9/11 brings changes to state’s disaster preparedness plans

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There were perhaps 200,000 people on the bridge that day, on foot, walking eastward — New Yorkers, evacuating lower Manhattan over the Brooklyn Bridge after two hijacked airplanes crashed into the World Trade Towers Sept. 11, 2001.

UAB’s Sarah Nafziger and Shannon Stephens, right, were in New York on 9/11. Nafziger says the event has changed the way we view disaster preparedness.

A handful of people were stemming that tide of evacuees, walking westbound into Manhattan, including a group of emergency medical professionals who had been attending a research conference in Brooklyn. Shannon Stephens, EMTP, a researcher in the UAB Department of Emergency Medicine, was one of them.

“I walked over the bridge with a paramedic from Pittsburgh,” Stephens recalled. “An officer with the New York fire department said they’d take all the help they could get. They had whole battalions they couldn’t reach on the radio. As we were crossing, the second tower fell. I remember the ash plume, you could see it come out of Manhattan, come across the water and sort of roll over us.”

UAB emergency physician Sarah Nafziger, M.D., was attending the same conference with Stephens and then-chair of Emergency Medicine Tom Terndrup.

“It was several hours before we knew what happened for sure,” she said. “We heard rumors there were hundreds of planes crashing in cities all over the country. We saw fighter jets in the air above us and didn’t know if they were good guys or bad guys.”

Nafziger, Stephens and Terndrup spent the day lending their medical skills to the New York authorities. Nafziger joined an ambulance crew traveling between triage stations before taking a shift at a hospital emergency department in Brooklyn. Stephens made it to the first command center and helped in the search for victims.

“We were pulling rubble off of people,” he said. “I remember there were five or six of us trying to move one huge piece of cement to see if there were people under it.”

“There were a lot of walking wounded — cuts, bruises, people dazed and confused,” said Nafziger. “We saw very few critically injured people. You either walked away from it with minor injuries, or you were dead.”

The UAB trio managed to get space on an Amtrak train to Washington, D.C., the next day. They hopped a commuter train to Reagan National Airport to rent a car, passing by the Pentagon en-route. They were among the few people in the country to see both the WTC and Pentagon sites in the first two days.

Ten years later, the memories are still vivid. The lessons learned are important.

“After 9/11, I think disaster preparedness became a household term,” said Nafziger. “We had been doing some work in the field of disaster preparedness, so it wasn’t a new concept for us. Most of our work was focused on preparing for a bio-terrorism event.”

The very scope of disaster preparedness has expanded in the past decade. Planners now understand that the same planning, same organization and the same approaches can be applied to any mass casualty event — from terror attacks, to tornados and hurricanes.

“We understood that we had to have systems that were scalable,” said Stephens. “We had to have systems that could handle a bus wreck with 20 victims but also be able to scale up to deal with thousands of victims.

Lessons learned in the past decade have been put to good use. Alabama now has a statewide EMS trauma system, and Nafziger is the assistant state EMS medical director.

“We do a much better job of communicating and coordinating across state and regional agencies now,” said Nafziger. “The system manages resources not only in response to a major trauma, but also in the event of a pandemic influenza outbreak or other public health crisis. We’re definitely thinking in terms of disaster preparedness more, we’re planning more, drilling and exercising for these types of events in a very inclusive manner.”

Nafziger acknowledges that the attack on the World Trade Center was a turning point.

“The whole experience of 9/11 for me was a call to action,” she said. “I felt the need to give something back to my community because it was demonstrated to me that my community can be very fragile and in a moment’s notice our whole lives can be disrupted. We had tornados here recently. And the response you saw from friends and neighbors was very like what we saw at 9/11. Friends helping friends, neighbor helping neighbors. Everyone set aside any differences to help each other. That’s something that has not changed in the past 10 years, and I’m very glad to see that.”