(Source: Kobe Fire Department, "The Great Hanshin-Awaji Earthquake [Kobe City Area]: Record of Fire Fighting in Kobe. 1995:12.)

The figures reveal a startling drop in the proportion of persons who lived after being rescued from collapsed buildings and underscore the critical issue of timeliness in emergency response. This same pattern of steep decline by day of rescue has been confirmed in studies of other disaster response operations. The cost in timeliness, measured in loss of lives, is sobering, and is directly related to the functioning of the infrastructure that does the decision making and action - government organizations.

For example (from Kobe, Japan), in a major disaster a fire department might operate on a "doctor-car" system for emergency medical services. When a citizen calls the emergency number, 911, the fire department responds by dispatching a team of paramedics that can administer first aid. If an injury is involved, the fire department also calls the local hospital, which dispatches a physician trained in emergency medicine. The firemen, even though they may be "first on scene," are legally prevented from administering any emergency medical procedure unless it is supervised by a licensed physician. While this procedure works well for traffic accidents or small fires, it hinders delivery of emergency medical services in large-scale disasters and it costs human lives!

While the toll in lives of this practice cannot be calculated by any exact measure, informed paramedics and physicians have been sobered by its consequences at major disasters and concur that it must be changed!

The size, shape, and timing with which the rescue system evolves are critical to defining not only the losses endured in the given event, but also the scope of interorganizational action required for reconstruction and recovery. Results from a recent study by Louise K. Comfort, Graduate School of Public and International Affairs, University of Pittsburgh, Pittsburgh, PA, USA are significant for at least four reasons.

The record reveals the gaps in information that seriously affect the coordination within and between jurisdictions. For more than four hours, neither the Hyogo Prefectural Government nor the National Fire Defense Agency in Tokyo had a clear picture of the degree of destruction and damage in Kobe. Constrained from action by the existing law until a request for assistance had been received from the City of Kobe, which is next to impossible after a major disaster, these governmental agencies did not enter the response system until more than four hours after the initial shock. In further irony, existing law kept the dogs from the French and American Rescue teams in quarantine, not allowing them to enter response operations until the fourth day after the earthquake when they extricated dead bodies, instead of living people. These conditions indicate the perverse effects of law, intended to protect citizens, in restricting the capacity of public managers to carry out their mission under dynamic conditions.