Gulf Region Disaster Response Preparedness Conference and Medical Workshop by Todd Wheeler

Conference Report

Gulf Region Disaster Response Preparedness Conference and Medical Workshop September 26-29, 2004 Manama, Bahrain

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Editors Alex Sonski Kent H. Butts Bernard F. Griffard Jeffrey C. Reynolds

The views expressed in this report are those of the participants and do not necessarily reflect the official policy or position of the United States Army War College, Near East South Asia Center for Strategic Studies, the Department of the Army, the Department of Defense, United States Central Command, or any other Department or Agency within the U.S. Government. Further, these views do not reflect uniform agreement among the conference participants. This report is cleared for public release; distribution is unlimited.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

CONTENTS FOREWORD – Professor Doug Campbell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v EXECUTIVE SUMMARY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii CHAPTER 1 – Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Opening Remarks BG Yousif Bahzad, Director of Training, Bahrain Defense Forces . . . . . Opening Remarks Rear Admiral Robert T Moeller, Director, Plans and Policy, J5, United States Central Command . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Opening Remarks Mr. Alex A. Beehler, Assistant Deputy Under Secretary of Defense (Environment, Safety and Occupational Health), Ofﬁce of the U.S. Secretary of Defense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 3 5

CHAPTER 2 - Security and the Environment: Regional Approaches . . . . .11 The History of Disasters in Bahrain Dr. Abdulaziz Hamza, Under Secretary, Ministry of Health . . . . . . . . . 13 Oil Spill and Response Coordination Eng. Adnan S. Al-Mukhareq, Ministry of Oil, Kingdom of Bahrain . . . 14 Incident in Bahrain, March 2003 Eng. Abdel Nasser Adbel Aziz, General Directorate of Environment and Wildlife . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 CHAPTER 3 – Disaster Preparedness Strategy. . . . . . . . . . . . . . . . . . . . . . . 29 Proposed Five Year Disaster Preparedness Strategy and Regional Disaster Response Coordination Mechanism Mr. Mike Shaw, Chief, Counterproliferation Division, J5, U.S. Central Command . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 CHAPTER 4 - Results of Medical Workshop . . . . . . . . . . . . . . . . . . . . . . . . 33 Brig. Gen. Annette Sobel, M.D., National Guard Bureau, and Mr. Mohammed Ash-sharhan, Director, Emergency Medical Services, Kuwait . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 CHAPTER 5 - Reports/Recommendations from Working Groups . . . . . . . 39 Executive Level Policy: RADM John Sigler (USN, ret), Near East South Asia Center, U.S. National Defense University and Dr. Kent Butts, Center for Strategic Leadership, U.S. Army War College . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 iii

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Regional Resources: LTC Kenneth Deal, Defense Threat Reduction Agency . . . . . . . . . . . . . 45 Regional Disaster Response Preparedness Capacity Building: Professor Richard Winslow, Center for Strategic Leadership, U.S. Army War College . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Regional Medical Security Preparedness and Response to Disasters: Professor B.F. Griffard, Center for Strategic Leadership, U.S. Army War College . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 APPENDIX A – PARTICIPANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1 APPENDIX B – AGENDA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

FOREWORD “Gulf Region Disaster Response Preparedness Conference and Medical Workshop” was a U.S. Central Command (USCENTCOM) conference cosponsored by the Office of the Deputy Under Secretary of Defense for Environment, Safety and Occupational Health, and the Center for Strategic Leadership (CSL) of the U.S. Army War College. Hosted by the Bahrain Royal Defense Force at the Sheraton Hotel in Manama, Bahrain, this conference brought together senior military and civilian leaders from Arabian Gulf Region, international academics, governmental and military subject matter experts, to examine critical ways to respond to environmental and man-made emergencies that can affect the region. Environmental Security and the Preparedness to Respond to Disasters have been important to U.S. strategy in the region. These themes complement USCENTCOM’s Cooperative Defense Initiative activities and offer valuable venues to foster regional security cooperation. This event was the third such conference that focused on the Arabian Gulf, and each has built on the successes of the previous endeavor. “Environmental Security Planning, Prevention, and Disaster Response in the Arabian Gulf Region” was conducted at Doha, Qatar, and focused developing regional capabilities in responding to and dealing with disasters. The first conference, entitled “The Role of the Armed Forces in Environmental Security” was conducted at Muscat, Oman to discuss environmental issues that have implications for planning operations, acquiring weapons, conducting training and military exercises in the region. This year’s conference focused on developing a five-year disaster preparedness strategy and to discuss the formulation of Executive Level Policy, the Identification of regional resources, the strengthening of regional capabilities to deal with disasters and emergencies, and the further development of medical response capabilities. The Arabian Gulf region has common threats from oil spills, shipping incidents, water shortages and petrochemical facilities. Natural disasters are common and are not governed by international borders. Successful solutions must be regional in nature, involving regional national economic and military authorities and at times, international organizations. This conference contributed to the security cooperation and development missions of the United States Central Command. It demonstrated that v

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

developing regional response capabilities can encourage cooperation in this strategically important region and help combatant commanders to develop relationships with their regional partners to promote security and stability.

Professor Douglas B. Campbell Director, Center for Strategic Leadership U.S. Army War College

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

EXECUTIVE SUMMARY By RADM Robert T. Moeller, USN, Director, J5 Plans & Policy, USCENTCOM RADM John F. Sigler, USN Retired, NESA Professor B.F. Griffard, Center for Strategic Leadership, USAWC

Uninterrupted access to and use of critical infrastructure in the Arabian Gulf region are key to the successful prosecution of the Global War on Terror (GWOT). To maintain access and use the U.S. Central Command (USCENTCOM) and its Gulf Region partners must deny outside organizations the ability to inďŹ&#x201A;uence these requirements through terrorism. Essential to this will be information sharing and shared capabilities. Regional cooperation is important because terrorist threats vary, both regionally and nationally. To facilitate this endstate, theater security cooperation initiatives that promote regional collaboration are underway to improve national disaster preparedness capabilities and effective disaster preparedness training with partner nations. Promoting Regional Stability and Security Objectives As a result of ongoing world events, interest in regional disaster preparedness processes such as consequence management, crisis response, and medical countermeasures, has increased. While the Weapons of Mass Destruction (WMD) threat is serious, it is not the sole threat facing forces and populations in the Arabian Gulf region. Petro-chemical plants near urban areas process and store tons of toxic chemicals, many of which are unstable and highly dangerous. An incident causing mass casualties could occur at any time, whether from terrorist action or industrial accident. Because these threats do not recognize State borders, a regional approach is necessary. Under the aegis of the Defense Environmental Intelligence Cooperation Program, the OfďŹ ce of the Deputy Under Secretary of Defense for Installations and Environment [DUSD (I&E)] teamed with the USCENTCOM to address these issues. The vehicle was the Gulf Region Disaster Response Preparedness Conference and Medical Workshop, conducted September 26-29, 2004 in Manama, Bahrain. This multilateral event focused on the process of developing standardized procedures for regional response to intentional or accidental manmade incidents. Hosted by the Bahrain Defence Forces, participants included Bahrain, Kuwait, Oman, Qatar, UAE, the United States, the Gulf Cooperation Council (GCC) secretariat general, and observers from Egypt and Jordan. The U.S. vii

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Army War College Center for Strategic Leadership (USAWC/CSL) and the National Defense University (NDU) Near East South Asia Center for Strategic Studies (NESA) provided operational, logistical, cultural, and administrative support for the workshop. Conducted in two parts, the September 26, 2004 Medical Surveillance Workshop looked at enhancing disaster preparedness response and enabling Civil Defense within the Gulf Region. It focused on building a regional baseline of disaster preparedness and medical surveillance capabilities. In line with the intent stated above, the Disaster Response Preparedness Conference, conducted September 27-29, 2004, employed individual work groups to explore Executive Level Policy; Regional Resources; Regional Disaster Response Preparedness Capacity Building; and Regional Medical Security Preparedness and Response to Disasters. The Journey The GCC nations, and Egypt and Jordan share an interest with the United States in developing the required support, teamwork, and knowledge bases necessary to prevent or mitigate a major national or regional disaster. This year’s Gulf Region Disaster Response Preparedness Conference and Medical Workshop built upon the work of the two previous regional cooperation efforts conducted in 2000 and 2002. Convened in Muscat, Oman in June 2000, the initial conference examined issues in our environment that can strongly affect national, regional and global security. While informational in nature, this meeting pointed out clearly that a manmade or naturally occurring environmental disaster does not necessarily adhere to national borders. Even incidents that occur in only one country can exceed that nation’s capacity to respond to the event and/or to the mitigation required in the aftermath. A need for cooperative mechanisms was clearly indicated. As a result, a second major conference was held in Doha, Qatar in September 2002. With direct support from the Chiefs of Staff of each of the Gulf nations and from the Commander, USCENTCOM, this conference established five functional working groups with assigned obtainable objectives. The groups were first: “Defining Environmental Security and Setting Regional Approach Objectives”; second: “Environmental Security Intelligence, Detection and Information Sharing”; third: “A Regional Center and Command and Control”; fourth: “Regional Training and Exercises”; and finally: “Medical Surveillance”. This final working group was a late addition, but considered necessary because viii

