Dr. Joseph Kotora
Learn the Four Phases
of Disaster Preparedness
Mitigation, Preparedness, Response and Recovery
Dr. Joseph Kotora’s career path became clearer after Sept. 11.
“Prior to 9/11, we really didn’t have disaster medicine at
all,” Kotora, DO, said. “Other countries were far superior to us in
disaster care, mainly because they had more natural disasters,
like tsunamis in Japan. So my interest was piqued after 9/11.
“I started out as a firefighter in 1996 and then shortly
thereafter became an EMT and got into the medical side of
first response. Following 9/11, it was crystal clear that this
country was very fragmented in its response to both natural
and manmade disasters. When it comes to manmade disasters,
particularly terrorism, I really want to try to do some good on
the medical side and improve the response and improve the
care on scene.”
Kotora was a Sept. 11 first responder. He also responded to
Hurricane Irene in 2011. But it was his fellowship in
emergency medical services and disaster medicine at Newark
Beth Israel Medical Center-Barnabas Healthcare System in
New Jersey that provided hands-on, real-life disaster training.
Hurricane Sandy hit New Jersey during his fellowship in 2012.
During the disaster, he provided direct medical care to patients
injured or ill during the storm; provided indirect and direct
medical care for paramedics responding to more than 300
incidents; and was involved in planning, logistics and
operational decisions in the New Jersey Department of
Health-Office of Emergency Medical Services.
Kotora holds eight positions, among them EMS regional
medical director for Navy Region Southeast; senior medical
officer at the Naval Hospital Camp Lejeune Emergency
Department in Camp Lejeune, North Carolina; and public
health emergency officer for Naval Hospital Camp Lejeune &
Marine Corps Base Camp Lejeune. Among his various prior
experiences, he also served as a Marine battalion surgeon in
Iraq for two years.
Emergency Nursing 2016 attendees will have the opportunity
to learn from Kotora when he leads the mass casualty
simulation event as part of the opening session.
The Four Phases
Kotora listed four phases of disaster preparedness: mitigation,
preparedness, response and recovery.
Mitigation is done to prevent emergencies or minimize their
effects. Preparedness includes plans made to save lives and
help response and rescue operations. Response involves
actions taken to save lives and prevent further property
damage in an emergency situation – in other words, putting
preparedness plans into action. Recovery concerns actions
taken to return to a normal or an even safer situation
following an emergency.
Recovery is probably the longest phase. Hurricane Sandy hit
four years ago, and the region is still recovering, Kotora noted.
He plans to discuss two interrelated hazard and risk
assessment tools during his presentation: the Haddon Matrix
and 360-degree threat assessment.
The Haddon Matrix was developed by William Haddon, the
first director of the National Traffic Safety Agency and the
National Highway Safety Agency, which were the precursors to
the National Highway Traffic Safety Administration.
“With the Haddon Matrix, it looks basically at the pre-event,
the event, the post-event and how they contribute to injury or
loss of life, as well as lost property,” Kotora said. “The big
ticket items in disaster preparedness and response are
preservation of life, preservation of infrastructure, trying to
preserve property and, lastly, conservation of the environment
to try to prevent environmental destruction.
“The 360-degree threat assessment is similar to the Haddon
Matrix except it looks at it from more of a 30,000-foot view. It
factors in socioeconomic factors, environmental factors, to see
what effect a specific disaster is going to be on a region.
“One is more detailed than the other. I usually start with the
360 and move into the Haddon once we have specific threats.”