ABSTRACTThe series of earthquakes and aftershocks that have hit Christchurch, New Zealand, for more than one year has been severe and sustained, resulting in major damage to homes, buildings, essential services, and resources in water, sewerage, food, access to health care, energy for heating and cooling, and unprecedented challenges to resiliency. Large swathes of destroyed buildings, land damage, and liquefaction have made rebuilding impossible for many. Populations have moved or report that they either wish to or plan to do so. For those who remain, a ”new normal” mindset has taken hold and serves as an objective measure for the process that defines daily life and future decisions. The new normal serves as an uncomfortable but realistic guideline by which further resiliency can be measured. A number of factors have led to the development of the new normal state for the Christchurch earthquake survivors.(Disaster Med Public Health Preparedness. 2012;6:33-43)

Introduction:The Canterbury Primary Response Group (CPRG) was formed following the threats of severe acute respiratory syndrome (SARS) and avian influenza worldwide. The possible impact of these viruses alerted health care professionals that a community-wide approach was needed to manage and coordinate a response to any outbreak or potential outbreak. In Canterbury, New Zealand, the CPRG group took the responsibility to coordinate and manage the regional, out of hospital, planning and response coordination to annual influenza threats and the possible escalation to pandemic outbreaks.Aim:To outline the formation of a primary health and community-wide planning group, bringing together not only a wide range of health providers, but also key community agencies to plan strategies and responses to seasonal influenza and possible pandemic outbreaks.Methods:CPRG has developed a Pandemic Plan that focuses on the processes, structures, and roles to support and coordinate general practice, community pharmacies, community nursing, and other primary health care providers in the reduction of, readiness for, response to, and recovery from an influenza pandemic. The plan could reasonably apply to other respiratory-type pandemics such as SARS.Results:A comprehensive group of health professionals and supporting agencies meet monthly (more often if required) under the chair of CPRG to share information of the influenza-like illness (ILI) situation, virus types, and spread, as well as support strategies and response activities. Regular communication information updates are produced and circulated amongst members and primary health providers in the region.Discussion:Given that most ILI health consultations and treatments are self or primary health administered and take place outside of hospital services, it is essential for providers to be informed and consistent with their responses and knowledge of the extent and symptoms of ILI and any likelihood of a pandemic.

Introduction: When disasters happen, people experience broad environmental, physical, and psychosocial effects that can last for years. Researchers continue to focus on the acute physical injuries and aspects of patient care without considering the person as a whole. People who experience disasters also experience acute injury, exacerbations of chronic disease, mental and physical health effects, effects on social determinants of health, disruption to usual preventative care, and local community ripple effects. Researchers tend to look at these aspects of care separately, yet an individual can experience them all at once. The focus needs to change to address all the healthcare needs of an individual, rather than the likely needs of groups. Mental and physical care should not be separated, nor the determinants of health. The person, not the population, should be at the center of care. Primary care, poorly integrated into disaster management, can provide that focus with a "business as usual" mindset. This requires comprehensive, holistic coordination of care for people and families in the context of their local community. Aim: To examine how Family Doctors (FDs) actually contribute to disaster response. Methods: Thirty-seven disaster-experienced FDs were interviewed about how they contributed to response and recovery when disasters struck their communities. Results: FDs reported being guided by the usual evidencebased care characteristics of primary practice. The majority provided holistic comprehensive medical care and did not feel they needed many extra clinical training or skills. However, they did wish to understand the systems of disaster management, where they fit in, and their link to the broader disaster response. Discussion: The contribution of FDs to healthcare systems brings strengths of preventative care, early intervention, and ongoing local surveillance by a central, coordinating, and trusted health professional. There is no reason to not include disaster management in primary care.

Introduction: Emergency services, including emergency medical services organizations and hospitals in New Zealand have adopted an incident command system or coordinated incident management system (CIMS) to provide coordination and control for the emergency response to major incidents. Incident action plans (IAP) play an important role in the implementation of CIMS during major incidents. Objective: This presentation describes the development of a training course for hospital-based healthcare workers on the preparation of an IAP. Methods: Developing the training course included the following steps: (1) survey of hospital-based healthcare workers who attended joint CIMS training courses regarding their perceptions of the IAP-related needs of hospitals;(2) identification of situations in which IAPs may be required at hospitals; (3) analysis of IAP use during planned responses; and (4) customization of the IAP structure used by emergency services organization for hospitals based on hospital needs. Results: A training course for hospital-based healthcare workers about preparing an IAP was developed. In this course, participants collectively develop an lAP for hospital evacuation, critique an IAP from an actual major incident, and then, in smaller groups, prepare IAPs for specific situations. Conclusion: IAPs from emergency services response planning may be adapted for hospital emergency response. A training course for hospital-based healthcare workers about preparing an IAP may assist the development of IAPs by hospital emergency managers during actual incidents.

Too often during major emergencies, those with specialty skills are perceived as unnecessary and are left sitting on the sidelines. Sometimes, they are not even considered. When they are utilized, they often are assigned menial tasks that, understandably, do not encourage a willingness to “buy in” to a response.