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Medical Surveillance was correctly recognized as a major requirement in the prevention, response and mitigation of a majority of disasters. Significantly, the Doha conferees created an Executive Committee composed of flag officers from each nation, entrusted to develop policy recommendations and to ensure continuity of each of the five working groups. As the importance of the GCC states, Egypt and Jordan to sustainment of the GWOT grew, the theater security cooperation effort in the region evolved. In Muscat and Doha environmental security was the discussion vehicle. During the 2004 Conference and Workshop in Manama, USCENTCOM presented a strategy proposal for implementing a disaster preparedness program that combines elements of the Cooperative Defense Initiative (CDI) and environmental security to support regional stability and security objectives. USCENTCOM Regional Disaster Preparedness Strategy Disaster preparedness is the conduct of civil-military activities to improve host nations’ national and regional capabilities to effectively prevent, prepare for, respond to, and/or mitigate the effects of man-made and natural disasters. The proposed USCENTCOM Regional Disaster Preparedness Strategy builds on the recognition by Host Nations’ leadership of a need for a regional disaster response capability. Using the Global War on Terrorism, the Theater Security Cooperation guidance, the USCENTCOM Area of Responsibility strategy, and the “war of ideas” as the foundation, the initial operational focus of the resulting Disaster Preparedness Program (DPP) is combating terrorism, antiterrorism, and counterterrorism. This program focuses on harnessing all of the various national and regional resources, collectively, to prevent disasters from happening in the first place, but if prevention fails, to respond rapidly and effectively. The establishment of such capability within the region will maximize the availability of high demand-low density skill sets and assets; boost interoperability if disaster affects multiple countries; and improve response capability to potential threats. Utilizing the enablers of humanitarian assistance and disaster response, humanitarian demining, NBC passive defense, emergency management, medical countermeasures, and consequence management to assist with implementation, the DPP aims to enhance regional stability and security. Accomplishment of this goal is dependent upon the development of effective disaster preparedness procedures and response mechanisms within the region.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Mitigating the Threat There is no doubt that natural or man-made disasters will occur sometime in the future-the question is when and where. Through regional cooperation, training, and exercising national and regional response capabilities the GCC States, Egypt and Jordan can build the required support, teamwork, and knowledge base needed to effectively respond and then mitigate the consequences of a major incident. Participants in the 2004 Gulf Region Disaster Response Preparedness Conference and Medical Workshop made great strides towards achieving this objective. The Medical Workshop used the premise that local disasters may have potentially widespread effects, but that these effects are mitigated through preplanning, regional capacity-building and medical surveillance/early warning systems. Key Workshop recommendations included: establishing a regional coordination center for rapid sharing and archiving of medical intelligence, to include medical surveillance, diagnostics, training, standards, unified disaster planning and response, and media sources; establishing regional standardization and credentialing programs; and developing a bi-annual regional exercise roadmap. All Disaster Response Preparedness Conference work groups bolstered the necessity for a regional coordination capability. Initially this was seen as a “virtual” information clearinghouse. With the onset of a disaster, the Regional Coordination Center would be established in the country where the incident has occurred. It would draw on the available database to determine capabilities and to identify requirements. This effort requires an established capacity building program that begins in the short-term with national exercises, progressing to bi-lateral and regional multi-lateral exercises in the long-term. In order to prevent redundancies the establishment of regional centers of excellence was encouraged. Not every country needs a particular training capability. Centers of excellence for a particular area of expertise would be established at one location to service the region. The Interagency Challenge At the conclusion of the discussions one point was clear to all attendees – military and civilian alike - disaster preparedness is an interagency challenge. While the military can bring significant resources to bear, they are unlikely to be the first responders, or be in charge of the response or mitigation efforts. x

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

When disaster strikes, the regional militaries are major contributors of heavy equipment and organized, disciplined manpower, but in most cases they will play a supporting role. Primary incident command responsibility normally resides with other government ministries, with fire and police forces, or with dedicated disaster relief organizations. Ministries of Health and Environment are directly involved in disaster prevention, response and mitigation, and Foreign Ministries coordinate the international effort. Coordination procedures with non-governmental and private voluntary organizations must also be in place. Implementation of the USCENTCOM Disaster Preparedness Program will ease the challenge of inter-agency and multi-national military coordination, and provide a regional framework for the development of the necessary defense doctrine, procedures and capabilities to ensure the capability for effective full coordination with multiple agencies of multiple nations. Conclusion As the third biannual event in the Gulf Region to address civil-military activities to improve host nations’ national and regional capabilities to effectively prevent, prepare for, respond to, and/or mitigate the effects of man-made and natural disasters, the 2004 Gulf Region Disaster Response Preparedness Conference and Medical Workshop successfully built on the outcomes of both the initial 2000 conference in Muscat, Oman, and the 2002 Disaster Response conference in Doha, Qatar. The improved national coordination and information sharing capabilities identified by the participants demonstrate a commitment to strengthening regional cooperation and coordination capabilities. With the proposed USCENTCOM five-year program the GCC states, Egypt, and Jordan have a roadmap that increases security and stability through effective national and regional civil-military coordination and “full spectrum” disaster preparedness.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Chapter 1: Introduction Opening Remarks BG Yousif Bahzad, Director of Training, Bahrain Defense Forces Opening Remarks Rear Admiral Robert T Moeller, Director, Plans and Policy, J5, United States Central Command Opening Remarks Mr. Alex A. Beehler, Assistant Deputy Under Secretary of Defense (Environment, Safety and Occupational Health), OfďŹ ce of the U.S. Secretary of Defense

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Opening Remarks Brigadier General Yousif Bahzad Director of Military Training, Bahrain Defense Forces

Distinguished guests, ladies and gentlemen: At the outset, let me welcome you all to this meeting and express my sincere gratitude to you for taking all the trouble to come all the way to the Kingdom of Bahrain to share with us the many essential topics related to the Disaster Preparedness and Response Conference. Please allow me, in this regard, to take this opportunity to convey to you all the very sincere welcome and wishes from his Excellency General Sheik Khalifa Bin Ahmad Al-Khalifa the Minister of Defense and Deputy Commander and Chief and General Sheik Mohammad Bin Abdulla Al-Khalifa Chief of Staff, Bahrain Defense Force for successful DP Conference and associated Medical workshop and for pleasant days that you will spend among friends and colleagues in this country. The Bahrain Defense Forces has taken the lead in arranging for such distinguished delegates and participating members from GCC, Egypt, Jordan, United States, Kuwaiti Ministry of Health and the Ministries of the Kingdom of Bahrain. We are proud to mention to you that this is the fifth meeting; in a series of four previous successful meetings, that I am sure was of great benefit to all. Our experiences have increased the core of regional experts and have expanded our collective technical knowledge base directly related to disaster preparedness and response. This meeting is a continuation of our five-year plan aimed at equipping our defense departments with the maximum knowledge and experience to combat any unforeseen situations and any such incidents that might reflect its catastrophic effects on all responsible authorities and services in any state. Therefore, I would like to give strong note of welcome to participants from other ministries. This all ensures regional coordination, improved information sharing capabilities, better evaluation and understanding of the associated infrastructure that supports disaster preparedness on a multi-lateral basis among military to military and military to civilian activities not forgetting the value of revalidation of regional and international threats and concerns in a world that has been attacked, disrupted, and harmed by man-made and natural disasters. 3

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Through this conference and workshop, I am pleased to state, and with greatest conďŹ dence, that our ability to make live demonstrations and succeed in working as one team will be successfully manifested. We have a head of us three remarkable days that I hope we can grasp the momentum to collectively enhance our experience, build and further strengthen our capability, not as individual nations but as allies and friends with common goals and objectives for a safe world. Thank you.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Opening Remarks Rear Admiral Robert T. Moeller Director, J5 Plans and Policy, U.S. Central Command

Welcome guests. It is a great honor to address such a distinguished audience. I would wager that everyone in this room is, by now, well aware of the perceived and actual dangers posed to all of our nations by natural and man-made disasters. While the threat of WMD is serious, it is not the sole threat facing forces and populations in the AOR. Petro-chemical plants near urban areas usually process and store tons of toxic chemicals, many of which are unstable and highly dangerous if not carefully controlled. An incident causing mass casualties could occur at any time, whether from terrorist action or industrial accident. Should these attacks or disasters include chemical, biological, or radiological components, the disaster preparedness and response challenges would be magniﬁed geometrically. We only need to look at recent history to realize that these dangers are not only real but also capable of producing signiﬁcant casualties and potential economic paralysis. Natural Disasters: -

The 1995 famine in Iraq resulting in over 800,000 affected.

The 1996 ﬂood in Yemen resulting in over 238,000 affected.

The 1999 and 2000 Jordanian droughts resulting in over 330,000 affected.

The 2003 earthquake in Bam, Iran resulting in over 30,000 dead, some 16,000 injured and 70,000 homeless.

Man-Made Disasters: -

The 1984 industrial sabotage attack of the Union Carbide plant in Bhopal, India that resulted in 16,000 dead and some 400,000 injured.

The 1990 – 1991 Iraqi occupation of Kuwait resulting in the destruction of over 700 oil wells, the intentional release of 11 million barrels of oil

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

into the Persian Gulf; this attack resulted in the economic loss of over $1.85 billion dollars and unknown environmental damage. -

The 1995 Sarin gas attacks in the Tokyo subway system killing 12 people and injuring over 5,000.

The August 2000 Gulf Air crash, that resulted in the death of 124 people.

The September 11th attacks against the World Trade Center and the Pentagon…though not NBC related…was a mass casualty event and killed over 3,000, injured thousands more, and sent our nation into an economic tailspin.

The Anthrax terror campaign waged in the months after Sept 11th attacks…the world’s ﬁrst major Bio-Terrorism attack…had signiﬁcant economic and psychological impact.

There is no doubt that natural and man-made disasters will occur sometime in the future – the question is when and where. Working together, we must strive to develop the most effective tactics, techniques, and procedures we can to provide our citizens the level of safety and security they deserve. Given this history – the question that we must now answer is: “How can we effectively prevent, prepare, and also respond in such a way as to mitigate the effects of any natural or man-made disaster?” I believe the answer to this question begins with your participation in the Disaster Preparedness (DP) Program. Recognizing that the DP Program is a framework, not necessarily a roadmap, to achieve our goal of mitigating the risk to our people, I strongly believe that we are moving in the right direction. A simple direction easily navigated by cooperation. Through regional cooperation, training and exercising our response capabilities, the Disaster Preparedness framework provides us the unique opportunity to build the required support, teamwork, and knowledge base we need in the event of a major national or regional disaster. The theme of this year’s conference is centered on preparing for and mitigating the effects of natural and man-made disasters. The key to our success will be to synergize our collective capabilities, expertise and efforts. Ultimately, this will make the difference between our success and failure. I applaud your participation in the Disaster Preparedness program, and encourage greater multilateral cooperation with each other and the U.S. The fact that we are all here tells me that our nations are willing to commit the 6

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

resources and time needed to meet the challenges of a coordinated response, to any disaster, regardless of its origin. Thank you all for your participation in this year’s conference. I hope that your participation proves rewarding and will strengthen our mutual commitment through this regional Disaster Preparedness program. Remember that what we are attempting to do is without a doubt of utmost importance. We are striving to develop the tactics, techniques, and procedures we need to protect our people, our families, and our innocent children . . . we should always remember this at the “end of the day” this will be our ﬁnal measure of effectiveness.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Opening Remarks Mr. Alex A. Beehler Assistant Deputy Under Secretary of Defense (Environment, Safety and Occupational Health)

I’m extremely pleased to be here in Bahrain for this important conference on Disaster Preparedness and the associated Medical Surveillance Workshop. I want to thank Crown Prince and Commander in Chief of the Bahrain Defense Force, His Highness Shaikh Salman bin Hamad Al Khalifa and the Bahrain Defense Forces for hosting this event. This is my first visit to the Gulf, but I have been told of the magnificence of Arab hospitality, and it has proven true in all respects! Its wonderful to be here with the United States’ good friends in Bahrain, the GCC Nations (stands for Gulf Cooperation Council), Jordan and Egypt, with whom we share so many interests. Some of these shared interests bring us together here to continue to build upon the work started with our first conference in June 2000. During that conference in Muscat, we all examined in some detail that there are issues in our environment that can strongly affect national, regional and global security. The worldwide demand for water is a prime example. Recently the United Nations identified nearly one hundred areas where water-related friction has already become an issue, and estimates show an increase in demand for water by at least 50% over the next twenty years. Certainly, you here in the Middle East understand this issue as well as anyone. While the Muscat meeting was informational in nature, it pointed out clearly that manmade or naturally occurring environmental disasters do not necessarily adhere to national borders. Even those that do occur in only one country can exceed that nation’s capacity to respond to the event or to the mitigation required in the aftermath. Cooperative mechanisms are clearly indicated. As a result, a second major conference was held in Doha in September 2002. With direct support from the Chiefs of Staff of each of the Gulf nations and from the Commander, United States Central Command, the second conference established four functional working groups with assigned obtainable objectives. The groups were first: “Defining Environmental Security and Setting Regional Approach Objectives”; second: “Environmental Security Intelligence, Detection and Information Sharing”; third: “A Regional Center

