HAZMAT disaster management in the Netherlands and Belgium · to have a good HAZMAT disaster...
Transcript of HAZMAT disaster management in the Netherlands and Belgium · to have a good HAZMAT disaster...
2012
Lisanne van der Schors I6008557 Bachelor European Public Health Faculty of Health, Medicine and Life Sciences Maastricht university Supervisor: Matt Commers Second grader: Peter Schröder-bäck Placement: EMRIC+ Placement supervisor: Marian Ramakers Placement supervisor content: Cindy Gielkens
[HAZMAT disaster management in the
Netherlands and Belgium] Bachelor Thesis European Public Health
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Outline
Introduction ............................................................................................................................................. 4
Euregio Meuse-Rhine ...................................................................................................................... 4
Background .......................................................................................................................................... 5
EMRIC+ ............................................................................................................................................ 5
Cross border collaboration of emergency services in the EMR ...................................................... 5
Madrid Convention .......................................................................................................................... 5
Benelux treaty ................................................................................................................................. 6
Anholt treaty ................................................................................................................................... 6
Treaty of Mainz................................................................................................................................ 6
Agreements of mutual assistance in case of disasters .................................................................... 7
Research question and goals ........................................................................................................... 7
Methods .............................................................................................................................................. 8
HAZMAT in the Netherlands ................................................................................................................... 9
GRIP structure ..................................................................................................................................... 9
Safety regions .................................................................................................................................... 11
HAZMAT defense at national level .................................................................................................... 11
Areas of disaster management ......................................................................................................... 12
Health in disaster management ........................................................................................................ 12
GHOR ............................................................................................................................................. 12
GGD ............................................................................................................................................... 15
RIVM .............................................................................................................................................. 16
HAZMAT in Belgium ............................................................................................................................... 17
Municipal phase ................................................................................................................................ 17
Provincial phase ................................................................................................................................. 17
National phase ................................................................................................................................... 17
Multidisciplinary plans .................................................................................................................. 18
Monodiscilinary plans.................................................................................................................... 18
Discipline 2 – medical, sanitary and psychosocial assistance ....................................................... 19
Internal emergency plans .............................................................................................................. 21
Alerting hospital services............................................................................................................... 21
Decontamination ........................................................................................................................... 21
The Netherlands and Belgium working together .................................................................................. 22
Discussion .............................................................................................................................................. 23
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Conclusion ............................................................................................................................................. 25
Recommendations ................................................................................................................................ 26
References ............................................................................................................................................. 28
Appendix ................................................................................................................................................ 33
Appendix 1 – Transcript interview doctor Lucien Bodson ................................................................ 33
Appendix 2 – transcript interview Michel Moors .............................................................................. 51
Appendix 3 – transcript interview Cindy Gielkens ............................................................................ 65
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Introduction
On the 11th of March in 2011, there was a nuclear disaster with the Fukushima nuclear power plant
in Japan caused by a tsunami. The area around the plant is exposed to a high level of radiation and
scientists fear that this will cause a huge amount of cancer cases and other adverse health outcomes
among the exposed people. This time the nuclear disaster happened in Asia, but these things can
also happen in Europe. (World Nuclear Association, 2012)
In Europe, 25 years earlier than the Fukushima incident, on April 26th, 1986, there was an accident in
a nuclear power plant in Chernobyl, Ukraine. This resulted in a radiological contamination not only in
Ukraine itself, but also in surrounding countries and even beyond the surrounding countries. This
incident lead to many major adverse health effects varying from an increased cancer rate (4000 extra
cancer deaths in the highest exposed cancer groups and 5000 extra cancer deaths in the surrounding
countries (WHO, 2006) ) to deformed newborns and reactivation of viral infections. Some people are
still suffering from the consequences of this accident (Morley, 2012 ). Incidents with hazardous
materials (HAZMAT incidents) can happen anywhere in the world and, as you can see in the examples
of Fukushima and Chernobyl, can have huge impacts on health. Therefore it is important to include
HAZMAT incidents in health policy to be prepared for any HAZMAT disaster.
As said, CBRN incidents do not always limit themselves to the country they happen in. This is also
seen after the Chernobyl disaster. Not only Ukraine had radioactive pollution after the incident, a
high rate of pollution was also found in the surrounding countries Russia and Belarus. There was
even pollution found in Scandinavian countries (IAEA, 2012). It is therefore not only very important
to have a good HAZMAT disaster management, but also to have a good cooperation with border
countries on this area to minimize the victims of such a disaster and to make sure that the disasters
are under control as quick as possible.
Euregio Meuse-Rhine
One of the border regions where more work could be done on HAZMAT disaster management is the
Euregio Meuse-Rhine (EMR). The EMR is a non-profit foundation that concerns the cooperation of
five regions within three countries. The countries are Belgium, the Netherlands and Germany and the
regions within these countries are the southern part of the province of Limburg (the Netherlands),
the province of Limburg which is Dutch speaking (Belgium), the province of Liege which is French
speaking (Belgium), the German speaking community of Belgium and the Region of Aachen
(Germany) (EMR, 2012). The EMR is a high density area with about 4 million inhabitants on 11,000
km².(AEBR, 2012)There has been cross border cooperation within this region for over 30 years
already. Within the EMR there is a large diversity. Not only are there three different languages
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spoken in the three different countries, but even within Belgium there are different languages.
Having to deal with this diversity means dealing with differences in culture, but also in laws and ways
people deal with things. This also means that there are different ways of dealing with disasters and in
this case dealing with HAZMAT disasters. Since HAZMAT incidents and their consequences can cross
borders, it is very important that there is an overview of what kind of procedures on HAZMAT
disasters exist in the EMR. This is important because when you know the procedures, you know what
you can expect from the other countries and you can establish a cooperation that is effective in
containing the disaster and keeping the adverse effects to a minimum. The diversity in the EMR
might on one hand be seen as a barrier for a good cooperation, this can mean that the process of
establishing an effective collaboration requires great effort, time, expertise and willingness to adapt
to other cultures. On the other hand it might also be seen as a chance to get other points of view and
to develop new, improved ways of HAZMAT disaster management. (Ramakers & Bindels, 2006).
Background
EMRIC+
EMRIC+ stands for Euregio Meuse-Rhine Intervention in case of Crisis. EMRIC+ is the follow up of the
Interreg project EMRIC which ended in 2008. The goal of EMRIC was to make previous agreements
and results available on internet and secure the agreements and results by developing a concept of
collaboration. This is done to make sure that people do not try to create solutions that are already
there (EMR-IC, 2006). EMRIC+ wants to continue the implementation of this development and add a
focus to innovation and scientific research (GHOR Zuid Limburg, 2008). In the first news letter of
EMRIC+, the project is defined as a project which facilitates, coordinates and broadens the
cooperation of emergency services like fire departments and ambulances in the EMR (EMRIC+, 2010).
Cross border collaboration of emergency services in the EMR
Before there was any cooperation between countries in the EMR, emergency services of one country
could not provide their services to another country (EMRIC+, 2010). In some cases this was very
inefficient, for example when someone had an accident in the Netherlands, but a hospital in Belgium
would be closer, the ambulance still had to go to the hospital that was in the Netherlands but further
away. This would often cost a lot of time, which can be essential in severe cases. Nowadays there is
collaboration in the EMR on the area of emergency services. There are several treaties, conventions
and agreements on these collaborations on European and international level.
Madrid Convention
One of the first European conventions on cross border cooperation is the European Outline
Convention on Transfrontier Co-operation between Territorial Communities or Authorities, signed on
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21st of May, 1980 by the Council of Europe, also called the Madrid convention (Council of Europe,
1980). Member states of the European Union that ratified the convention, declare that they will
commit themselves to improve cross border collaboration. The convention also makes it possible for
bordering member states to set up treaties on cross border collaboration. Resulting from the Madrid
convention, there were three treaties important for the countries of the EMR developed (Ramakers,
Bindels, & wellding, 2007).
Benelux treaty
The first treaty was the Benelux treaty regarding cross border collaboration between territorial
communities or authorities. This treaty was signed on the 12th of September in 1986 and entered
into force on April first, 1991 (Denters, Schobben, & van der Veen, 1999). The Benelux treaty makes
it possible for decentralized authorities (like municipalities and provinces) to set up a cross border
collaboration with other decentralized authorities. The treaty mentions three ways of cooperation.
Administrative agreements are the lightest form of cross border cooperation. This can be an
agreement on delivery of service or resources. A second way of cooperation is a shared cross border
organ. A shared cross border organ does not have any legal power and does not have any financial
resources. This can be a good base for cross border cooperation and can later on be expanded to a
public cross border body. The third and most intensive form of cross border cooperation is a public
cross border body. This body does have legal power and can therefore make binding decisions. These
decisions have to be in accordance with national law (Benelux, 2012).
Anholt treaty
Secondly, on the 23rd of may, 1991, the treaty of Isselburg-Anholt (also called the Anholt treaty) was
signed. This is a treaty concerning Germany and the Netherlands. The treaty offers a framework for
cross border cooperation of decentralized authorities of Germany and the Netherlands. The goal of
the treaty is to stimulate cross border cooperation between Germany and the Netherlands. With this
treaty as a base, public agreements can be made by the governing bodies of Germany and the
Netherlands. This treaty is also a very good base for cross border emergency service delivery
agreements. One example of these agreements is the public agreement on cross border neighbor-
ambulance aid. The Anholt treaty uses the same three forms of cooperation as the Benelux treaty
(Ramakers & Bindels, 2006).
Treaty of Mainz
Finally, the treaty of Mainz was signed on March 8, 1996. The treaty makes cross-border cooperation
possible between Belgium and Germany. It is comparable with the Benelux treaty and the Anholt
treaty and states the same three ways of cooperation (Ramakers & Bindels, 2006).
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Agreements of mutual assistance in case of disasters
Besides these treaties, there are agreements between Belgium and the Netherlands, Germany and
the Netherlands and Belgium and Germany on mutual assistance in case of disasters. All these
agreements have a similar content. Assistance is only given if it is in accordance with the possibilities
of the country that is asked for assistance. In these agreements, procedures of asking for assistance
and giving assistance are described. If assistance is eventually given, the commander of an
emergency service unit has to submit to the authority on the site of the disaster. The commander
steers his or her own unit. The countries need to pay the costs that they make by sending their units,
but for air transportation separate arrangements can be made. The country that receives assistance,
pays for the stay of the assisting units. If damages are made, the country that receives the assistance
will have to pay for these damages. This also applies when there is an exercise, unless stated
otherwise (Ramakers, Bindels, & wellding, 2007).
Research question and goals
Cooperation in the field of emergency services in the EMR is already visible. However, this
cooperation focuses mostly on general emergency services and there is no specific focus on HAZMAT
incidents yet. Cooperation in general emergency services will not be enough when dealing with a
HAZMAT disaster. There is a need for specialized collaboration when dealing with HAZMAT disasters.
