DMAT San Diego CA-4 * January 2004               Newsletter
****  Volume 13,  Number 1   ****
A deployable  Disaster Medical Assistance Team. Affiliated with the National Disaster Medical System. Founded 1991
DMAT San Diego CA-4 is a public benefit, non-profit  501(c)3 corporation., registered  in the State of California and with the IRS.

Co-Sponsored by: UCSD Medical Center & International Relief Teams
Mailing Address: 200 West Arbor Drive, San Diego, CA 92103-8676

DMAT CA-4 Information Line: 619-543-6216
eMail address of Newsletter Editor, Jake Jacoby:     ca4cdr@san.rr.com
DMAT CA-4 WEB site: http://www.dmatca4.org

CONTENTS
Calendar Of Events..........................................Page 1
Commander's Log.......................................... .Page 1
Distinguished Member of the Year......................Page 2
San Bernardino Mudslide Response- a member's experience., by Beverly Fitagerald......................Page 3


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CALENDAR of EVENTS:
DMAT CA-4 Team Meeting

Wednesday,
January 28, 2004
6:00 PM 

at our Ops Center
8830-G Rehco Road,  San Diego
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*NDMS Annual Meeting, Dallas, TX Apr. 17-21, 2004.

The 12th Annual Tri-Service Combat Stress Conference dates are 30 April (Friday) through 6 May (Thursday) 2004 at the San Luis Rey Officers Club, Camp Pendleton.  Conference segment 1-2 May; Critical Incident Stress Management (CISM) certification courses 3-4 May and 5-6 May.

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Commander's Log
* As January began, DMAT CA-4 has found itself still on ALERT status, which began on December 21st, after the Dept of Homeland Security (DHS) increased its Threat Assessment Category to HIGH (Orange), based on what I would call "correlative circumstantial evidence."  That is evidence of a nature that is not detailed, but based on an increased number of  activities on the part of surveilled terrorist contacts, that seemed to occur prior to other terrorist attacks, and therefore might be predictive of them, juxtaposed to the holiday season and numerous high profile events that occur in a scheduled fashion, rendering them possible targets.  The effect of this was the need for rostering a team and  loading the cache. An unusually large number of teams was placed on ALERT for this period of time, larger than previously alerted  in the past when the threat assessment level was raised to Orange.
   How did we do? We had just had a meeting with h e County of San Diego, after months of preparation, to learn how to use the County's digital communicator to send out computer generated home and work phone and page messages about the need to roster a team.  We had not really had a chance to introduce the operations plan to our members, but since the system was sin place, it was decided by your command group to go ahead and use it. By the end of the afternoon, we had 29 positive responses, which was a great start to the roster of 35 needed by the next morning.  The roster continued to be maintained up till January 5th and then was extended one more week, until the 13th. A bus rental  with Coach USA was arranged by FEMA Logistics, and remained available until we went off ALERT. However, the cache was maintained on our leased trucks, and remains so.
   Just from the ALERT, a number of lessons have been learned, and we will review those, and get your input, at the next meeting, at which time we will complete our After Action Report and submit it to NDMS.
   One other possibility for a deployment occurred during our ALERT phase.  The South  Pacific cyclone Heta, first tropical storm of the new year,  devastated the U.S. island territory of American Samoa and the neighboring nation of Samoa  on January 4th.  A news item by Bonnie Gillespie of the American Red Cross, on their web site, describes the storm  "per locals as the worst cyclone in living memory. The category 5 storm caused  45 foot ocean swells and winds gusting up to 200 mph. It downed power lines and caused extensive damage to housing, utilities and commercial structures across the island of 65,000 inhabitants. "  More than 600 homes were said to be affected, and water, power and sewer services were lost. The area most severely  affected by Heta was the island state of Niue, population 1,700. The majority of crops were lost and most buildings were damaged, including the island's only public hospital. One death occurred, in a collapsed structure.  .Despite the severity of the storm,   there was no direct medical mission, and no DMATs were deployed.

