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1) I followed up on the old safety features of the World Trade Center. Sprinklers were the only feature that stood out from a fire safety video by the New York and New Jersey Port Authority for the World Trade Center (made 1996). https://www.youtube.com/watch?v=aBM9-y8gfHo. However the fire was much too large for them to put out, and may have even made it worse because water, when in contact with molten aluminum explodes.

2) Next I looked into why and how the World Trade Center (WTC) collapse happened. The WTC did not have concrete core or outer. Most high-rise buildings have one or the other as concrete is not subject to fire. The WTC steel trusses and columns were fireproofed with spray foam which fell off the building on impact with the airplane. The crash through the building resulted in flammable debris getting pushed to the far walls and corners, the most vulnerable location, and fatally weakening the WTC’s steel core. NIST report never stated that the fire melted the steel beams, steel melts at 2750 degrees F, but looses half its strength at 1100 F. Parts of the WTC fires reached 1800 F on that day. With the weakening, the trusses began to sag, bowing inward causing all of the weight to rest on the perimeter columns which could not bear the load and eventually snapped. After the first floor fell, the “pan-caking” effect resulted in each floor collapsing the one beneath it.

3) Lastly I looked at the new disaster prevention features of One World Trade Center. The key features which the Twin Towers were lacking are: a concrete core with stairwells located in center, larger than required staircases, and a separate first responder stairwell. Many experts believe if the WTC had a concrete core, they would not have fallen. 

The goal of the Disaster Resilience Leadership Academy is to:

“…achieve increased resilience in communities and individuals impacted by natural and manmade disasters. Such leadership is guided by the ethics of the Triple Bottom Line: Equity, Environment, and Economy.”

1) I looked into how other countries that faced significant disaster dealt with their displaced populations. (http://fukushimaontheglobe.com/the-earthquake-and-the-nuclear-accident/situation-of-the-evacuees)

2) Next, I researched the American Psychological Association’s views on mental health and disasters. (http://www.apa.org/topics/disasters/)

3) Lastly, I looked into “price gouging” during and after natural disasters and both sides of the argument. Pros: (http://www.huffingtonpost.ca/peter-mccaffrey/5-reasons-price-gouging-is-okay_b_3487621.html) and cons: (https://www.uvm.edu/~vlrs/doc/pricegou.html)

The main focus of the article is mental health issues resulting in the aftermath of a major disaster. Mental health is rarely discussed in these types of environments but persists long after the dust has settled and the houses rebuilt. This article seeks to explore the current state of mental health care in disaster environments.

The points I followed up on to get a better understanding of disaster aftermaths, especially ones involving nuclear technology were: 1) Fukushima 2) Three Mile Island and 3) more research into the Chernobyl incident through other articles.

How did it happen (complete failure of cooling and reactors exploding)?

                Although the earthquakes killed workers and wreaked havoc on the region, Japans’ nuclear plants were not compromised by the quakes. It was only the tsunami that caused Fukushima Daiichi 1, 2, & 3’s power and backup power to fail, allowing the meltdown to take place. (world-nuclearworld-nuclear.org)

Why was radioactive water released (purposely) into the ocean as stated in the article?

                I found that although radioactive water was never “purposely” released into the ocean, it was known that it would likely end up there due to the failed ocean barrier wall. The water came from the necessity of cooling the overheated plants to prevent further meltdown and further contamination. The good news is that by 2012 the water within the Fukushima area was considered non-toxic to humans and aquatic species that live there. However, less is known about the effects on the ocean floor, where the radioactive matter is collecting in the sediment. (cnn.com)

What (if anything) has been done to further an international response team/plan for nuclear emergencies?

While my research turned up little results for international response development, countries have been developing their own response teams. China will have a national nuclear response team by the end of 2018 which will be made up of over 300 individuals and will meet the requirements for an international response team. This makes sense since China has more nuclear power plants than any other country in the world and expects to double its nuclear output over the next few decades. (firedirect.net) 

Dr. Byron Good is a professor of Medical Anthropology at Harvard University. “Dr. Good’s present work focuses on research and mental health services development in Asian societies, particularly Indonesia. He has been a frequent visiting professor in the Faculty of Medicine, Gadjah Mada University, in Jogyakarta, Indonesia. He has conducted research with colleagues there on the early phases of psychotic illness for more than 10 years, and is co-director of the International Pilot Study of the Onset of Psychosis (IPSOS)” (Harvard bio).

This article draws mainly from Partners In Health projects in Rwanda and Haiti, using them as case studies to support their argument.

The majority of citations are attributed to MSF and other humanitarian organizations. This incite frames the viewpoint from which this article was made.

            This past spring break (2016), on a Monday night while at home, I responded to a motor vehicle accident as a Good Samaritan. The accident happened at approximately 19:00 hours on my street in Blackstone, Massachusetts. My father was on our front porch when he heard a car barreling down our back country road which has a long straight away before taking a sharp turn. Before the impact he knew that the driver would not anticipate the curve fast enough at the speed he was traveling. Sure enough, there was a loud bang and the sound of a car rolling over, which I could hear from inside the house (approximately ¼ mile from crash).