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

and Command and Control”; and finally: “Regional Training and Exercises”. It also, significantly, created an Executive Committee composed of flag officers from each nation, entrusted to develop policy recommendations and to ensure continuity of each of the four working groups. During the meeting, the need for a functional working group in Medical Surveillance was identified. Medical surveillance was correctly recognized as a major requirement in the prevention, response and mitigation of a majority of disasters. The Doha meeting was, of course, punctuated by the terrible events of the previous September and gave greater emphasis to the potential manmade events that might occur. The global war on terrorism has numerous facets and this challenge is one of them. As we meet here in Manama, we’ve had a name change – from Environmental Security to Disaster Preparedness, but the imperative is the same. We must harness all of our various resources to be able collectively to prevent these disasters from happening in the first place, but when prevention fails, to respond rapidly and effectively! One point that all of us fully recognize is that this is an interagency challenge. While your Defense Ministries and our Department of Defense can bring significant resources to bear, we are unlikely to be the first responders and – depending on the disaster – may not even be in charge of the response or mitigation efforts. Certainly our nations’ militaries can contribute heavy equipment and organized, disciplined manpower. But, the primary responsibility may reside with Interior Ministries, with fire and police forces or with dedicated disaster relief organizations such as the United States Federal Emergency Management Agency. Our Ministries of Health and Environment will be directly involved in disaster prevention, response and mitigation. There will be a requirement for our Foreign Ministries to coordinate the international effort. And, we shouldn’t forget that many non-governmental organizations and private voluntary organizations might be involved as well. What this means is that multi-national military coordination – highly challenging in or of itself – is not enough! We must design doctrine, procedures and capabilities that allow our defense establishments to make a constructive contribution in full coordination with multiple agencies of multiple nations. But, at the same time I know that the momentum established in 2000 and 2002 is in the correct direction. All of us understand the necessity of continuing that momentum here in Manama and beyond. And I know that we’ve got the right people working on it! 9

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

I want to thank each of your governments for sending you to this important meeting. My ofďŹ ce, along with U.S. Central Command, the U.S. Army War College and the Near East South Asia Center for Strategic Studies will continue to support this critically important endeavor. We greatly appreciate both the ownership of this program that you in the GCC, Jordan and Egypt have taken, as well as your willingness to allow the United States to continue to contribute. Working together we are going to save lives and contribute to regional stability. I wish you success in this challenging endeavor and I look forward with great anticipation to the report of this conference.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Chapter 2: Security and the Environment â&#x20AC;&#x201C; Regional Approaches The History of Disasters in Bahrain Dr. Abdulaziz Hamza, Under Secretary, Ministry of Health Oil Spill and Response Coordination Eng. Adnan S. Al-Mukhareq, Ministry of Oil, Kingdom of Bahrain Incident in Bahrain, March 2003 Eng. Abdel Nasser Adbel Aziz, General Directorate of Environment and Wildlife

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

History of Disasters in Bahrain Dr. Abdul Aziz Hamza Under Secretary of Health Kingdom of Bahrain

Dr. Abdul Aziz Hamza opened with the dictionary, United Nations, Arabic definitions. He explained the translation of the word disaster to English was very difficult. The word disaster was loosely translated as “Profound sadness.” He also emphasized an overlooked portion of man-made disasters termed nontechnical, which included religious influences and civil strife. He continued with significant disasters in Bahraini history: 1904 - year of “Al Rahma” – 5, 000 people died of Cholera 1925 - year of “Al Tabaa” – 5,000 people died during a rare hurricane 1940 - Bahrain attack by Italian air power. Dr. Hamza stated his surprise with the proficiency that the Bahrainis displayed during the response to this disaster and directly repelling the attacks. 1961 - The Hottest Summer. Heat Stroke was prevalent He spoke of many regional disasters that did not directly impact Bahrain, but illustrated the need for regional disaster preparedness. Dr. Abdul Aziz Hamza asked the rhetorical question, what is the cause of war? “Stupid things”. He also assessed war is a significant source of disaster. He also touched on the significance of the role media plays during disasters. He pointed out how the media can influence events as well as providing crucial survival information to the general population. Dr. Abdul Aziz Hamza closed his presentation with again emphasizing the importance of regional cooperation with regard to disaster preparedness.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Oil Spill Response and Coordination Engineer Adnan S. Al-Mukhareq Ministry of Oil, Kingdom of Bahrain

Good morning, and thank you for asking me to make a presentation at this conference. Among the most likely environmental disasters that can occur in this region is the oil spill. SO I would like to present to you some of the causes of spills, the clean-up techniques for them, and the contingency plans that Gulf countries have for dealing with oil spills. Sometimes, oil can seep into the water as a result of some kind of unavoidable event, such as an earthquake, but most often, spills result because of some kind accident caused by carelessness. Sometimes, vandals or terrorists can dumping oil and contaminants into the sea waters or contaminate the land, and, as we have seen in the past fourteen years, wars can cause damage to oil ﬁelds, or the deliberate release of oil onto land and water can be used as a tactical ploy to wreak destruction on the opponent for months to come. This chart explains some of the causes of accidental spills.

Incidence of accidental spills greater than 700 Tons by cause, 1974-2003, ITOPF

What about prevention? Effective prevention plans could include.

• • •

Improved piloting; training of ship and tanker crews Training of storage and pipeline facility crews Enforcing pollution rules at sea 14

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

• • •

Building more spill-resistant vessels Maintaining vessels and pipelines Preparing for spill response through effective training, planning (contingency planning), and practice drills.

The Arabian Gulf area is the site of major seawater contamination by oil spills. This is the route of shipment for more than 50% of the world’s total oil consumption.

After the oil spill that came at the end of the Gulf War in February 1991, problems of oil pollution in the Gulf became extremely important, because it was one of the most terrible consequences for both people and wildlife. This was the largest oil spill in human history and nobody will ever be able to determine the exact amount of spilled oil. The estimate ranges from 2 to 11 million barrels but 6 to 8 million barrels (about 1 million tons) seems most likely. Most of the oil washed ashore, and a continuous band of oil covered over 700 km of coastline from southern Kuwait to just north of Jubail. It destroyed vast amounts and forms of wildlife that live in coastal habitats. The Kingdom of Saudi Arabia, with the help of many countries and international organizations, managed to contain the spill.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Pollution of 1991 Gulf War hit sea wildlife severely

What happens to oil when it spills?

When a crude oil or petroleum product is spilled, it generally ďŹ&#x201A;oats because it is lighter than water. Many changes happen at once and the oil spill moves and spreads, and it becomes subject to a number of transports and transformation processes collectively termed weathering. 16

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

The fate of crude oil in the marine environment

Some mechanical forces such as gravity and interfacial tension effect the spill, and consequently, a horizontal expansion or spreading is occurred. Some of the oil, which is the lighter Hydrocarbons, will evaporate and transfer to the atmosphere. The water-soluble components of oil break down and dissolve and dissolution occurs. The sedimentation process occurs due to the force of gravity. I will now discuss several oil spill cleanup techniques:

Chemical dispersants (sprayed onto oil slicks)

Dispersants are chemicals that act like detergents to break oil up into tiny droplets to dilute the oil effect and to provide bite-sized bits for oil eating bacteria that occur naturally.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Containment and recovery of ďŹ&#x201A;oating oil using booms

Surround the oil with booms and recover the oil (for cleaning and reuse) with skimmers. Skimmers separate oil from the water.

Shoreline cleanup

High pressure hoses rinse oil back into water to be skimmed up. This usually does more harm than good by driving the oil deeper into the beach and by killing every living thing on the beach.

Burning

Burning causes black smoke, but it is not more toxic than if the oil were burned as intended in fuels Bahrainâ&#x20AC;&#x2122;s National Oil Spill Contingency Plan was developed under the authority of His Excellency the chairman of the Environmental Protection 18

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Committee pursuant to the amiri decree number 7 for the year 1980. Its purpose is to provide for a safe, timely, effective and coordinated response to any oil spills affecting the land and marine environment. The National Oil Spill Contingency Plan: •

Outlines Bahrain’s duties and the organization of its forces dedicated to responding to an oil spill on land and on Bahrain’s coastal and offshore waters, and what its primary tasks are.

•

Identiﬁes the role of the Public Commission for the Protection of Marine Resources, Environment and Wildlife as the lead agency for responding in cooperation with other responding bodies.

•

Establishes a Technical Advisory Committee (OSTAC) and Response Operations Section.

•

Provides a list for oil spill personnel and environmental resource specialists, and suppliers of equipment, services and materials.

•

Provides guidelines for shoreline survey, treatment and clean up; wildlife rescue and rehabilitation; media relations and public communications; waste disposal; and safety for everyone concerned.

Bahrain’s Response Strategy •

The Public Commission for the Protection of Marine Resources, Environment and Wildlife is the lead agency and have overall responsibility for the formulation and administration of the national policy to control oil pollution.

•

It is responsible for planning and coordinating response activities to control pollution from the discharge or spillage of oil or other harmful substances to the environment.

•

Each Government authority and industry is responsible for the protection of its own seawater intakes or other sensitive installations.

•

Each authority or industry should purchase, install, operate and maintain its own protection and cleanup equipment.

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BAPCO oil spill contingency team

As a quasi-government entity, the Bahrain Petroleum Company (BAPCO). has a mature oil spill response and contingency plan which is revised regularly, and implemented during oil spill incidents by a team of trained personnel from the different departments. BAPCO is a founding member of the oil spill cooperative organization GAOCMAO (Gulf Area Oil Companies Mutual Aid Organization) comprising major oil companies in the Gulf. The Bapco Oil Spill Contingency Plan is intended to assist Company personnel in achieving a rapid and effective response to any oil spill arising from Company operations. Its scope allows BAPCO to effect an appropriate response to a number of scenarios ranging from minor incidents to a major incident. It also recognizes BAPCO’s responsibilities under the Bahrain National Oil Spill Contingency Plan. The plan identiﬁes speciﬁc authorities responsible for initiating and carrying out clean up operations and provides guidance on activation and mobilization of resources and expertise to assist in clean up. Rapid action is essential to effectively minimize environmental damage arising from an oil spill.

Areas addressed by this plan are: •

Incidents arising within Bahrain Territorial Waters when a request for assistance is received from the Bahrain Government.

