A High Stakes Game of Risk : Disaster Preparedness

The 2022 Winter Olympics in Beijing, China, have just concluded and the spirit of these games is being lost on high-risk statesmanship between Russia and the Ukraine that has the potential to be calamitous for the region and the world, as it continues to emerge from a deadly pandemic. Much like the game of Risk, ¹ nations are readied to move about with little consideration for human safety and health. Although not a treatise on current events, this piece is intended as a stark reminder of preparedness for disasters and the consequences of not preparing.

Disasters, whether brought on by humans or by nature, often result in significant death and destruction. Throughout recorded human history, there have been refugees who have been moved around like pawns on a chessboard with limited access to basic human needs—food, shelter, health care, safety, education, etc. A difference in opinion, beliefs, land, natural resources, terrorism, nationality, etc. are often the causes of war, which always results in the displacement of individuals. Similarly, natural disasters dislocate individuals from their homes; the recent underwater volcanic eruption that devastated the island nation of Tonga is a prime example.

Over the past several decades population centers that have been impacted by disasters, whether brought about by war or natural disasters, have been aided by telemedicine in some way. ² The North Atlantic Treaty Organization (NATO), although established after World War II to prevent another war in Europe, may very well be pushed to the brink of a costly conflagration that may impact eastern Europe much more than can be imagined.

Another side of NATO is the NATO Science for Peace and Security Programme (SPSP). In 2014, NATO SPSP developed the Multinational Telemedicine System for disaster response. This project included Romania, Russia, and experts from the United States. ³ After Russia's invasion and annexation of Crimea, Russia's role in the project was terminated and Finland, Moldova, and Ukraine became partners. The project concluded in 2017 with a final report and a published book presented to NATO. ⁴

The concept of a multinational response system has been proposed in the past, and the NATO SPSP was the largest to date. It was deployed in Lviv, Ukraine, which is in a western province near Poland. It was successful and demonstrated the utility of such a system to responding in a disaster. ^4,5 In the coming weeks, we will see how significant the damage is and how many refugees may result from this current event.

This journal has reported over the past several decades articles on the utility of the need for preparedness in disasters. The important lessons learned from past disasters and wars have given us a strong foundation for being responsive.

Risk, in the aforementioned case, is focused on one nation's intent toward another. Risk is also a key for all of us for not responding. If we agree that telemedicine, telehealth, mobile health, etc. are of key importance, then the risk of not using this capability in any situation may have a negative impact. The pandemic has clearly demonstrated the utility of telemedicine and telehealth and returning to the pre-March 2020 paradigm will increase the risk of individuals not getting access to the care they need and have come to expect.

Are the stakes high that refugees from war or for any of us will not gain access to the care we need? Yes, if we are not prepared, then absolutely, we will not serve our communities well. Are we willing to accept that risk?