Rasa Selenas

Good evening and thank you for being here. I think that your interest is a very wonderful positive sign as a community we know what the score is and we're prepared to arm ourselves as well as we can. I normally talk to civilians, but I thought it would be useful today especially since we are a military community to give you an idea about what the military's role is in homeland medical security.

A couple of years ago in many areas there was an attitude among the civilians and among the military if we had homeland issues and terrorism, particularly with chemical and biological weapons, but the locals would just pull out and the military would just come in like in the movies and everything would be hunky dorey. And that's just not true. Now San Antonio is unique and very interesting because we have such a strong local military presence that has a lot of implications, both as a liability to the community and as an asset to the community. And I'd like to emphasize the second part of that. Because I think that role is a more important factor. There's been a lot of things going on as a number of speakers have alluded to. We have been participating in planning with the community emergency response as long as the military bases have been here. We have standing agreements with the city, that our fire and police departments help each other out. And because of the trauma center arrangement, which is absolutely unique in the United States. Our two large military hospitals are part of the community's medical assets. So we have been working together all along on a number of issues. We've got good communications among each other and we know each other, which is always very nice to have. That's the mutual support agreement. These are actual agreements in writing that say that we will help each other to the extent that we can. We've provided a fair market subject matter support meeting. Somebody wants to know about anthrax and if we have someone who knows about anthrax we'll send them over and share our knowledge. And also there is a laboratory response network which was organized by the centers for disease control, which categorizes hospitals and laboratories according to how much they should be able to do in the protection of bioterrorist activity. Two of our military laboratories in the city are standing side by side, not as the ones who are taking over, but shoulder to shoulder with metro health districts laboratories as partners in the laboratories' response network.

In any disaster, including a terrorist event, the shock troops are the short of people that are sitting at this table here. Shock groups work with Dr. Guerra, work with Dr. Bauer and work for Chief Miller. When the military come in, the principal military responder are the National Guard especially in communities that don't have an active military presence there. But the important thing about the National Guard is that it's a safe asset. And therefore the governor can call up the Guard without going through all of the federal "mother may I" chain. And believe me, there is a Federal "mother may I" chain. The active duty members, fill in the gaps for what the Guard need, and provide additional support. We're activated either locally, for life-saving situations on the commander's authority for the short term or on orders for Washington. It's always in a support, we never take over. There are some things that we cannot do. By law we are not allowed to perform law enforcement except in a support role. So if the police department or the state troopers say we need a couple of extra bodies here to guard the fence, the National Guard or the military can participate in that. It's always under careful delineated civilian control. We cannot substitute for local capability. Our locals need to be able to at least get started on a response. Then we can come in the backfield. And then San Antonio, which we discovered, I mean we knew this would happen, but it's always a little bit breathtaking when we're forced to do it. In a national crisis we are occasionally compelled to shut down the civilian trauma. This has a big ripple effect through the cities medical community. We know it, we plan for it and we get back online as soon as we can. But those are some of the things that we're involved with.

The types of roles we can play in a civilian support capacity would include logistics-moving stuff around. That's no small task in a big medical event. If we had to provide prophylaxis or antibiotic for even a tenth of the city, that's over 100,000 people. That's a lot of traffic control. That's a lot of moving equipment and supplies into the distribution centers. And it's not out of the question that the military would participate in that. We do participate in detection and testing to diagnose chemical and biological agents. And we have some strong medical capabilities that will remain available to the extent that we will be able to support medical activity and planning is ongoing on how we can do this better and better. Those of you who were watching the Houston floods this summer, may remember we were able to watch a team from Wilford Hall very quickly to help the city of Houston out. And that very rapid response, light weight capability will probably become more and more important to the National Guard. If you have any questions, I'll be happy to take any during the question and answer period.