title: Utilization of military support in the response to hurricane Marilyn: implications for future military-civilian cooperation.
abstract: BACKGROUND
  The past decade has been a period of evolution for the Federal disaster response system within the United States. Two domestic hurricanes were pivotal events that influenced the methods used for organizing Federal disaster assistance. The lessons of Hurricane Hugo (1989) and Hurricane Andrew (1992) were incorporated into the successful response to Hurricane Marilyn in the U.S. Virgin Islands in 1995. Following each of these storms, the Department of Defense was a major component of the response by the health sector. Despite progress in many areas, lack of clear communication between military and civilian managers and confusion among those requesting Department of Defense health resources may remain as obstacles to rapid response.
  
  
  METHODS
  This discussion is based on an unpublished case report utilizing interviews with military and civilian managers involved in the Hurricane Marilyn response.
  
  
  RESULTS
  The findings suggest that out-of-channel pathways normally utilized in the warning and emergency phase of the response remained operational after more formal civilian-military communication pathways and local assessment capability had been established.
  
  
  CONCLUSIONS
  It is concluded that delays may be avoided if the system in place was to make all active pathways for the request and validation of military resources visible to the designated Federal managers located within the area of operations.
authors.affiliation: Emergency Health Services, University of Maryland-Baltimore County, USA. mweddle@mindspring.com
authors.forename: M
authors.initials: M
authors.lastname: Weddle
authors.forename: H
authors.initials: H
authors.lastname: Prado-Monje
mesh_terms: D001291:Attitude of Health Personnel; D003659:Decision Making, Organizational; D004189:Disaster Planning / Q000458:organization & administration*; D004190:Disasters; D005378:Financial Support; D005544:Forecasting; D006270:Health Facility Administrators / Q000523:psychology; D006801:Humans; D007373:Interinstitutional Relations; D008887:Military Medicine / Q000458:organization & administration*; D019982:Organizational Case Studies; D015397:Program Evaluation; D012066:Relief Work / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014767:United States Virgin Islands