Everyday humanity witnesses an opportunity to take a new step forward. Every morning millions of people enter a new day hoping for happiness and joys of life, and believing in a cloudless future. In everyday life with its troubles and problems, most people forget that their future wellbeing and happiness are endangered by thousands of missiles and nuclear warheads aimed at mankind itself. According to United Nations Reports, there are 50,000 nuclear warheads on Earth today. Their explosive energy is equal to over one million bombs of the kind dropped on Hiroshima in 1945. Unfortunately, some politicians and some members of the lay public do not know (or rather do not want to know) the simple truth that mankind has produced and keeps in store a power that can annihilate its creators. Let me recall Jolio Curie's words: “People should not allow the forces they have managed to discover and learned how to handle now be the cause of their destruction.”

Natural and man-made disasters continue to be a major cause of morbidity and mortality. Natural disasters include earthquakes, storms such as hurricanes, floods, fires, drought. Man-made disasters include fires, explosions, chemical and radioactive releases, major transportation accidents, terrorism, and war. The effects of disaster include injury, death, damage to infrastructure, environmental exposure, population movement, and increased incidence of communicable diseases.

A disaster manager must be able to evaluate staff members in order to make effective staffing decisions during the transitions between phases of a disaster and to help improve the performance of the operation by determining what aspects of an individual's work needs improvement. Criteria for personnel appraisal and measures of performance, objective or subjective, are essential to conduct a fair and thorough evaluation. Errors introduce bias into the appraisal in the form of a “halo” effect, harsh or lenient ratings, a central tendency error, or recency effect, but recognition of these errors helps reduce their effect. A results-based appraisal program is favored because it focuses on what the worker achieves. Regular appraisal periods are suggested for optimal improvement in performance. Suggestions are given for an effective personnel appraisal, such as focusing on positive work performance, being aware of biases in judging people, and being specific when citing examples of work performance.

World attention has been focused on Bosnia/Hercegovina, where war erupted in 1992. The regional hospital of Mostar, an industrial city with a population of 100,000, operated -with chronic shortages of medical supplies including general anesthetic agents. In February 1992, just prior to the referendum for independence in that republic, a shipment of medical supplies with anesthesics, food, and clothing was delivered safely to Ljubuski, a village near Mostar, for Mostar hospital and surrounding clinics by a small, private organization from Birmingham, Alabama. No difficulties were encountered in delivering the supplies despite warnings from the U.S. State Department, the lengthy transit from Austria through Croatia to Bosnia, an active black market, and the inexperience of the relief agency. This disaster relief effort by a small, private sponsor was representative of both the positive aspects of such a project, as well as typical negative aspects. These efforts had been discouraged in the past, but as disaster medicine matures, there may be room for such endeavors, if properly directed.

Special Needs of the Elderly During Disasters – Suggested Strategies and Lessons Learned from the 2007 Tulsa, Oklahoma Ice Storm. On the evening of December 7, 2007 an ice storm occurred in the south central United States causing severe power outages in Tulsa, Oklahoma. In Oklahoma alone, 900,000 people were without power for periods of up to 3 weeks. Approximately 13.2% of the population in Oklahoma aged 65 + live in institutional care (2000 US Census Report). There are 498 nursing home facilities in Oklahoma serving this majority of this population (a small percentage live in other types of care facilities). Of these facilities 143 lost electrical power for up to six days, 88 lost power but had generators available within 24 hours or less, and 55 had no alternative source of power. Of the 55 without power, 42 relocated residents. Critical infrastructure failures during natural disasters can create a cascade of direct and indirect losses due to a number of physical, social and economic interdependencies that exist (Rinaldi, Peerenboom & Kelly 2001). The elderly present some unique characteristics that make them more vulnerable during natural disasters. Chronic health problems, physical mobility and cognitive limitations make them unable to adequately prepare for disasters (Aldrich & Benson 2008) making them entirely dependent on the facilities. In the three years since the storm the Oklahoma Disaster Institute has focused its efforts on developing and implementing mitigation strategies to address power loss in nursing homes. These strategies included discussions with the Department of Health, Emergency Medical Services Authority and local hospital officials. As a result of these discussions, table-top exercises were conducted in multiple venues, and speakers from the Department of Health, EMSA, and emergency management were arranged in an Extended Care Facility Workshop. This paper will look at lessons learned, mitigation strategies and successes in protecting the elderly in nursing homes during natural disasters.

Crisis, disasters, terror attacks or any other traumatic event may cause among the survivors acute stress reaction (ASR). The main goal of the first responder in terms of mental health in the acute phase is to provide the victim the basic support that will stabilized the needed coping resources and re-establish the sense of control and safety (Kutz & Bleich, 2005). This process encourages the shift of the victim's perspective from a helpless victim to a coping survivor. The emergency mental health interventions are differentiated by the location: Location 1: The event's location: Pacing & Leading using varied communications channels. Re-establishing sequences of contingency. Regaining sense of control. Using the cognitive communication channel. Yes-set sequences. Location 2: Emergency rooms or Traumatic Stress First Aid Centers (TSFAC) Stress symptoms reduction using suggestive techniques Memory Structure Intervention (MSI). Psychological Inoculation (PI). Group interventions. Basic deferential diagnosis: ASR-PTSD Patent release decision making. The higher the number of casualties, the more likely is the need for early interventions by non-professionals. This may be particularly true for a mega-terror attack, when the numbers of survivors with ASR can flood the hospital gates. The general principles for intervention by non-professionals, adopted by the Israel Ministry of Health (2002), are: a. Establish personal contact with the survivors and provide words of comfort or supportive touch. b. Encourage survivors to verbalize their experiences. c. Provide orienting information about what happened and what is about to happen in the hospital. d. Ensure physical needs such as hydration, food, and rest when appropriate. e. Enable contact with any significant other as soon as possible through phone or personal contact. During the presentation the above subjects will be elaborated and demonstrated by case studies and short videos.

The true threat of bioterrorism remains mysterious and elusive to the common citizen. It principally has become the dominion of a few “experts”, many of whom have limited apparent expertise, who have failed to effectively communicate the risks and realities to society, and have instead created an air of uncertainty surrounding the topic. Unlike the great classic deceptions of modern life (e.g., “the check is in the mail”), the misinformation and misperceptions associated with bioterrorism can be dangerous and are not merely humorous. Indeed, it is possible to grasp the facts as well as fallacies associated with bioterrorism, and, as a result, demystify this nightmare scenario and prepare for the “unthinkable”.