Be Prepared
Public health systems must be vigilant to guard against bioterrorism

By Barbara Brown, Ed.D., RN, FAAN, Editor, Mountain West Edition
November 5, 2001

Building safer systems-whether health care, air travel, public health, schools, food and drugs or personal security-is the call to action being heard throughout the world.

In health care, we design systems to ensure that patients are safe from accidental injury and hospital-acquired infections. As we travel nationally and internationally, we find intensely increased safety and security systems so that travelers who arrive late (less than two hours before departure) are apt to miss their flights.

The continuing threat of bioterrorism with anthrax, smallpox or other germ warfare has placed everyone on alert. Defense mechanisms-whether individual, community, state or national-are being built with multiple barriers in order to protect us.

During the Gulf War, our individual barriers were gas masks given to every employee and patient at the King Faisal Specialist Hospital in Saudi Arabia. Because we were the community leaders in health and safety, we had nuclear, biological and chemical warfare suits to protect us as we tested the environment for chemicals when an Iraqi Scud missile was dropped in Riyadh.

The hospital was sealed off to prevent chemicals from entering in an attempt to keep a safe environment. Donald Trunkey, MD, from the National Institute for Emergency Medical Services in Baltimore, came to the hospital to ascertain our preparedness. This included the development of an ambulance bay, where trained personnel could detoxify equipment, vehicles, etc., that were exposed to chemicals. This is not unlike what is being done as anthrax appears through the U.S. Postal Service.

As American citizens working in Saudi Arabia, we also were subject to terrorism and had to be on the alert, making ourselves less visible in public arenas. I was chief warden for more than 1,000 Americans and had to develop an evacuation plan. All were advised to have at least three days' water and food supply available at all times. We had shelter areas in different places, where mattress pads, water, food, telecommunication and gas masks were available. I still have my MRE (meal, ready to eat) from the military. Fortunately, the war was over before we had to use most of what we prepared for.

There is a letter to the editor in this issue ["Culture shock"] from a nurse who also worked in Saudi Arabia, and what she has written is true. But there were also many positive people experiences in caring for patients from this Islamic culture; people are not to be discriminated against because we believe differently than they do.

Let us not allow a few extremists who create such distrust that we forget why America is the best. We need to develop nationwide public health systems to offset whatever bioterrorism may be launched next. We need to teach everyone to be prepared with supplemental water and food supplies, and even determine where there might be a safe place away from a targeted area.

Nurses can make a major difference in this awful war, but we need to be prepared.

©NurseWeek Publishing