Estimating mass care resources: the example of the Kumamoto earthquake

I've been trying for over 20 years to estimate the amount of mass care resources that would be required in a disaster. In 2004 when Florida was hit by 4 hurricanes in a 6 week period I had multiple opportunities to try and figure this thing out. One thing I learned pretty quick in the 6 weeks was that when someone wanted me to provide a mass care resource they wanted it RIGHT NOW. Or, preferably, yesterday.

I also learned that in the State Emergency Operations Center during a hurricane response we weren't able to do "right now." For certain things that were already in the State Logistics Staging Area (like bottled water) we might even be able to do "tomorrow." More likely it was going to be day after tomorrow. And if they wanted something that we hadn't already ordered it would be, well, days until they would get it. That is if the requester was lucky and everyone, including me, did everything right.

There was a lot of things that I remembered and a lot of things that I forgot after Charlie, Francis, Ivan and Jeanne paid us all a visit. My big takeaway was that we needed to be able to estimate mass care resource requirements before the damage assessments were completed and in some cases, before the event actually happened.

How in the world are you going to do that? you may ask. Think about it. If a Category 5 Hurricane is lined up on Miami and forecast to hit there tomorrow we don't need to say, "Well, as soon as the damage reports are compiled, probably a few days after the storm hits, we'll know what we need to order. We'll just have to wait until then to figure out what we need."

We have to do better than that.

The things we need to order are always the same: cots, field kitchens, shelter managers, bottled water. What we don't know are what numbers we need to put in the quantity blocks of the requisitions. What frequently happens are conversations like this:

MASS CARE GUY: I need cots.
LOGISTICS GUY: How many?
MASS CARE GUY: I have no idea.
LOGISTICS GUY: "I have no idea" doesn't fit in the quantity block of the requisition.
MASS CARE GUY (MAKES UP A NUMBER): What about 10,000?
LOGISTICS GUY (WHO DOESN'T CARE WHAT THE NUMBER IS BECAUSE YOU'RE JUST ONE MORE PROBLEM BETWEEN HIM AND THE END OF THE DAY): OK.

I've had those conversations during a disaster. More than once, I'm afraid to say. But what could I do? There wasn't a manual or instruction book explaining how to do all this stuff I was doing. I decided that there had to be a better way of doing things than making up the numbers.

After 10 years of talking, explaining and arguing with some knowledgeable mass care people we've come up with a process to estimate mass care resources. The process is crude and needs a lot of refining, but guess what? Doing it this way is better than making it up.

The demand for mass care resources after an event is based on three factors: population, intensity and vulnerability. The population numbers we can get from the Census. To estimate intensity levels we developed this chart:

Table to estimate event intensity.

What we do next is estimate the number of people who were affected by each intensity level. For hurricanes we have the Saffir-Simpson Scale.  The U.S. Geological Service puts out PAGER Alerts after significant earthquakes. The basis for measuring earthquake intensity in these Alerts is the Modified Mercali Intensity Level:

The PAGER system provides fatality and economic loss impact estimates following significant earthquakes worldwide. This information is usually available within hours of the quake and provides an immediate estimate of the number of persons affected.  The USGS put out a PAGER ALERT for the Kumamoto, Japan earthquake that happened several weeks ago. The PAGER looked something like this:

The PAGER showed estimates of the number of persons affected by MMI level. Using the Event Intensity Table I came up with the number of persons affected by High (194k), Medium (1,410k) and Low (2,865k) intensities. I entered these population numbers into the Mass Care Planning Tool spreadsheet that we've developed to estimate mass care resource requirements

Remember: the demand for mass care resources is a function of population, intensity and vulnerability. Using the Intensity Table and the PAGER we were able to estimate the population affected by intensity. From these numbers we need to estimate the % of people who need to be fed and sheltered, for each intensity level. The percentages would vary according to the vulnerability of the people.

In some places, for example, the percentages for sheltering would be 10% for High, 5% for Medium and 1% for low. There are different percentages to estimate the feeding numbers. I had no idea what %'s to use to make a shelter estimate for a Japanese earthquake so I used the 10/5/1 that I had. The estimate using those percentages for the Kumamoto earthquake was 118,550 persons needing shelter (see Table below). Then I waited for the off chance that I might actually be able to get an estimate of the number of persons requiring shelter.

A few days later I read in the Wall Street Journal": “A total of 41 people were confirmed dead in Kumamoto prefecture, the epicenter of a magnitude 6.5 quake on Thursday night and a magnitude 7.3 quake 28 hours later early on Saturday. About 110,000 people were taking refuge at temporary shelters there as of Sunday afternoon, a Kumamoto prefecture spokesman said.”

Weather.com also reported that: “Local media reported that nearly 200,000 homes were without power and an estimated 400,000 households were without running water…[and] 180,000 are without shelter.”

