Administration Most Fowl
Having just finished a chicken
salad, the HR Doctor thought it would be a good idea to write
about bird flu. In reality, though, this is an article not
just about the risks of bird flu, but more generally about an
issue we have not really had to face in Public
Administration - a major, pandemic public health
a former county chief administrative officer in California,
this author remembers well the Mediterranean fruit fly and
gypsy moth agricultural crises. Souvenir traps still adorn my
office. However, even those battles against pests are not
quite the same as the pandemic risks of a human health
HR Doctors work history includes service as a vice president
of human resources for the countrys second largest public
health system - University of Miami/Jackson Memorial.
This was before and during the Sept. 11 crisis. In our
limited-term administrative memory, we focused brain power and
some limited resources on bioterrorism and questions of
capacity, planning and coordination should there be a smallpox
attack, an anthrax attack or any other attack, real or
perceived, that affects the publics physical health. However,
any such attack or even media sensationalism about the
possibility of an attack also affects the publics mental
we saw in reviewing the Tokyo subway bioterrorism attacks of a
decade ago, there were few actual victims of the sarin poison
exposure, but there were thousands of hysterical people
believing that they, too, had been victims.
the country and its public sector responders prepared for the
consequences of a pandemic? In this authors opinion, the
answer is a very clear "no." The interagency dysfunction still
being felt six months after the last hurricane season is one
dramatic example of a preparedness gap.
very smart and very experienced trauma surgeon who was a
senior officer in the Israeli Defense Force and was sadly
often involved in mass casualty responses made a very profound
comment when he said that "mass casualty" incidents are not
medical problems. They are management problems.
spores, viruses and bacteria, if not radioactive particles
that may be involved in bioterrorism, chemical or radiological
assault, have no awareness at all of what jurisdiction they
are in - or whether they are violating a federal
regulation - or, for that matter, how much the budgets of
public agency emergency planners and responders have been
They also do not care about
interagency squabbling, different badge shapes, wording or
whether the responders, let alone the victims, are Democrats
or Republicans. They just do what for them is natural. That
is, they find and exploit hosts in order to multiply and grow
at the maximum possible sustained rate.
is we, the human public administrators, who live in worlds
marked by silos, interagency bickering, jealousies or
competition that can be as destructive as the germs
previous articles entitled, "Silos Are for Grains" and "The
Department of Homeland Insecurity: Forging One Nation Out of
Separate Tribes," the HR Doctor spoke of the inherent
difficulties in a bureaucracy when the core values are
example, the core value of service in a county government
should not be service to my department or my union bargaining
unit. The core value has to be a focus on public service. The
motto of Rotary International, "service above self," should
never be forgotten in any form of public service.
place to start putting grain in silos instead of bureaucrats
is at home at the local level where neighboring fire
departments should come together and share resources. Perhaps
they can even consider merging when the merged unit could be a
better service delivery agent than individual departments. It
is a time for multi-year budgets for responding agencies with
strong financial incentives for inter-agency work.
is a time for more cooperation than ever before between
hospitals, the physician community and local governments based
on a very realistic set of assumptions. The assumptions should
be that there will be, rather than there might be, a major
public health crisis coming to a county near you soon.
"Normal" bureaucratic responses will not be enough and will do
harm instead of help to solve the problem. The first
obligation of a physician, such as the HR Doctor Daughter, Dr.
Rachel, is to "do no harm." Taking no action in the face of
very realistic threats is a form of doing great harm. I hope
the leaders of the nation and the states are listening, as I
know local government leaders are.
Cooperation and innovation must
be the norm and must be rewarded and recognized rather than
discouraged. It will not only be the doctors, nurses and
paramedics, as well as the few members of the National Guard
who are not otherwise committed, who will be involved in the
management of a medical pandemic catastrophe. Rather, every
one of us who works for government - therefore, works for
the people - must begin now to put aside narrow loyalties
and "get with" a national program of renewal of the spirit of
caring and innovation in public service.
message to each of us and to our federal friends, who often
intend well but implement poorly, is to accept the imperative
of the higher loyalty of service.
That was some chicken