IN THE AFTERMATH of the December 26 tsunamis in South Asia, I read an article on about how Israeli doctors, who were among the first on the scene in Sri Lanka, have the ideal training for dealing with a disaster of such proportions. As Professor Avi Rivkind, head of both the Department of Surgery and Trauma Unit at Hadassah University Hospital, Ein Karem, Jerusalem, is quoted as saying, “We will try to use our broad experience in dealing with terror attacks and rescuing masses to help in this disaster as well.”

This makes sense. Whether it's a suicide bomber or earthquake-induced killer waves, the resulting medical challenges are similar. One would hope that the Israeli docs' terrorism training also will stand them in good stead as they move from treating broken bones to the expected outbreaks of malaria and other diseases. While the treatment for intestinal infections and anthrax may be different, training in the mechanics of dealing with massive outbreaks — locating vaccines and medicines, triage, setting up places to care for patients under less-than-ideal circumstances, coordinating with government officials, etc. — are certainly similar.

After 9/11, I hoped the U.S. would follow Israel's lead and become more proactive in our emergency preparedness. So it was with dismay that I read a report from Trust for America's Health, which studied the state of preparedness for a bioterror attack in the United States — and found that just six states are adequately prepared to distribute vaccines and antidotes in the event of an attack.

Fortunately, CME providers are doing a better job preparing our docs than our politicians have done in preparing our infrastructure. According to a recent article in The Lancet, programs like the ones co-authors Bruce W. Clements, MPH, associate director of the Institute for Bio-Security at Saint Louis (Mo.) University School of Public Health, and R. Gregory Evans, PhD, MPH, director of the Institute, have developed for the CDC for use by state and local health departments are critical. The exercises are designed to help physicians see how things may unfold in an atypical outbreak of smallpox.

“In a bioterrorism incident, physicians will have to interface with the FBI and other government agencies that they've never had to speak with before,” Clements said in a press release. “This type of communication doesn't come naturally. It's learned.”

The Israeli doctors have, unfortunately, had a need to develop this expertise for quite some time. Now, we're beginning to catch up. Thank you, dear readers, for your work in preparing our docs to handle the medical fallout, from tsunamis to terrorist attacks.
Sue Pelletier, (978) 448-0377,