EMRIC+ expresses that there is need for a clear overview of what the countries of the EMR are doing
on the area of HAZMAT disaster management. Such an overview is needed to be able to handle and
cooperate quick and effectively in case of a HAZMAT incident without losing precious time on having
to look for all regulations and procedures before being able to act. Creating an overview might also
give opportunity to find best practices, which might eventually be a base in creating a general
protocol for the EMR. A general protocol on HAZMAT disaster management can prevent confusion
and promote a better cooperation between emergency service units from different countries, which
will help containing the disaster as quick as possible and getting the least amount of adverse effects.
Therefore the research questions will be:
What are protocols, laws, treaties and agreements in Belgium and the Netherlands on the
acute phase of HAZMAT disasters on the area of health?
What are parts of the HAZMAT disaster management on the area of health in these countries
that are good and what can be improved?
What would be recommendations for both countries and for the cooperation in the EMR on
the area of HAZMAT disasters on the area of health?
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The focus in the paper will especially be on Belgium and the Netherlands, another research paper
with a focus on Germany and the Netherlands will be released by Judith Brehm. The goals of the
paper are to give an overview of protocols, laws, treaties and agreements on disaster management in
the acute phase of HAZMAT disasters in Belgium and the Netherlands, to compare the two countries
and look for best practices, to see what is already done in the EMR and to give recommendations for
cooperation in the EMR.
Methods
To answer the research questions, there was made use of several different ways to gather
information. One way is a literature research, this was done in databases with scientific papers like
Pubmed and Google Scholar and on relevant websites of organizations that were important for
disaster management in their country. The literature research was in the first place to gather basic
knowledge on HAZMAT disaster management. After finding literature, it was analyzed on its
relevance by looking at the content, but also at the year it was published and the writers and their
possible interests in the matter. Another way in which information was gathered is by an internship
at the project EMRIC+. This project is very relevant to the topic of the paper. In the internship,
information from EMRIC+ was be gathered, and the colleagues of the project helped getting relevant
knowledge and useful websites. The contacts of EMRIC+ were used to get more information on
HAZMAT disaster management in Belgium and the Netherlands. There were three interviews done
(transcripts can be found in the appendix) with Mister Bodson (clinical supervisor, Emergency
department emergency plans, Chemical, biological, radiologic and nuclear supervisor), mister Moors
(civil protection expert) and Miss Gielkens (Health advisor HAZMAT) Especially the Belgian interviews
were very useful on getting a clear picture of the Belgian system. Miss Gielkens joined in all the
interviews, she first gave a presentation about the Dutch system and about EMRIC+, after this I asked
my questions. There were questions asked about how the disaster management structure was, if
there were ever problems with the system, good things about the system, problems with
international cooperation and what could be done better in the future. After the interviews, another
literature research was done to support the outcomes of the interviews and to be able to elaborate
more on the outcomes of the interviews. When there was enough information gathered on a part of
the paper, the information was analyzed, written down and compared. In the end of the paper some
recommendations were done for the Dutch system, the Belgian system and the cooperation of the
two systems. Some of these recommendations were based on the opinions of the people that were
interviewed.
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HAZMAT in the Netherlands
GRIP structure
In the Netherlands you have the GRIP structure, GRIP stands for coordinated regional disaster
management procedure. GRIP is the procedure of upscaling or downscaling that happens in case of
disasters and incidents. The GRIP stages go from GRIP 0 to GRIP 4 where GRIP 0 can be a mild
incident and GRIP 4 can be a large disaster. The main characteristics of the different stages are
explained in table 1. All GRIP procedures are in principle the same in all safety regions (explained in
‘safety regions’), but the safety regions do focus their plans on specific risks in their area. For
example the area around the Meuse would take into account that the river could flood.
Table 1.
GRIP 0 Daily process
GRIP 1 Source control
GRIP 2 Source and effect control
GRIP 3 Threat to the public
GRIP 4 Incident involving multiple municipalities.
GRIP 0
The status of GRIP 0 is for incidents that do not interrupt the daily process of emergency services.
GRIP 1
When an incident is local and the effects limit themselves to the incident site, but a multidisciplinary
alignment between services is needed to manage the incident, the incident gets the status of GRIP 1.
To control the operational processes, a command center is placed on the incident site. The command
center leads the deployed emergency services. In the command center the operational leader is
appointed. The operational leader is most of the time the officer on duty from the fire brigade, but
the mayor can also appoint someone from other emergency services. The operational leader leads
the command center on site and keeps the mayor updated. The people that are usually present in
the command center on site are the officer on duty of the fire brigade, the police officer on duty, the
GHOR officer on duty, the officer of public discipline and safety and the information manager. The
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command center can also call different specialists, depending on the nature of the incident, to advice
them.
GRIP 2
When the effects of the incident exceed the incident site, it is upscaled to GRIP 2. In GRIP 2 a regional
operational team is started, this team focuses on the management of the environment around the
incident site. The regional operational team is the highest you can upscale in the operational area.
The tasks of the command center on site stay the same, but the leader of the regional operational
team becomes the operational leader. In most cases this will be the regional commander on duty of
the fire brigade. The people that are usually present in the regional operational team are the regional
commander on duty of the fire brigade, the commissioner of the police, the head of the GHOR, the
liaison of the municipality in which the source of the incident is, the information manager of the
safety region. Like in the command center on site, the regional operational team can also call in
professionals. Besides the regional operational team the core of the municipal policy team gets called
together to support the mayor.
GRIP 3
The status of GRIP 3 is given to incidents that may cause profound impact on the society. This impact
can be on health, but also on the environment or materials like essential infrastructure. Because
complex decisions need to be made, the municipal policy team gets called together. This team leads
the regional operational team, although the leader of the regional operational team stays
operational leader. The people that are usually present in the municipal policy team are the mayor,
the commander on duty of the fire brigade, the district police chief, the regional medical officer, the
municipal secretary, the officer of public discipline and safety, the public prosecution and the
information manager. The municipal policy team can also call in professionals for advice.
GRIP 4
If the incidents exceeds the municipal borders, it gets the highest GRIP status; GRIP 4. In this case
more municipalities are involved and these municipalities need a high degree of alignment. To get
this degree of alignment, the regional policy team gets called into action. The people that are usually
present in the regional policy team are the coordinating mayor (often the mayor of the biggest
municipality in the region), the general director of the safety region, the commander on duty of the
fire brigade, the police chief, the regional medical officer, the chief prosecutor, the involved mayors
(only if possible and desirable) and the information manager. In this stage the operational leadership
goes to the general director of the safety region. (Vogels, 2011)
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Safety regions
In the Netherlands there are several institutions that play a role in disaster management. Since the
GRIP system goes from small to large areas, it is logical to start with the sub national safety regions,
veiligheidsregio’s in Dutch. These safety regions are created under the law safety regions (LSR). The
LSR was accepted begin 2010 and replaced the fire brigade law of 1985, the law of medical help in
case of disasters and incidents and the law on disasters and major incidents. The main goal of the LSR
is to get the assistance of services like the fire brigade, medical assistance and other emergency
services organized in case of a disaster. A reason for instating these safety regions is that emergency
situations were often already handled at a very local level, but municipalities and other local
authorities regularly did not have the means to be prepared for a bigger disaster. Another reason is
that disasters are often not confined to a municipality, disasters can affect the near surroundings of a
municipality, but also a whole country. (Rijksoverheid I, 2012) (Ministerie van Binnenlandse Zaken en
Koninkrijksrelaties, 2009)
There are 25 safety regions in the Netherlands. In these regions the police, fire department and
medical help in case of disasters and incidents (GHOR) work together to be prepared for disasters
and to manage them effectively. The municipalities and emergency services work together with so
called crisis partners. Examples of these crisis partners are public prosecution, and the regional
military. Besides these crisis partners, there are other private organizations with whom the
municipalities work together during a crisis. These organizations are organizations like hospitals,
organizations that are responsible for the public transport, energy and chemical companies. Because
of their expertise and capacities they can play an important role in crisis management. (Rijksoverheid
II, 2012) (Ministerie van Binnenlandse Zaken en Koninkrijksrelaties, 2009)
HAZMAT defense at national level
On Governmental level you have the National Crisis Center (NCC). The NCC makes sure that there is a
consistency in decision making during a crisis or during the threat of a crisis. The NCC distinguishes
three different situations: Cold, lukewarm and warm. Whenever there is a cold situation, there is no
crisis or threat. When the situation is lukewarm, there is a crisis threat and extra attention should be
paid to that particular situation. When the situation is warm, there is a crisis or a very large crisis
threat. (Ministerie van veiligheid en justitie I, 2012) However, the NCC is not only active during
lukewarm or warm situations, when there is a cold situation, the NCC wants to make sure that crisis
professionals and organizations are constantly trained and kept upto date so they are more able to
handle potential disasters. To train these professional and organizations, the NCC has its own
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institute, the NCC academy. (ministerie van veiligheid en Justitie II, 2012) During cold situations, the
NCC also wants to improve the area of crisis communication by advicing authorities and helping them
with the policymaking on this area. Developing a good method of crisis communication will help
contain a disaster as fast as possible and informing people in case of a disaster. (Ministerie van
veiligheid en justitie III, 2012)
Areas of disaster management
Disaster management in the Netherlands is divided into four areas:
1. Military; in this area one can think of things like a bomb squad
2. Emergency services; police, fire and rescue services fall under this area
3. Health; regional health services, GHOR and RIVM are in this area
4. Environmental protection; emergency planning and advisory unit, national laboratory
network
From now on the focus is going to be specifically on health.
