從國內外經驗談我國之災難應變處置

Review and Suggestions for Disaster Management and Planning in Taiwan Based on Worldwide Experience

陳永福(Ying-Hock Teng) ； 蔡益堅(Yih-Jian Tsai) ； 林志成(Chih-Cheng Lin) ； 周志中(Chu-Chung Chou)

《中華民國急診醫學會醫誌》 2卷1期 (2000/01) Pp. 89-98

摘要

國內（台灣地區)及世界各地都不斷有災難發生，各國對這些災難的應變處理能力不同，對災難救治的成效自然就有所差異；某些先進國家對災難應變處理投入比較多財力、人力加以研究規劃，其所採用之模式值得我們參考與學習，而我國正步入已開發國家，對災害的處置理應達到這些先進國家的水準。本研究的目的除收集及查訪各直轄市及縣、市衛生局及消防隊之災害防救計畫與經驗，歸納出國內目前的運作狀況及面臨的困難外，並收集國外有關災難應變處置的文獻，歸納其經驗，研析其組織形態，提出應有的建議。
國內目前面臨的困難是災害防救策略不夠明確，執行不夠落實，救護人員未預先協同演練，若無上級長官出面協調，則不能發揮同心協力的成效。雖新的災害防救方案已於民國83年8月經行政院發佈，但各級相關人員卻還在摸索各種災害防救措施。總結國內外之防災救災及救護理論實務，我們發現國內現有困難並提出建議如下：(1)應加速救災救護指揮中心的成立，並強化其功能。(2)建立現場指揮協調系統，充分授權，不必由地方首長督陣。(3)虛心檢討災難應變計畫與實務之差距，並確實加以改進。(4)整合民間救災救護資源，擴大參與。(5)成立災難醫療協助隊，隨時待命，可隨時前往救援，必要時亦可遠赴國外支援，提升國際形象與地位。(6)重新塑造災難動員模式，強化各相關單位之橫向聯繫合作。(7)加強救災救護及災難醫學之研究發展，邀集專家學者及實務工作者加強研究。(8)強化我國災害預防體系：包括建立明確的防災考核獎懲制度，督促各相關單位人員做好防災工作；注重災後心理復健，加速重整生活秩序；普及防災觀念，落實防災教育，推展國家防災運動，使防災成為國民日常生活的一部份。

關鍵字

災難處置 ； 災難計畫

並列摘要

varies. The results can also be disparate. Taiwan has become an industrialized country. The ability to manage a disaster is of the utmost importance. Thus, the need to upgrade this capacity to a level at par with other developed and industrialized countries is imperative. Most of these countries put in more resources for research and planning along these lines. The models they have adapted are valuable for our study and comparison.
For our study, we visited the different disaster response related agencies, especially those dealing with planning and management. These involved the fire and health departments of every country and city in Taiwan. We collected data on the ongoing situation. We also noted the present problems facing its implementation. Comparison was done with models from other countries. We then came up with our own suggestions to our system.
The problems encountered are the following: Disaster planning strategy is not clear-cut. Rescue operations are not have thoroughly done. Rescue workers do not have enough drill experience. Higher officials do not have communication. Thus, a unified action cannot be carried out. The disaster planning has been assigned to the Executive Yuan. But the designated authorities of different places still have varied ways of handling similar situations.
To conclude, we suggest the following: (l) Establish a complete protocol for handling disasters, as well as to improve the function of the dispatch and effort coordinating centers. (2) Develop the Incident Command System, and evolve a more comprehensive authorization, such that orders can be carried out smoothly and sufficiently without waiting for the approval from the local heads. (3) Be cognizant of the fact that there is a big difference between planning and actual work situations, and efforts to look for better solutions must be sustained. (4) Coordinate and collaborate with the different non-government organizations available that are involved with disaster response. (5) Provide more resources for research and study on Disaster Medicine, prehospital and rescue care. Involving both the Disasters planning experts and field personnel for such undertaking. (6) Establish the Disaster Medical Assistance Team that can respond immediately on notice. Overseas mission can also carried out on occasion, thus improving status and obtain international recognition. (7) Redesign the disaster rescuer model and promote cooperation among rescue workers from different localities. (8) Support a strict enforcement of a disaster prevention system. Establish a clear-cut system for rewards and penalties, and supervision of the implantation of the disaster prevention program. Providing psychological support and rehabilitation facilities for rescue personnel and victims. popularizing disaster prevention concepts education, promoting disaster prevention activities, maintaining preventive awareness.

並列關鍵字

Disaster management ； Disaster planning