In the Czech Republic, the system of modern rescue service has achieved considerable level of efficiency in the years before the terrible terrorist attacks in the USA on September 11th 2001.
After long lasting efforts of physicians active in the Emergency Medical Service (EMS) [predominantly anesthesiologists] by the end of 90ties, important steps ahead were achieved in the legislative basis as well as in the technological and personal equipment, in monitoring and in operational management of the EMS.
In 1998 Minister of Health has established Emergency Medicine (EM) as a higher medical specialization. According to the statement of professor Delooz, president of the European Society for Emergency Medicine, we have achieved such professional level of emergency medicine as the seventh state in Europe. Consequently, the past Chair for Prehospital Immediate Care and Disaster Medicine in the Institute for Postgraduate Medical Education in Prague has been renamed as the Chair for Emergency and Disaster Medicine. Emergency Medicine is the only one of our medical specializations containing integral chapters from disaster medicine. Immediately, we have started the specialization education of physicians (till now 220 physicians have achieved the specialization degree in EM). Furthermore, courses of continuous education for specialists in Emergency Medicine are periodically organized. And, more to this, we have initiated and offered First Aid training program in order to achieve higher level of knowledge and skills in first aid among physicians. Consequently, in 2001 the Ministry of Health has decided that all physicians have to pass successfully our First Aid course and training before their admission to the examination in elected specialization (first degree).
By the end of 2000, three basic laws related to disaster situations (on Integrated Rescue System, on Crisis Management and on Economical Measures for Crisis States) were issued.
In July this year, during floods from rivers swollen by heavy rains on the territory of the Czech Republic, the largest floods in our known history, all rescue capacities of the country have passed an enormous test.
The flood disaster has started in southern Bohemia. During following days, permanently increasing masses of water in the river Vltava /Moldau/ have moved to the North, to Prague and later on to the confluence of the river Vltava /Moldau/ with the river Labe /Elbe/. The flow of water in Prague has reached the maximum of 5 500 cubic meters per second - when compared to the normal value of 150 cubic meters more then 36times!
According to the report of the Ministry for Local Development, as issued on August 28th, 505 localities placed in 31 districts with 1 600 000 citizens were flooded totally or partially (see picture). Up to the definitive report, dated September 4th, 2002, 753 villages and cities were severely damaged by floods. In Prague, the territory along the river was overflown and further seven regions were inundated. Loss of 17 human lives was confirmed. More than 27 000 men and women - comprising 3 800 professional firemen, 11 500 voluntary firemen and 4 800 policemen = were put in the rescue work first and later on in the removing of damages. They were reinforced by 1 350 soldiers. Further 5 700 soldiers were destined for the rescue work.
The recently by law constituted Integrated Rescue System (cooperation of the Police, the Fire Rescue Corps and the Emergency Medical Service with the Army, with the Civil Protection capacities and with some smaller rescue organizations) proved to be a very effective instrument for organization and performance of rescue operations in large dimensions. In tens of minutes some 230 000 people were evacuated from threatened locations into emergency lodgings. The policemen and firemen predominantly have shown appropriate psychological approach to people who were suddenly, even during night, demanded to clear their lodgings in shortest possible time in order to save their lives. Approximately 4 000 of them have refused to leave their home. Later on, when in immediate danger of death, they were rescued by firemen - in necessary cases using the helicopter. Many rescuers were risking their lives when releasing those who had refused before the evacuation in time.
One man was instantaneously killed by a splinter when observing from the prohibited zone on a bridge the explosion of a boat who had created dangerous obstacle on the water-level in front of one support of the bridge.
Very serious danger for the population as well as for the territory has arisen in a big chemical factory Spolana in the city of Neratovice on the river Labe /Elbe/. Large stocks of dangerous chemicals like chlorine, mercury, dioxin and hexene were flooded with unexpected enormous amount of water. Unknown amount of chlorine and mercury has escaped in the river. The management of Spolana has published the necessary warning to the population with delay. Nevertheless, the chemist specialists of the Army and of the Fire brigade were successful in control the actual risks of the situation. Later on, the management of Spolana has reported officially losses of some other chemicals as follows: dichlorethane 1.2 - 50 kg, sulphuric acid 10.6 tons, masout 30.5 tons, crude oil products 13 717 1. The bulk of those was collected in the factory area. Out of the factory area escaped further ammonium sulphate 2 380 tons, calcium hydroxide 150 kg and many other substances. Fortunately, no significant toxic pollution of the river Elbe was identified in Germany.
In the course of crisis days, the rescuers from Emergency Medical Service were assisting the firemen during extrication of persons from blocked flats and houses, during removing obstacles endangering the stability of bridges etc. Two firemen died from sudden cardiac insufficiency. The number of emergency calls was lower compared to the normal regime of work. In days just after the fall of high water, many problems have arisen to be solved by the Health Service. Enormous amount of mud and sum brought with the danger of large contamination of different infections like hepatitis A, leishmaniosis, salmonelosis, dysentery etc. Workers of the Hygienic Service have organized and performed the vaccination for members of rescue teams and have distributed 1,5 million leaflets describing regulations for prevention the infectious diseases. According to the decision of Minister of Health, small children also have been vaccinated against hepatitis A.
We were able to compare the efficiency of rescue operations now with the similar disaster experience from big flood in 1997 when approximately one third of the eastern territory of the Czech Republic was damaged. Undoubtedly, the constitution of the Integrated Rescue System endorsed by law has significantly contributed to very good cooperation of basic parts of the system (Police, Firemen, EMS, Army etc.) since the very first moments of the flood disaster. There was less improvisation and more cooperation of all participants. In 1997, the loss of lives has achieved 50 compared to 17 deaths this year.
Similarly to the terrorist attacks on New York and Washington last September, the floods in the Czech Republic have confirmed the significance of the "professionalism" and "preparedness" on all levels of the society, mainly in places with higher risk of disaster. First of all, the Integrated Rescue System must be ready on all its levels. There should be stressed the absolute necessity of preparedness in all types of the management. They have not only to tolerate but also to guarantee the existence of the efficient crisis management as a real necessity for the contemporary world.