Health in disaster management
GHOR
GHOR stands for medical assistance organization in the region (Geneeskunige
hulpverleningsorganisatie in de regio). Each safety region has a regional GHOR bureau, these bureaus
are responsible for medical assistance in disasters or large incidents in the region where the bureau
is situated. The help GHOR offers is divided into three disaster management processes: Medical
assistance, psychosocial assistance and preventive public health. (GHOR I, 2012)
Medical assistance
One of the processes in a disaster is taking care of wounded victims, this is done based on the
upscaling from daily care. The upscaling from daily care is making organizations that are responsible
for daily incidents responsible for the care in disaster situations. In case of disasters these
organizations need to be deployed to the incident site at a large scale. To make this large
deployment possible, agreements are made. (GHOR II, 2012)
One of the emergency services that go to the incident site is ambulances, the ambulances are sent by
the Central Ambulance Post (CPA), which received the emergency number call. From the call the CPA
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paints a picture for the ambulances. After this, the CPA keeps communicating with the ambulances,
hospitals, medical workers and GHOR officials. The ambulance first to arrive at the incident site has
to explore the site and make a report for the CPA. The crew has to set op triage. Triage is a often
used system in which the gravity of the injuries of victims is identified. After this the victims are
categorized in order of the gravity of the injuries and helped in order of priority. (Vermeersch &
Verborgh, 2005) The crew keeps coordinating the medical emergency services that come in until the
medical officer on duty takes over. Ambulances from border regions can also be called by the CPA,
they meet op at an easy place and will be guided to the incident site so they do not get lost. If the
incident is too large for the CPA to handle, the CPA sends a transport coordinator to the site to
coordinate it from there. (GHOR III, 2012)
Another medical emergency service that goes to the incident site is a medical combination. A medical
combination is a team that can treat injured victims on the incident site, the main goal is to get
victims ready for transport to a hospital. The team consist of three parts, an ambuteam, a mobile
medical team and a rapidly deployable group for medical assistance. The ambuteam consists of an
ambulance nurse with a driver and performs triage and provides the most necessary treatment to
protect or recover vital organs. The ambuteam does not transport victims. The mobile medical team
stabilizes victims and prepares them for transport. The rapidly deployable group for medical
assistance is a group of volunteers with a special education from the red cross. The group assists
professionals in the field and they can set up a tent for a ‘nest’ of wounded people that are placed
together after the triage. The group can also staff a treatment center for lightly injured people
together with a nurse and a doctor. (GHOR IV, 2012) When the victims are stable, they can be
transported to hospitals, in the agreement of treatment and coordination of the injured, the GHOR
states that the victims need to be spread over different hospitals as much as possible to take the
pressure of the hospitals so they can focus on treating the victims that they have. (GHOR V, 2012)
Psychosocial assistance
GHOR wants to give victims psychosocial support directly after an incident if they need it to prevent
long term psychological problems like the post traumatic stress syndrome. The GHOR wants to
provide psychological assistance to both direct victims (victims that experienced the incident) and
indirect victims (victims that are in a way related to direct victims). Next to taking care of the victims,
the psychosocial workers also need to register the victims. The staff from the psychosocial team can
come from more organizations like the GGD, mental health care and general social work. (GHOR VI,
2012)
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Preventive public health care
In the process of preventive public health care there is a focus on the protection of public health in
disasters that compose a danger to humans or the environment. The GHOR states that public health
is at risk in the following kinds of disasters: HAZMAT disasters, terrorism and other environmental
related disasters like floods or extreme weather. (GHOR VII, 2012)
The preventive public health care process wants to protect public health in the different stadia of
disaster management. The different stadia are prevention, preparation, combating and aftercare. In
the prevention phase the GHOR takes care of giving advice to the municipalities in licensing activities
with hazardous materials and giving advice to the public administration, as well as charting risks and
giving advice and educating on risks and prevention measures. In the preparation stadium the GHOR
delivers well educated and trained GHOR officers, protocols for different kinds of incidents and
disaster management plans. During this stadium the GHOR also gives advice about the self reliance
and the use of safety equipment of civilians, and it preventively staffs and equips for example large
events. (GHOR VIII, 2012)
When an incident takes place, the medical advisor hazardous materials (GAGS in Dutch) together
with other experts of the GHOR look at the health risks and give information on the incident.
The GAGS plays a very important role in HAZMAT disasters. When there is a HAZMAT incident, the
GAGS looks at which substances there are released, what complaints are usually experienced with
the substances and what complaints are experienced. From this information the GAGS advices on
which measures people need to take to prevent or minimize the adverse health effects and what
needs to be done to treat the complaints of victims. Sometimes the health complaints do not match
the complaints people should be having from the released substance, in this case the GAGS will
notice it and warn the people at the incident site, because there might me another hazardous
material released that did not show up on the measuring systems of the fire brigade. The GAGS is an
important spider in the web, connecting the medical side to the side of the fire brigade. (Gielkens,
2012)
After an incident happened, the stadium of aftercare takes place. In this stadium the GHOR helps
with looking for the cause of the incident and estimates the after effects on public health of the
incident. (GHOR VIII, 2012)
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GGD
The GGD is the municipal or regional health service, Gemeentelijke/gemeenschappelijke
Gezondheidsdienst in Dutch. The task of the GGD is to protect, guard and improve public health.
(GGD I, 2012) There are 28 different GGDs in the Netherlands. (GGD II, 2012) All these GGDs are
connected by GGD Nederland, the umbrella organization. In GGD Nederland, knowledge and
information are being actively gathered and exchanged. In the management of disasters with
hazardous materials, the GGD is more responsible for the aftercare and the prevention, while the
GHOR is responsible for the acute medical care. The GGD and the GHOR work closely together and
this connection is still growing, in some safety regions the GHOR is even part of the GGD. GGD
Nederland expresses the importance of the connection between GGD and GHOR in the bullet points
of the policy area of care and safety for 2012, where strengthening the cooperation between GHOR
and GGD is a bullet point. In this bullet point the GGD stresses that this cooperation will be beneficial
for the public health and coordination in disasters and that it will create new opportunities to make
new agreements for the cooperation between hospitals, general practitioners, trauma centers and
ambulance services. One of the bullet points is that the GGD wants to map health risks like chemical
plants before anything goes wrong. They want to do this so the municipalities or provinces can look
for alternatives before it is too late. In prevention the GGD has a large focus on the environment. The
GGD has a department of environmental health, this department has environmental medical doctors
that often double as medical advisor hazardous materials. (Drijver & Henk, 2009) The task of
environmental health is conducted by community and health doctors, social nurses and
environmental health doctors that often double as medical advisor hazardous materials with the
support of epidemiologists. When there are complex issues, the GGD get advice from a supra-
regional environmental health doctors. (NVMM, 2012) The department of environmental health also
develops guidelines for environmental factors that can form health risks. These guidelines can differ
from guidelines on noise and smell to guidelines on hazardous materials in the air, soil and water.
(RIVM I, 2012)
GGD Zuid Limburg
The GGD that is responsible for the Dutch part in the EMR is GGD Zuid-Limburg (GGD-ZL). This region
is one of the regions where the GHOR is a department of the GGD. GGD-ZL has 16 subjects it focuses
on, one of these subjects is disaster management. Since Zuid-Limburg is a part of the EMR and is
surrounded by other countries, the importance of international cooperation is emphasized in this
subject. The important role of the GHOR is also stressed in the subject of disaster management.
(GGD-ZL, 2012)
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RIVM
The RIVM is the national institute for public health and the environment. A part of the RIVM is the
center for health and environment. This center supports the GGD and the GHOR with their tasks in
environmental health with advice in normal situations and on the aftercare of incidents. During an
incident the center does health research as a part of the aftercare; after a disaster the center gives a
comprehensive, independent, expert contribution to the decision making on health research in
disasters. Next to health research, the aftercare the center delivers also consists of psychosocial help.
The center for health and environment has a team of environmental health that supports the
environmental health professionals at the GGD and the GHOR in projects, educating the public and
making guidelines and information flyers. The environmental health team also organizes information
meetings, and facilitates the uniform registration of environmental health complaints. The
environmental health team also does research to develop new measuring methods, models and
instruments. Besides this, the team creates working plans based on the need of GGDs.(RIVM II, 2012)
(RIVM III, 2012)
Another part of the RIVM is the environmental accidents service. The environmental accidents
service is available 24/7 and can be called when there is an incident with chemical or biological
substances. In such an incident, the service can support the fire brigade with a team of people with
protective suits and making risk estimates about the effects of the incident on health and the
environment. These estimates are based on measurements they make of hazardous materials in the
air, soil and water. The environmental accidents service has advanced measurement instruments and
a team of experts available for the measurements and analysis. The service gets support from the
national intoxication information center for medical toxicological knowledge. (RIVM IV, 2012)
In case of large incidents, the environmental accidents service is supported by the policy support
team for environmental incidents (BOT-mi). this team consists of the environmental departments of
the RIVM and other organizations that can play a role in environmental incidents, like the national
meteorological institute (KNMI) and the national institute of food safety (RIKILT). Together they
monitor the development of the incident and collect information about the possible dangers to
public health and the environment, and they develop advices and intervention measures to prevent
the adverse effects as much as possible. (RIVM V, 2007) (RIVM VI, 2012)
17
HAZMAT in Belgium
Since the royal decision on emergency and intervention plans of February 16th, 2006, Belgium has a
phasing system to manage disasters. This system consists of three phases; the municipal phase, the
provincial phase and the national phase.
Municipal phase
The municipal phase is in action when the size of the incident is so big that the mayor needs to
coordinate the emergency services. When the municipal stage comes into action, the mayor needs to
notify the governor of the province. There used to be a phase before this phase which was limited
action and coordination on municipal level without the mayor, but in the royal decision of 2006, this
phase was removed. (Federale Overheidsdienst Binnenlandse Zaken, 2003)
Provincial phase
There is a provincial phase when either the emergency situation is so severe that it requires the
management of the governor or when the incident surpasses the borders of the municipality. The
governor is the authority in this phase and needs to notify the minister of internal affairs and the
minister that concerns medical, sanitary and psychosocial assistance. (service public federal interieur,
2006)
National phase
The national phase can be started because of upscaling from the provincial phase, or straight away if
the incident seems severe enough. The incident has to have some characteristics in order to start the
national phase; the incident must involve two or more provinces, the province does not have enough
or the right resources to combat the incident adequately, numerous people are either in danger or
already wounded or dead, the incident has a large influence on the environment or the essential
needs of the citizens (e.g. on the food supply of the country), there is a need for coordination of
different ministries or federal institutions and there is a need to inform the entire country. (Federale
Overheidsdienst Binnenlandse Zaken, 2003)
Each area in each phase has to have an emergency and intervention plan, this plan consists of
multidisciplinary plans, monodisciplinar plans and internal plans. (Bodson, 2012)
18
Multidisciplinary plans
The multidisciplinary plans are the plans in which the disciplines of the monodisciplinar plans work
together to manage disasters.
The multidisciplinary plans consist of a general emergency and intervention plan and a particular
emergency and intervention plan.
General emergency and intervention plan
The general emergency and intervention plan consists of general information and guidelines of the
concerning area, like a inventory of risks, a list of the functions involved in disaster management in
that area, a list of services and their available resources and a general disaster plan. The goal of this
plan is to alarm the involved persons and services, and to set up coordination of assistance as quick
as possible. In this plan there are agreements on the coordination and cooperation between
different disciplines. (Gemeente Torhout, 2008) (service public federal interieur, 2006)
Particular emergency and intervention plan
The particular emergency and intervention plan complements the general emergency and
intervention plan. The particular plan consists of a description of all specific risks, for example a
company that works with hazardous materials (this is called a seveso industry in Belgium) in a certain
area, the possible intervention methods, the people involved in the specific risks, disaster scenarios
and the ways to inform the public about a certain disaster. The particular plan also includes the
geographical situation of the risk and the general information about the risk, the responsible people
of the company that forms a risk and the materials of the risk company itself. (service public federal
interieur, 2006)
Monodiscilinary plans
Next to the multidisciplinary plans, you also have monodisciplinary plans. These plans are
intervention plans per discipline, the plans are in accordance with the existing emergency
intervention plan. Every discipline has its own operational leader. In case of a disaster, all these
operational leaders come together in an operational command post lead (CP-OPS in Dutch and PC-
OPS in French) by the director of command post operations. There are 5 disciplines; (IBZ, 2007)
1. fire department and civil protection
2. medical, sanitary and psychosocial assistance
3. police department
4. logistical support
5. information
19
again, only the medical part will be covered, in this case that will be discipline 2. (Bodson, 2012)
Discipline 2 – medical, sanitary and psychosocial assistance
According to the royal decision on emergency and intervention plans of 2006, discipline 2 is
responsible for providing medical and psychosocial care for direct and indirect victims of incidents,
taking measures to protect public health and transporting victims. These tasks are conducted by
emergency medical services and the services that are included in a monodisciplinary intervention
plan. In case of a disaster, the administrative authority is the federal health inspector (FHI). The
operational authority over all medical, sanitary and psychosocial assistance on the incident site is the
director of medical assistance (Dir-Med). The Dir-Med is a medical doctor appointed in the
monodisciplinary intervention plan of discipline 2. Either the Dir-Med or the assistant Dir-Med
represents discipline 2 in the CP-OPS. (service public federal interieur, 2006)
The monodisciplinary intervention plan of discipline 2 is divided into four components; the medical
intervention plan, the psychosocial intervention plan, the sanitary intervention plan and the risk and
manifestation plan. The plans each state how to coordinate their subject.