•

Incidents arising within all areas controlled or operated by BAPCO.

•

Incidents arising outside of Bahrain Territorial Waters but threatening Bahrain.

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BAPCO’s Oil Spill Response Activation Procedures Level 1: Assess the situation and combat the spill if it is within its capabilities. If more drastic action is needed, the BAPCO activates Level 2. Level 2: Assess the situation and put strategies and resources in place to combat the spill. Level 3: Full mobilization of Team including reliefs for crews and additional resources as needed for extended clean-ups. BAPCO & National Oil Spill Contingency Plan is implemented in conjunction with the National Oil Spill Contingency Plan. BAPCO is a member of the permanent Oil Spill Technical Advisory Committee (OSTAC) to the Government of Bahrain, which was established by the National Oil Spill Contingency Plan.

Regional Organization for the Protection of the Marine Environment

The eight coastal states of the Arabian Gulf region were aware for a number of years of the vital necessary to coordinate a common action to protect the semienclosed sea surrounded by them. On July 1, 1979, the regional organization for the Protection of the Marine Environment (ROPME) was established.. Chronology of the August 1980 Oil Spill (Before establishment of the environment protection committee) 1. On Aug. 25, 1980, large quantities of crude oil from unidentiﬁed source began invading the north and west coasts of Bahrain. 2. Reports from ﬁshermen and coastal zone residents alert the authorities. 3. All oil-carrying pipelines and vessels in Bahrain’s waters were checked immediately for the spill source, with no results. 21

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

4. Samples taken from the spill showed that its characteristics were similar to that of Arabian light crude. 5. On the morning of Aug. 26, BAPCO representatives met with government ofďŹ cials to discuss. 6. As the magnitude of the spill became apparent (app. 20,000 bbl), H.H. the Prime Minister requested the establishment of a ministerial subcommittee to handle the cleanup operations under the chairmanship of the Minister of Health. 7. The minister requested BAPCO to undertake coordination of oil spill cleanup activities on behalf of the government. 8. BAPCO immediately agreed. 9. The cost of the operation totaled approximately 1.3 million Bahrain Dinars.

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Sea-borne Oil Incident in Bahrain, March 2003 Eng. Abdel Naser Abdel Aziz General Directorate of Environment & Wildlife Kingdom of Bahrain

Initial Notiﬁcation: On Saturday 15th March 2003 the Flying Wing Division at MOI notiﬁed a noticeable oil spill at the north of Fashet Al Jarhim

Response • • • •

The coastguard was asked to check the spill’s existence and its type. Water & Power stations were asked to protect their water intakes. The Port Authority was informed about the spill. A trajectory model was used to estimate the spill’s movement

Situation: By Sunday 16th March 2003 the spill was observed by air surveillance to be at the east of Fashet Al Jarhim.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Response • • •

The coastguard was asked to follow up the spill. The Water & Power stations were again reminded to protect their water intakes. A trajectory model was used to estimate the spill’s movement.

On Monday, 17 March, air surveillance observed that the spill had broken up into patches that were located between Fashet al Jarhim and Fashet al Debeal. A trajectory model was used to estimate the spill’s movement. The wind data provided by the Meteorology Directorate showed that the wind speed for that week would be variable and not less than 10 KN. By Tuesday 18th March 2003 oil reached the east and north of Muharraq Island coasts. • • •

A survey conducted by port operations reported 4 locations polluted by oil. A meeting with the Municipalities and their contracts was held to start the cleaning operation. Containment booms were provided to the contracts.

Containment Boom

Shoreline contamination 24

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• •

Samples taken for source investigation. Back-up booms were requested from KSA through MEMAC.

A second oil spill

Another notiﬁcation was received on Friday 21st March 2003 from both FWD & MEMAC about another oil spill to the west of Bahrain. As this spill was incomparable with the last one, and the lesson was learned, MEMAC was requested to arrange for aid from the region.

The response from KSA was fast and a skim-boat was provided from SAUDI ARAMCO. 25

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

It took around 47 working hours to ﬁght the spill by this vessel.

These actions proved that the Contingency plans were up-to-date, familiar to all concerns parties, applied quickly. Practicing these contingency plans paid off! Lessons learned: •

Contingency Plan – Updated – Familiar – Exercised – Executable

•

Equipments – – –

Have the minimum requirements Maintained Operate-able

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Documentation of the oil spill and the clean up actions should be wellorganized and include – – – – –

Video Tapes Photos Written reports Inventories of supplies and equipment Daily log sheets of actions taken and times

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Chapter 3: Disaster Preparedness Strategy Proposed Five Year Disaster Preparedness Strategy and Regional Disaster Response Coordination Mechanism Mr. Mike Shaw, Chief, Counterproliferation Division, J5, U.S. Central Command

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Regional Disaster Preparedness Strategy Proposal Mr. Mike Shaw Chief, Counter-Proliferation Division, Plans & Policy Directorate, US Central Command

Good Afternoon and thank you for attending this important conference. In order to build on the efforts in disaster preparedness that have been accomplished so far, I would like to present a strategy proposal for implementing a Disaster Preparedness program that supports regional stability and security objectives of the GCC states, Egypt, and Jordan. Most importantly, todayâ&#x20AC;&#x2122;s objective will be to auger a way ahead for 2005. This strategy proposal is a combined effort, not a United States effort. Its aim is the development of a regional DP capability, which also includes bilateral proposals. We plan to submit the results of this conference through the Security Assistance OfďŹ cer and will provide you a revised strategy proposal that you can discuss with your leadership. Throughout the year we will continue to modify the strategy. Disaster preparedness (DP) consists of civil-military activities that effectively prevent, prepare for, respond to, and/or mitigate the effects of manmade and natural disasters. The strategy is designed to improve DP capabilities nationally and regionally throughout the Middle East in order to build offensive regional capabilities, prevent and mitigate effects of man-made and natural disasters, and enhance the regional stability, and save lives. A regional DP capability is important because it maximizes the availability of high demandlow density skill sets and assets that exist in the area, enhances interoperability if disaster affects many countries, and improves the ability to respond to potential threats. In past conferences, we agreed that we need some type of regional disaster response capability. We need to develop a regional civil military DP program that leads to the creation of a regional DP mechanism to effectively respond to disasters, enhance regional stability, and save lives. Such mechanisms could be a permanent command and control site or a rapid response force. Multilateral activities should focus on an all purpose mechanism concept that will be cost effective, easier to design and implement, eliminate overlaps in training and resources, and maximize ďŹ&#x201A;exibility. Bilateral activities will focus on the secondary effort of enhancing national DP capabilities across the national and operational levels that support the regional DP mechanism. Civil-military cooperation will be both essential because a regional DP Operations center will involve an unprecedented level of ministerial coordination. No one organization contains 31

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

all the expertise or equipment to single handedly respond to a regional incident. Therefore, we must use all organizations for effectively plan for a regional DP program. Due to scarce resources and the nature of this region, this effort should develop a regional training program that supports the disaster preparedness mechanism. It should be based on the likelihood of the event. Therefore, we should agree on the threats that the region faces. Once prioritized, the near term training focus will be to develop first responder level training that is based on those threats. This will build a pool of technical skills. Next, we can enhance those skills through specialized training while conducting operational level tabletop and small force exercises. Finally, we can conduct strategic level regional DP exercises. The near term goal is to develop regional procedures for disaster preparedness. With the common regional threats identified, we must identify the type and level of regional support, such as medical, logistical, and engineering assets, from which we can also create a coordination list with points of contact. There are resource and political challenges we must face, but we should not wait for these issues to be resolved. We can start to draft regional procedures and scenarios in the meantime to develop a regional procedure that can be tested and refined. If this is not possible at this time, then we can at least develop a concept for some kind of a regional response center. Now is the time to start so we can gain some momentum. A regional DP center -- will it be a permanent site, a rotational site, or multiple sites? Will it be established in the country that suffers from an incident with other supporting countries offering liaison officers to assist? The DP five-year plan should be a building block approach that enhances regional DP readiness over the five-year span. It begins by developing a mechanism and a regional coordination center concept while conducting regional and bilateral DP related activities. The 2005 road ahead should start by finalizing the DP strategy and fiveyear plan. We must continue the feedback cycle and guidance from host nation leadership through their host nation representatives. Perhaps this can be achieved this year through aggressive DP task force and follow-on meetings. Meanwhile, we must continue to conduct DP supporting activities such as exercise EAGLE RESOLVE 05, the regional medical workshop, and future DP conferences. We must continually examine the components and find a common ground to devise an effective plan and then put it into practice.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Chapter 4: Results of Medical Workshop Brig. Gen. Annette Sobel, M.D., National Guard Bureau, and Mr. Mohammed Ash-sharhan, Director, Emergency Medical Services, Kuwait

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

OUTBRIEF OF THE MEDICAL SURVEILLANCE WORKSHOP 27 SEPTEMBER 2004 Brigadier General (Doctor) Annie Sobel (USA) Mr. Mohammed A. Ash-Sharhan, Director, Emergency Medical Service (Kuwait)

Brigadier General (Doctor) Annie Sobel thanked CENTCOM and the Kingdom of Bahrain for inviting her to participate in this week-long conference. She then added that the purpose of the Medical Surveillance Workshop was to enhance the disaster preparedness responses of Civil Defenders within the Gulf Region. Specifically, the workshop hoped to accomplish these objectives: 1. Build a regional baseline of disaster preparedness and medical surveillance capabilities, 2. Define requirements for information sharing 3. Define future opportunities for environmental security coordination and cooperation 4. Identify critical shortfalls and gaps for regional disaster preparedness 5. Prioritize action items necessary for sustainable regional disaster preparedness 6. Define measures of success Attendees at the Medical Workshop then split into four groups for a focus group exercise. Upon completing this exercise, the participants decided upon the following recommendations for future conferences and workshops: 1. to establish a regional coordination center for training and operations, 2. to establish programs that guide standard practices and professional credentialing among the countries in the Arabian Gulf region, 3. to develop a plan for regional exercise that will take place twice a year, 4. to develop a common operating system for communications, early warning and medical surveillance. Here are the recommendations from each focus group.

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The Medical Practices Group was chaired by Dr. Firas Hussain of Bahrain and Dr. Abdul aziz Al Muhairi of the UAE. Following active discussion, the panelists recommended: •

that the Gulf countries of the region establish a regional coordination system to include medical surveillance of the public health, diagnostics, training courses, uniform professional standards, and uniﬁed disaster planning and response actions,

•

establishing partnerships between local institutions, national ministries, regional organizations that also include international organizations, such as the World Health Organization and related non-governmental organizations, and

•

establishing a regional network of experts and rapid response and training teams.

The Intelligence Group was chaired by Colonel Sami Al Essa of Kuwait and Dr. Dana Focks of the USA. These panelists discussed and then recommended •

establishing protocols and agreements for regional sharing of information and early warning of infectious disease outbreaks from intelligence organizations

•

multi-faceted communication system within Gulf Cooperation Council

•

establish uniform reporting procedures

•

use all news media for the purposes of media for education and public awareness

•

disseminate lessons learned from historical events.

