High Alert Institute



Everything That’s Old is New Again: Preparedness & Playbooks in an AHOHN Framework

by | Feb 16, 2023

Everything That’s Old is New Again:
Preparedness & Playbooks in an AHOHN Framework

Co-Authors: Maurice A. Ramirez, DO, PhD, and Allison Sakara, NP, MSN, RN, PHRN

“We are always creating new tools and techniques to help people, but the fundamental framework is remarkably resilient.” – John P. Kotter

Arising from the concept that all living things and habitats are interconnected, the AHOHN Framework – All Hazards, One Health, One Nature – is becoming the common ground across government agencies and non-government organizations to address any challenge. This shared foundation emphasizes the need to address any threat or risk to health, nature, medicine, and security in an integrated and wholistic manner. Every plan of action stemming from this unified perspective, then, already has a built-in appreciation of cause and effect for all living things and habitats. In this article from our AHOHN Framework series, we will discuss another real-world application of this approach – Disaster Preparedness.

Inclusive of “all hazards” by definition, the AHOHN Framework is an ideal fit for Disaster Preparedness. Having a goal-oriented plan to address any hazard is key. In addition, that plan must be understood by everyone and be well-practiced. The AHOHN Framework provides the shared vision and mission for addressing any hazard or risk, regardless of specific cause. Using this common foundation, the impact of both the hazard and the response are viewed as essential to the success of the plan. But how can disaster professionals, businesses, communities, and individuals alike employ this approach to create or improve their disaster readiness plans?

Anyone who ever has played or identified with a team sport understands the strength, as well as the flexibility, of a good playbook. While fine adjustments may be made when facing a specific opponent, having a shared construct that provides the fundamental plays is essential. Disaster response, from the personal to the global level, likewise benefits from good playbooks. By addressing all hazards and risks from a unified AHOHN Framework-based plan, we can develop and execute goal-oriented playbooks that serve and protect the needs of the entire community – people, animals, plants, and the environment. That may sound like an overwhelming task, but fortunately, the AHOHN Framework concept actually lightens the workload. Sharing a planning perspective to achieve the same overarching goals enables the sharing of the basic playbooks from one group to another. This also provides the opportunity to refresh and improve existing education and methods, making them simultaneously more valuable and inclusive. Yet how would this work for disaster readiness?

Traditionally, Disaster Preparedness addresses the 4 phases of any disaster – planning, preparation, response, and recovery. These phases are commonly referred to as the Disaster Life Cycle. Knowledge gained from every phase returns back to the planning phase, allowing for continued improvement before the next event. Employing the AHOHN Framework, we can look at these same phases with the understanding that every phase of this cycle will impact all living things and their habitats. With this as the common theme, regardless of the hazard or the population affected, the playbooks for each phase of a disaster lifecycle are united from the onset. So how will these playbooks begin to take shape?

One of the substantial advantages of using the AHOHN Framework is the generalizability of all-hazards concepts and teachings. This provides for broad application of available information, tools, and training across all teams and players. Subsequently, the resulting comprehensive knowledge base benefits everyone’s playbooks for planning and preparation. Driven by a shared desired outcome, the barriers from one playbook to the next begin to disappear. This frees a wealth of education and templates that already exist but previously were inaccessible or may not have seemed applicable. During the response phase, each team in the affected community likely has an individualized team playbook to support resilience and continuity. However, what the AHOHN Framework brings to this phase is the scope of what is considered during the response – the wholistic view of the community and the totality of the environment. Once the community enters the recovery phase, we once again return to a shared playbook to begin restoration. And the additional contribution of the AHOHN Framework at this phase focuses on the scope of the recovery and unites plans for wholistic restoration with those of improvement.

From 2002 to 2022, the US government alone spent more than $20 billion on research, education, resources, and activities currently known as One Health Security (the most recent implementation of the AHOHN Framework at the federal level). Most of these programs and projects are available to the general public at no cost. But accessibility and an understanding of applicability have been significant barriers. The information and tools were housed in specific places; how they could be used or adapted was not common knowledge. With the widespread implementation of the AHOHN Framework, however, we are opening the door to the vast potential for these resources to benefit every community and to be inclusive of all populations historically underserved. 

Experts, agencies, and governments internationally are broadening their missions, responsibilities, and operations by adopting an AHOHN Framework. From this wholistic perspective, our understanding and ability to respond to any hazard are deepened and magnified. In addition, this framework reminds us that it is not enough just to be disaster-ready; we also must be responsible, inclusive, and proactive. And Disaster Readiness is a perfect real-world example of how the AHOHN Framework can revitalize older approaches, to yield greater accessibility and clarity when addressing any challenge. 

About the Authors:

Maurice A. Ramirez, DO, PhD, is a physician and innovator with over a quarter century of service in emergency medicine, artificial intelligence, computing, regulatory affairs, and disaster response. Dr. Ramirez is the recipient of the Lifetime Achievement Award in Disaster Medicine and Co-Founder of the High Alert Institute.

Allison A. Sakara, NP, MSN, RN, PHRN, is a nurse practitioner with decades of experience in pediatrics, hematology/oncology, regulatory affairs, software as medical device (SaMD) consulting, and disaster response. Allison is the Co-Founder and Executive Director of the High Alert Institute. 

The High Alert Institute is a 501c3 not-for-profit educational public charity dedicated to providing disaster readiness education and resources to unserved and underserved communities, industries, and charitable organizations in an All Hazards, One Health, One Nature Framework. Learn more about the High Alert Institute at www.HighAlertInstitute.org

Griffin Works offers Pawsitive Interactions with Service Dogs During Response Operations©, an audience-customized training that breaks down barriers by offering hands-on handling training and demonstrations with working service dogs for fire departments, EMS agencies, and public safety organizations.