Coordinating staff
Part of the coordinating staff is the FHI. The FHI is the representative of discipline 2 and as
mentioned he is the administrative authority as well. He is assisted by his assistant for operational
support, and will, depending on the situation, either be seated in the coordination committee or
support the Dir-Med on the incident site, or be part of the operational staff. For the psychosocial
aspects of the situation, the FHI is supported by a psychosocial manager. The psychosocial manager
also oversees the operation of the psychosocial intervention plan. The FHI is also helped by the
secretarial coordinator. The secretarial coordinator organizes the administrative tasks at the incident
site and the medical post outside of the red zone. The administrative tasks include registering the
victims and other involved people and where they are transported to. (PIBA, 2008)
Another coordinating staff member is the Tri doctor, a doctor, preferably an emergency doctor of the
first mobile emergency group, who makes an overview of all the patients and performs the triage. He
reports back to the Dir-Med and the coordinator of the medical post outside the of the red zone. The
assistant of the Tri doctor is a nurse of the first mobile emergency group. The coordinator of the
medical post outside of the red zone is a doctor or nurse of a mobile emergency group, that person
organizes the entire medical post. The coordinator makes a task division and makes sure that
everybody executes their tasks properly. The coordinator also creates different classification zones
where victims can be put after the triage is performed. The coordinator reports back to the Dir-Med
and tunes his decisions with the coordinator of regulation. The coordinator of regulation is a doctor
Opmerking [A.E.1]: Verklaren of andere benaming.
20
or nurse of a mobile emergency group that regulates all victims that need to be transported to
hospitals. He knows which hospitals are available and where all the victims were sent. (PIBA, 2008)
To get the medical supplies (like oxygen, drugs etc.) and the logistic supplies (tents, heating, catering)
to the places where they need to be, the logistics coordinator is instated. The logistics coordinator
does not only make sure that everything is where it needs to be, but also that the use of the supplies
is optimal. If needed the logistics coordinator can discuss with the main responsible of discipline 4.
The logistics coordinator does however not take care of the ambulances, that is the task of the
coordinator of the ambulance park. The coordinator of the ambulance park is under the direct
control of the coordinator of regulation, and make sure that patients are transported efficiently and
according to the instructions of the coordinator of regulation. (medics4medics, 2012)
When it is necessary to have someone from the medical dispatch center (HC 100) on site, the
coordinator liaison HC 100 gets sent to the incident site. This coordinator stands for a fast
communication between the CP-OPS, Dir-Med and the HC 100. (PIBA, 2008)
Operating staff
Besides the coordinating staff, the services that deal with patients are also very important. In
Belgium, on the medical area, the services that directly come in contact with the patients are
ambulances, medical corps and nurses, the paramedical intervention team, hospitals and the Belgian
red cross. The ambulances sent to the incident site are usually connected to the dispatch center of
the area of the incident, but if there are more victims than the ambulances of the dispatch center can
handle, the dispatch center can call ambulances that are not meant for emergency assistance, or
ambulances of the red cross. Because border areas of Belgium have agreements with the bordering
countries, border areas can also count on the support of the bordering countries. There are several
different doctors and nurses that can be deployed in discipline 2; doctors and nurses of the mobile
emergency group, hospital doctors, doctors of the fire brigade, general practitioners and nurses.
Next to these doctors and nurses, doctors and nurses that offer to help at the disaster site can also
be used, they will get an action card which tells them what to do. The paramedical intervention team
is a hospital team consisting of a nurse specialized in emergency and intensive care and an
ambulance assistant. They can execute the most necessary procedures and transport the victim to
the hospital. The paramedical intervention team is used in discipline 2 for pre-triage, support of the
medical post outside of the red zone and for transporting victims. The hospitals are also important
players when dealing with victims. In case of a disaster, the victims are divided over the hospitals in
the area and if needed hospitals outside of the area of the disasters are included. The Belgian red
cross can also be deployed in case of a disaster. The red cross is part of discipline 2 since 1972
21
Internal emergency plans
Each company needs to have an internal emergency plan. This plan is to keep the effects of an
emergency situation limited to the company itself. If an emergency situation cannot be handled by
the internal emergency plan, the particular emergency and intervention plan come into action. (IBZ,
2007)
Alerting hospital services
Besides an internal plan, all hospitals except psychiatric hospitals, hospitals that specifically treat
long-term diseases and specialized hospitals need to have a plan called ‘alerting hospital services’ for
when there is a large incident outside of the hospital. This plan needs to be designed actualized and
validated by a permanent committee lead by the head doctor of the hospital. The plan needs to be
approved by the governor of the province where the hospital is situated. The plan must include the
creation of a command- and coordination cell that leads the operations and collects the information
about the incident and that represents the hospital towards families, authorities and the press. The
hospital has to give an indication of their capacity to take care of patients. The plan must describe
the different levels and phases of internal mobilization and reorganization and the efficiency of these
phases. The person that decides over when which phase is applicable must also be appointed in the
plans. In order to have efficiency in these levels, it is necessary to have a list of the staff of the
hospital that says which people are at the hospital and which people can be called into the hospital
so there is a clear overview of which staff is available. The hospitals need to appoint rooms for triage,
press, family, authorities and corpses and provide psychosocial support where needed. The
regulations on the identification of these corpses need to be in the plan. Because the large incident
can be an incident with hazardous materials, the hospital needs to take contamination into account.
The rules and regulations on decontamination and protection against contamination of materials,
victims, staff and the rest of the hospital are therefore described in the plan.
Different staff members need to be educated for these kind of situations and instruction manuals
need to be provided, as well as the alerting hospital services plan summarized in an easy to read
table. The hospitals themselves can decide on how many trainings and exercises will be given on this
subject. (ministerie van Volksgezondheid en van het Gezin, 1964)
Decontamination
The reason why decontamination is brought up extra in the Belgian system is because in Belgium
there are some very interesting discussions going on about decontamination. From the interview
22
with mister Bodson (appendix 2) it became apparent that only decontaminating at the incident site is
not enough to prevent contamination of others outside of the incident site. He said that people that
were in an incident with hazardous materials are not going to wait until all the ambulances have
arrived. The circumstances might be very bad, it might be raining or freezing, they will not stay
around. Victims are going to hospitals themselves with their own car or public transport. The victims
can walk straight into the hospital, contaminating the entire hospital. That is, as mister Bodson
states, a reason for large decontamination areas where ten to twenty people can be decontaminated
at the same time. These areas need to be in front of the entrance of the hospital so the people
coming in can be blocked and under pleasant circumstances. These ideas come from France and are
slowly taken over by Belgium. There are already a couple of hospitals in Belgium with these large
decontamination areas, but the plan is to get more hospitals to do this. These kind of large,
permanent decontamination areas are not yet implemented in the Netherlands.
The Netherlands and Belgium working together
There are agreements for the cooperation between Belgium and the Netherlands and when Belgium
needs help from the Netherlands or the other way around, it works out most of the time without
problems. However, from the interview with mister Bodson one can conclude that sometimes the
laws and regulations slow down the process of handling in a disaster situation. The authorities that
make the rules are often not people that work in the field and that know how the reality is. They
want emergency services to follow every step of the guidelines and sometimes that means losing
valuable time. Also different countries have different regulations, which makes cooperation hard
sometimes. Although this is the case, mister Bodson and mister Moors both say that in practice it
almost always works out. In one case however, when Dutch ambulances came to help with the
shooter in Liège, according to miss Gielkens the ambulance staff could not help the victims, because
the Dutch ambulances have nurses and in Belgium only doctors can treat victims on an incident site.
The Dutch nurses are well qualified to treat people and this is an example of how regulations stood in
the way of disaster management. Problems with international cooperation that were mentioned by
both mister Moors and mister Bodson were problems with communication, especially in the French
speaking part of Belgium, because most of the French speaking Belgians do not know Dutch, German
or English, which makes it hard for other people to communicate with them, since a lot of people do
not know French either. Another communication issue that came forward was that different
countries use different terminologies and measurement systems, which makes it hard to understand
what people mean. A problem that miss Gielkens raised was that a lot of people do not know each
23
other. This makes that you do not know what capabilities a person has and what you can and cannot
expect them to do. The main problem with cooperating with other countries is in the
communication.
Discussion
From the results you can see that the Netherlands and Belgium have similar systems of upscaling in
case of a disaster. The Netherlands works with the GRIP system with five stages and Belgium has a
system with three stages, municipal, provincial and federal. Both systems start at a small area
(municipal) and as soon as the incident seems to be larger than the services appointed to the current
stage can handle, the situation is upscaled to a higher stage. Although the systems are quite similar,
the difference can be clearly seen. The system of the Netherlands is more detailed and elaborate
with five stages and a clear and a detailed description of what happens per stage. The Belgian system
has less stages, and the description of the phases was not that elaborate in the documents that
instated these stages. However, it seems that Belgium has done this on purpose, since the system
previously consisted of four stages, but in the royal decision of 2006 on emergency and intervention
plans it was reduced to three stages. It could be that Belgium chooses not to focus on the definition
of the stages, but more on what happens within the stages. The structure of upscaling seems like a
good system to get a clear coordination in disasters, this can also be derived from the interview with
miss Gielkens (appendix 3). In small disasters you do not need to involve the entire country when
smaller authorities like mayors know more about the situation of a specific area. With large incidents
it is good to have larger authorities that can connect emergency services of more areas and that have
more power to call in the more expensive, specialized services.