Now that I had some actual numbers of people needing shelter I could see that the estimate of 118k needing shelter was low.  The 10/5/1 shelter percentages that I used weren't high enough, and probably should have been higher.  In other words, their vulnerability to the hazard was greater than I estimated.

As we socialize this estimation process in the mass care community and people start using it in disasters our ability to estimate these vulnerability percentages will improve. The conceptual framework for this estimation process has been included in the new FEMA L418 Course: Mass Care/Emergency Assistance Planning & Operations Course. This concept is also included in the new (soon to be released) Red Cross Feeding Standards & Procedures.

 Like I said, the process is crude and needs a lot of refining. But take my word for it: estimating mass care resource requirements this way is one HECK of a lot better than making up the numbers.

Notes from a trip to the earthquake zone

The magnitude 8.8 earthquake that struck at 3:30 A.M on February 27 of this year was the fifth largest in recorded history. For the survivors in the Chilean coastal city of Constitución the shaking was only Act I in a drama that was repeated in other towns along the coast. The two minutes of shaking by the earthquake was followed in twenty minutes by a tsunami that inundated and destroyed the low-lying portions of the city on the water’s edge.


During a visit that I made to the city in July I got a chance to talk to some of the survivors. I was in Chile on a visit organized by the Greater Los Angeles Chapter of the American Red Cross. The eighteen members of the group included not only members of the LA Chapter, but state officials from California’s emergency management agency, scientists from the U.S. Geological Survey, a civil engineering professor from the University of Colorado, a physician, and me, a state emergency manager from Florida.


On the afternoon of the second day of our tour of the earthquake affected region, we departed the city of Talca, the capital of the Maule region of Chile, for the city of Constitución. The city lay at the juncture of the Maule River and the ocean, gradually occupying and then filling the valley as we descended from the mountains. When we arrived at the river’s edge in the center of town we were presented with a view of the Pacific. Dusk was approaching and the spectacle of hundreds of sea gulls circling to our front diverted us from the panorama of an orange band that separated the horizon from the low hanging clouds.


As our vehicle crept forward, I saw an island in the river to our right, and eventually the reason for the interest of the birds. The Constitución fishing fleet was unloading their catch; orange, blue and white plastic tubs filled with strips of silver. Young men muscled the tubs from the boats and stacked them by the street to be loaded on waiting trucks. The fishermen wore slickers and had dark, sunburned faces. They stood on their boats and stowed their nets with practiced hands, repeating the motions of centuries.

The thought came to my mind: what a hard job.


Beyond the fishermen was the island, and I tried to imagine that awful morning. On the day of the earthquake the city had planned a traditional annual festival. In order to get a good view of the festivities and the fireworks, local inhabitants and visitors from out of town camped on the island that divided the river as it passed into the sea. When the terrible shaking had ended, three fishermen were able to use their boats to begin evacuating the island. They knew what was coming, and what would happen if those people could not be taken off. They carried away forty-five, and then went back for more. When the tsunami hit two of the fishermen were killed. Later, when they searched the island, dead children were found hanging in the trees.


The tragedy of the deaths is great, but what is surprising is that more didn’t die. Of the five hundred and seventy six deaths from the Feb 27 earthquake, approximately half were from the tsunami. The 7.0 earthquake that struck Haiti the prior month was several orders of magnitude less severe, yet the death toll was in the hundreds of thousands. Haiti is not like Chile, as anyone with a cursory knowledge of the two countries could tell. Yet Chile clearly handled the response to the earthquake very well, despite the size and severity of the event. Why did they do so well? That question was the reason for our visit.



The big measure of the quality of the Chilean response was that the coverage of the disaster dropped off CNN after a few days. As every emergency manager knows, if Anderson Cooper is still camped with his TV cameras in the middle of your response after two weeks, then you must have done something wrong.



We are writing a report of our findings and look to have the first draft completed by the end of this month. When the report is completed I will share it with you. I will be making presentations on what we learned at every opportinity in the upcoming months.

On our way to Constitución we stopped by a temporary village, or Aldea, that the government had constructed for those left homeless by the tsunami or earthquake. Two women inhabitants approached us, drawn by the strangers and not afraid to talk about their plight. The Aldea, constructed on the empty land of a nearby sawmill, consisted of small wooden structures, called mediasaguas. Communal bathrooms and showers served for sanitation. Utility poles were installed in May and brought electricity to the dwellings. Although protected from the rain, the poorly insulated houses could not keep out the cold.

We asked if we could see inside one of the mediasagus, and after a moment’s hesitation, the women to the left in the above photo said yes. She led us down a muddy street, where a trio of girls made mud pies with toy dishes. Inside the home a man, probably her husband, crouched over a tub of dishes in the middle of the floor. He stood to greet us with dripping fingers. The home was clean and neat, but the man’s eyes clearly conveyed the daily struggles of their existence.