The Medical Operations Group was chaired by Lieutenant Colonel Ismail A. Rahim of the UAE and Colonel Douglas Robb of the United States Central Command. This group recommended the following practices and institutions be put in place: •

Establish a regional center for rapid sharing and archiving of medical intelligence, to include media sources

•

Develop a prioritized strategy to assess risks to the region 36

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

•

Establish a regional control center and uniﬁed GCC regional response plan

•

Develop and execute a plan for two exercises a year that are integrated with regional disaster planning meetings to develop a regional template.

The Training Group was chaired by Colonel Mohd Ibrahim of Qatar and Dr. Wajdy Hailoo of the USA. This group presented the following recommendations: •

Establish redundant, interoperable regional communications and common operating systems

•

Encourage Management Support at all levels

•

Increase Resources, Equipment, and Facilities

•

Establish Regional Training Center under the auspices of the Gulf Cooperation Council

•

Clearly deﬁne priorities and standards

•

Create standardized training systems for regional Early Warning and Disaster Response

•

Hold a GCC Country meeting of Ministries to build an exercise training roadmap that focuses on prioritized risk assessments

All agreed that local disasters have the potential to create varied and widespread effects. These harmful consequences can be less sever through pre-planning, building capacity in the Gulf region, and by developing systems for medical surveillance and early warning.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Chapter 5: Reports/Recommendations from Working Groups Executive Level Policy: RADM John Sigler (USN, ret), Near East South Asia Center, U.S. National Defense University and Dr. Kent Butts, Center for Strategic Leadership, U.S. Army War College Regional Resources: LTC Kenneth Deal, Defense Threat Reduction Agency Regional Disaster Response Preparedness Capacity Building: Professor Richard Winslow, Center for Strategic Leadership, U.S. Army War College Regional Medical Security Preparedness and Response to Disasters: Professor B.F. Griffard, Center for Strategic Leadership, U.S. Army War College

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Working Group on Executive Level Policy Special Advisors: RADM John Sigler (US Navy, Retired), Near East South Asia Center, U.S. National Defense University and Dr. Kent Butts, Center for Strategic Leadership, U.S. Army War College

Goal: To review and agree upon a proposed 5-year Strategic Plan Objectives: •

Reﬁne the 5-year Strategic Plan

•

Review and gain full understanding of regional policy and security issues

•

Deﬁne Regional Coordination Center requirements. Approach this by examining existing cooperation, coordination, information-sharing capabilities, and associated infrastructure that support disaster preparedness on a multi-lateral basis among Military-to-Military and Military-to-Civil authorities.

Discussion: The Regional Co-chair was MAJ Adel Ahmed Algaoud of the Bahrain Defence Force. Representatives for Bahrain, Qatar, Kuwait, Oman, UAE, Jordan, Egypt and the USA participated. The USA is not the lead in this effort, but is acting as a facilitator and making a proposal for regional approval. CENTCOM is facilitating in drafting a Disaster Preparedness strategy to meet regional approval from combined thoughts from previous meetings. Bahrain, UAE, Oman, and Qatar agreed that the 5-year plan is adequate and should be ﬁnalized for implementation. Egypt did not have an opinion on the plan. The previous meeting in Doha, Qatar agreed upon the need for a Regional Coordination Center (RCC) and the speciﬁc requirements of the RCC would be discussed in follow-on meetings when the Regional Response Plan (RRP) takes a draft form. Some requirements were spelled out such as: •

A data base is essential for coordination but what type of elements are in the data base as well as what communications systems will be used throughout

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

the region. All agreed that there would be sensitivities regarding the types of information that could be shared. •

Attendees discussed priorities for sharing information and researching the use of existing ﬁber optic GCC connections to use as common electronic media. CENTCOM proposed a look at other joint and combined examples of connectivity throughout the world such as NATO.

•

Civilian entities should be involved in the planning process of the RCC and RRP. Stafﬁng the RCC would be dictated by the incident involved and a regional POC coordination list for disaster preparedness would be created in order to call in designated, specially trained responders.

Kuwait, UAE, and Bahrain endorsed the ﬁve-year plan. Oman requested time to further study the plan. Jordan and UAE also desired more details before they commit. The policies and agency in charge for national response to a disaster varies by country from Ministry of Defense to Ministry of Interior. Kuwait plans on the MOI to control disaster response. In Jordan, the Ministry of Defense is in charge of the national center. In UAE, each Emirate has a local agency in charge of any disaster suffered in that Emirate, and if the disaster exceeds the capability of that emirate other emirates are called for assistance. However, there is a federal agency that manages overall response to disasters. All countries agree that military and civilian agencies will have to work together in creating the regional coordination center and a response plan. The list of regional threats compiled from the last meeting in Doha was revalidated with Jordan’s addition of the uncontrolled migration of refugees. This resulted from Operation Iraqi Freedom. Several countries expressed an eagerness to start actions in drafting the strategy and plan. The majority also agreed that it is time to culminate the previous four years of meetings into the drafting of a regional procedure. A proposal for the next meeting would require all nations to bring their national procedures together in order to glean best practices. These could be used to draft a regional operating procedure, which can then be tested in a tabletop exercise. Attendees proposed that the next meeting focus not on lengthy documents but to explain each country’s response mechanisms for when they receive assistance or give assistance to other nations. The meeting should present a common understanding of each nation’s mechanism for crisis response. The need for a Regional Coordination Center (RCC) was unanimous; in fact most countries currently have an existing RCC of some sort. Many unanswered questions on the RCC remain: type [permanent, virtual, rotating, 42

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

or mobile], manning, Control and communications systems, general equipment, procedures, location, and even in what phase of task force discussions shall these issues be addressed. It was agreed that a separate work group should be conducted to tackle the multitude of complex issues once a draft regional procedure is created that identifies the regional response requirements. Qatar informed the group of a meeting in Riyadh over the past year where Saudi Arabia has already initiated GCC discussions on a regional response plan. A plan has been drafted however it is not operational because it lacks the final element - creation of a regional coordination center. Qatar has agreed to brief this plan at the next Disaster Preparedness conference. The Center of Naval Analysis has also worked on a regional response plan for the EAGLE RESOLVE exercise in May, 2005. Center for Naval Analysis’ plan has been completed and is currently getting approvals at the executive level of the organization. The CENTCOM Disaster Preparedness Branch Chief will request the Center for Naval Analysis to brief their template at the next disaster preparedness conference. This panel presented the following briefing slides to the conference attendees: KEY ISSUES • • • • • •

Disaster Preparedness Five Year Plan accepted – Time for action • Future Workshops develop details/milestones Regional DP threats reviewed and conﬁrmed – Uncontrolled Migration added Regional and National SOPs – National best practices on DP and early warning – Topic of follow-on DP Task Force meeting NESA Center educational opportunities – Educate populace for disaster mitigation Regional Coordination Center – Type: virtual, permanent, mobile – Location: permanent, rotating, distributed Data Base Development (Management Information Systems) – CENTCOM model (CENTRIXS) – Data elements – GIS – Security 43

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ROAD AHEAD •

Short-Term (6 – 12 months) – Conduct Regional Response Plan (SOP) development workshop (Mar 05) • Introduce Riyadh GCC Response Plan • Brief National Response Procedures (including data requirements) • Brief CNA GCC Response Template • Brief CENTCOM J6 CENTRIXS for data requirements – Develop draft Regional Response Plan (RRP) – Submit draft RRP to regional decision makers for review – Identify Regional Coordination Center requirements • Type, location, manning, equipment – Conduct scheduled EAGLE RESOLVE 05 (May 05) • Collect ER 05 Lessons Learned for draft RRP refinement – Refine draft RRP (Jun 05) – Conduct Regional scenario driven table top (Oct 05) • Test draft RRP • Identify C2 requirements – Crossing national and ministerial seams – Submit final draft RRP for GCC approval

•

Mid-Term (2005 – 2006) – Follow-on EXCOM meeting – Agreed upon RRP – DP exercise plan – Multilateral and bilateral training workshops – Identify regional centers of excellence

•

Long-Term (2007 – 2009) – Regional Coordination Center Operational – Annual DP exercise – Maintain Regional Response Plan

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Working Group on Regional Resources Advisor: LTC Kenneth Deal, Defense Threat Reduction Agency, International Counter-Proliferation Program (TBD)

Goal: To identify regional resources needed to prevent and mitigate terrorist effects, trafﬁcking of WMD, man-made and natural disasters, and managing the consequences of those disasters. Objectives: •

Understand the role of national and regional military support to national organizations responsible for planning, prevention, mitigation and response to disasters.

•

Examine actual and perceived global patterns of international trafﬁcking of hazardous materials.

•

Determine the requirements for helping regional agencies to detect, interdict, identify and investigate illicit trafﬁcking of WMD and related materials.

•

Share information regarding port security and establish requirements for future information exchanges.

Discussion: This working group selected COL Mohammed al-Faresi of Kuwait to be its co-chairman. This working group discussed several issues, all centered on deterrence, detection, and interdiction of Terrorist or Natural disasters (physical and man-made disasters such as earthquakes, oil spills and terrorist attacks). After many case studies and creating large databases of information the Crisis Management Five-year plan and project was started. This plan allocates funds from the central government to accounts controlled by each ministry department designated cash management representative, which is directly responsible for the particular disaster. This includes involvement from three or more services (various departments) across the ministry. This proved to be very successful and allowed auditing after spending which was very efﬁcient. The Ministry of Finance reviews and audit every line item to ensure proper record keeping for all money spent after the disaster.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

The members of this working group believed that no bad decisions are made during a disaster or terrorist attack. Each individual team leader has ownership of decision on the spot. It is better to be proactive and make onthe-spot decisions than be passive and let the tragedy continue throughout the country. One main concern was to establish a database which allow for information sharing across the spectrum, not just in certain areas of responsibility, creating a greater net of security. This group felt that the key threat came from the transport of hazardous materials, rather than from the effects of any disaster caused by the weather. Drought, and the depletion of underground water aquifers and natural springs in the region is a situation that all countries should try to address regionally. However, this condition would not be considered a disaster. Here are the brieﬁng slides that this working group presented to all the attendees at the conference: KEY ISSUES Vulnerabilities: HAZMAT (ammonia, chloride, LPG, Radioactive materials, oil, arms, HE) • •

• • •

Issue #1 Current Status: “Satisfactory with room for improvement and modernization” Issue #2 Indications and Warnings – Early Warning – Shared Information – Public Awareness Issue #3 Veriﬁcation Issue #4 Crisis Management – National and Regional Command and Control Issue #5 Training Capacity – Standards, Requirements, Obligations

