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EU summit in Göteborg 2001 – KAMEDO-report 83

The Kamedo-reports are published by the Swedish Disaster Medicine Study Organisation (Kamedo), at the National Board of Health and Welfare. Observers study the medical, psychological, organisational and social aspects of disasters. The results, with a focus on experiences gained, are presented in the reports.

This report is entirely in Swedish. Only summary in English.

Summary

For the first six months of 2001, Sweden held the presidency of the Council of the European Union, the main decision-making body of the European Union. The member state that holds the presidency is also responsible for the meetings of the European Council at which heads of government, certain heads of state and the president of the European Commission meet. One such Regular Council Meeting was held in Göteborg 15-16 June 2001.
The president of the United States, George W. Bush, attended the Regular Council Meeting to meet with European heads of state and government. The meeting was covered by an estimated three to four thousand journalists. According to the Swedish Police’s threat scenario analysis, there was risk that opinions would be expressed through demonstrations and confrontations between the police and demonstrators.
Unfortunately, the misapprehensions turned out to be justified. A summa-tion after the EU summit shows that 143 people with injuries related to the Council Meeting had been treated in the medical care system, including 86 at acute-care hospitals. Most of the injured, 94 percent, had minor injuries and were treated at local medical clinics.
The Swedish Police and the Västra Götaland Region Prehospital and Dis-aster Medicine Centre (PDMC) had begun planning for the Council Meeting a year in advance. In June 2001, the PDMC drafted a plan for medical disaster preparedness that was distributed to all affected facilities in the region. Guided by this alignment document, disaster preparedness was reinforced at hospital emergency departments in Göteborg. The disaster management committees were also prepared so that they could move swiftly into command position. The ambulance service was reinforced with about ten ambulances for the period of 14–17 June 2001.
Despite attempts to open a dialogue, a conflict between police and de-monstrators arose on 11 June before the Regular Council Meeting had even begun. In the following days, houses were searched and people were ar-rested on suspicion of preparing to commit aggravated assault and sabotage. Despite the construction of extensive barriers, a violent riot began on 14 June and continued over the following days. During the worst of the unrest, the prehospital care system was faced with severe problems due to the con-stantly changing scenarios and geographical locations. There were multiple injury sites at the same time, which impeded management and coordination. Göteborg was at times a divided city and it was impossible for emergency response vehicles to get from one side of the city to the other.
Regional Medical Disaster Management had strategic coordination and management responsibility and gathered on each day of the EU meeting in the medical care command room at a fire station in the Gårda district of Göteborg. Hospitals and primary care clinics submitted daily status reports regarding resources and injuries treated to the Gårda fire station.
For various reasons, there was no space prepared for coordination staff in the police command center. Events were happening so fast that the medical care system was impeded in its efforts to set up an efficient prehospital management organization at injury sites.
In order to gain a better overview of the sites where there was risk for bo-dily injury, a coordination officer with experience in the ambulance service and emergency/rescue service rode along in the police command vehicle. This officer was able to provide valuable status reports to the strategic man-agement committees of both the medical care system and emergency/rescue services.
In connection with the shots fired on 15 June, which triggered the declaration of disaster status lasting for about one hour at Sahlgrenska University Hospital (SU). SU is made up of formerly separate hospitals located in different areas of the city . The decision was made by on-call staff in the surgery department at SU/Sahlgrenska based on the information provided by Regional Disaster Medicine Management. Disaster status was also declared at SU/Östra and SU/Mölndal for unknown reasons.
The medical care system had a well thought-out strategy for covering the need to publicize information about injuries, although the press information service at Sahlgrenska University Hospital was at times severely overloaded.
Observers’ conclusions
• It is important to establish smooth cooperation between the medical care service, police, city emergency/rescue service and other actors from the beginning in the planning phase.
• The plan made prior to an event should include a description of basic facts, management organization, reinforcements and guidelines for dis-tribution of the injured that provide valuable guidance to the medical fa-cilities involved.
• The daily inventory of hospital resources carried out by Regional Medi-cal Disaster Management provided a picture of resource status and was valuable to strategic management efforts.
• Space in the police command center should be provided for coordination staff from the medical and emergency/rescue services.
• In connection with civil disturbances or riot-like situations, it can be difficult for emergency/rescue and medical services to act with security in the vicinity of an injury site. An experienced coordination officer in the police command vehicle can provide medical and rescue services with valuable information.
• On several occasions, it was unclear whether one or more police actions were taking place and Göteborg was at times a divided city. Conse-quently, the medical care system had problems creating a prehospital management organization. This emphasizes the need for strategic man-agement in order to coordinate medical interventions and smooth coop-eration among the police, emergency/rescue services and the medical care system.
• When the press information service at Sahlgrenska University Hospital became too overloaded, the disaster management committee at the hos-pital should have taken over responsibility for providing information to the media.
• The ambulance service in Greater Göteborg now communicates with both SOS Alarm (that is the Swedish emergency notification system) and the city emergency/rescue services command center. In future, a single, clear route of communication should be created, preferably to SOS Alarm.
• Opinions differ in the Västra Götaland Region as to how strategic man-agement efforts should be organized. Roles and allocation of responsi-bility between Regional Medical Disaster Management and the Central Disaster Committee at Sahlgrenska Hospital should be clarified.
• Clear command staff instructions and adequate space for a command centre would make efficient command possible. The current command room for Regional Medical Disaster Management is too small.

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Contact

Susannah Sigurdsson
+46 (0)75 247 30 00