The system in the Netherlands is institution-based, every institution has its task when there is a
disaster. The different disciplines (medical, fire brigade, etc.) and organizations within the disciplines
(for health for example the GHOR and the RIVM) are brought together by the safety regions. Within
the safety regions the organizations have their own protocols to handle disasters. In Belgium, the
system is based on plans. The different disciplines are brought together under the multidisciplinary
plans and the disciplines themselves have the monodisciplinary plans on how to handle disasters in
their own discipline. Within the monodisciplinary plans there are organizations that work together in
case of disasters, like in discipline 2, the red cross and hospitals, but the organizations adhere to the
monodisciplinary plan of the discipline they are in. What stands out is that the Netherlands has a
special organization for health in disasters (GHOR) while Belgium does not have anything like it. The
24
reason for this might be that Belgium is more focused around plans than organizations and that the
monodisciplinary plan of discipline 2 is comparable to the GHOR, but the GHOR is an organization
that also does a lot of preventive work, while it seems like discipline 2 is a plan made for the case of
disasters and not for prevention of disasters.
What also stands out is that the Belgian system does not seem to have specific health services for
HAZMAT disasters. In the Netherlands there is the GAGS function (health advisor HAZMAT), the
environmental health department of the GGD and the health and environment department of the
RIVM. Especially the GAGS function plays an important role in HAZMAT incidents; the GAGS is
specialized in the health effects of HAZMAT, this means that they know how to treat HAZMAT health
effects and in some cases that they can see from the complaints of citizens with which substance
they have come in contact with. From the interviews with mister Bodson and mister Moors
(appendix 1 and 2) it became apparent that there is definitely not such a function in Belgium. That
there is not a large focus on HAZMAT in the health department, does not mean that HAZMAT is
completely ignored. It is very common that HAZMAT falls under the fire department, they do the
measurements and try to control the incident, in Belgium and the Netherlands this is also the case.
Mister Moors states in his interview that he thinks that a specific function like the GAGS would be
good to have in Belgium. He says that because there are no specialized functions like this, which
results in one person taking on a task like this next to his official task.
In terms of decontamination one can see that Belgium is a little more ahead of the Netherlands with
their large, permanent decontamination areas in front of hospitals to prevent contaminated victims
that got to the hospital on their own without being decontaminated first from contaminating the
hospitals. This idea is still growing in Belgium, and only a few hospitals have these decontamination
areas, but in the Netherlands there are no hospitals with decontamination systems this big.
The cooperation between Belgium and the Netherlands might not be as smooth as possible, but in
practice almost always works out. However, it is important to keep improving the cooperation,
because misunderstandings due to miscommunication or differences in laws or materials may lose
valuable time, and time is of the essence when you manage a disaster. If people are contaminated
with chemical substances for example, the more time you waste on getting to the disaster site and
decontaminating victims, the more victims will walk away contaminating others, making the disaster
even bigger. The most problems lie in the communication, there is not only a language barrier, but
also a difference in jargon and not knowing people and therefore not knowing what you can ask from
them. There are also differences in regulations and measurement materials. The difference in
25
measurement materials makes that the outcome variables can also be different, this makes it hard to
communicate on the measurements.
Conclusion
There are similarities and differences between the systems of the Netherlands and Belgium. Both
systems use a structure of upscaling when there is a disaster. This seems like a good structure to
have, as it does not unnecessarily involves big authorities, and the smaller authorities like mayors can
efficiently manage smaller incidents without having to report back to all kinds of other authorities.
One of the main differences between the Dutch and the Belgian system is that the Dutch system is
more institution based and the Belgian system is plan based. In my opinion the Belgian system is
clearer, the system is based on three phases which each have the same sort of plans. The plans are
instated by law. In these plans it says exactly what happens when there is a disaster and who does
what, this gives a clear overview. In the Netherlands there is not such a legal plan structure, but more
an institution structure, for example, you have the safety regions in which emergency services work
together. Within these safety regions there are own agreements, there is not a specific guideline on
what these own agreements have to be like.
Another difference is that the area of health within disaster management in the Netherlands has a
much larger focus on HAZMAT disasters than Belgium, especially with the GAGS function of the
Netherlands. An expert that covers the medical part of HAZMAT seems like a very useful staff
member to have in case of HAZMAT disasters. Not only does it reduce the workload of other people,
it is also good to have an expert on the case that knows about the effects of hazardous materials on
people and that has the information in his head, so it does not take extra time to look everything up.
This is not the only HAZMAT focus of health in the Netherlands, the GGD and the RIVM both have
departments that focus on environmental health and within environmental health a focus on
HAZMAT. Belgium does not have a large focus on HAZMAT within the medical area, I did not come
across any special health services or special functions that relate HAZMAT to health. One of the
reasons could be that there is no such thing, but another reason might be that these functions are
hidden deeper in the system and that I simply did not come across any of these functions. However,
from the interviews it became clear that the Belgian side does not have a function like the GAGS. So I
can conclude that the Netherlands does have a larger focus on HAZMAT in health than Belgium.
However the Netherlands can learn from Belgium too, since their ideas on decontamination are
more developed than in the Netherlands. Decontamination is a very important part of HAZMAT since
you can prevent a lot of extra contaminations if you decontaminate properly.
26
The cooperation between Belgium and the Netherlands is already pretty good, in the field the
problems that are experienced are not seen as vital problems that make cooperating impossible.
Nevertheless, there are some problems that could probably easily be solved. It would be good to
work on solutions for those problems to make the cooperation more efficient.
Overall both the Dutch and the Belgian system are good systems, I did not come across any major
problems in the systems and everything seems to be working fine. Nonetheless, there are things that
can be improved to be more efficient and to prevent more victims after a disaster. Both Belgium and
the Netherlands are already slowly trying to improve their systems, and I am sure that they will
continue to do so.
Recommendations
The Dutch system seems to be a good system, the Belgian experts that I interviewed even thought
that there was not much for the Netherlands to learn from Belgium. However, there could be some
improvements. The Dutch system could have a clearer structure or one document that states the
entire structure. In terms of decontamination the Netherlands can learn a lot from Belgium as well, it
would be good for the people responsible for decontamination on both sides to talk with each other
about their ideas, how the large decontamination areas in hospitals in Belgium were realized and
how they could be realized in the Netherlands.
The Belgian system comparable to the Dutch system and also not a bad system. There could
nevertheless be a larger focus on HAZMAT in the area of health. It would be good to have more
specific functions that connect the HAZMAT part of the fire brigade to health. This will also take some
of the workload of coordinators and authorities, that will save time and give the coordinators and
authorities more time to focus on the rest of their tasks.
The cooperation between Belgium and the Netherlands is also not bad, but there is still a lot that can
be improved. For the language barrier it would be good to either create a uniformity in terms
everybody uses, or to make a small on site dictionary. The dictionary cannot be longer than 2 pages
and has to be plasticized so it can be used in all circumstances. It will strictly contain the terms that
are most used and the terms can be on the paper in Dutch, German, French and maybe even English,
this way the cards can be used in the entire EMR. Not every country has the same measurement
devices, to solve this, the measurement devices of one country can be the standard and other
countries just have to get new materials. The replacement of these measurement materials is very
expensive, so another solution would be to have tables on site that transfer the measurement
values. The table has to be easy to read and understandable. It might take a little bit more time than
27
when everybody has the same measurement devices, but it saves a lot of money. Another problem is
that people often do not know their colleagues from abroad, that makes cooperation harder. If you
know someone and what their function is, you do not hesitate to call them when you need
something, and you know who to call for what you need. Different emergency services in the EMR
need to meet each other more regularly. This does not have to be every week, but if emergency
services in the EMR would come together once every half year or year, maybe even just for a cup of
coffee, it will improve the contacts. People will know who does what, and who they can call for what
problem. Finally I think that the EMRIC+ project already forms great support in setting up
cooperation in the EMR, and if the countries keep on working with EMRIC+, there will be many
solutions to problems that occur now.
28
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Appendix
Appendix 1 – Transcript interview doctor Lucien Bodson
Clinical supervisor, emergency department emergency plans, chemical, biological, radiological
nuclear coordinator.
May 8th, 2012
LB = Lucien Bodson
CG = Cindy Gielkens
LS = Lisanne van der Schors
Interview doctor Lucien Bodson
LS: Can I record this interview?
LB: Yes, I am Lucien Bodson and I stand completely behind everything I say.
LB: All authorities in Belgium know about my ideas and why I have these ideas. My goal is not to
make anarchy. My goal is to give positive ways to construct good collaboration, but pragmatic.
CG: I totally agree. The main part of our research and part of the project is public health advice in
incidents with hazardous materials, there is a part of the fire brigade, the exposure assessment is
done by those people. We call it the red column in the project. They have a working group and are
looking for uniformity and cooperation in monitoring across the borders. Michel Moors is from
Belgium in that working group. He is from the exposure side in Belgium. Our column, we call it the
white column, the medical expertise on hazardous substances and our main goal, but this is very
ambitious, is to have at one point in the future a hazardous materials team specialized in the medical
expertise which is cooperating across the borders. But now the focus is on making a network of
experts so we can know each other and know who has which expertise, who we can call when there
is an incident with some sort of materials. and of course there would be some training and exercise.
But I think in this phase of the project, training and exercise should consist of getting to know each
other and each other’s expertise. I have some examples of disaster, but I don’t think I have to show
them to you, since you probably already know the big international incidents. Here you have the
radiation incidents with Chernobyl and Fukushima. Last year there was a very large fire in the
34
Netherlands, I don’t know if you’ve heard about it. There was a very large black cloud which went
over several regions of the Netherlands. Even in one country there are difficulties, mainly on political
level. When there is a large incident, people on national level want to overrule the experts in the
field and there were some difficulties, especially when we look at the Public health risk assessment
and communication to the people. In one region people needed to close their windows and doors
and in the region where the fire was, that message wasn’t given to the people. There were some
inconsistencies. This was just to illustrate that there is a lot of work to do even in one country. Some
euregional examples; there was in April 2010 a release of nitrogen oxide in chemelot, the great
industrial plant in the south of Limburg. People saw a yellow cloud when they looked out of the
window in the morning.
LB: beautiful
CG: there wasn’t anything of public health complaints in the Netherlands, but at one time the fire
brigade gave the message that the cloud was going to Belgium so case closed, but eventually, in
Belgium the land is higher so the cloud did come on the living level. People smelled…
LB: No victims…
CG: no but people saw it and smelled it and were afraid, so I think there should be… when there was
some more collaboration and public health communication, it would have been better.
CG: This is a fire, also on the Dutch side and the clouds went to Germany and there were also some
miscommunications about having windows closed and that kind of stuff. There were a lot of
questions on the Dutch side eventually, and I think that this could have been forecome when there
was some more attention for the public health side. Maybe the fire brigade can really solve the
problem on their side and they think they can give the message that there is nothing going on and
there is no reason for fear, but people want to have the message in another package. They want to
hear it from a doctor or from someone from the public health side and get a good explanation why
there is nothing going on and not just the message that there is nothing going on. Another example…
what I want to illustrate with this example is that when there is a large incident that can have a large
influence on public health, we do need information about the exposure side of it. Which chemicals
are released, how much chemicals are released, what is a good situation? To say something about
what are the health risks, but on the other side it is for us very important to know which complaints
are there under the people, are the complaints the complaints we expected when we know the
release or are there very other health complaints? And maybe when there are other health
35
complaints, we have to look if there’s another chemical released. We do have examples from that
kind of problems.
