8 comments

  1. A thought might be the use of ECM in growing organ replacements. Between the advances in cellular scaffolding and advanced shape shift I’d think it wouldn’t be hard to create market opportunities:

    http://www.kurzweilai.net/nanopatterned-natural-biological-scaffold-for-stem-cells-may-allow-for-softer-engineered-tissues

    http://www.sciencedaily.com/releases/2010/07/100713191219.htm

    As for mine detection and disease detection…I might suggest dogs instead. They have a longer lifetime making the training to functional worklife ratio more productive than a rat would be. They are also easier to manage, less easily lost, and more accepted by humans in most settings without causing alarm.

    Dogs are good at detecting cancers, and have been used by military and government agencies for bomb/ordinance detection and disposal for years so there’s a nice training protocol already established. They have more behaviors that can be used to signal trainers about their perception as well. I’ve handled rats, and while they are very smart they don’t generally communicate with humans well.

    http://www.dogsdetectcancer.org/
    http://www.npaid.org/Our-work/Mine-Action/What-We-Do/Clearance-of-Mines-and-Explosive-Remnants-of-War/Mine-Detection-Dogs

    TB is fairly simple to test for and cheap. A tb tine test is small, easy to administer even by a novice, and produces a small reaction at the site of the test that is obvious to most. It isn’t 100% though and sometimes follow on xrays are needed to confirm that someone may have the illness, or may no longer have the active illness but have old lesions on the lungs, or may be giving a false positive with no disease present. Most health and school workers in the US are required to have annual TB tests, as are the military in some fields.

    Besides, dogs are snuggly. 🙂

  2. As background…

    A TB test is low to no tech.

    They poke the inside of your forearm lightly with either a needle or a small thing with little fine tines that looks like a chart pin. The tines contain a protein derivative that th infected persons react to. 48-72 hours later if you don’t develop a red swelling where you were poked your test is negative. Its just that simple.

    An amateur can give the test and read it pretty much. I’ve had these done real life, it is not a big production.

    The link below explains the specifics for those interested. It also explains situations where you might not have an accurate test (too recently infected, have been vaccinated, etc.)

    http://www.medicinenet.com/tuberculosis_skin_test_ppd_skin_test/article.htm

    It is not an expensive test and should work anywhere normal biological responses can be expected.

    A concern might be whether tb is relevant on a Shadow.

    Another issue is that most healers could probably just tell the person was ill by looking. If that’s who makes up your team, this might not be as big of a priority. If you have teams that are short on healers, it might be a bigger priority.

  3. My recent experience as a non-shapeshifter assisting shapeshifters has taught me respect for the fact that use can generally be found for an intelligent calm set of manipulating appendages in almost any disaster zone. The amount of use depends on the situation, and the creativity. And that no matter what the skill bases, the vastness of the universe will give you challenges you hadn’t prepared for.

    However, this does suggest that, once the disaster corps is online, I may want to create a less crisis-focused arm.

    Fortunately, for either, one of the short-term projects will be the recruitment program across various shadows. I’ll likely start with those with public awareness of the multiverse. The powers such as shapeshift, magic, technology, or simple knowlege, will vary. However the skill in stepping into disaster zones and problem solving in a destruction-limiting way will be welcome.

    Anyone with ideas about shadows which might be good candidates for the recruitment of creative problem-solvers of an essentially cooperative nature who spawn the occasional half-starved adrenaline junkie, I’d be delighted to hear of them. May want to make sure they leave their equivalent of genetic samples behind, though. Don’t want to accidentally breed out the traits I most want. (:

    1. (as this thread came before your later and, in my case, final post…)

      Many healers are shape shifters, very good ones, but not all healers have that mechanism of healing. It can be an important point to keep in mind in managing your different volunteers and their needs.

      One of the most important things to consider in my experience as Gudrun (thinking back particularly to her work in the military burn units after First Casablanca), is triage and healer management.

      Triage saves lives in any emergency, any evacuation, and later in field or ordinary hospitals when assigning cases based on resources available. Skill and judgement are required and some diagnostic/assessment skills, but actual medical ability may be much less critical and arcane skills are actually a detriment in a triage position in most cases. Never let a full fledged healer work the triage station! There may be some exceptions for very very experienced healers with a lot of self control but its a bad idea. (I’ll explain why in a minute.)

