planning it is the adequate execution of these plans that often require scrutiny.
As Port Arthur is ninety minutes by road from Hobart Hospital there was a need for helicopter transport. As an inquiry concluded these facilities were insufficiently equipped with adequate resuscitation equipment.
Communication difficulties at both incidents related to channels being overloaded with information that could not be adequately processed.
Port Arthur was lucky in that the distance and geographical terrain provided time for the local hospitals to prepare for the incoming victims, but also increase transport times for critically ill patients.
In conclusion, both incidents lacked adequate medical pre-planning and communication resources. There were different medical management issues at both incidents. The World Trade Centre incident was affected by poor communication and the inability of the responders to access the victims. The Port Arthur incident was affected by communication inadequacies and geographical isolation and limited resources.
Evaluate the psychological impact on emergency medical service responders to incidents such as the World Trade Centre and the Port Arthur.
The psychological impact of medical responders to Major Incidents has far reaching ramifications. Three distinct event stressors are elicited by Smith and these include: ‘personal loss or injury; mission failure and; traumatic stimuli’ (Smith 2005, p. 5). It is apparent that post traumatic stress from a major incident may be intensified because of the incident adding to an already high stress level accumulated from working in an already stressful industry (cumulative stress) (Smith 2005, p.7). Emergency personnel, such as Police, Fire and Ambulance Services Personnel may all develop this form of cumulative stress, making them more vulnerable after a Major Incident. It is apparent that being involved in a Major Incident is not a necessary prerequisite for the establishment of Post Traumatic Stress. Hodgets et al state that ‘psychological problems are common; they occur in the injured survivors, and the rescuers of Major events’ (2002, p. 199). The ability of the individual to cope with traumatic stress depends on personal coping abilities and the amount of pre-accumulated stress that has occurred for that individual. According to Homer, the effects of Critical Incident Stress may be broken down into the following categories:
(2005, p. 5)
Acccording to Homer, further factors that influence the severity of an incident are:
1. taking it personally
2. mistakes in judgment
3. making the situation worse
4. equipment failure
5. command failure
6. line of death or injury
7. role confusion
8. role conflict
9. aspects of victims
10. types of injuries
11. aspects o the incidents
12. aspects of the helper; and
13. triggering incidents
(2005, p. 8-9).
It is obvious from these factors that many were apparent at both the Port Arthur massacre and at the World Trade Centre incidents. As an example there was command failure at the World Trade Centre and equipment failure at the Port Arthur massacre. Especially during the early stages of both major incidents there was little or no available stress management available. They were unable to moderate their stress in the early stages. This stress was further enhanced by their general rescuer mentality, whereby officers were compelled to continue until completion of their duty, regardless of fatigue. There was also anger when some officers were instructed to attend to other matters whilst the disaster was in progress.
Post Traumatic Stress can affect individuals differently but the effects of Critical Incidents previously listed give an indication of possible outcomes.
In evaluating the psychological effects on the responders it is apparent that the size of the incident does not necessarily correlate with the extent of the Post Traumatic Stress; as even a minor incident or stimulus may be enough to render a victim subject to this disorder. It is up to the medical management to be able to evaluate the effects o the responders and provide appropriate action. This was clearly not done effectively at the World Trade Centre and was also lacking at Port Arthur. At the World Trade Centre incident responders were left too long at the scene and had to attempt to cope with the death of their colleagues and the insecurity of not having sufficient knowledge of what was occurring. Comparatively, the responders to the Port Arthur Massacre did not have colleagues who died in the incident; however, many of the first responders were locals and would have known people there, and had to work with uncertainty that the perpetrator’s location was unknown.
The role of the medical manager in the provision of care for the responders was lacking at both disasters. The role of critical debriefing sessions are still debated. Many believe that a critical debriefing session is essential after a Critical Incident, just after the event. However, according to Gist and Woodall, as cited by Smith, ‘immediate group and peer debriefing sessions may cause a secondary psychological trauma’ (2005, p. 5). Furtheremore, it should be noted that it is just as critical to recognize stress during the incident and for medical management to take appropriate action, as afterwards (Homer 2005, p.9).
Every responder would have experienced varying stressors at the incident however every responder would have reacted differently to the situation. Only time would have been able to depict how much a responder was affected. Therefore, debriefing sessions and counseling should be available to all responders, even years after an incident.
According to Byrnes, ‘probably the biggest post-incident issue for rescuers within the World Trade Centre incident was having to come to terms with the gruesome reality that the overwhelming majority of victims were atomized in the collapse’ (2002, p.200). This was intensified by long shifts and the inability to locate workmates. This concept was further considered by noting that ‘horrendous effects of frustration and stress become apparent when working for extended periods at a Major Incident’ (Byrnes 2002, p. 200). Responders to both Major Incidents became only too aware of their own mortality and vulnerability, while medical management failed to mitigate this stress as they were poorly prepared for such Major Incidents. As with many other incidents, they were considered too unlikely to prepare for such an event.
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