Target: Providence

The Gilbert Stuart incident reveals a woeful state of preparedness

by David Andrew Stoler

When three students set off pepper-spray at the Gilbert Stuart Middle School on March 12, Providence got a quick and bitter taste of exactly the sort of bioterrorism scenario for which the US is trying to prepare: an unknown toxin was released into a public space and students and teachers were fainting, vomiting and displaying other signs of some sort of poisoning as they showed up en masse at Hasbro Children's Hospital. Indeed, Mayor Vincent "Buddy" Cianci implied that while the incident that sent some 76 students to area hospitals was serious, the efficiency with which the Providence fire and police departments, Hasbro and RIPTA responded to the emergency was worthy of praise.

But according to officials in the Rhode Island Emergency Management Agency (RIEMA) -- the agency in charge of preparing and coordinating the state response to a chemical or biological terrorist attack -- the Gilbert Stuart incident did not bode well for our statewide preparedness. Says RIEMA program manager John Aucott, "What happened was busloads of children with some substance on them showed up and the hospital didn't have the personnel-protection equipment. And what they did have they had trouble putting on."

Instead, Aucott says that the overwhelmed hospital became contaminated itself. "It's an example of how the system would fall apart if there actually was a chemical terrorist incident in Rhode Island. The doctors and nurses would become victims. You can't do your job to help people if you become a victim," he says.

Chris Harwood, the interim director of Emergency Medical Services at Brown University, says that Rhode Island, in general, is vastly under-prepared for any major toxic event. Harwood knows: he recently researched and wrote a paper that outlined major faults in the state system. "They're basically unprepared -- in terms of personnel available, equipment they had available, what were their lines of communication, who is going to step in," he says.

It's the lack of clear lines of communication that most puts Rhode Island at risk -- without a solid network of responders, piece-meal attempts at triage can often even exacerbate the contamination of a bioterrorist attack. Both Aucott and Harwood agree that other state systems are in better shape. For example, Massachusetts state officials divided the state up into six sectors, then set up a complete response team to deal with biological-emergency situations. The idea is that one well-linked, funded, and coordinated response team per area is better than a disparate, under-funded team in each town.

Rhode Island, though, doesn't have even one complete team. So whereas Providence, which recently received a $300,000 federal grant in order to help them prepare a team, may be -- may be -- in OK shape, other Rhode Island towns will find themselves left in a lurch. "In Massachusetts, if a team is needed in a region, they come together and fix the problem. We only need one team æ but we don't have that. To me that's a deficiency," Aucott says.

Things are happening in Rhode Island to try to right that situation -- the federal grant should help Providence's readiness, and a recent bioterrorism conference at Rhode Island Hospital began questioning the problems associated with bioterrorism and the issues of contamination for which Hasbro was so unprepared. But Aucott says that unless a statewide network is put into place, local responders are going to find themselves quickly overwhelmed. "For the most part all hospitals should be able to handle one or two victims. But who's prepared to handle 80 people who show up and need to be decontaminated?" he asks.

The Gilbert Stuart incident is an obvious indicator that, as a community, we are not. In order to receive the incoming grant, the Providence team had to have already undergone training, but that training had clearly not been passed on to the hospitals. "The disaster scene just got shifted from the scene to the hospital -- doctors were coming down with symptoms," Aucott says. "They need to look at that event a week-and-a-half ago as a wake up call."

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