      Most military members are trained in basic first aid and “buddy care”, this training can sometimes exceed what civilians would imagine. One of the big parts of that training is deciding about the criticality of injuries. This makes it possible for them to be “first on the scene” decision makers and it makes for more rational choices in terms of resources and evacuation priorities (no, it doesn’t make the choices any happier for any involved). Emotions aside, you can often reasonably rely on a unit’s prioritization of casualties with just a few corrections, the folks are pretty pragmatic.

      In civilian situations, you can’t. So you need both security and a triage team. One to handle irrational expectations and demands, the other to sort the traffic and assign priorities to cases.

      In civilian emergencies, the advon team is also key. These people go in first to assess the limits of the local infrastructure to support incoming aid, assess areas for transport of relief supplies and storage of supplies safe from continuing threats in a disaster, and assess and brief all incoming teams of relief workers on conditions and local health threats. This helps in establishing a useful pipeline for supplies and medicines (you don’t ship malaria drugs with a deployment package to the arctic for instance, not usually at least). With cross shadow operations this could be really crucial in determining what health threats apply or any known information about treatments that do or don’t work, and all important….cultural acceptance of medical practices.

      Ideally the advon team also includes communications infrastructure and command and control so they can gatekeep the efforts coming in and out. It is a real problem to land 1000 relief workers in a newly devastated area with no water, sanitation, and food without having them become part of the emergency! Coordinating the right combination of personnel and supplies is critical. It also explains why relief efforts sometimes seem so frustratingly slow to set up.

      Reading up on the response to the crisis in Haiti can be helpful. There were conflicting NGOs on the ground working against each other, supplies were bottlenecked coming in to the mostly non-functional ports, and many of the aid agencies showed no respect for what the Haitian people found acceptable as help. It was a second and continuing phase of the disaster. (three weeks ago RL I sat in a seminar with 4 education workers who have been rotating in and out of Haiti for the last several years and it was interesting hearing their take on things)

      So triage, advon, security, are all important.

      Assessing the phase of the disaster is also important at the higher level. Priorities shift as the emergency progresses. Medical authorities generally have a sad timetable for these…cholera, secondary infections and illness, dehydration, camp diseases…the effects of too many people in close quarters with barely adequate sanitation usually leads to a second phase of emergent illnesses. Supplies need to shift to cover the differing needs…and the experts change in the later phases particularly as the focus shifts to helping the affected population restore their own control over their infrastructure, schools and so on.

      (OOC: I realize some see me as a know it all. I can’t help that perception. I don’t know it all, but I’ve been in a lot of odd places and learned from it. I was seconded as a logistics officer for my unit in Desert Storm, trained as a Chem/Bio/Nuclear contamination control coordinator for my unit for about 1800 people for almost 2 years, had mandatory training in medical triage for non-medical personnel and as a civilian did projects with HHS and the Public Health Service Commission Corps right in time for Katrina to hit…so I learned a lot from first hand conversations with those coordinating the response.)

      (In game…)

      Gudrun’s experience working with the military in Casablanca taught me a lot about good organization and special topics in medical triage for work with arcane healers. Essentially I was assigned a corpsman whose prime role was to keep me away from patients I hadn’t been assigned to. Many healers, me in particular, see something and feel compelled to fix it on the spot. This is a problem because you may waste your energy. On the flip side, you may overextend for things you shouldn’t try or which may save one person at the expense of 2 others. Typically I was assigned hard cases when I was fresh, and pulled off in many cases as soon as I got them stable and moved to the next patient. This required brute force at points. The corpsman and triage officer then stepped me down through the cases until I was too tired to work and then called security to see me to food and bed. Rinse repeat. As the needs of the most number of patients were met, and mundane healers kept stable patients afloat until the healers could make a second round, the cases got easier, more patients got discharged to ambulatory care, etc.

      Managing your healers is important if you have them. It is not instinctive for a healer to “stop in the middle” but it can be really strategic if you are trying to save the most number of people or if you have wards of burn patients with high needs that would use up a healer on a one to one basis. (First Casa was tank warfare, burns in that type of conflict are really frequent and difficult to treat.)

      I’m sure you will hit on your own strategies.

      LIMFACS: Limiting factors are an important thing to identify at each stage of a crisis. If you’ve ever played “Civilization” or done project management the concept of dependencies will be familiar. A LIMFAC can be anything. Some typical ones are: runway length (affects types of planes, largest equipment size for earth movers and cargo weights…thus impacts objectives and schedule), proximity to coastline (can you park a carrier or hospital ship offshore and shuttle supplies in and patients out?), weather, civil disorder, power grid, personnel, etc.

