While drills and procedures are important, there's little substitute for the actual experience of reacting to a bomb or biological attack, said a local expert.
"Even during exercises, nothing goes perfectly well; there are always gaps in your plans and lessons learned," said Ed Jasper, director of the Center for Bio-Terrorism and Disaster Preparedness at Philadelphia's Thomas Jefferson University Hospital. "When you throw in a real event -- and the chaos that occurs and the emotions that occur -- you have a much higher chance of things going wrong."
"The lessons you learn," he continued, "are things you can't really learn from an exercise."
It's common knowledge that Israel has a wealth of experience in responding to terrorism, in terms of the sheer number of incidents and its cutting-edge methods to save lives, treat the wounded and identify the dead.
When Jasper discovered that four of Israel's leading disaster-preparedness specialists were in the region talking to other groups, he threw together a conference at Jefferson, thinking local personnel could benefit from the insight. He said he had no idea how many people would show up on such short notice.
'They Are the Experts'
As it turned out, roughly 150 people -- doctors, nurses, paramedics, police officers, social workers and even some government officials -- attended the June 13 conference co-sponsored by the Israeli Consulate and the American Friends of Magen David Adom. Topics included on-sight and emergency-room response, as well as how forensic investigators and social workers perform their duties under the grimmest of circumstances.
Jasper said that the Israelis have developed a coordinated mass-casualty response that's second to none in terms of organization that incorporates all aspects of care, including mental-health workers at the scene.
"We are all here because of the Israeli experience. They are the experts," said attendee Diane Adler, an assistant professor of nursing at Temple University Hospital who sits on its emergency-preparedness board.
According to Isaac Ashkenazi, a former surgeon general for the Israel Defense Force's Home Front Command who's now affiliated with Harvard University, it wasn't until after 1991 -- when Iraq fired more than 30 Scud missiles into Israel -- that the country developed its current, standardized system for response.
Israel learned from its mistakes back then -- when, for instance, a turf war erupted over who was in charge of the emergency response, said Ashkenazi.
He added that the preparedness and resiliency of the public goes a long way toward determining how well an area copes with a terrorist attack.
It's imperative to have private citizens who are prepared in their homes for an emergency and who can serve as volunteers in times of crisis, stressed Ashkenazi.
Alon Basker, who directs training for Magen David Adom, said that his organization's wide network of volunteers partially accounts for its rapid arrival times at disasters.
"You should be ready for suicide attacks in the United States -- small ones, not big ones like Sept. 11," concluded Ashkenazi.
Jasper noted that while homeland security may not be in the news as much as it was in the fall of 2001, the level of expertise and commitment of officers involved is "very impressive. I think the public doesn't really appreciate how much time and effort goes toward readiness behind the scenes."