I am concerned about what the Sept. 11 commission has not said in its interim reports about the emergency response in the Washington area on the day of the Pentagon attack.
My wife worked in Crystal City and was caught for more than three hours in the debris plume from the plane crash and fire. She has suffered physical and emotional problems since, most likely -- according to her doctors -- as the result of exposure to some unknown toxic materials released by the plane crashing into the Pentagon.
Some urgent issues must be addressed concerning emergency response in the metro area. They include:
The lack of a coherent evacuation procedure.
Thousands of people may have been exposed to toxic substances on Sept. 11, 2001, in addition to the obviously increased chances of traffic accidents, panic and other secondary effects. Certainly, staying inside for a few hours would have been safer than what happened.
Slow and uncoordinated medical response.
Many seriously injured victims from the Pentagon arrived at Virginia Hospital Center via private vehicles. People apparently gave up on waiting for ambulances or could not find out when to expect them.
Information available via the media inflamed the situation. Rumors of additional attacks were reported -- especially the frequently repeated story about a car bomb on Capitol Hill. People evacuated areas that were not in danger, adding to the congestion and exposure for those who were affected by the attack.
Breakdown of cellular networks.
Cell phones were almost useless, as undamaged networks promptly overloaded. People's inability to communicate via cell phone added to their anxiety and probably led to poor choices about when and how to flee.
Lack of information about hazardous materials released by the fire.
The difficulty the Arlington Fire Department had in obtaining a full list of hazardous materials potentially involved in the Pentagon fire is a general problem with federal classified facilities protected by metropolitan fire departments. This difficulty needs to be resolved for the safety of the surrounding populace, as firefighting efforts could have increased and accelerated the release of hazardous materials.
Lack of follow-up information and reporting regarding exposure to hazardous materials.
There was and is no protocol for recording cases of respiratory, digestive or other physical distress that could have resulted from toxic exposure.
Lack of monitoring or reporting of mental health consequences.
There was not and is not any coherent way of recording and connecting presentations of emotional symptoms that might be related to the traumatic event. Some people with no prior history of mental disorders may have experienced psychotic states because of heavy metal exposure; we will never know.
Victims with psychological symptoms and no prior psychological treatment tend to turn to faith-based counselors. This was the case in the Oklahoma City bombing, where many people sought counseling only many months later. Faith-based providers need better information about helping victims of traumatic events, and they should be encouraged to report (to some central agency such as the Centers for Disease Control and Prevention, with proper safeguards) clusters of people presenting similar symptoms.
Poor dissemination of information about what services were available.
The information available to victims concerning what services they might obtain was poor, scattered and inconsistent. So were the mechanisms for collecting information about the quality of services that people did receive. My wife was offered free grief counseling while still in the hospital, when she was overwhelmed by her physical problems; later, when she was ready for counseling, she could not find it.
Overly restrictive criteria for offering services.
My wife was denied counseling services on several occasions because she was not officially a victim of the crash since she wasn't in the Pentagon itself. People emotionally affected by proximity to the event should be eligible for trauma counseling and, in some cases, screening for exposure to toxic substances.
By 11 a.m. Sept. 12, Arlington police were issuing parking tickets to vehicles parked in safe places, not blocking traffic, but with expired meters. This enforcement action hardly can be called helpful.
Uncoordinated, poorly justified, hasty responses to assumed needs.
The large amounts of money disbursed to state and local governments for "improving emergency response capabilities" within the year after Sept. 11, 2001, preceded any analysis of where improvements were most needed. Were these disbursements mostly wasted?
For example, having four to six more federal biohazard teams probably would increase quick-response capability to a bioterror event much more than the large expenditures localities received with the vague direction, "do something to improve your emergency medical capabilities."
The Sept. 11 commission has done valuable work. However, much remains to be done. Congress and the administration must focus on what we need to learn, and the media and the public need to follow up to make sure that the needed improvements occur.
-- Douglas A. Samuelson
is a former federal policy analyst
with experience in emergency planning.