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The Emergency Medical Treatment & Labor Act (EMTALA) goal is to guarantee everyone access to emergency care at hospitals (Medicare, Health & Human Services, or CMS participating ones) regardless of ability for the patient to pay for the services or not. This was aimed to open up equal access to critical treatment regardless of class, social standing, or wealth.

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1) “From the first moments to the last, however, their efforts were plagued by failures of communication, command and control.”

2) ''It's a disgrace,'' he said. ''The police are talking to each other. It's a no-brainer: Get us what they're using. We send people to the moon, and you mean to tell me a firefighter can't talk to a guy two floors above him?''

3) “Throughout the crisis, the two largest emergency departments, Police and Fire, barely spoke to coordinate strategy or to share intelligence about building conditions.”

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 I researched more into why the fire department’s Radios were having difficulties and issues, especially on the higher floors. First, the agency primarily used VHF (very high frequency) radios which are better for long distance when there is line-of-sight form point-to-point with minimal obstructions. UHF operates on a higher frequency and thus transmits with shorter wave-lengths which is better for object penetration. There are many challenges with radio communications in a city like NYC, starting with the sheer fact that to transmit directly from the ground to the top requires going through over a hundred stories of steel and concrete.

The repeaters worked to an extent. We know that they were operational and working, at least partly, as they recorded the relayed transmissions. The police used a separate but almost identical repeater as the fire department with mostly success. The NYFD experienced more issues. I found reports that claimed from fire fighters in the towers that while the transmissions were getting through, they were not understood due to the loud working environment and congested radio traffic.

The Incident Command System was largely ineffective. The only agency that was properly trained in ICS was the fire department which made inter-agency command and control through ICS moot. It was because of the events on 9/11/2001 that resulted in the development of the Nation Incident Management System, by the Department of Homeland Security, which encompasses ICS and more. Federal funding for emergencies now requires that NIMS be used as well as all first responders that respond to hazardous materials incidents be trained in the ICS.

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Didier Fassin—

“Didier Fassin is an anthropologist and a sociologist who has conducted fieldwork in Senegal, Ecuador, South Africa, and France. Trained as a physician in internal medicine and public health, he dedicated his early research to medical anthropology, illuminating important dimensions of the AIDS epidemic, mortality disparities, and global health. He later developed the field of critical moral anthropology, which explores the historical, social, and political signification of moral forms involved in everyday judgment and action as well as in the making of international relations with humanitarianism. He recently conducted an ethnography of the state, through a study of urban policing as well as the justice and prison systems in France. His current work is on punishment, asylum, inequality, and the politics of life, and he is developing a reflection on the public presence of the social sciences. He occasionally writes for the French newspapers Le Monde and Libération. His recent books include The Empire of Trauma: An Inquiry Into the Condition of Victimhood (2009), Humanitarian Reason: A Moral History of the Present (2011), Enforcing Order: An Ethnography of Urban Policing (2013), At the Heart of the State: The Moral World of Institutions (2015), and Prison Worlds: An Ethnography of the Carceral Condition (2016).” (https://www.ias.edu/scholars/fassin)

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“Based upon research that the DRLA leadership has conducted with reputational leaders in the field, including leaders from within other premier academic institutions, international organizations, prestigious NGOs, the United Nations, the donor community, think tanks and the Red Cross movement, it is widely agreed that a systematic and interdisciplinary approach to leadership is widely needed in the community and insufficiently addressed in most academic programs. As Tulane University itself has exhibited such resilience and strength of leadership in the aftermath of Hurricane Katrina, it represents and ideal setting to support such an approach to disaster resilience leadership education and allows students to experience the living laboratory of recovery and resilience that is the city of New Orleans.” -- Louisiana Voluntary Organizations Active in Disasters.

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1) I did more research into our role and mental health in the EMS system as EMTs. I found this article to be particularly insightful: Managing Psychiatric Emergencies (http://www.emsworld.com/article/10931747/managing-psychiatric-emergencies).

2) Bettering and improving EMS care by bypassing EDs and transporting patients to mental hospitals.

(http://epmonthly.com/article/pilot-project-trains-ems-to-bypass-the-ed-with-mental-health-patients/)

3) Learned about FEMAs policies and programs for mental health following a disaster in the U.S. (https://www.fema.gov/recovery-directorate/crisis-counseling-assistance-training-program)