Utebliven snöstorm i NY – Början på en ursäktshetskultur?

Om man gör sitt bästa och följer de protokoll och metoder som står till buds men att det ändå inte blir helt korrekt, skall man då be om ursäkt? Denna fråga har nu blivit aktuell efter att den historiska snöstormen över New York delvis uteblev. Om det är så att krisberedskapsaktörer förväntas att börja be om ursäkt för sin strävan att skydda den enskilde och samhället i stort vid vad man uppfattar som en annalkande fara, då behövs det ett raskt byte av modell från att arbeta proaktivt till att enbart agera reaktivt.

Professionella bedömningar av enskilda experter sker inte i ett isolerat vakuum utan som komponenter i ett system av system av aktörer. Att den enskilde experten skall be om ursäkt för att en bedömning av ett framtida händelseförlopp inte matchade det faktiska utfallet känns otidsenligt. Man får hoppas att de ursäkter som bland andra meterologen Gary Szatkowski [https://twitter.com/GarySzatkowski] gett uttryck för på Twitter handlar om en ödmjukhet inför sin maktposition snarare än ett behov av att bemöta kritik.

NY_forecast

Det är naturligtvis alltid viktigt att kunna vara självkritisk och att i efterhand våga vrida och vända på vad som skulle kunna gjorts annorlunda samt identifiera svagheter. Men sådan självkritik behöver göras i ett sammanhang där det är systemet som kritiseras, skärskådas och debatteras, inte individerna. Alltför ofta söks det efter enskilda hjältar och enskilda syndabockar. Branden i Västmanland, Massvaccineringen vid Svininfluensan, Tsunamihanteringen, branden på Backaplan är alla exempel på händelser där det söks hjältar men där det framförallt söks efter syndabockar.
I efterdyningarna efter branden i Västmanland får man nästan bilden av att det var räddningstjänsterna som skapade branden och det torra vädret. Nog var det väl så att Lars Danielsson utlöste jordskalvet som skapade Tsunamin, Mass-vaccineringen var väl ett resultat av en ondsint medicinsk sammanslutning. Eller hur?!?

Skall samhällets krisberedskap kunna utvecklas för att kunna möta de framtida utmaningarna så krävs det ett lärande, baserat på framgångar och misslyckanden, utifrån ett systemperspektiv. Det finns annars en stor risk att krisberedskapsaktörer kommer att utveckla en ursäktshetskultur där enskilda roller inte kommer att vilja göra professionella bedömningar i situationer som kännetecknas av dynamik, osäkerheter och tidspress.

Leaving Liberia, but longing to come back.

Today is the last day in Liberia and it is with pleasure that I am looking back at a very exciting and insightful field study. The amount and level of challenges faced and overcome by clever and insightful actions by the Swedish response personnel is astonishing. The fight against Ebola is far from over even if this health disaster now seems to shift into another phase here in Liberia, there is still a lot of difficult issues that the Liberian government must address.

Visiting Hans Rosling at the Ministry of Health in Monrovia.

I am back in Monrovia after a fantastic time with the MSB-personnel in Greenville. Yesterday, I contacted Hans Rosling that is working as an advisor for the Ministry of Health (MoH) here in Liberia. He invited me to come over to the team at MoH IMG_4632to learn about their work on ebola epidemiological surveillance . MoH is just 500 meters from the hotel were the MSB Liberia HQ is located, so it is just a short hop by car or a nice walk.

During the visit to Hans, I was introduced to Knut Staring (University of Oslo) that has arrived from Oslo to Monrovia as an expert of the health management information system (DIHS2) that is in use to monitor and analyze the ebola outbreak. DIHS has a long history and Knut and his colleagues at Oslo University have worked on various versions of this system for many years. When following Hans and Knut in their work at MoH, it was evident how many young, smart and ambitious people that work in the team. The atmosphere was similar to a start-up company with a high tempo, serious conversations in a positive attitude with lots of smiles and laughs. The picture shows Hans next to his visualization of the process for case management and contact tracing.

The visit to the team at MoH gave additional insights about the possibilities created when you combine ambitious people, organizing skills, domain expertise and technology use. I would argue that these aspects are important in all types of response work, since without them it will be very difficult to be able to adapt to changing conditions or having flexibility to make use of sudden opportunities. A designerly attitude is also very important, and I have often seen this attitude among the international response personnel and the Liberian personnel in both small scale situations as well as in larger and more complex situations.

Sadly, I will leave the MSB Ebola response team and Liberia on friday.

A few words from Greenville, Liberia

I have for the past few days been in Greenville in the south of Liberia. This small town  has experienced several Ebola-cases. MSB has set up a rapid response ETU that has taken care of Ebola patients. The medical care of the patients has been done by local medical personnel and the MSB-personnel has been in a support and coaching-role. At the moment there are no patients at the ETU. When talking with the local medical staff, the challenges becomes evident, that these fantastic people are facing when working in PPEs taking care of the Ebola-patients, having in mind the temperature and risks in relation to the wage.