* As the team members know, NDMS  moved into the Dept of Homeland Security on March 1, 2004. Since that time, the entire way business was done in NDMS has changed.  NDMS, a former joint partner system managed by DHHS, appears to this observer to have been downgraded to a mere section of FEMA, and almost 2/3rds of the entire NDMS staff have been moved to other job s within FEMA or DHS.  All this has occurred, while  the teams were being asked to provide NDMS with records of past deployments, as institutional memory seems to have disappeared with the move, and no trace of actual deployments per team could be found.  No ID cards have been issued for new applicants in the last 5 months, despite assurances that the system would not suffer from the "merger" (or, 'takeover". Of major significance is the just -announced recategorization of DMATs, based on how they have done during the last year, when asked to submit rosters, and whether the membership p is adequate, and a whole host of other issues that appear to have been sued to demoralize some of the newer teams within the family of NDMS. No longer treated like family members but more like cogs in a wheel, a large number of the deployable teams were downgraded in the last few weeks from deployable to developmental or personnel only teams, and have been taken off the roster. We, however,  were notified that we are a "Type 1 Fully Deployable" team. [The other Categories are"Type II: Deployable." Type III:  Personnel deployable only" and "Type IV: Developmental ."
We cannot share the numbers of teams that were downgraded here, since the newsletter is posted on our web site, but this will be discussed at the next team meeting.  Obviously many volunteers on the teams that were downgraded are unhappy, irate and angry that(  a) no "grace period" was given to them to correct deficiencies that NDMS team evaluators found.... perhaps a short grace period could have allowed teams to correct their issues and make the system better as a  whole, without endangering morale--such as focused recruitment or purchase of cache items that might be missing.
(b) no equivalent critique has  ever had any effect on NDMS, as it takes as long, or longer than it ever has, to get new members through the system, and FEMA until recent weeks has not had any procedure at all for getting response teams into the Federal payroll system. (c) Some teams were  faulted for not having  a  completed cache, but it is NDMS that is supposed to supply those caches, and  thus the fact that teams had to be downgraded for such a deficiency speaks more about the ability of NDMS to deliver, rather than the teams.  At CA-4 we are still missing many items from a full basic load., but we must have had more points from other aspects of our operation to avoid a downgrade.  A 2-hour conference call was held 2 weeks ago by the teams that are members of  the National Association of DMATs.(NADMAT), and 30 teams were represented. A summary of the many points brought up were relayed on a subsequent  NDMS conference call to Capt. Gary Sirmons, interim NDMS section chief. More on this at the meeting. Should make for an exciting NDMS Conference  all members meeting, or team Commanders meeting with the NDMS/FEMA directorate, come April in Dallas.  I hope we can get lots of people going, as we have in the past.

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CA-4 Distinguished Volunteer Member of the Year Selected for 2003
Congratulations to our newest Volunteer member of the Year for 2003!    The selectee of the team is Zona Wahrenbrock. Zona was an original member of  the CA-8 DMAT, and became a CA-4 member as the two teams merged in 1999. She was an OR nurse for many years at the Coronado Hospital, now Sharp Coronado, and currently works part time in a private physician's office.   Zona has been  our Administrative Officer for three years, after being on our roster as a Supervisory Nurse, and clearly runs our personnel paperwork like clockwork. The procedure on our end has never been smoother. Zona was recognized as someone who is "always there to help out with paperwork problems," with a glowing and warm personality that makes something so tedious become almost effortless. She is truly a valuable asset to our team, and has made many valuable contributions to the smooth running of the administrative function of our team when on stand-by as well as on deployment. She  deployed to Guam for Super Typhoon Pongsona, and to Ground Zero in NYC after the Terrorist Attacks on America. She has been to many exercises over the years, and currently works 15 hours per week handling the administrative load for  the team.  Zona will have her attendance at the Annual Meeting of NDMS in Dallas,Texas paid for, including hotel, airfare and meeting registrations, and will be recognized by   NDMS at the Awards Ceremony  for Distinguished members.  Congratulations also to the other nominees.  We are privileged to have had so many members nominated this year. Again, congratulations to our Distinguished Volunteer member of the Year.

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Waterman Response/ SD Sheriff's Dept.  SAR K-9 Unit

(CADAVER DOG TEAMS)

by Beverly Fitzgerald
 
EMT, K-9 Handler, SDSD SAR, K-9 Unit
[Editor's note: On Dec. 25,2003, a flash flood and mudslides in Devore and San Bernardino killed 15 people after a downpour fell on hillsides that had been stripped of vegetation by the fires. With nothing to hold the soil in place, mud and water swept trees and rocks down the hillsides, into a
trailer park and a number of homes. Nikita, or Nikki, as everyone knows, is a Search and Rescue Dog (German Shepherd) who takes Beverly Fitzgerald, long time member of our DMAT, along on his  escapades.This is her story...]

 We were called out Friday afternoon (Dec. 26) via a mutual aid response thru the Sheriff's Dept., for the Waterman Incident, the name given to the Mud slide disaster in San Bernardino.  They were specifically requesting Cadaver Dogs Teams.
 
We headed out about 03:00 hours  to meet up with a K-9 Unit from BORSTAR (Border Patrol), and arrived at the ICP about 05:30.  We signed in, ate breakfast, got our briefing about the incident and current conditions, including safety hazards, ground conditions (which `were still soft mud and very thick in areas, about ankle to knee deep at times).  We were informed that they did recover two bodies in Division D, the lower portion of the canyon (the search area that I was assigned to) the day before.  Even though they did recover two whole bodies they were coming up with mostly "parts" in that section.  Each Search Area was approximately 1 mile long and about 200-400 yrds wide. We were to try and focus the dogs on the "trap" points, where clumps of debris  had collected, since that was where they were finding a large number of the remains.  Because of the cold conditions, the dogs that worked the day before were right on top of the scent before they alerted or even showed any interest.  So that was how we had to work the dogs, more directed send outs.  I worked w/ Dog Team D, which included a "live find" dog, Guinness, a yellow lab, and a "Cadaver Dog," Blaze, a border collie.
 