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

ROAD AHEAD - TRAINING •

•

Short-Term – National • Workshops and tabletop exercises (inter-ministry) • Specialized team training • National Management Training (National leaders) – Exchange of Experts (PME, Lessons Learned, Observers) Mid-Term – Regional • Workshops and tabletop exercises • Strategic Management Training (Regional leaders) • Exercise capabilities (simulated and live) Long-Term – Global • Workshops and tabletop exercise • Integration of Global Systems

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Regional Disaster Response Preparedness Capacity Building Advisor: Professor Richard Winslow, Center for Strategic Leadership, U.S. Army War College

Goal: To strengthen regional capabilities to prevent, prepare for, respond to, and mitigate the effects of a man-made or natural disaster Objectives: •

Identify and discuss similarities and relationships of Disaster Preparedness and Consequence Management

•

Determine the requirements for regional professional training development of mid-level and tactical level ﬁrst responders

•

Examine current exercise and sustainment activities and identify options for further program enhancement

•

Determine the requirements and make recommendations for developing future cooperation, coordination and collaborative planning requirements for disaster response across regional ministries (Civil and Defense)

•

Identify and deﬁne the speciﬁc roles of military support to civilian authorities in response to a regional disaster

•

Understand the mechanisms for disaster response (internal, regional, international and non-governmental)

•

Strengthen the coordination framework through information sharing

•

Explore the capabilities and limitations of the international community’s humanitarian response to disasters

Discussion: The following countries were represented: Bahrain, Jordan, Kuwait (by USOMC), Oman, Qatar and the UAE. LtCol Saad Mohamed Al-Ali (Qatar) was selected as co-chair and LtCol Hamad A. Al-Noaimi (Bahrain) was selected as presenter. Goals and objectives were briefed with particular attention paid to short, mid, and long range objectives in the areas of training, exercises, planning, and information sharing. Following the initial comments, LTC Bruggeman (USMC) 48

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

from the Chemical Biological Incident Response Force (CBIRF) presented a brief whose main points were: •

Lifesaving Organization

•

Incident Response Forces (IRF’s)

•

Mission Executed in Contaminated Environment

•

All Capabilities for WMD Mass Casualty Events

•

Self Contained and Flexible

•

Incident Command and Military C2 System

•

Operates in Inter-agency Environment

•

World Leader in WMD-Mass Casualty TTP’s

Dr. Winslow followed by canvassing the attendees with regard to their experience operating a disaster response operation center. The experience levels varied with Jordan having the most experience, 3 yrs and Oman having the least. Oman’s disaster response is limited to their Army only. Dr. Winslow explained the working group was for the beneﬁt of the attendees and the U.S was available to lend any support necessary. The discussion on training was initiated by the Facilitator with the following questions. What is the risk assessment? At what level is the training to be conducted? And, who needs to be trained? The Jordanian representative stated the expectation should be for all countries involved to be prepared for all types of disasters. The consensus of the group was all countries should maintain an overall minimum essential capability to respond to all contingencies, however those members that have a less likely chance of an event occurring (snow) they would require help from a member nation. The Bahraini representative pointed out the need for standardization and an establishment of a sequence in training. The Jordanian representative suggested the short-term goal for training should be conducting a self-assessment. The Qatari representative disagreed and suggested the shortterm goal should be the establishment of regional training standard. The group agreed with this proposal and the following goals were established: Short Term: Establish regional training standards Mid Term: Each participating country should apply these standards to their internal training 49

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Long term: Establish a regional operations and training center that will provide the training standards, a qualiﬁed staff to train national trainers and oversight of training region-wide. The discussion on exercise goals started with an explanation of the close relationship of training and exercises. The Bahraini army representative voiced concerns of who would train the trainer and who will provide the trainer. His questions were answered with the proposal of an interim committee and an eventual regional operation center. The Jordanian representative recommended information sharing should be a priority. The Bahraini representative (medical corps) suggested semi-annual exercises should be conducted with rotating locations and scenarios, based on the current risk assessment. The group felt that semi-annual exercises are too ambitious and the annual exercises would be more practical and sustainable. After some discussion, the group agreed on annual exercises. MAJ Yaqoob (BDF Medical) restated the need to based exercises on risk assessments. The facilitator paraphrased his comment to ensure understanding and validated the assertion that risk assessment is not static and must be continually updated. The facilitator pointed out the need to identify what country has existing capabilities and to build complementary capabilities rather than duplicating existing capabilities in the region. The Jordanian representative felt that all countries should have some capability in all areas. After extended discussion, the group agreed that all countries should have a base-level (minimal) capability to deal with threats identiﬁed by its risk assessment but that they should rely on neighbors for backup, reinforcing capabilities. The following exercise goals were established, and briefed to all attendees: • Short term: Conduct National exercises •

Mid term: Conduct Bi-lateral exercises (example: SA-KU or BA-QA) US involvement possible but not necessary in all cases,

•

Long term: Conduct Multi-level exercises (All GCC, All GCC plus Egypt, Jordan, US)

Dr. Winslow explained the concept of bi-lateral exercises to rotate through neighboring countries rather than repeatedly conducting exercises with same partner. The group also recognized the need to have a set of threat scenarios based on the risk assessments and the need to rotate through the scenarios. When establishing goals for training and exercises, the discussion brought to light that the ﬁrst requirement is to have a set of plans based on the risk 50

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

assessment. Plans establishing requirements for capabilities and training should focus on developing capabilities identiﬁed in the plans, with exercises designed to validate the plans and assess the state of training. All agreed, and planning goals became the ﬁrst priority in the sequence of regional disaster preparedness. LTC Moore of United States Special Operations Command, Central (SOCCENT) also recommended providing some type of education forum for the decision makers in order for them to understand the process. The Jordanian representative added they have a defense college that addresses such issues. And follow on conferences should be held. The Bahraini representative (army) disagreed and recommended the proposed committee should be the executive agent for all issues dealing with regional disaster preparedness. The discussion shifted to the formation of the committee. The group recognized that while this series of conferences has been productive and has developed good recommendations, implementation will require a standing oversight body. All agreed it has to have a written charter and the composition of the members should be clearly stated. It would also have to have appropriate administrative staff to preserve its records and disseminate information to the members. The work group briefed the following planning goals to all attendees: •

Short term: Establish a DP planning, training and exercise committee at the GCC level with members appointed for at least two-year terms.

•

Mid term: Committee becomes executive agent for regional disaster preparedness issues.

•

Long term: Committee become core staff of regional operations and training center.

The ﬁnal discussion point pertained to information sharing. Dr. Winslow explained information sharing was essential for all concerned to have a common understanding, situational awareness coupled with a need to share lessons learned. All agreed. During the ensuing discussion, additional needs were identiﬁed to have a shared geographic information system, a database of regional experts and of existing disaster response capabilities, and to develop protocols and procedures for sharing early warning information. The working group established these goals for sharing information and briefed them to all attendees:

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

•

Short term: Develop a database accessible to all concerned that includes: Situational awareness/common operational picture DR capabilities Experts Lessons learned

•

Mid term: Develop a geographic information system (GIS)

•

Long term: Establish a research division, which will reside in the regional operations and training center.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Regional Medical Security Preparedness and Response to Disasters Advisor: Professor B.F. Griffard, Center for Strategic Leadership, U.S. Army War College

Goal: To strengthen the medical capability to mitigate the consequences arising from man-made disasters Objectives: •

Discuss practical means, especially medical surveillance, to reduce human, infrastructural and environmental consequences of disasters arising from man-made incidents, and to promote civil-military cooperation

•

Review civil-military cooperation, especially the medical component, for ﬁrst-response and subsequent response to disasters

•

Medical infrastructure reinforcement including hospital surveys, biological mobile labs, medical logistics and sustainment training.

•

Identify and prioritize regional threats and concerns.

Discussion:

The Regional Medical Security Preparedness and Response to Disasters work group discussed means to strengthen the medical capability to mitigate the consequences arising from man-made disasters. Participants included representatives from Egypt, Bahrain, Kuwait, Jordan, Oman, Qatar, the United Arab Emirates (UAE) and the United States. As a guide to the discussion the facilitator, Professor B.F. Griffard from the Center for Strategic Leadership, U.S. Army War College, introduced the work group objectives and recommended they be used as a discussion guideline. Medical Surveillance

A key area of medical security awareness and response is a medical surveillance capability. The ﬁrst order of business was for the work group to agree on a working deﬁnition of Medical Surveillance. As pointed out 53

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

by the US Department of State (DOS) representative, medical surveillance can mean different things to different people and under different conditions. His concern was that medical surveillance is not only a survey method to track trends, but also a capability to provide ongoing information. The State Department representative also pointed out that it is important to understand that everyone’s (each user country) needs are different and this requires customized information links. A measure of success for medical discussions in the GCC would be the standardization of definitions, information control, and share and store procedures. There must also be a realization that there is a subtle difference between incident mitigation and incident management. Management infers treatment, while prevention/mitigation infers active intervention before or after an incident. The State Department classifies surveillance as either active or passive. As a starting point, the work group agreed to work under the accepted United States Centers for Disease Control definition of Medical Surveillance for this discussion. “ Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of data (e.g., regarding agent/hazard, risk factor, exposure, health event) essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.”

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Following agreement on the definition, a US representative from the Edgewood Arsenal (a sub-post of Aberdeen Proving Ground, Maryland) discussed Edgewood Chemical Biological Center’s environmental surveillance capabilities. He reviewed the Forensic Analysis Center, a multi-agency for primary chemical analysis, capabilities. He pointed out that in the U.S. the individual States are well trained, but slightly different in their approaches. Confirmation of agents such as anthrax is very labor intensive. A betterautomated system is needed to raise efficiency. Decontamination is also labor intensive, inefficient and expensive. He further described the mobile surveillance laboratory capabilities available in the U.S. This presentation was later reinforced by a presentation on the USMC’s Chemical Biological Immediate Reaction Force (CBIRF). Consisting of two reaction forces: a one-hour ready force (120 men); and a four-hour ready (200 men). The CBIRF is designed to help first responders in first eight hours of an incident. It is capable of detection (~120K toxic industrial chemicals, all known chemical warfare agents, and 8 biological agents), ID, EOD, surgical, extraction (trench/high angle), decontamination extraction, SAR. Its Medical unit operates in “warm” zone to triage and initial decontaminate victims for transport to a medical facility. It is transportable by road, rotary wing, fixed wing, and amphibious craft. 55

