Below is an excerpt from a podcast featuring Atyia Martin, MPS, EMT-B, Director of the Boston Public Health Commission’s Office of Public Health Preparedness, recorded during the 2014 Preparedness Summit, April 1-4 in Atlanta. In this podcast, Ian Goldstein, MA, Web & Digital Media Specialist for NACCHO, interviews Ms. Martin about the role of the Boston Public Health Commission in responding to and recovering from the Boston Marathon bombings on April 15, 2013. Listen to the podcast to hear the whole interview.
Q: Can you walk us through the afternoon of the Boston Marathon? Where did that day start for you and where did it end?
A: So we at the Steven M. Lawlor Medical Intelligence Center had already been activated to perform our usual duties associated with the Marathon, which is to support staff that are out in the field, including our Boston Medical Reserve Corps volunteers, who support injured runner tracking. I was also leading our collective efforts to facilitate the coordination of information associated with the marathon, and anything that was happening elsewhere in the city that might affect the marathon.
So, it had actually been a pretty slow day, and then at 2:49 PM we had the first explosion, with the second happening relatively soon after. My first notification was in the medical intelligence center, I was the ‘MIC manager’—we call the Medical Intelligence Center the ‘MIC’—where I received a radio transmission from one of our staff out in the field letting us know that there had been an explosion, and that they were receiving casualties at the medical tent.
When we got the first radio transmission, we began to get a sense of what kind of explosion, what type of impact we were talking about, and working with the people out in the field to get a sense of what had actually happened. We ended up working a lot with the hospitals to track the patients and to figure out who was where, I think that first night we had about 164 patients that had been transported from the scene to hospitals within the City of Boston. Once we accounted for all of our MRC volunteers and accounted for all of our staff, we did a transition of command in the Medical Intelligence Center so someone else took over for me.
Q: Can you elaborate on what government and non-governmental agencies that you interacted with in order to coordinate this response?
A: We coordinated a protracted response, and we were doing things for months after the bombings. In the initial days we worked very closely with hospitals, with Boston EMS, which is part of the Boston Public Health Commission, and we were working with the Boston Police Department. We also worked with the American Red Cross, the Salvation Army, the Mayor’s Office of Emergency Management, the Massachusetts Department of Public Health, and some of the mental health providers in the area including our own Boston Public Health Commission Clinicians.
Q: The MRC is a national network of volunteers dedicated to strengthening public health, emergency response, and community resiliency. Boston has a robust MRC network: Can you describe the role that they played?
A: As I mentioned earlier, their primary role in the Boston Marathon is injured runner tracking, meaning that over the course of the day along the entire route starting outside of Boston in Hopkinton, MA, all of the enhanced medical tents were staffed by MRC volunteers. At the point of the bombings we had to shut down some of those tents and had to relieve some of those volunteers. Once the bombings happened, MRC volunteers continued to track patients, some from the mass casualty incident after the bombings. Once this became untenable, and some of the injuries were recognized to be so severe that EMS had to just get directly to the hospital, we released the MRC volunteers and our staff.
After the event, we provided our MRC volunteers with ongoing mental health support. We brought them back, we had people come in to work with them, and to remind them that what they had experienced was horrible and what they were feeling emotionally, and that the things that they were going through physiologically were all normal.
Q: After all of the sirens, and the lights, and cameras go away, what types of recovery do you have to deal with in the long term? I’m speaking with regard to mental health and PTSD, and other long term health effects.
A: The amount of responsibility that public health had after the bombings was actually very interesting. I think that, collectively, it is easy to forget these kinds of events once all of the cameras and sirens have cleared as you noted in your question. Once all of these things have cleared, you are left with the people, and they have a number of different needs. Some of the work which we did was simple, such as family reunification—we did a lot of that the first night after the bombings, and this work was the entire point of us tracking those patients. As time went on, our work became more about social services—we set up a family assistance center that was just for people that were physical injured by the bombings, as well as their family members and loved ones.
We also needed to provide longer term forms of assistance such as housing re-modification. Many patients could not be legally released from the hospital unless their homes could accommodate their new disability status. We had to move some people, and we worked with the Boston Housing Authority to move patients from where they had been located to accessible housing.
The need was vast, and it varied widely. This also doesn’t include the ongoing community resilience work which we did with the general public, such as the businesses that were in the area and the residents who lived in the crime scene area. We are still doing work with survivors, and we have support groups that are working right now as we speak.