LB: The same problem since years and years and years, but there is no solution.
CG: In the Netherlands I think that it is not exactly where want it, but probably health hazmat
advisors, the function I do with some colleagues. We have a team with five colleagues in the south of
the Netherlands and we are being called much more often than a few years ago and I think that
mainly for the public and communication that we can play a role in that game.
LB: You THINK so.
CG: yes, but you have to be idealistic
LB: I will prove that we have in the Netherlands, Belgium and Germany no good solution, but we
have to try to find one. I will explain that later.
CG: Yes, but we have to start somewhere. I think that when we have the good people, the end result
can be more than zero, I hope.
CG: We can give advice about the measures and the communication and when we are talking about
cross border incidents I think that should be in collaboration, that we give the same measures in all
the three regions, not that we have in one region the windows closed and in another region
evacuation and in the third region there is nothing going on. I think we can split it up in phases we
have the hazard evaluation and exposure assessment when there is an incident going on, but that is
mainly the part of the fire brigade. This is how it is in the Netherlands, and I’m not saying that this is
how it should be, but this is the way that we’ve arranged it. When there is a toxicological effect an
evaluation and risk assessment the public health advisor hazmat is coming in the picture. We call it
GAGS in the Netherlands, the public health advisor, I don’t have the English name.
LB: It’s funny in French and in English, Gags, Jokes!
CG: this is a German slide, but just to show this is a spider in the web. There are a lot of institutes and
involved people when there is a large incident.
LB: very classical from years and years and years, but effective? No.
CG: Okay, but I still want to try to convince you that… well, I will not convince you but we agree that
there is more needed
LB: Yes, we have to work together, but I will explain why it is not a hundred percent functional.
36
CG: yes, well in the Netherlands you have the police, the fire brigade and the medical people. They
are at the incident location and at national level there are some institutes, you have the GPs, the
hospitals and the public health services and all the people want to do something and to say
something. The public hazmat advisor as we have them, is a spider in the web. What do we do as
public health hazmat advisor, well as I told you, we give advices about public health risk, measures
that need to be taken, protection of the aid workers in the acute phase, but also public information
to the people in the effect location on the basis of the measurements of the fire brigade, but also our
advantage above people of the fire brigade is that we look at the health complaints of the people.
This can be a big advantage.
CG: I just put this slide in it, maybe you know it, this is how it is arranged in the Netherlands when
there is an incident and when there is a small incident; a little fire with chemicals and it can be solved
by running business as usual, the daily business, then we call it GRIP 0.
LB: then you have different steps? From small incidents to major accidents?
CG: yes, that is GRIP 5
LB: classical model
CG: is there a structure like that in Belgium?
LB: yes, but it is unusable. It is theory from people who are not in the field, it is only theory. A very
difficult topic. Maybe it would be interesting to make a little stop and I will explain.
I am a medical doctor, anesthesiologist intensive care unit and a specialist for emergencies and
disasters, but I am also medical officer firemen and commander in the Belgian army on reserve. As
you have seen on my card I am coordinator for nuclear, radiological biological and chemical problems
and all emergency plans. I explain each time that I am not a HAZMAT problems specialist but I am a
coordinator because I am an emergency physicians and working on the butter field, why? Generally
we have very accurate specialists, in your country and in Germany of course there are very clever
people that are HAZMAT specialists. But they are not practitioners and they have a very special point
of view of the risks, it’s an engineer’s point of view. It is interesting of course, but generally it is not
applicable to medical practice. If you work in this area, what is it for? To save people, maybe as a
second goal to save material, houses and so on, but first it is to save people. To have very few deaths
and very few severe injuries, this is the goal. Who can appreciate the gravity and the severity of
health injuries? The medical doctors, or in your country you have the very good staff for nurses and
ambulance staff. I include of course this kind of people, very clever, very accurate.
37
CG: the white column
LB: so the problem is to speak about the same risks and to have the same point of view between
architects, chemists, engineers, firemen and medical teams. The reason why since a few years, the
first time was for exercise eulux in Luxembourg with the civil protection of Belgium, Germany,
Luxembourg and France to save 250 people with radiological contamination and chemical
contamination. Three hours, thirty minutes before the first teams were on site, close to the victims
and since the beginning of the contamination. Is that OK for you?
CG: that’s very long
LB: it’s not OK for me. It’s completely incredible. And the problem was that the only goal of this circus
show was for the ministers of the country to show the people: this is the trucks that we bought with
your money, very nice, a blue one, a red one, a yellow one. But on the field the efficiency was zero.
What do you think what will happen with 250 people, maybe 20 are dead, maybe 20 or 30 others
have big problems, immobile, but 200 people are walking. What do you think they will do during 3
hours and 30 minutes, will they all stay there until we come with showers and so on? Will they stay
with biscuits and cigars, just playing cards? What are they doing?
LS: they will walk around, contaminating others
LB: where?
LS: public spaces
LB: yes, but what public spaces? Hospitals. If you don’t protect hospitals, you will get big problems
with contamination of emergency departments of different hospital, because you will have a wild
evacuation of all these people with taxis, busses, private transport. This evacuation will happen
before you know there is an explosion or a problem on that side. This is the reality. I was last year in
val de grâce, Paris for a big demonstration of the day of HAZMAT and the fire brigade of Paris, very
well known, made a show with firemen of course. It was sunny, 20 degrees, all the firemen were in
swimming suits. It was very easy to say ‘oh, you are here, come this way, do this and this’. They
pretended that 80 people each hour were contaminated. I said ‘it’s impossible, show me.’ And I
explained also the different problems. Just imagine the same situation in your country, your country
is not tunesia or Algeria. It’s just like our country. You are in January, in the night, 2 am. Civilians, not
firemen, not the army, not soldiers. Men and women, muslims, catholics, protestants, children. Snow
everywhere, 2 am, you are in the countryside, what do you do?
CG: yes, that is a large problem
38
LB: they never speak about a problem like this, this is a real problem. This is why we have to speak to
meet and to speak together, because this is reality, not a circus show you see in your country and I
see in my country or Paris and so on. Yes, it’s interesting to have a decontamination system for
soldiers because the decontamination system follows the brigade and so on, for decontamination of
material. But not for an explosion in civilian towns or villages, because when a truck is exploding
during transportation of chemical substances, the situation is completely different. And this is a case
we have to speak about. If we can solve this, we can solve a lot of problem. But I know it is a
problems also in the US, in China. It’s a reason why I travel all around the world and I know the
different answers of each and I know they all have big problems, but since 20 years they all have
these items, these are basic items of the problem. Very easy, but how to go further to the real
answers. This is the reason why I accepted to meet you, because I hope with EMRIC+ to go to real
pragmatic answers. But I refuse to participate to ministries, to dinners, walking dinners, Champagne,
caviar, big sentences, long speeches without any efficiency. So it was just to speak about my job. My
job is real, pragmatic and I know about the problems of firemen, because I am also a medical fireman
and I am in contact with a lot of people and we try worldwide to find solutions. Do you know the
company hot zone solutions? You have to have a look at them, the company has an office in the
Hague.
CG: and it is a company?
LB: this is one of my contacts, it is a former commander of the Belgium army, he’s retired now, but
he works for the hot zone solutions. And here is the address.
CG: and what do they do?
LB: it is only for civilian purposes, they propose to make exercises with real chemical and radiological
agents. They did exercises in Czechoslovakia, in Chernobyl, different zones. This is the only civilian
company authorized to work with real chemical and radiological agents.
CG: they develop exercises for people?
LB: yes
CG: and what kind of… just civilians or also people that work with those kind of agents?
LB: it’s for firemen, policemen, industries who want to exercise and test their own material, it’s very
important to be in contact with these people. You can contact them and say you know mister
Bodson, it’s OK.
39
CG: Okay
LB: I go to China because since 2 years we prepare France, Belgium, China and all the people, a group
exchange about chemical risk and we hope we will have success for international meeting of a
platform for all specialists, but to make all these specialists, different specialists, architects,
engineers, firemen, chemists and so on not to know more about their own practice, because they do
this by themselves, but to try to let them speak the same language. And when they are on an
accident to have the same point of view and to speak the same language and to have good
coordination. And I will give you the reference for this international conference, because it is the first
time we do this in China, shanghai in June. But probably twice a year and it will be bigger and bigger
and of course you will be invited, because you have probably a lot of things to say and to hear with
all these people.
CG: yes, Thank you.
LS: Now I want to ask you a few questions. I have some basic questions about how things are
arranged in Belgium, if you want, I can give you the questions as well. I would like to start with the
basic national information. If there would be some sort of disaster with hazardous materials, what
would happen, can you paint me a picture, how in your opinion things would go. Like in the
Netherlands we would have the GRIP structure, is there something like this in Belgium?
CG: if there is an incident with some sort of chemical and there are health complaints, what would
happen in Belgium, which people would be called, who will give you advice, that kind of stuff.
LB: do you know about the Belgian laws?
LS: Well I tried to research it, but I don’t think I know enough
LB: since 2006 we have a law describing all the process when a disaster occurs. That’s what we
named PUI. It’s in French plan d’urgence et d’intervention. Intervention emergency plan. Three main
levels: communal, provincial, national. Town, province, national. At each level you have a PUI, the
PUI is composed of PGUI. General emergency and intervention plan, general philosophy of
intervention what kind of disaster can take place. Plus PPUI, particular plans for emergency
intervention, for example all seveso industries, nuclear centres and so on, they have particular plans.
Plus monodisciplinary plans, five disciplines 1. Firemen 2. Health(red cross) 3. Police 4. Big logistics
(civilian protection and maybe the army and also the red cross) 5. Information (radio, television) with
authorities. Plus PIU, it’s internal emergency plans. All companies, all big companies also hospitals
must have an internal emergency plan in case of fires, explosions, flood and so on. The PUI is
40
composed of all of these plans at each level. For a hospital we must have of course like all companies
a PIU, it’s a security service, plus MASH planning, in French: mise en alerte de service hospitalier.
Hospital services alert system. So, if we hear about a disaster and we expect to receive in a few
minutes or hours a lot of victims, more than usually, we start the MASH plan in two levels, level 1 and
level 2. Level 1 is only internal reorganization, because we just take some new beds, some nurses
from here to here, because we just expect a number of victims, but not too many. For example here
we expect about 15 victims with 2 major, 4 medium and the others the relient victims, it’s level one.
For more it’s level 2 because we have to call back doctors, nurses and so on. This is the general
organization, the ministerial law of 2006. Of course, if we have a chemical hazard, directly you
probably have the PPUI that will start the specific procedure and also discipline 1 and 4. Maybe if it’s
with a company the PIU, the company itself. With people trained for chemical risk and with special
material to detect, to measure, maybe to count everything, that is a problem for firemen and also for
civilian protection, maybe army.