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

In both cases these presentations spotlighted the U.S. capability to move surveillance capability to the incident site; a capability that fits into the U.S expeditionary military strategy. This contrasts with the GCC members fixed site capabilities. It raised the issue as to whether there was a mobility surveillance requirement in the GCC? If so, should this be a regional capability provided by a designated nation? Identification and Prioritization of Regional Threats and Concerns Given the below listed threat areas: •Air •Water •Vector •Ground •Radiation Representatives of each country were asked to disclose what they felt could cause their most significant man-made disasters, from a medical response perspective. In general, the participants were concerned with the health dangers posed by either accidental or terrorist induced industrial incidents. Egypt focused on the consequences of mishaps at industrial plants resulting from the dumping of industrial wastes, destruction from terrorism and damage from sandstorms. The sandstorm issue was further expanded on by Oman. These storms can send all sorts of bacteria and toxins into the air and can cause many pulmonary and eye-related illnesses. Kuwait added that a lack of training, which could lead to accidents at oil refineries, is a major vulnerability there. The representative from Jordan said that any industrial accident that releases hazardous material could cause several medical problems, and these facilities are found through the country. The Qataris added that industrial accidents and nuclear medicine wastes could cause contamination of the drinking water, to which his country could be vulnerable. The representatives from Bahrain suggested that any mass casualty event overwhelming hospitals could be considered a medical disaster and suggested joint exercises to practice a national response to this contingency. All representatives agreed that countries should practice against self-determined threats under a national or regional authority. Standards need to established and enforced, and water contamination by industrial waste must be tracked to its source in the same way that oil spills are traced to their source.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Participants also discussed the various thresholds for a regional event, and the necessity for a threat based response. Regional response capability is required when the primary event crosses borders (e.g., radioactive/chemical cloud), or when a single country event overwhelms a nation’s resources. A recent example was the SARS crisis that required regional cooperation. Medical Infrastructure Reinforcement: Hospital Surveys, Biological Mobile Labs, Medical Logistics And Sustainment Training. To support the leveraging of capabilities in the region participants provided a quick overview of their processes and capabilities. The Kuwait Ministry of Emergency Services coordinates agencies and hospitals. CB capabilities added prior to OIF. Tested with coalition forces and hospitals. Not completely satisfied with information handling and is looking for more automation. Kuwait has 24hr response team. Jordan has effective coordination between first responders and the hospitals. CB and decontamination capabilities come from the military. There are written procedures that are practiced and followed. In Oman, the Ministry of Environment is in charge with Civil Defense handling small events. Following the Gulf Air crash, Bahrain formed their Disaster Committee and Disaster Command Center. These organizations meet and train together several times a year. The BDF is the first responder and coordinates with the Navy and holds regular exercises. They are working to improve and automate information exchange. Qatar has three committees that form a National Defense Advisement Center. They have initiated development of a computer automated information system, but it still needs improvement if it is to provide effective information exchanger during an emergency. The UAE uses its current infrastructure and established training schools to address the issues. In Egypt the Armed Forces play central roll in all emergency response programs. USCENTCOM is on standby for requests from country or regional center. Each country has better ability to process the problem. Can help with training country personnel. Existing tools in Gulf: GCC Civil defense exercises occur once a year. As mentioned above a limited CBRNE laboratory capability exists in the region. At present it is a question of acquiring the suitable equipment and them determining whether this capability is required to be mobile. It was accepted 57

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

that the Laboratory capability was essential if proper and timely action is to be taken on a regional basis. A critical shortfall in the establishment of a Regional capability is the absence of standardized information sharing requirements. How, what, and where is a point of debate. PROF Griffard discussed the option a a “virtual” medical coordination center that could feed information to a virtual or ﬁxed Regional Incident Coordination Center. It was suggested by the participants that the RCC should be information based where the key personnel would move to the country where the incident had occurred and just plug into the database. Civil-Military Cooperation Participants were polled on the levels of civil-military cooperation in each country. Bahrain: The Ministry of Health/Military are separate but cooperate ion incident response. Other agencies info: wx, food supplies (FDA) predict famine etc. Immunization records forecast future outbreaks. First Responders in Bahrain is the Bahrain Defense Force, to include chemical-biological response. Qatar is Civil Defense force. Larger events handled by Armed Forces. Identiﬁed training improvements. The possibility of establishing regional centers of excellence for training was discussed. Some existing schools that might be the basis for such regional centers include: •

Egypt-First Responders

•

Qatar- Training courses

•

UAE-Exercises with other countries (medical)

•

Kuwait-Technology/First Responder exercises.

•

Egypt and Japan identiﬁed as having basic medical surveillance to help other countries.

ESOH: Help military & other countries as broadly as possible. Don’t get locked into ﬁxed procedures as ﬂexibility is key. The GCC should focus individually (country) then regionally comparing capabilities to identify any excess capacity that could be shared with in the region. Find cooperative efforts.

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Summary: KEY ISSUES • • • • •

Identiﬁcation of Regional Threats & Surveillance – Air borne, Water borne, Vector, Ground, Radiological Regional Coordination – Information capabilities, training & manpower Regional Coordination Center – Incident Management; Medical Surveillance; Information Technology Regional Centers of Excellence – Examples: Regional Paramedic Training in Kuwait; Life Flight Training in the UAE Joint Exercises – Full integration of medical play in Joint Regional Exercises (Eagle Resolve; CPXs; Simulations) ROAD AHEAD

•

Near-Term (2004-2005) – Eagle Resolve 2005: Transnational Contgaminated Patient Movement (in/out) [CM] – Asian Games Terrorist event scenario: Use National CC as RCC for event. [Qatar] – Paramedic/First Responder Training [Kuwait/Egypt] Mid-Term (2006-2007) – Virtual Regional Medical Information Source – Regional Medical Surveillance System – Full integration of medical play in Joint Regional Exercises Long-Term (2008-2009) – Medical Protocol Standardization – Regional Medical Centers of Excellence

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Appendix A ATTENDEE LIST State of Bahrain Maj Yaqoob Mohammed Abdulla Royal Medical Services Bahrain Defense Force

LCDR Ebrahim Abdullah Al-Haram Bahrain Royal Navy Force Bahrain Defense Force

Dr. Feras Husain Abu Zeyad Military Hospital Bahrain Defense Force

Dr. Munawar Al-Hoda Emergency Dept. Salmamiya Medical Complex Ministry of Health- Bahrain

LtCol Mohammed Hussain Salem Al Dosseri Joint Operations Directorate Bahrain Defense Force

Capt Eng Osama Hussain Ali Medical Services Bahrain Defense Force

Major Sami Saleh Al Kaabi Bahrain Defense Force

LTC Rashed Subah Alkhalifa Bahrain Royal Navy Force Bahrain Defense Force

1 Lt Nasser Kahlid Al Khalifa Headquarters 6th Mechanized Battalion Bahrain Defense Force

CAPT Ahmed Hamad Al-Khalifa Bahrain Royal Navy Force Bahrain Defense Force

Maj Salah Yousif Al Mahmeed Bahrain Defense Force

LtCol Jehad Al-Mahmood Supply Bahrain Defense Force

LT Abdulla Nasser Al Noaimi Bahrain Royal Navy Force Bahrain Defense Force

Dr. Ali Hasan Ebrahim Almajed Bahrain Defense Force

Capt Yusuf Ahmed Albuainain Bahrain Defense Force

2ndLt Ehab Ajami Al-Mannae Bahrain Defense Force

1Lt Abdulla Abdulaziz Al-Burshaid Bahrain Defense Force

LtCol Hamad Abdulla Al-Meâ&#x20AC;&#x2122;araaj Civil DenfenseMinistry of Interior-Bahrain

Maj Ebrahim Yousif Al-Dosseri Bahrain Defense Force

Mr. Adnan Saeed Al-Mukhareq Economic Research Directorate Bahrain Defense Force

Col Rashid Salman Al-Dosseri Military Cooperation Directorate Bahrain Defense Force

LtCol Ahmed Abdulla Almusallam Bahrain Defense Force

Maj Adel Ahmed Algaoud Bahrain Defense Force

A-1

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

LTCOL Waleed Anwar Almutawa Bahrain Royal Navy Force Bahrain Defense Force

Maj Abdullah Othaib Fahad Royal Medical Services Bahrain Defense Force

Maj Saad Hassan Al-Noaimi Ministry of Interior-Bahrain

Dr. Abdullah Abdul Aziz Hamza Ministry of Health- Bahrain

LtCol Hamad Abdullah Alnuaimi Bahrain Defense Force

Maj Ebraheem Hassan Ministry of Interior-Bahrain

Maj Mohammed Abdulla Al-Otaibi Bahrain Defense Force

LtCol Khalil Abdulwahed Hussain Military Hospital Bahrain Defense Force

1stLt Ghanem Mubarak Alramihi Bahrain Defense Force

1st Lt Mohammed Jassim Jamsheer Bahrain Defense Force

LTC Hamad Abdulla Al-Ruwaiâ&#x20AC;&#x2122;e Bahrain Defense Force

Sergeant Anwar Mohammed Joher Bahrain Defense Force

Capt Waleed Salem Al-Saad Bahrain Defense Force

Mr. Shiju John Ministry of Health- Bahrain

Maj Mishal Zayed Al-Zayed Bahrain Defense Force

Maj Abdul Rahman Jumaa Bahrain Coast Guard

Maj Adnan Ateeq Military Cooperation Bahrain Defense Force

Mr. Mirza Salman Khalaf Environmental Monitoring Directorate Public Commission for the Protection of Marine Resources Environment & Wildlife

Maj Adnan Ateeq Bahrain Defense Force

LT Faisal Ali Khalfan Bahrain Royal Navy Force Bahrain Defense Force

Dr. Osama A. Awad Emergency Department Ministry of Health- Bahrain

Sergeant Ahmed Ebrahim Maraj General Headquarters Bahrain Defense Force

A. Naser A. Aziz Environmental Monitoring Directorate Public Commission for the Protection of Marine Resources Environment & Wildlife

Capt Mohammed Salman Mohammed Bahrain Defense Force

Brig Gen Yousif Abdullah Bahzad Bahrain Defense Force

LtCol Adnan Ahmed Mubarak Bahrain Defense Force

MAJ Adel Abduall Bani Hammad Bahrain Royal Navy Force 4th Batallion Infantry Bahrain Defense Force

CAPT Ahmed Ghali Rashied Bahrain Royal Navy Force Bahrain Defense Force Dr. Ali A. Saleh Ministry of Health- Bahrain

A-2

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

LtCol Salman Mohammed Salman Civil Defense Ministry of Interior-Bahrain

Sgt Maj Mohammed Yousef Royal Medical Services Bahrain Defense Force

LTCOL Ala’a Abdulla Seyadi Department of Naval Operations Naval Security Force Bahrain Defense Force

Arab Republic of Egypt LtCol Mahmoud Fathey Mahmoud Abdelall Ministry of Defense-Egypt

COL (Dr.) Ahmed Megahed Ahmed Saleh Ministry of Defense-Egypt

Brig. Gen. Ahmed Mostafa Mahfouz Kamal Ministry of Defense-Egypt

Hashemite Kingdom of Jordan LtCol Abdelra’uf Khalid Al-Dalabeeh Crisis Management Center

Col (Dr.) Moh’d Ibrahim Tarawneh

Maj Omar Nasser Khrais Civil Defense

State of Kuwait Mr. Abdul Abbas Redha Department of EMS Emergency Medical Services