I grabbed both of my personal first aid kits and a flashlight while my father called emergency services. I walked to scene with my father and younger brother. I sped walked and arrived at the crash site first.

The vehicle was a ‘90s sedan that went straight into a telephone pole, which broke like a toothpick, and rebounded backwards and flipped 90 degrees on its left side. Parts of the car, tools, and glass were on ground, airbags deployed. There was a car seat in back, and for a moment I thought a child but it was just clothing. Front right tire was up inside front passenger compartment. Hazards flashing. Driver window was rolled down. No people in the car.

My brother and father directed traffic on either end of the crash site. They almost certainly prevented at another crash by a car who didn’t see the accident but saw my brother flag them down with his light.

I saw man standing 20’ from crash site, talking to people in a gold SUV. When I arrived I start asking medical questions and the people in the SUV leave – they were by standards who pulled up but left after I started taking over. The man in question appeared to be a lower/middle class white/Hispanic, male in his 30s. He was driving an older car with lots of tools in the back which were now all over the road. Our neighborhood is a small country community and I know he was not from our neighborhood. I assumed he was some kind of mechanic, bases on tools in car. He was wearing dirty jeans and stained hoodie. He was definitely a blue-collar worker. He may have been from downtown Blackstone which is largely lower middle class and blue collar, or he may have been from Woonsocket, Rhode Island, which is known as “the Detroit of Rhode Island”.

As I tried to obtain basic medical information from the patient, it was apparent he had an altered mental status, and did not appear to understand fully what was going on. I am not certain if it was alcohol and/or drugs as for safety reasons I did not get close enough to the patient/suspect to tell. He was ambulatory and verbal. The interesting part of our conversation was to the best of my ability as follows:

“Are you sure you’re okay? Umm yeah. Are you hurt anywhere? I’m fine. [I did visual inspection of patient using flashlight which revealed no major injuries other than minor cuts from airbag]. [He starts to edge away from scene]. You should wait for ems to check you out. Wait, you’re right! I might die?! You appear to be okay externally but things like internal bleeding, and a full assessment could reveal other problems. Naaaa [turns and starts to walk away down street]”

I attempted to convince the patient to wait on scene but he was going through several mode swings during my interactions with him from fear, anxiety, agitation, and anger. While I was talking to the patient, the first officer from the neighboring town arrived on a motor cycle. I informed the officer at the scene of the situation about the patient/suspect fleeing the scene. The officer took note of it and continued to work to secure the crash site. Another officer arrive from my town from the west. I informed the same and he stated that he would need me to make a witness statement and proceeded to the crash site. A third and fourth officer arrived together the same time as two ambulances (indicated because of rollover) from the east. One of them told me again that they would need a witness statement.

I met back up with my dad and brother who were no longer needed to control traffic with law enforcement on scene. Neighbors had started coming out to see the commotion. We were all talking near the scene while waiting for officers. Finally one of the officers asked another officer if he should go look for the suspect. He left approximately 20 minutes after my last contact. I never spoke with the arriving EMS as they came from the east and I was on the west of the accident but officers told them that the patient was missing. Eventually multiple officers and cars were out looking for patient/suspect but was not found as far as I am aware. I finally was given the chance to give my testimony which, to the best of my knowledge, mirrors this report. After reading out loud in front of the officer and my father and brother to confirm accuracy, the officer asked me something very strange. First, he asked me to add what the suspect was wearing (which I had forget to include), but then he also asked me to state that I saw the suspect drive into the telephone pole and that I smelled alcohol on the patients breath. Neither of these things were what I told any of the officers and ran counter to my testimony as written. I include the suspect’s clothing description but I did not add the second mention and stated that I had not witnessed those things. After my report I left the scene with my brother and father.

Some of the policies and procedures relevant to this case were: scene safety, dealing with aggressive/combative patients, and HIPPA did not apply to me as a bystander so I gave full testimony including medical status to the officers.

After reflecting on the education I received and didn't receive, there are a few things that would have allowed me to be better prepared for this incident. How do I convince patients to stay on scene? When do you give up? I wish my EMT class was a little better scene on safety training. Being distracted by the emergency at hand, I did not truly take into account the fact that the power lines were live and drooping with half of the telephone poll pulling on them. Only supported by the next and previous poll but not drooping more than 3’ from normal, more than 15’ from ground, and 10’ above vehicle. Reflecting on it, I did not really consider the threat as I should have, and neither did the officers on scene. I don’t understand why it took so long for police to search for the suspect who could have had major medical issues. Should I have followed suspect/patient alone? When is a citizen arrest allowed/appropriate? Should I have asked for the badge number of the officer who asked me to misrepresent the truth on an eye witness testimony? What is the process to do that anyway? If I had the answers to these questions I feel I may have been able to provide better assistance, but then again perhaps not.