CG: and the health is not playing a role in this?
LB: only a part of this.
CG: there can be victims that need to go to the hospital and medicine is involved, but when there are
complaints that aren’t necessary to be treated in the hospital but people are afraid that kind of
stuff…
LB: of course if we have that kind of problem, we start our MASH plan, part of the MASH plan is
composed of what to do if CBRN problems occur, but for example the contamination in Belgium is
not good, I explained you the circus show of a few years ago and each year we have a circus show
like that. And until now we have no protection of our hospitals. If you have 10 people coming wildly
from an accident with contamination of their clothes and so on, we have a very big problem, I will
show you our small protections for this hospital. This hospital is a major hospital, one of the 2 state
university hospitals of Belgium, one in Gent, the Flemish part, one here, liege. 4800 work here,
because we have different sides, this is the main one. 80000 people each year come into the
emergency department, just to get an idea. But I will show you our very small protection system if we
have radiological or chemical problems. If we have 1 or 2 victims, it’s ok, if we have 10 or 100 victims,
it’s impossible. I don’t know how it is in your country, but here it is very difficult. That’s the reason
why I come back to what I said a few minutes ago, the real problem is the wild evacuation from a
disaster site with thousands or maybe hundreds of people going directly to the hospital and this is a
very big problem.
41
CG: when there is a smaller incident and there is said that chemical A is released and the health
complaints are much different than what you would expect it would cause by chemical A. on basis of
the health complaints you would expect that it would be chemical C, is there someone who pays
attention to these differences? In our country the public health advisor hazmat is playing that role.
Looking are the complaints those that you would expect, and is the fire brigade measuring the right
chemical, are they putting the right carrier in the air? Do you know examples from that kind of
incidents?
LB: yes, theoretically we tried to do the same, but in practice..
CG: there’s no one that pays attention if that could happen?
LB: they try to, but the timing is very hard.
CG: and who is trying? The fire department?
LB: the fire brigade and civilian protection on the field, but 99% of the accidents we’ve had, the
information was wrong, for example, if you cross our country from liege to monts and you follow la
meuse and somewhere we have a valley with a lot of companies with chemicals. Producing or
receiving chemicals or using chemicals. Included the nuclear central of tirage, four reactors. Try to
know about the main wind direction of the country.
CG: that will probably be the same as with us…
LB: we have wind turning all the time, this is one kind of information they try to give, but in fact it is
quite impossible, but all the emergency plans are based on this kind of information to decide which
country we have to protect. Closing the door or to evacuate.
CG: on paper it’s looking nice, but in reality…
LB: yes, it looks very nice on paper, on site very bad. Remember, the first industrial disaster in the
world was in ainsy (?) a few kilometers from here in 1929, with a company préons reppelles. And you
have an inversion of temperature, metereologic problem, yes. And the smoke pushed on the road. 60
persons dead, 1000 people with problems, eyes, pulmonary problems. It was the first industrial
disaster in the world. In 1952 the same problem was in London, 1200 people died.
CG: in other words you’re saying we didn’t learn anything. Is public health services playing a rolein
those monodisciplinary ?
42
LB: yes, because hospitals start the MASH plan of course. Some hospitals can send on the field
intervention vehicles with a medical team, you know our system, one medical doctor and one nurse.
Sometimes a driver, but for financial reasons generally it is only the nurse driving the car and one
doctor. And they go inside. In Belgium maybe 5 people are trained to go into contaminated sites and
know what to do, to respect and to take care in that case. So not enough exercises, not enough
information, it’s a reason why the university here asked me, we must change this, we must improve
this, because everywhere in Belgium, this is not enough, we are in danger. You know our hierarchy?
For the 2nd discipline, for health, public health ministry, national is one minister for health safety, but
we have also in each province a health inspector. He is an administrative medical doctor. And in
some provinces, not all sadly, but in liege for example, and I was the first one 24 years ago, we have
24/7 a medical director on duty. If there is something happening, he is directly on site and he is the
commander of all the medical teams on site and he decides how we are going to send people to
hospitals and so.
CG: we have that aswell
LB: yes, I thought so. Here we have the abbreviation dirmed from this law also. Dirmed is the
mandatory emergency specialist with complementary education for disaster situation and it stands
for direction de l’aide medicale, so it’s for director of medical help.
CG: we call it the white services, GHOR
LB: and he is the head of all ambulances and meuch, medical interverntion vehicles, but also red
cross. General red cross is a very special part, but when a disaster occurs, the dirmed is the head of
all the red cross systems. And also PSM, also on duty 24/7 for psychosocial management.
CG: and the communication to the public, when that is necessary 5 flies in?
LB: yes. On site, you know we apply the French method with PMA, post medical avance, advanced
medical tent, campaign hospital, triage of course and evacuation with regulation with different
hospitals and the dirmed is head of all the systems on site, but the dirmed is present in the command
room with all the disciplines. So on site the tactic 2-level: strategic (authorities, burgemeester,
government of each province and national is a minister, 2 ministers, the interior minister and the
health minister) and tactic (operational) so it’s level communal, provincial, national. Town, province,
national. Tactic, you have on site during a disaster PCops integé, integrated operational command
room with all the disciplines. You have dirPCops, generally a fireman officer and he coordinates the
disciplines. I am here as dirmed, but you have dirC (?), the fire brigade director, then you have
dirmed, medical, me; dirpol, police directory; dirlog, logistic directory and dirinfo, representative of
43
authorities but outside for information. Only dirPCops gives information to the authorities. The
information needs to be approved and each half hour goes to the crisis center. You can have the
crisis center for a town, local, it’s communal crisis center, provincial crisis center and here national
crisis center or federal in Brussels.
CG: yes, it’s the same in the Netherlands. And the directors are getting the information from the
people in the field?
LB: yes
LS: and this is for Belgium entirely?
LB: yes. Now the problem is if we have a cross border problem, who communicates with whom. This
is why it’s interesting to meet and to put our hierarchy… but very simple, not one or twothousand
pages, one or two pages. And who can speak with whom.
CG: we when we have the public health hazmat advisor, we advice when there’s a little incident, the
people in the field and when we have GRIP one or two then the tactic level is in the air and then we
advice the number two, the medical director.
LB: what is the translation of GRIP?
CG: I always forget that, it’s the… coordinated regional incident management procedure.
LB: but it’s not specific for chemical incidents?
CG: no, it’s for all kinds of disasters
LB: sometimes of course when we have a company problem in the operating command room we
have 6th man from the company, an expert or director or contact of the company. Because it’s
interesting of course to have a man of the company to say ‘the problem is over there, here is the
architecture and so on.’ But he is only for information for all the directors.
LS: how do you feel disaster management in Belgium is handled?
LB: it’s not bad, but it needs to be improved and the last problems we’ve got, for example, in fact
theoretically we have to wait the official declaration of disaster at level 1,2 or 3 by the burgemeester
or the governor, or the people replacing them. And sometimes this can delay, but in fact on the field
we decide with no problems, but the law asks us to wait the official decision of level 1 and so on. So
we have to improve the information at that level to be sure that we can work freehand, even if we
don’t have the official statement of the governor that this is a disaster. I’m sorry, but we have to
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move faster. So we just have… in practice it is no problem, but theoretically it is not good. No, our
system is not, but what we have to improve is exercise in different situations, because we don’t have
two of the same disaster in the world. All are different, different conditions. Remember, we’ve had
explosions, gunner in December, 125 victims, 60 victims had a wild evacuation, directly into the
hospitals, this is a big problem.
CG: if we could prepare all incidents and disasters, then there wouldn’t be any disasters anymore.
LB: yes, I am sure that we just need a philosophy of management, but we have to put well trained old
people, not young people coming from the schools in the field and let the good sense work. But with
a general philosophy. It’s unnecessary to make large plans with thousands of pages, completely
crazy. Generally in a few pages you have the good summary for e good philosophy for people.
LS: and there are no particular cross border regulations or plans, if something happens cross border?
LB: I think since 20 years there must be, somewhere in a box, in a case of a minister. I don’t know
who, why, where, but I think there will be some regulations. In practice it works well, the 112 center
in liege will give a call to the 112 center in Maastricht ‘we need you’, that works well and that are real
problems. But if you know about a text, just send it to me, it will be funny. I’m sure you will find a
text, from a lot of meetings with good champagne, nice caviar and so on.
LS: I haven’t found anything yet, but I also starting to expand my piece about the Netherlands more.
LB: If you want, I can send you some texts.
LS: That would be great, yes, thank you. I think the most important parts for me are covered now.
LB: sure? Let’s take a look at the questions. *reads questions* can you explain how a risk analysis
works if an incident takes place? Risk analysis is a very big problem worldwide, that’s the reason why
I go to China next month for the platform I told you about and to speak about the same thing and risk
is very different if you speak to an engineer, an architect, a producer, a worker, a fireman, a
policeman and a doctor. That’s 6 different analysis
CG: that is what I mean with a spider in the web, it could be our role to translate the technical results
of measurement to the health interpretation and explain them to the public, which have a total other
perception than we have as professionals. I think that could be an advantage of the public health
advisor hazmat, to be the intermediate between all the different disciplines.
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LB: if you want you are welcome to the congress during the 6th and 7th of June very close to shanghai,
it’s 12 hours by airplane. I will give you the website, if you want to have a look. It’s in Chinese and
English.
CG: I don’t know if I will make it this time, but you said there will be more, then maybe I can make it
next time.
LB: Yes, I will just give you the website.
CG: I think it’s is a really big problem that the different disciplines use different reference values and
to make a good risk analysis, you should choose the right risk values and I think we have a role in that
part of the game.
LB: I suppose you know about Reach and you know about FDS for example or all the books with all
chemical substances and for a doctor it’s funny, because you have a very good chemical description,
fusion point and so on and first help: call a doctor. And the doctor: ‘wow, what can I do?’
CG: that is why we are educated, we learn about all the aspects; toxicological, chemical, you call it
and we try to be an intermediator in that
LB: you think you know about toxicological…
CG: yes, the basic aspect, but you don’t need to know all the details to get to the right persons and to
be that spider
LB: toxicological experience is only bad experience worldwide, but you have two the same
experience, so it’s very difficult. It’s very difficult to make experiments of course, you may not ask to
20 people ‘just take this’ just to see the effects. So it’s very difficult and I’m sure toxicology will
improve during the years, it will become better and better, but until now they generally are too late
to give answers on site during a disaster. After 30 days or 2 months they explain why people are
dying, but that’s too late. My people are on site and ask ‘what can I do? Is it dangerous or not?’
nobody can give an answer directly.
CG: I don’t dare to make a statement that we always can, but the cooperation between the people
and to get the right knowledge from the right people and then you will get an answer very quick, but
then you have to meet each other.
LB: I’m sure, but then you have to speak the same language, not only the same language for example
English, but using the same words, saying the same things with good instrument for communication.