The other day, we visited a small village that has had several Ebola-cases. Together with health and psycho-social personnel forIMG_4151 the Greenville hospital, we participated in a meeting with the people in the village to inform and discuss about the intervention. The intervention has been successful and the village does not have any more Ebola-cases. There is still monitoring activities in place to follow up on individuals that have had contact with those that were sick. The visit gave important insights into the amazing work done by the health teams and the work by the local community in their fight against Ebola.

It seems as there are challenges for the international community in channeling the material and personnel capacity that exists in the Monrovia area to ensure and build up capacity on a district-level and community-level where the frontline battle against Ebola is taking place. This is not a surprising observation since in all natural- or health-disasters, the coordination of resources is complex. But when observing the small means that these local health teams are working with, one also realizes that coordination in general should perhaps be given an even stronger attention as well as support.

// Greenville, 4th of January

Field-study of the Swedish Ebola Response in Liberia

During the intense autumn with interesting field studies at MSBs national situation room, I got in contact with the team that were intensely engaged in the planning of the Swedish response operation against Ebola in West-Africa. This resulted in an opportunity to conduct field studies on location in Liberia. The studies on location i Liberia will be done in collaboration with DRL (The Disaster Resilience Lab) at Tilburg University and Agder University that already has been to Accra in Ghana and studied the UNMEER-operations. So my studies will together with the work by Tina Comes and Bartel van de Walle hopefully result in important insights regarding how to further advance technology use and management of international response efforts in times when agility, flexibility and a designerly attitude is more important than ever in the fighting of a continuously shifting health-disaster. My focus in Liberia will be on the Swedish operations and the challenges they face and learn from the experiences they make. The field studies starts today and will end on the 10th of january.

My field study has become possible due to MSBs openness to and interest in research combined with support by URBSEC at Chalmers and Gothenburg University. I will whenever possible, provide updates from the field here on the blog.

Small scale field-experiment for improved situation reporting

Today, I had the opportunity to study a small yet powerful field experiment at the County Administrative Board of Västra Götaland. The county administrative board has a geographical responsibility for crisis preparedness and crisis response at the regional level. The field experiment took place at the county administrative board’s newly designed situation room facilities.

At the field experiment, the TiB-organization (the duty officers) tested new ways of conducting multi-actor situation reporting conferences. In a series of small scale, yet cleverly designed, sessions, the duty officer invited three different fire & rescue services, the police, the paramedic organization, the national 112-organization, the traffic authority and the Swedish meteorological and hydrological institute to participate in a multi-actor situation conference.
Until now, such conferences have mainly been done in the form of a multi-actor teleconference, where verbal reports are the mechanism for sharing information. But today, the multi-actor conference was mediated using collaborative tools, opening up for a richer set of mechanisms for information sharing.

The field experiment provided several insights regarding the delicate balance of striving for improved communication capabilities while at the same time keeping a strong attention to avoid the addition of unwanted side-effects. The session today also showed how a cleverly designed field experiment can be accomplished without creating a hyped expectation bubble that most experiments rarely are able to fulfill. The county administrative board presented great skills in running a field experiment that was nicely embedded into the ongoing discussions on how to further improve multi-actor situation reporting.

Many thanks to Marcus Green, Charlotta Källerfeldt, Maria Göransson for arranging the event, and also many thanks to Malin Lintzen, Per Marklund, and Per-olof Hårsmar (SMHI) for the experimental design.

 

Maximized inspiration after a great week of field work at MSB:s national situation room.

It is nice to be back at the office with loads of impressions and ideas after a fantastic week of field work at a National Situation Room at the Swedish Civil Contingencies Agency (MSB) in Karlstad.
The field studies are a direct consequence of the insightful workshops hosted by JRCC/ Ispra with Tom de Groeve and his team of researchers, where these workshops during 2013 and 2014 provided me the network necessary to make the field studies possible. So, thank you Tom!
Another group of researchers that have had significant inspiration for me during the field studies are Kees Boersma and Jeroen Wolbers with their provocative yet constructive way of discussing the consequences of applying a too strong command and control management model instead of exploring other possibilities that might be more feasible, or could open up for new design perspectives. Thanks Kees and Jeroen!

From a system support point of view, it is fascinating to see how little traditional command center work that is evident in a situation room. My conclusion from the field studies are that we probably have new category of solutions waiting to be designed if we truly would like to further support the work in situation rooms. Solutions that are based on a command center idea will likely fail to support and extend situation room work practices.

Since situation rooms is an interesting socio-technical setting for authorities on national levels, but also an environment and a way of working that we also see traces of on regional and even local levels. One could assume that the new category of solutions that target situation room work, might be of general interest rather than being specific for a very limited group of people.

As one might realize at this point of this blog post, the field studies were great and provided a material that is truly inspiring to start analyzing. So, lastly, thank you all at MSB for the welcoming atmosphere and openness.