Part of the National Domestic Preparedness Consortium and home to the National Emergency Response and Recovery Training Center, TEEX has been leading homeland security training since 1998. The major TEEX programs include fire and rescue, infrastructure and safety, law enforcement, economic and workforce development, and homeland security. As a member of The Texas A&M University System, TEEX is unique in its ability to access a broad range of emerging research and technical expertise. Beginning with course design and development all the way through hands-on instruction and national certification testing, TEEX delivers comprehensive training through both classroom and hands-on instruction and as online courses.

The National Child Traumatic Stress Network (NCTSN) was created by Congress in 2000 as part of the Children’s Health Act to raise the standard of care and increase access to services for children and families who experience or witness traumatic events. This unique network of child-serving professionals, caregivers and young adults, researchers, and national partners is committed to changing the course of children’s lives by improving their care and moving scientific gains quickly into practice across the U.S. The NCTSN is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) and coordinated by the UCLA-Duke University National Center for Child Traumatic Stress (NCCTS). 

The Emergency Management Institute (EMI) is part of the Department of Homeland Security’s Federal Emergency Management Agency (FEMA). The EMI provides national leadership in developing and delivering training to ensure that individuals and groups having key emergency management responsibilities possess the requisite skills to effectively perform their jobs.

The High Alert Institute maintains a list of reviewed courses provided by governments, universities and professional organizations. This list is geared towards the non-emergency management person who participates in disaster planning, preparedness, response, recovery or mitigation as part of their job responsibilities.

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Koi need forever homes, too! For pond enthusiasts, freshwater exotic and ornamental fish may not be available through pet stores or rescues in their area. The High Alert Institute Aquatic Pet Shelter Rehoming Program will be happy to assist you in stocking your new pond or adding a new finned friend to your school. Coming soon – when you adopt a Koi from the High Alert Institute Aquatic Pet Shelter Rehoming Program, we can arrange for delivery to your door anywhere in the continental United States.

Have you always wanted a Koi pond but don’t have the space one? Sponsor a Koi in our community shelter pond and we send you photos of your sponsored animal. Coming soon are live Koi Cameras above and below the water to enjoy your sponsored Koi anytime.

Dumping of freshwater non-native species and exotic aquatic pets into wild habitats is a man-made disaster that is truly preventable. The Institute’s Aquatic Pet Welfare Partnership works to raise awareness and reduce the impact on healthy ecosystems through education, as well as rescue and rehoming. Joined by champions of animal welfare and environmental stewardship, this  association of aquatic pet rescue operations and aquatic pet shelters across the United States aims to save our finned friends and preserve our waterways together.

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Make your donation twice as nice by rehoming aquatic pets and providing a rehabilitation companion pet to a deserving person, family, or facility. Sponsor part or all of a Joy of Koi Program pond installation – complete with rehomed koi – and give the gifts of love and recovery.

Professional photographers, amateurs, and legal copywrite holders are all welcome to participate in the High Alert Institute Nature Photo Donation Program. Sales of the images benefit the Institute and donors are eligible for tax deductions equivalent to the fair market value of their photos. Landscapes, seascapes, animals, flowers – all may be accepted – whether new or vintage  images. People may be included in the photo but only if unidentifiable (i.e., blurred figures at a distance).

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Disasters are defined as situations in which needs exceed or overwhelm available resources. Some disasters affect an entire community, while other disasters impact individuals and families. Crises of physical or psychological health can be very personal disasters.
The therapeutic value of pets during illness, trauma, and recovery is well established. And Koi fish may be well suited for people who are not able to provide verbal pet commands or physically care for pets like dogs and cats. Koi ponds are also a source of beauty and peace, providing an ideal setting for quiet reflection or meditation.
We are working to partner with pond installers and aquatic pet rescues/shelters to offer free or reduced-cost ponds with rehomed Koi fish to people seeking this type of pet therapy.

Disasters disrupt life and impact our sense of personal, family, and community safety. Survivors and responders alike often are not aware of the emotional, psychological or spiritual challenges that they may face from disaster onset through recovery. With two decades of experience training responders and communities to prepare for the behavioral health aspects of disasters, we will continue to provide education and a curated list of resources to groups or individuals.

Non-medical factors that impact overall health are termed Social Determinants of Health or SDoH. Noise pollution, poor air quality, and poor water quality are three environmental factors known to have a strong link to overall health. And the same environmental factors that impact humans impact their pets and other animals in their care. We continue to assist in advocacy, education, and technology development to mitigate the impact of SDoH on humans and animals alike.

Our efforts in shelter and rescue are the main focus of our environmental stewardship, reducing the environmental impact of non-native aquatic animals being dumped into public waterways. The High Alert Institute also assists innovators with the design, development, and evaluation of green and renewable energy technologies. Reducing the carbon footprint associated with disaster preparedness, response, and recovery furthers our continued mission to mitigate risk and improve resilience.

We partner with public and private organizations, sharing resources and fostering partnerships to improve disaster preparedness, response, and recovery, and mitigation.

The High Alert Institute team has over a century of combined research experience in medical, nursing, behavioral health, and disaster sciences. Our team provides support to researchers and technology developers through comprehensive literature searches and reviews, as well as failure mode database searches and adjudicated reviews.

When disaster strikes, most aquatic pet owners have limited options to secure the safety of their pets. Sheltering in place may not be possible if there is no power to provide aeration and “pet-friendly” shelters do not include ponds or aquariums. Our goal is to provide an option for aquatic pet owners in need of rescue and shelter for their finned friends.

Our goal is to share our two decades of disaster readiness experience with animal welfare organizations, shelters, caretakers, and pet owners, as they implement contingency  plans for natural and manmade disasters.

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