If you are interested in contacting your Member of Parliament to find out more about disaster preparedness in Canada, please visit the Parliament of Canada - Members of Parliament web site.
CEEP Parliamentary Letter
Dear Member of Parliament:
Attached you will find a briefing paper on deficiencies in Canadian health care disaster preparedness. This paper has been created by the Centre for Excellence in Emergency Preparedness, a non-partisan, not-for-profit Canadian organization dedicated to improving our health care readiness in the event of a disaster.
Recent events in Japan have highlighted that even the most advanced and wealthy nations of the world can suffer catastrophic events and should be prepared. Reviews of Canadian preparedness have exposed deficiencies that can and should be corrected.
Implicit in our organizational mandate is public education and, within that context, we have discussed these issues with the media in the past and will continue to do so in the future. We hope you find this briefing paper useful in responding to media questions related to Canadian disaster preparedness should they arise.
Please feel free to contact us if we can be of any service.
Yours sincerely,
Daniel Kollek, M.D.
Executive Director - The Centre for Excellence in Emergency Preparedness
Associate Professor - McMaster University, Emergency Medicine
Health Care Disaster Preparedness Briefing Paper
Recent events in Japan highlight the risk disasters pose to even the most developed nations. The majority of disasters are not health disasters in the first instance but virtually all have a health care component. Fires, earthquakes, hurricanes or toxic spills all have health care impacts although their origin is not health-related. Japan has proven to be phenomenally well prepared to respond to their unprecedented challenges. The question one must ask is "would Canada’s health care system be ready should an event of similar magnitude occur here?" Data from published peer reviewed objective research would suggest that the short answer is no.
Two studies, that reviewed Canadian readiness have identified significant readiness gaps in the health care system. The reason for these gaps is that there are two very conflicting sides in health emergency management: one medical and the other organizational. The health care system is reasonably knowledgeable on the medical and paramedical issues related to a disaster; however, it is vastly unprepared when it comes to the larger disaster response. Front line health care officials lack expertise in the general principles of disaster response. Should a significant disaster occur, major gaps in health care delivery will arise that will stem from the lack of overall system readiness, not lack of health care specific knowledge.
Conversely, individuals who specialize in emergency preparedness often do not have an adequate understanding of the health care implications of the event they are responding to.
A glaring example of this is the 2009 pandemic where the medical care required was clear and known; the problem lay in the delivery. There was inconsistency between the roll-out of the national pandemic plan and the health care workers delivering the services on the front lines. Public health plans varied between jurisdictions, sometimes within a few kilometres’ drive of each other. Hospitals often planned in isolation of their neighbours, or developed ad-hoc plans when existing frameworks were available. In many jurisdictions, the interface between Public Health, hospitals and the community was variable, making uniform messaging difficult. Since response was not coordinated and data collection was not seamless, it is now almost impossible to reach evidence based conclusions as to what responses were the most effective.
In addition to the fact that health related disaster preparedness is orphaned between two Ministries at the Federal level (Health & Public Safety), we also recognize the Federal-Provincial divide when it comes to the delivery of health care. Unfortunately, one of the consequences of this divide is that there is a lack of overall leadership, a role that should be filled by the Federal Government.
Finally, it is no secret that our health care system is strained to a significant degree under normal conditions. Present Emergency Department overcrowding is such that should a sudden surge in demand take place there would be no capacity in the system to absorb it.
Common national guidelines and tools should be available to all health care facilities in Canada. They should be objective, scientific and evidence based. Currently there are no national standards for disaster training or guidelines for emergency preparedness in the health care field. A uniform approach is necessary to ensure all health care professionals have a baseline of knowledge and are able to speak the same language in a crisis.
The Canadian expertise to resolve this problem exists and the groundwork has already been done. The Centre for Excellence in Emergency Preparedness (CEEP) has developed guidelines for the front lines of the Canadian health care system on how to prepare for disasters. These guidelines could be a resource provided to front line care givers across the country from the Federal Government, initially in written form, then followed by a disaster preparedness course for Canadian health care providers and organizations. The course could be promoted through the appropriate professional organizations, accredited through the relevant colleges, and delivered it where the need exists.
The Centre for Excellence in Emergency Preparedness (CEEP) is a not-for-profit organization comprised of over 200 health care and non-health care experts from across Canada who are dedicated to improving our resilience to any emergency event that has a health component. It has within its ranks a large body of expertise in this field, perhaps the largest in Canada, and there is no equivalent organization in this country. The content of the guidelines developed by CEEP is based on needs assessments, the input is almost exclusively from Canadian authors and an external peer review was performed by international experts in health care disaster response.
So despite the existence of a national pool of expertise on health care disaster preparedness, and despite the availability of a planning resource that would help Canadian hospitals close the readiness gap, and in the face of well documented deficiencies, no national attempt has been made to help Canadian hospitals achieve a common standard of readiness. More so, there is no central leadership to ensure coordinated health care disaster planning at the national level.
The core content is ready and simply needs to be disseminated. The Ministry of Public Safety has been briefed in detail on the deficiencies. We have attempted to work on this project with The Public Health Agency of Canada however, despite their willingness and interest, the agency is under resourced and repeated changes of leadership combined with complex government processes have made it impossible to make any headway.
The Centre for Excellence in Emergency Preparedness has dedicated the past years to helping Canada prepare for the health impact of disasters. We urge you to not let this opportunity pass to support the need for improving our readiness. As the Japanese people found out on March 11th, there is no way for any of us to know when this preparedness is going to be put to the test in Canada: it could be four years or it could be four days from now.