Dr. Faisal Al-Ghanem Ministry of Health-Kuwait

LtCol (Dr.) Sameh Al-Ansari Prevention of Weapons of Mass Destruction Dept. Kuwait Armed Forces

Maj Ibrahim Ahmed Al-Kandari Special Operations Kuwait Armed Forces

LtCol Mohammad Khalil Al-Awadi Environmental Branch Kuwait Armed Forces

Nabeel M. Al-Kandari Ministry of Health-Kuwait

COL Sami Abdul Rahman Al-Essa Chemical Warfare Research and Development Kuwait Armed Forces

Dr. Mohammad A. Ash-Sharhan Emergency Medical Services

Col (Ret) Mohammed Al-Faresi

A-3

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Sultanate of Oman Maj Hassan Saif Al-Balushi Medical Services Sultan’s Armed Forces

Maj Mohammad Sulaiman Al-Hatali Medical Services Sultan’s Armed Forces

CDR Mohammad Humood Al-Dhali Naval Forces Sultan’s Armed Forces

Maj Nasser Mohammed Al-Sawaﬁ Medical Services Sultan’s Armed Forces

State of Qatar LtCol Saad Mohammed Al Maadeed Al-Ali Air Force Qatar Armed Forces

LtCol Mohammed Nasser Al-Sahal Crisis Management Center Qatar Armed Forces

Col Engr. Mohammed Ibrahim Al-Mohanadi General Head Quarters Qatar Armed Forces

Mr. Masoud J. Fayadh Central Environmental Lab Supreme Council for the Environment and Natural Resources

LtCol Mohammed Nasser Al-Sahal Crisis Management Center Qatar Armed Forces

United Arab Emirates Col Juma’a Salam Mohammad Al Dhaheri

Maj (Dr.) Hussain Saleh Abdullah Al-Mas’abi

LtCol Mohammed Saif Al-Ali Training Directorate

Dr. Abdul Aziz Bin Butti Al-Muhairi Medical Corp UAE Armed Forces

Col (Dr.) Ismail A. Al-Housani Emirates American Environmental Sci. Center

Maj A’arif Rashid Al-Za’abi

Capt Saeed Ali Dhahi Al-Ka’abi

A-4

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

United States of America MAJ Michael Ammons Ofﬁce of Military Cooperation OMC-Muscat-Oman

Lt Col Robert Bruggeman Chemical Biological Incident Response Force

Mr. Kent Anderson CCJ5C CENTCOM

Dr. Kent Butts Center for Strategic Leadership US Army War College

Ms. Alane A. Andreozzi Combat Support Directorate Defense Threat Reduction Agency

Mr. Marti Campbell Naval Support Activity

Mr. Robert Andrew Ofﬁce of U.S. Foreign Disaster Assistance US Agency for International Development

CAPT Thomas A. Carlson Strategic Gaming Center US Army War College

Mr. Ronald Jennings Banister Jr Naval Security Force NAVCENT

Mr. Daniel Clark CCJ5C CENTCOM

LCDR Mary F. Beckett Branch Clinic-Bahrain NAVCENT

Mr. Dale Cockman NESA National Defense University

Mr. Alex Beehler Environment, Safety, and Occupational Health OSD-US

Mr. Gilbert Collins Ofﬁce of U.S. Foreign Disaster Assistance US Agency for International Development

CAPT Suzanne Bonner Protocol CENTCOM

Col Jim A. Davis USAF Counterproliferation Center

Mr. Curtis Bowling Environmental Readiness and Safety OSD-US

LTC Kenneth L. Deal International Counterproliferation Program Defense Threat Reduction Agency

PO3 Kevin D. Brinson N10 NAVCENT

JOSN Joseph Ebalo NAVCENT

Col Eric J. Brooks United States Air Force US Embassy Doha

Capt Sharief M. Fahmy CCSG CENTCOM

Lt Col James M. Brosky Ofﬁce of Military Cooperation US Embassy

Lt Col William R. Fearn Operations (N3) NAVCENT Ms. Kirsten Fontenrose NESA National Defense University

A-5

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Dr. Michael P. Foose International Programs US Geological Survey

Mr. Kenneth C. Keating On-Site Inspection Defense Threat Reduction Agency

LT Darrell Foster CUSNC

LTC Richard Klein CENTCOM

Mr. James Gazay Safety (N019) NAVCENT

Dr. Richard B. Knapp Nonproliferation, Arms Control & International Security Lawrence Livermore National Laboratory

CDR Charles Gerringer Safety (N019) NAVCENT

LtCol Edgar A. Knouse Ofﬁce of Military Cooperation-Egypt CENTCOM

PO1 Darrell D. Grier NAVCENT

Mr. Stephen E. Lawhorne Edgewood Chemical Biological Center

Prof. Bernard Griffard Center for Strategic Leadership US Army War College

LCDR James Lebakken NAVCENT

MAJ Corey A. Grifﬁths OMC-Kuwait Land Activity Division CENTCOM

CDR Philip L. Liotta DIA Executive Support Ofﬁce Defense Intelligence Agency

Mr. Rob Grubbs HQUS Army Corps of Engineers

Ms. Carla Lopez Plexus Scientiﬁc Corporation

Dr. Wajdy Hailoo Occupational and Environmental Science Stony Brook Health Sciences Center School of Medicine

MAJ David Lyles Special Operations Command Central SOCCENT

MAJ John Haynes Ofﬁce of Military Cooperation-Kuwait CENTCOM

Mr. Don Marr NSA Emergency Management Naval Support Activity

Mr. Jeff Hinte US Army R&D Center Edgewood Chemical Biological Center

Ms. Jeri-Anne Martin Protocol CENTCOM

LTJG Walter Johnson Collections Management (N23) NAVCENT

Col Abubakr A. Marzouk HQ, CCSG CENTCOM Mr. Robert Massie Emergency Management Ofﬁce (EMO) NAVCENT

A-6

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Mr. Michael D. Mazur Defense Threat Reduction Agency

Mr. Ronald Rook CCJ5C CENTCOM

RADM Robert Moeller CENTCOM

Ms. Ninette Sadusky Ofﬁce of Environment and Safety OSD-US

LTC Clyde Anthony Moore SOCCENT

CDR Efren S. Saenz Surgeons Ofﬁce NAVCENT

Maj Curtis E. Moore II US Embassy

Adar Abdulaziz Abduldaher Salam Self-employed Interpreter

CAPT Lee Morin US Department of State

HMC James Schloegl Theater Medical Surveillance Team NAVCENT

Mr. Tommy Joe Morris Telemedicine & Advanced Technology Research Center US Army Research & Materiel Command

LTJG Josh Scott Naval Support Activity

Mr. Paul Mundt CCJ5C CENTCOM

Col Michael A. Shalak Strategic Planning Division Joint Staff

Dr. Keith Nakanishi Lawrence Livermore National Laboratory

Mr. Michael Shaw CCJ5C CENTCOM

Mr. Gregg Nakano Ofﬁce of U.S. Foreign Disaster Assistance US Agency for International Development

RADM (Ret) John Sigler NESA National Defense University

CAPT John Nickle Force Surgeon NAVCENT

LCDR Daniel A. Singer US Department of State

Maj Mardis Parker CCJ5C CENTCOM

PO2 Kia S. Sligh Administration (N00) NAVCENT

Ms. Kathleen Potthoff CCJ5C CENTCOM

LTC Mickie Smith US Military Training Mission

Col. Douglas J. Robb Surgeon General CENTCOM

Brig. Gen. Annette Sobel National Guard Bureau

A-7

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Mr. Alex Sonski Center for Strategic Leadership US Army War College

LT Steve M. Vajda Plans & Policies (N52C) NAVCENT

Capt Jeffrey Stiff Chemical Biological Incident Response Force

Maj Karl Wilson Surgeons OfďŹ ce Coalition Forces Land Component Command

Maj John Storey Combat Support Directorate Defense Threat Reduction Agency

Dr. Richard L. Winslow Center for Strategic Leadership US Army War College

Mr. John A. Tempone Counterproliferation, Consequence Management, and Force Protection CENTCOM

1stLt Mary Zajac National Guard Bureau

PO2 Jason Trevett NAVCENT

LT Eve Carroll Zentrich Theater Medical Surveillance Team NAVCENT

A-8

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Appendix B CONFERENCE AGENDA

Monday, 27 September 2004 0830-0930

Opening Ceremony Al Taj Ballroom, Ground Floor • Host Welcome: BG Yousif Bahzad, Director of Training, Bahrain Defense Forces • Welcome Remarks: RADM Robert T. Moeller, Director, J5, U.S. Central Command • Opening Comments: Mr. Alex A. Beehler, Assistant Deputy Under Secretary of Defense (Environment, Safety and Occupational Health), Ofﬁce of the U.S. Secretary of Defense

0930-1000

Group Photo Tea and Coffee Break

1030-1030

The History of Disasters in Bahrain Dr. Abdulaziz Hamza, Under Secretary, Ministry of Health

1130-1130

Session One – Disaster Preparedness Strategy Al Taj Ballroom, Ground Floor Mr. Mike Shaw, Chief, Counterproliferation Division, J5, U.S. Central Command and a representative from the Bahrain Defense Forces Objectives: • Proposed Five Year Disaster Preparedness Strategy • Regional Disaster Response Coordination Mechanism

1130-1145

Break B-1

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

1145-1215

Session Two – Results of Medical Workshop Al Taj Ballroom, Ground Floor Brig. Gen. Annette Sobel, MD, MS, National Guard Bureau, Joint Staff and Mr. Mohammed Ash-sharhan, Director, Emergency Medical Services, Kuwait Objective: • Provide results from 26 September 2004 Medical Surveillance Workshop

1330-1330

Session Three – Framework for the Working Groups Al Taj Ballroom, Ground Floor • Executive Level Policy: RADM John Sigler (USN, ret), Near East South Asia Center, U.S. National Defense University and Dr. Kent Butts, Center for Strategic Leadership, U.S. Army War College • Regional Resources: LTC Kenneth Deal, Defense Threat Reduction Agency • Regional Disaster Response Preparedness Capacity Building: Professor Richard Winslow, Center for Strategic Leadership, U.S. Army War College • Regional Medical Security Preparedness and Response to Disasters: Professor B.F. Griffard, Center for Strategic Leadership, U.S. Army War College

1900

Dinner - hosted by USCENTCOM Awali Ballroom, Ground Floor

Tuesday, 28 September 2004 0830-1330

Working Group Meetings Ground Floor

B-2

Gulf Region Disaster Response Preparedness Conference and Medical Workshop

Wednesday, 29 September 2004 0830-1030

Reports/Recommendations from Working Group Co-Chairs Al Taj Ballroom, Ground Floor

1030-1100

Tea and Coffee Break

1200-1200

Closing Remarks Al Taj Ballroom, Ground Floor • Bahrain Defense Forces • Mr. Curtis Bowling, Director, Environmental Readiness and Safety, Ofﬁce of the U.S. Secretary of Defense

B-3