Research Scholar Tells Library Audience Consolidation Preferable in Emergency

Ellen Gilbert

Near the top of physician and research scholar Laura H. Kahn’s list of reasons for advocating consolidation of the Township and Borough is the belief that it would enable better emergency preparedness.

Speaking at the Princeton Public Library Monday evening, the Princeton resident spoke about her recently published book, Who’s in Charge? Leadership During an Epidemic, Bioterror Attack, and Other Public Health Crises. An example of successful leadership, she said, was the mayor who told Milwaukee residents to boil their water when presented with strong evidence that it was contaminated.

“Imagine if there were two mayors,” Ms. Kahn said. “Imagine the mayors and the governing bodies fighting over how to handle that crisis. The chain of command is split. The need for a single, responsible individual is absolutely critical for effective responses to emergencies.” In the case of Milwaukee, “there was a single mayor and the buck stopped with him.”

Princeton Health Officer David Henry was among the members of the audience at Ms. Kahn’s talk, which was cosponsored by the Princeton Regional Health Department.

In her book, Ms. Kahn looks at recent public health threats posed by anthrax, SARS, mad cow disease, cryptosporidium, avian flu, and the H1N1 virus. On Monday evening she gave special attention to the anthrax scare in which Princeton Borough was “ground zero,” and the Hamilton Post Office was likely to have been contaminated.

She lauded the actions taken by then-Mayor of Hamilton, Glen Gilmore, but had less than favorable reviews for then-Acting Governor Donald DiFrancesco and the Acting State Health Commissioner at the time, George T. DiFerdinando, Jr. “It was not an optimal situation,” she said, noting that Mr. DiFrancesco and Mr. DiFerdinando did not know each other, and were both new to their posts.

In the face of finger-pointing and unwillingness to assume responsibility among State and Federal officials, Mr. Gilmore’s “prescient” appointment of an emergency task force, inclusion of the local hospital’s CEO in ongoing conversations, and location of stored antibiotics made the Hamilton Township community of 900,000 people “as ready as one could be” for the ensuing crisis, said Ms. Kahn.

Mr. Gilmore credited his readiness to assume responsibility to his military training, which instilled in him the notion that “when in charge, take charge.” Otherwise, said Ms. Kahn, there was “a lack of concern all around. Thank goodness they had Glen Gilmore as mayor.”

Ms. Kahn emphasized the need for establishing relations and fostering good communication among public officials. She also pointed to the disconnect between “bureaucrats and politicians” as a major stumbling block in effectively handling crises. She warned about politicians’ tendency “to give false reassurances” (e.g., the flu vaccine “is just around the corner”), and the lack of reportage from local doctors, “the eyes and ears” of the community who are the first to see particular trends.

“There is no systematic data gathering in this country,” said Ms. Kahn, noting a “lack of uniform medical records,” the absence of a “constant stream” of local information into a centralized office, and a failure among public health officials to deal with “political realities.” Ironically, perhaps, it is the “flying off the pharmacy shelves” of Pepto-Bismol in particular communities that becomes the tip-off that something is awry.

Another irony might be seen in Hamilton’s failure to re-elect Mayor Gilmore. Unlike New Orleans Mayor Ray Nagin who, during Hurricane Katrina “didn’t step up to the plate,” but got re-elected anyway, Mr. Gilmore put “the health and well-being of his community first and foremost,” said Ms. Kahn, adding, “There’s no rhyme or reason.”

To learn more about Ms. Kahn, go to www.princeton.edu/~lkahn.

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