Strengthening state disaster preparedness and response: An Alaska perspective

Guidance for resource allocation and crisis standards of care for disaster preparedness and response vary among states. As seen in Alaska, the far north, and other remote areas, there are significant challenges. Planning that incorporates supply chain, staffing, and patient movement becomes critical. Forty health facilities throughout Alaska were surveyed on topics addressing if facilities had a preparedness plan, previously had faced resources allocations, conducted emergency preparedness trainings, had a protocol for staffing during emergencies and/or a written duty report.  There was a 100% response rate. These data, current state regulations, and reports based on comprehensive statewide disaster response exercises are primary sources for the assessment of the current status and provision of direction for state disaster planning and response. Alaska towns and villages are dependent on three primary, often distant cities for medical supplies, consumer supplies, and staff. Transportation is heavily dependent on variable climatic conditions. Rapid disaster response can be difficult. Responsibilities of urban areas to support disaster preparedness in rural areas are issues to be addressed. Stockpiling is expensive and needs strategic planning.  If fundamental goals of disaster preparedness are resiliency and sustainability, then chronic disasters (e.g., poverty) and a lagging, overburdened public health system must be a central focus. Implications of chronic disasters and unprecedented conditions for disaster preparedness, impact, response and recovery, with a particular focus of limited resources, will emphasize the need for imperative community-based planning and interventions.