04 November, 2013

Who is my leader? Lessons from a hospital disaster drill in a less developed country


Introduction: A paucity of literature exists pertaining to the role of leaders during the health response to disasters. The minimal published literature regarding disaster leadership suggests that health leadership in a disaster should adopt an approach similar to that of professions such as law enforcement, military and freighting.

Aim: This paper aims to describe observations pertaining to disaster leadership during a mock disaster scenario.

Background: This case study is set in Surkhet, Nepal, a small city prone to disasters such as earthquakes and floods. This case presents a mock disaster scenario of an earthquake set at a nongovernment health facility.

Methods: Observations were made of the performance of responders in establishing triage, treatment and command centers. Results: Institutional leaders among the responders struggled to apply the disaster plans in the face of spontaneous disaster leadership.

Conclusions: Both the recognised leadership of an organisation, and those who in a disaster may step up as disaster leaders need to be confident in implementing the disaster contingency plans. Leadership in disasters must have a clear distinction between incident controller and ‘clinical leader’ roles.

Discussion and recommendations: This paper provides recommendations that may have applicability to leadership in real world disasters.


Filmer L, Ranse J. (2013). Who is my leader? Lessons from a hospital disaster drill in a less developed country. Australasian Emergency Nursing Journal. 16(4)170-174. doi:10.1016/j.aenj.2013.08.004 

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