This is the transcript from a presentation I gave about the connection between Homeland Security and the field:
Good Afternoon, I’m speaking about a connection between Homeland Security and the field of medicine that is generally ignored. The two fields are often thought of as completely separate, although cooperative. My presentation is a basic overview on the subject.
The field of Homeland Security conjures thoughts about counter-terrorism, infrastructure protection, and intelligence analysis. The field of medicine brings about images of treating patients; surgery, diagnostics, cardiology, neurology and so on. But, the two are linked by a large number of factors that need to be acknowledged.
The National Strategy for Homeland Security lists six critical mission areas, in this order. Health Care mostly fits under the Emergency Preparedness and Response category. However, it can be shown that, pending the circumstances, it can fit under the other categories as well.
Emergency Preparedness & Response is most often associated with first responders. By the nature of their title, they are usually the first to arrive at an emergency situation. EMTs, and if the circumstances warrant it, hazmat units, are the first to provide medical care. Planning is a basic foundation of preparedness. In 2005, the Homeland Security Council published the National Strategy for Pandemic Influenza. The plan sets aside the department of health and Human Services as one of the lead agencies to implement the strategy. Also, in 2007, President Bush issued Homeland Security Presidential Directive 21 to establish a national strategy for Public Health and Medical Preparedness. A few weeks ago, it was discovered that the water supply of Alamosa, Colorado was contaminated with Salmonella. The cause remains unknown. It is unlikely that it is an act of terrorism, but in an area with a population of about 10,000 almost 400 people have been treated for Salmonella. Jim Martin, director of the Colorado Department of Public Health and Environment and Hans Kallam director of the Colorado Division of Emergency Management worked together closely to solve the problem. The water system has been thoroughly cleaned, water bottles have been brought in with the aid of helpful companies, and an investigation as to the cause of the situation has begun.
The Medical field holds high stakes in the planning for Chemical, Biological, Radiological, and Nuclear incidents. After an incident of this kind, health care would be a high priority and capability would be stretched to its limit. Bioterrorism does have a small history in the United States including an incident of salmonella poisoning intended to affect an election and the Anthrax attacks. In the case of an attack today, the Department of Health and Human Services is charged with deploying medical personnel and equipment to aid other agencies. The Department of Homeland Security works with the Centers for Disease Control and Prevention along with the Department of Veterans Affairs to detect biological and chemical attacks.
The relationship between Homeland Security and Health Care is a two-way street. Healthcare serves the purpose of Homeland Security and Homeland Security also serves the purpose of Healthcare. As a critical infrastructure sector, public health is important to the daily functions of the U.S. Public health services need security and an insurance of continuity of operations.
The area of intelligence and warning is important for taking preemptive, preventive, and protective measures. The field of medicine can be involved here through medical surveillance. David Siegrist from the Potomac Institute for Policy Studies describes medical surveillance as the prospective statistical analysis of health-related data for rapid detection of anomalies that indicate the outbreak of disease in a population. This information can be used to detect a natural epidemic or act of terrorism. It can be useful for medical response and for the capture of a perpetrator. The shooting last year at Virginia Tech has highlighted a need to work more closely with the mental health system and to improve mental illness interventions. It is always helpful to know who is a threat to the security of the nation or the safety of citizens. Any actions in this area must maintain patient confidentiality. This is not necessarily an important term in Homeland Security but it is very important to the area of health care. Trust between a health care provider and a patient has become one of the bases of the U.S. health system, and patient confidentiality should be respected by Homeland Security and other fields that begin to work with mental health organizations.
May 24, 2007 a potential threat to the health and safety of United States citizens crossed the border from Canada to the U.S. Andrew Speaker, diagnosed with multi-drug resistant Tuberculosis was allowed freely into the U.S. despite an alert that he should be restrained and health officials should be notified. In this situation, border security had direct involvement with public health; failing in their responsibility to contact health officials could have put numerous people in danger of contracting TB. Fortunately no one is known to have contracted TB from Speaker and his diagnosis has been downgraded to a less resistant form.
Domestic Counterterrorism is essentially a law enforcement field. However healthcare professionals can provide helpful skills and resources. The Department of Health and Human Services, for example, offers training to protect workers from infection or contamination. Psychologists and Psychiatrists can be called on to help with interrogation. A new, controversial tool for interrogation and lie detection involves Neuroimaging. A medical technique that, in this case, uses Functional Magnetic Resonance Imaging. Extensive research and testing has been, and continues to be done on effective countermeasures to biological, chemical, and radiological agents. The Agency for Healthcare Research and Quality, a sub Health and Human Services agency, has computer simulation models for response planning and training modules on bioterrorism.
The connection between Homeland Security and the field of Medicine is expansive and essential. For the field of Homeland Security, securing the nation requires a partnership with the medical community; and for the field of medicine maintaining the health of citizens requires a partnership with Homeland Security.
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