One Thousand Knives and a Million and a Half Flames

On November 8th, 2013, Super Typhoon Haiyan made landfall in the Philippine archipelago. Locally known as Typhoon Yolanda, Haiyan, at its height, measured 8.1 on the 8 point Dvorak scale used to measure the intensity of tropical cyclones. 314 km/hr winds with gusts of up to 370 km/hr brought massive storm surges up to 6 meters high that rushed over the eastern seaboards of Leyte and Samar provinces. The events of November 8th have been described as the "Night of 1000 Knives,” in reference to the flying debris that wreaked injury and death on the Filipino population. In the end, the official death toll reached 6,293 souls.

Almost exactly 13 months later, Typhoon Hagupit made its first series of landfalls along the same geographic seaboard, just north of Haiyan's path. In the days leading up to landfall, the two storms shared similar characteristics and profiles, but local and international responses differed significantly. Whereas the general response to Haiyan was reactive, with most agencies waiting for the storm to make landfall before enacting assessment and response, the Philippine response to oncoming Hagupit was proactive. Widespread public health and civil defense measures that had been established in the interim between Haiyan and Hagupit were initiated in the days before landfall. At landfall, the two storms were ultimately different in magnitude and destructive profile. However, the striking differences in tolls taken on human life and suffering should not be attributed solely to differences in storm intensity. It must be considered what might have been the differences in casualties had Hagupit made landfallwith its initially projected intensity.

As director of a small volunteer medical relief NGO, I have had the unique experience of serving as a team leader of light and fast,Civilian Mobile Forward Surgical Teams (CMFSTs) in both the Haiyan and Hagupit disaster theaters. From a medical responder's perspective, although no two storms are the same, certain patterns are reproducible. Valuable lessons can be taken from each and applied to the next. The initial differences between the disaster response to Typhoons Haiyan versus Hagupit are striking. The simple fact that the Philippine Government was able to evacuate more than a million and a half million citizens out of harm's way is a testament to their dedication to learn and evolve as super storms occur on a more frequent basis. The pre - emptive actions of the Philippine government,military, medical, and civilian sectors should serve as valuable lessons for the rest of the world as we collectively begin to embrace mass casualty education and preparedness on an individual, national,and international platform. Although the response to Hagupit was not perfect, it was much improved from that of Haiyan. The use of progressive communication through social media and Short Message Service (SMS) texting played a large role in this success. Perhaps Hurricane Hagupit should be named the "Night of a Million and a Half Flames,” owing to the 1.7 million plus souls that got the message and simply walked away from the storm, alive.

The dichotomy in organized response seen between Haiyan 2013 and Hagupit 2014 can be shown between our own super storms Katrina 2005 and Sandy 2013. As with Haiyan, the Hurricane Katrina experience was a glaring low point in terms of public opinion and confidence in governmental response to natural disaster. The Government response to Hurricane Sandy showed marked improvement in pre-emptive planning and execution on the part of federal, state and city government. FEMA must be commended in the coordination of a large scale integrated response that encompassed all levels of government, private and nonprofit sectors, faith based organizations, communities and individuals. Still, challenges existed,communication being at the forefront. Despite the combined pre-emptive efforts of the Obama and Bloomberg administrations,according to the 2013 Hurricane Sandy After A ction Report and Recommendations to Mayor Bloomberg, only 70% of New Yorkers heard the public announcements for mandatory evacuation of Zone A. Of those who heard the announcements, 60% chose to ignore them and postured to fight the storm rather than evacuate. Ultimately,the Sandy experience demonstrated significant progress over the FEMA response to Katrina but also confirmed that larger scale incidents will stress the agency’s capacity for effective response and recovery. In New York specifically, one of the poignant lessons learned was that the communication disconnect existed on both sides of the equation; a more effective message needs to be sent and citizens need to be willing (or rather educated) to listen.

These conclusions are concerning compared to the recent success of the Philippine Government to motivate their population to evacuate. Possibly, the New York population had not been sensitized to a super storm as had those in the Philippines with Super Typhoon Haiyan in their very recent collective memory. Possibly, there are cultural differences of independent-mindedness (bordering hubris), that promotes one group of people to ignore disaster warning systems while another group pays closer attention. Possibly, there are factors yet to be investigated that allow one form of public disaster announcement to gain more traction than another. Or, possibly, it is a simply a matter of education.

The recent Philippine Hagupit experience provides us with another opportunity to learn. Although no system is perfect, if the motivation to continually improve our national disaster response is a driving force, we must study all storms, especially those with successful outcomes, and determine how we can apply these lessons to our own public health and disaster preparedness programs. Although most would agree that we need to invest more resources in mass casualty education, disaster preparedness and civil defense training, we need to identify what obstacles exist to prevent the success of such an investment. A good place to start would be Typhoon Hagupit. What we learned last month from the Filipino experience was that an intense, internal critique of last year’s tragic events pre-emptively created a sound public policy program of readiness for this year. These lessons, combined with a progressive, well communicated message, delivered to an educated and willing population, averted disaster. As a result, a million and a half flames still burn tonight.