      Managing a crisis is managing LIMFACS and gradually working up from a very primitive state to a more complex state. At first just getting in some generators, light-alls, diesel fuel, water, a truck or two and canvas for elementary shelter will be an accomplishment. Getting in a civil engineering group to move rubble will be huge. A water purification/desalination package is an event. It really is crawling your way up while still trying to do something about the overwhelming level of need all around you.

      Some sample units that are typical as part of relief efforts:

      ADVON (Advance On the Ground Team) Assesses needs, tracks progress, acts as organizational memory as elements come and go,

      Command and Control (Organizers, liaisons with host govts, legal/cultural advisors, civil affairs, translators, experts on medicine and whatever else the situation uniquely calls for)

      Search and Rescue team/dogs (Search rubble and free trapped survivors that can be gotten to with human work)

      Security element (Secure supplies, avoid mobbing, avoid looting, create a zone of order)

      Communications (Lines to the outside world, communication between elements on the ground, warning for incoming weather or deteriorating disaster events)

      Civil Engineering (In early in increments to set up basic shelter, sanitation/latrines, light, electrical power and debris clearing. Assists in heavier work when search and rescue finds complicated rescue scenarios. Improves landing strips and ports, improvises bridges, repairs equipment. Most important: Disposal of the dead!)

      Medical (Treats casualties and works to improve physical and mental health of survivors. Works to improve overall health conditions in the improvised environment to prevent secondary illnesses.)

      Water desalination/purification (Works to ensure clean functioning local water supplies and restoration of services)

      Maintenance (Ground and Aircraft) (Works to ensure equipment remains functional, that necessary supplies are gotten for repairs, that equipment doesn’t get stranded broken down and interrupt cargo flow)

      Its a big cast and it all has to work together. There are a lot of interdependencies.

      As a disaster moves to a new phase, additional teams are brought in to work on more permanent repairs, restart education and civil life and so on.

      Hope you find this helpful, but there are a lot of roles for people to play.

      1. (Sorry didn’t have time for this portion yesterday…)

        Logistics Planning

        This will go mainly on a military model, but so do most civilian groups ultimately because they are often interfacing with military assets in a crisis response anyway and because its stupid to have to reinvent the wheel.

        The portion above omitted both what happens in pre-staging areas and rear areas as well. That level of detail may be too far outside the scope of the purpose here, but just to be clear almost all disaster efforts have off site staging areas and rear areas where coordination and decisions are taken. A complete relief effort includes dealing with issues along an entire logistics pipeline.

        In the most general terms it is important to know that disaster response relies on: previous worked up scenario plans for similar disasters (which may be accurate, out of date, or right on in any specific case), previous assessments of particular world areas (the military keeps plans on every country in the world and what it ought to know if it needed to go there and updates them annually…again sometimes problems happen when a world region is ‘glossed’ and then later ends up printed on top of your movement orders! (See Iraq and our total failure to understand religion, history, culture in the region…ditto Afghanistan), but most importantly there is a very detailed set of deployment roles described as “packages” that have been created as modular elements for deployment.

        A “package” is the personnel and equipment needed to support a particular mission requirement. An example might be a headquarters element for a group of 1000 people whose mission includes generating air sortees; a hospital package that would support the medical needs of 5,000 people; a firefighting package that would support an installation of 1000 to include associated aircraft…etc.

        These are meant to be mix and match. It is not at all unusual to task a headquarters group to deploy to a location where all the subordinate members of the deployment come from packages sourced from other bases. This gives flexibility and may allow you to work around times when components that are used to working together have part of their compliment already tasked.

        A TOE or TOA is a table of allowed equipment or table of allowances. Planners devising packages come up with a list of the supplies needed for that mission to take place on the ground. So if it were a hospital element deploying a package description would include the number of doctors, nurses, orderlies, therapists, administrative/records clerks and so on. It would give a listing of pre-existing conditions needed for deployment (a security detail, electrical generators on site, so much fresh water, etc), and it would give a TOE (operating tables, stethoscopes, cots, tents, wash sinks, medicines, xray machines…down to the last thermometer) A TOE usually includes follow on resupply suggestions and is only meant to stand a unit up and have it function for a set period of time before resupplied.

        Logistics planners then figure out how much space it takes to pack the “chalks”. A chalk is a palletized unit of cargo or a specific number of personnel. Planners figure out what it will take to get that cargo delivered from point a to point b.