As we said good-bye to the people in the Aldea, the woman who had shown us her home embraced the women in our group and, in the custom of her country, exchanged kisses on the cheek with the men. We were leaving to continue our journey into the earthquake zone and eventually return home to our families and homes. She was left to continue her life of cold, wet and mud in a small wooden shack to which the earthquake had condemned her.



“No nos olvide,” she called out to us as we climbed into our vehicles. “Don’t forget us.”



Her plea broke my heart; the first, but not the last time this was to occur while I was in Chile. No, I won’t forget her. Hopefully, you won’t either.

The Chilean earthquake of February 27

The 8.8 magnitude earthquake that affected Chile on February 27th of this year was in the top ten in recorded history, affected 80% of the country's population, and caused $30 billion in estimated damages, a sum equaling 18% of the country's Gross Domestic Product. Considering the immensity and size of the quake, the death toll of 576 (nearly half of which came from the impact of a tsunami on the coast) is remarkable. Why were the number of deaths so low?

I am here in Santiago with a team assembled by the American Red Cross to find out why. The team of 18 includes a civil engineering instructor from the University of Colorado, a scientist from the U.S. Geological Survey, a trauma surgeon, as well as public health and mass care specialists from the Red Cross and the states of California and Florida. The government of Chile and the Chilean Red Cross have made available to us in the last two days key individuals who have provided us with a wealth of information. This information is being captured by the team and will be included in our final written report.

At the end of each day we meet to go over what we have we have heard and attempt to digest what we have learned. A word that I have seen in many emergency management articles in the last six months is "resiliance" and this word has come up in our discussions about Chile. The people and country of Chile appear to have developed a culture of resiliance. How did they do it, and what can we learn in order to transfer this culture to our own country?

The largest quake in recorded history was a 9.2 magnitude that ocurred in 1960, off the southern coast of Chile. The quake affected a part of the country that was less densely populated, but did result in a change to the building codes. Another quake in 1985 resulted in a further strenthening of their building codes. Consequently, only two large buildings collapsed during the 2010 quake. Over 300,000 buildings were damaged or destroyed in the recent quake, but they were all older, smaller buildings made of adobe.

The coastal inhabitants of Chile are primarily involved in the country's large fishing industry, and they grew up listening to stories about the 1960 quake from their parents and grandparents. The warning they heard was, "If the ground shakes so much that you cannot walk, then when the shaking stops you must run to high ground. Don't wait for a warning from the government. Run." And run they did. Most of the tsunami deaths were from tourists visiting the coast who failed to follow the locals as they moved to high ground. This is what we mean by a culture of resilience. 

We have heard what the people in the capital have had to say about the government's response to this catastrophe. Tomorrow we drive into the earthquake zone to talk to the people who had to experience it on the ground. We are interested in hearing what they have to say. 

My trip to Chile with the Red Cross

I was invited to participate by the American Red Cross as a mass care subject matter expert on a team of 18 persons on a trip to Chile. The purpose of the trip is to gather some of the hard lessons learned by the Chileans as a result of the terrible earthquake they suffered in February of this year. We depart on this Red Cross sponsored trip this Sunday, July 18 and will return to the United States on July 28th.


Although I am taking leave from my job to make this trip, my emergency management responsibilities required that I request and receive permission to leave the country during hurricane season. My condition for participation to the Red Cross was that I be allowed to scurry home if a big storm threatens Florida.


I have known about the possibility of this trip since May, but was afraid to talk about it (or even think about it) until the last few days, when it looked like the Storm Gods were going to smile on me for at least the next 7 days. But now that it looks like I am going to be able to go, I am excited and see this as a once-in-a-lifetime adventure.


My lifelong urge for once-in-a-lifetime adventures was dramatically diminished after Iraq, but it it has been six years since my return from the Middle East, and I feel ready for another adventure, even if it is only of the small, ten-day variety.


I have seen the tentative itinerary, and after some initial meetings in Santiago, the capital, we travel south by vehicle into the earthquake zone. I have studied the local newspapers on the Internet, and the stories I read have confirmed that the country is still suffering through numerous, complex problems caused by the event. Yet, since these problems are no longer reported by CNN or Fox News or the New York Times, the people of the United States know nothing about them.


But I will.


I have been to every country in Latin American except Cuba and El Salvador (I have been to Chile twice). I speak fluent Spanish. But this trip will be different. Traveling outside the capital by vehicle, and getting to see and talk to emergency managers and survivors of one of the largest earthquakes in recent history, will be educational and enlightening.


There are real emergency management lessons to be learned there in Chile, lessons that we can bring back home for use in California, and even in Florida. I am going to do my best to find them.