We got to our assigned area, grabbed our gear and headed out by 0700 hrs. We started just above the construction site at the base of the canyon.  The conveyer belt system, used to move dirt, was just torn apart. Heavy equipment had moved hundreds of yards from their original spot, and large boulders were piled high on top of broken trees and mud. A water truck was practically covered and metal and rocks had been thrown thru the front windshield.  We sent the live find dog thru the area first, then the cadaver dog would follow concentrating on specific areas of debris collection.  We would mark areas where the dogs either "showed interest" or "alerted" w/ orange tape, which would later be replaced with yellow tape if remains had been located there.  With the areas that Blaze alerted on, we would dig out as much as we could.  If we did see something,  we would call it in and move on. Or we would  have Fire and the Medical Examiner remove the remains if any were found. If we couldn't get very far we would call in a ground crew with equipment to cut thru the logs and dig out with heavy equipment.  Because some of the crews were busy in other areas, we would call in the GPS coordinates, to dig it out at a later time.
 
It was slow moving for the most part but we did get some good hits, which were confirmed by the other dogs.  We found various items, lots of tattered clothing, children's clothes, baby diapers, toys, still wrapped Christmas gifts, pillows, blankets, and shoes among other items.  Pierre found a candle which he gave to a grief counselor when we got back to base camp to give to the family members of the victims.  It was hard to see these things and not get emotional, but we had our job to do and kept moving along.  Some portions of the middle of Division D were steep and we had to do a little climbing, which was taking it's toll on the dogs and they were started to look tired.  Our last big hit was about 1600 or 1630 , in one pile just before the bridge crossing at the lower portion of Division D.

 
Shelly's dog, Guinness, showed a great deal of interest on this pile, but continued on a bit and waited until Cathy's dog, Blaze, went thru to see if she would also show interest.  Blaze gave a good solid alert, and Shelly came back to tell us that Guinness had shown more interest in this spot then in any other area he had shown interest in today.  I climbed up onto the pile of trees, broken branches and mud, lots of mud.  Within seconds of starting to pull out branches, I saw a white kid's tennis shoe.  My heart jumped up into my throat. I paused for a second and announced my find.  As I went to pull at it, it seemed to be stuck either under a branch or was forming a suction in the mud....or it could have been still on the child.  I moved more debris away and pulled at it again, this time it came out....it was just the tennis shoe.  We continued to move what we were able to and Tammy called for a ground crew to assist.  They weren't too far behind us and were there within minutes.  We dug a little, and would bring Blaze back to confirm that we were still where we needed to dig, as scent travels around in this type of debris pile, but she was still alerting in the same spot.  We pulled out a Barbie doll that was unclothed and missing one leg, a pillow, and pieces of torn clothing.  Cathy and I had Blaze go around to the back of the pile that was along the water's edge, and she again alerted right around where the ground crew was digging. They moved what they could and said that they would have to get chain saws in to move any more.
 
They called for a CDF Crew to come in, and Cathy made the decision to pull Blaze out of the field, as she was started to show signs that she was tired.  Blaze did a great job for an 11 year old dog!  The CDF crew continued to search the pile, but Command decided to pull the crews out for the night and resume in the morning.  We started to head out on foot to meet with our ride back to ICP.  Blaze and Cathy got a ride out.
 
A large number of family members were at the ICP, holding photos and other personal items and were awaiting the news conference.  We ran into Donna, a CARDA Handler from Riverside Co. She and her dog Rasta, a long haired GSD, had made 3 finds that day up in Division A, the site where the cabins were located....she was very emotional, as one of the victims she helped to dig out was a little girl who was about 5 yrs old.  She knew that some of the victims that we were trying to locate were children, but didn't realize how deeply this would affect her. She talked quite a bit about her experience with us and said that she was going to consider returning tomorrow....she did, so I heard, but she couldn't put in another full day on Sunday.
 
We headed out around 1700-1730 and I got home around 1900 hrs.  I told my roommate  I was going to take a shower and head off to bed, but never made it to that point. I laid  down on the couch to rest and ended up sleeping there until 7:30 am...I guess I was more exhausted then I thought.
 
Our team from SD aided in locating 2 more bodies today (Sunday. Dec. 28) and more parts in the lower portion of Division D. Sandy could neither  confirm nor deny that anything was found in our last pile....she was almost certain that something was indeed found there, but did not know the details. Lt. Redditt was going to try and get details of our "hits" as to whether or not there was anything there and get back to us.  This was a difficult assignment, but all-in-all, this was a very rewarding experience.

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Irving "Jake" Jacoby, MD, FACP, FACEP
Team Leader, DMAT San Diego CA-4
Attending Physician, Dept. of Emergency Medicine, UCSD Medical Center, San Diego, CA
Associate Director, UCSD Hyperbaric Medicine Center, San Diego, CA
Clinical Professor of Medicine, UCSD School of Medicine, La Jolla, CA

200 West Arbor Drive
San Diego, CA 92103-8676
Telephone: 619-543-6216
FAX: 619-543-3115
Pager: 619-290-2700
eMail:<ca4cdr@san.rr.com>

DMAT CA-4 24 hour STATUS/Information Line: 619-543-6216