        When a pre-deployment order is issued, advon teams go out first to confirm the mission elements needed. Planners then come up with a schedule of events for deployment. This orders the sequence of personnel and materials that deploy. In order, elements receive alerts to prepare, then deployment orders are issued as the schedule unfolds.

        Logistics planners then juggle figuring out what has to be in place before the next thing arrives, how to get it there, and how to do it without stranding transport in areas with no refuel or maintenance capability. Its a giant puzzle. And sometimes there are screw ups, but usually it works surprisingly well considering all that is involved.

        I mention this for a few reasons. Firstly because it would be quite simple in game for you to get hold of some examples of deployment packages and TOEs for various mission requirements through Spec Ops. Don’t reinvent the wheel, adjust it to run on your road. This should save you some time and trouble doing basic planning and let you customize to unique situations.

        Second, it gives you something to talk about with your intended targets of assistance. They will want to know what you have on offer, how it might mesh with their models, and whether you are organized enough to deliver and be relied upon.

        Third, it will give you a sense of how much “Scope” you have to start. That way you can be specific about what you can offer and what capabilities you have.

        Fourth, you may want to specialize in certain types of assistance or augmentation of relief efforts, this gives you a framework for it.

        Fifth, it lets you know how many resources and how much funding you will need to start.

        Sixth, it alerts you to the need for a survey requirement. This is akin to decades of governments sitting down to think up what is needed to go to a particular location…except you are dealing with a lot more than just one planet. Part of your planning will need to be identifying areas you are competent to go into. It isn’t unusual for various aid groups to specialize in one area of the world…there are solid reasons why they do. You may need to be really clear, especially as you are just getting started, where you are able to be helpful and where you are not yet ready to lend aid.

        Again, good luck and this is probably the best I can offer you at this point without going into detail that’s far to granular for game purposes.

  4. (Tim says last post. I gathered some info for you:

    An example NGO:
    Positioning MMM for Rapid, Self-Contained Humanitarian Action
    http://www.mammothmedicalmissions.org/positioning-mmm-for-self-contained-humanitarian-action/

    For mobile field hospitals in a more modern setting…its a long time since MASH:
    Disaster Medical Facilities & Mobile Field Hospitals
    http://www.blu-med.com/en/

    DRASH Shelters:
    http://www.drash.com/Products/Shelters.aspx

    HDT:

    http://www.hdtglobal.com/products/shelters/

    An example of a specialized container modified for a specific use that can be transported by air, rail, or truck:

    http://www.seabeecook.com/equipment/new/cont_kitchen.htm

    These come in kitchens, data centers, surgical centers and so on, but the idea is they roll off the back of a truck or plane ready to go with the needed equipment already included, sometimes with generators/refridgeration/air conditioning etc.

    This is high end but very good to have.

    Kitchens make a good example because treating the wounded doesn’t help if they have nothing to eat.

    Example kit for headquarters elements (We used to put these together by hand):

    http://www.garrettcontainer.com/deployment-kits/qfe4a

    Example kit for military dog handlers (Maybe a model for other animal wranglers):

    http://www.garrettcontainer.com/deployment-kits/mp-mwd-deployment-kit/

    For tech areas:

    Telesurgery via Unmanned Aerial Vehicle (UAV) with a field deployable surgical robot.
    http://www.ncbi.nlm.nih.gov/pubmed/17377292

    AngelMed

    http://www.angelmedflight.com/?osadcampaign=adwords&_kk=medical%20airlines&_kt=e0d91baa-d8f8-46d8-a204-e76387057a2c&gclid=CMebzKam6r0CFQ5gMgodiDsAQg

    It would be worth talking to the life flight folks about evacuations. Whether you use conventional vehicles or carriages, you have a sense of what the needs would be for trauma care during transport and evac.

    Manual on Joint Deployment and Redeployment Doctrine Multinationally:

    http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CCwQFjAB&url=http%3A%2F%2Fwww.dtic.mil%2Fdoctrine%2Fnew_pubs%2Fjp3_35.pdf&ei=jT9RU4HNHKfV0QGAooHoCg&usg=AFQjCNFaN9I_4EdZImYhDFzXYZBkjoH-iw

    Use of ships as platform for disaster relief:

    http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=9&ved=0CHAQFjAI&url=http%3A%2F%2Fwww.dtic.mil%2Fdtic%2Ftr%2Ffulltext%2Fu2%2Fa567221.pdf&ei=rj5RU-arE6jl0QH8uIDoDg&usg=AFQjCNE20FMDCf6j0oAWqZondcEX9Jdcbg

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