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Your system is not compatible with our system and our system not with the French system. But
communication and information is the key of success, I’m sure.
CG: and we need to trust each other, I mean that when you ask me something, you have to trust that
I give the answer you want and not discussing on the location, that costs valuable time.
LB: I will look at the rest of the questions, just to be sure.
LS:How do you think your country handles HAZMAT disasters?
LB: Very badly, because not enough exercise, I also think last years the ideal in Belgium was nurses
and doctors may not go on contaminated site, may not use uniforms or protections, because they are
not trained for this and so on. I agreed with this until a few years ago. I think that not all, but a part of
nurses and doctors have to train, because if in certain circumstances we will have to work in
dangerous sites that’s the reason why I am in contact with hotzone solutions. I don’t say everybody
has to be trained each month with protection and so on, it’s not possible.
LS: What aspects of HAZMAT disaster management are you personally very proud of?
LB: I am very proud of my ideas, and I just tell you some years ago everybody that heard about me
said ‘he is crazy, completely foolish’ now they begin to change. That is the reason why I am proud of
my ideas. Do you want another example? Speak about the decontamination system. Have you ever
seen a decontamination system?
CG: yes, I did.
LB: a tent, showers, people inside with protection. OK? Communication between people with
protection is zero. Generally they don’t have speaking systems, so it is difficult. There is, if you have a
real disaster, a lot of noise, so they will not speak to each other. Have you seen people nude or with
small clothes entering the tent for the beginning of the contamination?
CG: yes, on a film, not in real life.
LB: ok, I hope you will see in reality with 5 degrees outside and during the night. It’s not easy with
civilian people. and another parameter nobody thinks about, you need liters and liters of water.
Generally we say 10 liters per person, that’s crazy, it’s not enough, it’s 50 or 60 liters per person. So
generally if you have 100ds of people to decontaminate, you need a nice barrack. But what is
interesting, if you really have contamination, of course you remove 80% of the contamination by
removing clothes. But if you decontaminate people, the reason is because they are still
contaminated. The first guy entering the tent, you have a washing system with water generally, it’s
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ok for him. The second person, it’s ok. The third one, the fourth one, the fifth one enters with no
protection, no respiratory protection, he enters an aerosol of contaminated substances and this
person will go back directly, because he will contaminate these people. more than before they enter
the tent. Did you think about that?
CG: no, this is a very good lesson
LB: so I am proud of my ideas, I have nothing to prove, very soon I will be retired, my career will end
in about 5 years. I am not searching to win a Nobel price or to be the head of anything. So I can speak
about my ideas with no problems. I don’t want to win a price or something.
CG: your ideas are proving themselves.
LB: yes. I just hope that my ideas can make other people think and that we can meet and speak
together, that we say oh, this is right or we have to correct this and this and we find solutions
together.
LS: On what areas of HAZMAT disaster management could there be done more?
LB:On training and decontamination in front of the emergency rooms of hospitals. I am sure to
decontaminate on site is crazy, because of the time and the wild evacuation. But I think all hospitals
an surely big hospitals must have decontamination system/tent to block these people before they
enter the emergency rooms. Outside but with light and warmth to decontaminate gently 10 or 20
people, because they will arrive like this.
CG: I once heard a presentation at a congress, a Belgian hospital has built such a decontamination
room, probably Genk, can that be?
LB: yes, but very few, too few hospitals have that. If you have an accident here, people will not walk
to Genk. I will show our decontamination room for one person. And because we are the hospital for
nuclear central, and decontamination rooms just for one person, but very slow. We need more, but
that will probably next year. I think all hospitals should have a decontamination system, even if the
system is very simple, they will have great benefit in doing this.
LS: Is environmental monitoring during and after major chemical incidents legally regulated in you
country?
LB: Theoretically yes, but in practice not really.
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LS: Who are the national competent authorities supervising environmental monitoring in case of
major chemical incidents in your country?
LB: It’s the ministries and they have consultants, but it’s not well organized, it’s not sufficient for me
and it’s not rapid. But it’s better than 10 years ago, each year it gets better and better.
LS: do you expect any misinterpretation of shared data? What would be the main reason for this?
LB: Yes! Because we don’t speak the same language, we don’t realy have the same procedures, the
same names for the same thing, so the reason to meet to put our systems and the german and
French system parallel to say ‘this is this, this is that’ just like a dictionary and the most important,
everyone must have the dictionary. Not only the ministers.
CG: no, it would be nice if it is compact and pragmatic and you can put it in your pocket.
LB: yes, very simple, maximum 3 or 4 pages. I am a fan of the 1 page protocols, they are the best.
LS: are there official arrangements on cross-border collaboration in case of major chemical incidents
in place in your country?
LB: I think so, but very secret, only with the people the same with champagne and caviar and so, but
if you ask people from my department if they know about this, they will say no, but they are the
people on the field, the ministers not.
LS: give example of disaster close to borders, what happens?
LB: I can give you examples, I don’t have my presentation, but I can send you. In 2000 you have a
train with wagons with different kinds of chemicals coming from Holland. You know the company
DSM?
CG: that is the chemelot site.
LB: the train falls and the management went completely crazy, not from DSM, but our firemen and so
on. And I took pictures and the pictures had a very deep impact the next weeks, because I proved
‘oh, you worked there, everything was ok?’ ’yes, everything went well!’ ‘take a look…’ 20 people with
only their white coats, 2 meters from the wagon with acrylonitryl dripping out of it. And during all the
phase of re-establishing the wagons and so on, firemen had very light clothes and so on. Take a look
at the pictures. It was twelve years ago, in the past. Since this problem everything got better.
LS: how does it work if you have different emergency services from different countries at the incident
site?
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LB: it’s difficult..
CG: with the shooter in December I had some stories about that there were Dutch ambulances on
site, but there were nurses and they weren’t allowed to save victims and I think that is the point you
make, you know that our nurses are well educated and can do the job, but the people at the site at
that time didn’t know that.
LB: but in fact ministers with caviar and champagne know since years and years that we have some
differences, but these differences are very few and can be summarized in one page. We just have to
say ‘ok, don’t have to meet 10 times with champagne and caviar to say this.’ We can just write down
for example nurses from Holland are able and authorized to do this and this and so on. Of course this
is a problem for the ministers to say ‘oh, our laws are different, but in a disaster we accept the help
of Holland with their way of work.’ One line! They don’t need to meet 20 times for this! And you will
have it all in one page! I know that it is different in Belgium if I want to send a victim to AZM in
Maastricht, it is not possible, just like in our country, when we give a call and say the patient will
come in half an hour, in Maastricht they won’t accept. But it is a problem for the ministers to say ‘oh,
in disasters we all work the same way and we do not have to accept everything that is done and we
dispatch and we send directly and the hospital in Maastricht is obliged to accept the victim. This is
not my problem. My problem is I try to send the victims first to Belgian hospitals of course, but if
there’s not enough hospitals, I don’t want to wait hours and hours to wait for the acceptance of
hospitals in Eindhoven, paris and so on. This is the problem with the ministers and I thought last
years that the meetings with champagne and caviar were focused on this problem and that we would
have a summary of one or two pages. But do you know about such a summary? No. why? Because
champagne and caviar are very expensive. And I wait for the summary. If they continue to meet with
champagne and caviar with no result, they don’t have to expect that I will continue to meet for
nothing. I am a soldier in the field, not of ministries or buildings. I think I have been clear for you.
LS: are there arrangements for data exchange with neighboring countries?
LB: no.
LS: do you feel that there is a need for more cooperation in the EMR on HAZMAT disasters? Why?
LB: yes! To speak the same language and to have this summary of our ministers. I can put on one
page the real questions and I give you and I ask my ministers and you ask your ministers and the
German ministers and I just want them to put yes or no as an answer. This is just one meeting, one
bottle of champagne, no more.
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LS: how do you see disaster management in case of HAZMAT working in the future?
LB: Better and better.
CG: are you interested in the project and if so, would you like to work with the project?
LB: on the field we need anwers to very simple questions and we pay our ministers to give answers
to these questions. What I expect from EMRIC+ is to say ok, now we meet these ministers so we
don’t have to lose any more time. Please mister or misses minister, answer our questions, because
maybe this afternoon a cross border problem will happen and we need the answers since years and
years, and we don’t have them.
CG: yes, that’s a good point you make. And from the public health hazmat part of the project we are
just in the beginning phase and hopefully we will get more results and I think that this meeting for us
is more result already.
LB: but to conclude with a positive speech; each time we’ve had a problem in Belgium and I was on
site; explosion of gasses in heimaten, very close to Aachen, but in Belgium. Very rapid, excellent help
from helicopters from Germany. The problem with the train in visé, cross border, dsm director on
site, there were problems with our staff, but not with Holland. Explosion in coqruilles in liege, 16
burn victims, 2 dead and 1 call from the 112 center from liege to Maastricht, directly ambulances and
helicopters from Holland. The problem with guilland giere (?) gas explosion close to the north of
France, in Belgium. Big help, directly, no problem with just one call to France. Professor Goldstein
from Lille came with 30% of their material and people from France directly. The problem in Liege
with the shooter in December, one call and directly ambulances came from the Netherlands, so we
know that in practice nobody had any problem because they did this, no, they are very happy to have
helped and very little problems on the field. But it is better to have the approval of the authorities
saying ok, just 1 call and we will do this and there is no problem for anybody with the laws and so on.
CG: I want to thank you very much for your time and I am very interested about the information
about the congress and so on.
LS: yes, thank you very much, this was very useful for me.
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Appendix 2 – transcript interview Michel Moors
Civil protection expert
May 10th, 2012
MM = Michel Moors
CG = Cindy Gielkens
LS = Lisanne van der Schors
Transcript interview Michel Moors
LS: ik wil eerst graag wat basic information over Belgie vragen. Kunt u een soort van beeld schetsen
van wat er zou gebeuren als er een groot incident met schadelijke stoffen is. Wat gebeurt er in
Belgie, bijvoorbeeld in Nederland hebben we het GRIP systeem, hoe zit dat in Belgie?
MM: in Belgie is dat echt moeilijk op het moment. We zijn op het moment vooral bezig met de civiele
veiligheid, vroeger was dat the civiele bescherming, nu de civiele veiligheid. Wat zit er in de civiele
veiligheid, bijvoorbeeld de brandweer en de civiele bescherming, de civiele bescherming heeft niks te
maken met de brandweer, wat hebben ze nu veranderd? Ze hebben een reorganisatie gedaan, ze
hebben zones gemaakt van de brandweer. Luik is dan bijvoorbeeld zone 1 in Luik is de brandweer
van Luik, van Warem (?) van verschillende brandweercorpsen tezamen en vroeger als Luik dan een
speciale wagen nodig had, werd de civiele bescherming opgeroepen. Wat doen ze nu onder elkaar,
als ze bijvoorbeeld een nieuwe CBRN wagen moeten kopen, dan zeggen ze bijvoorbeeld we kopen
dat voor zone 1 en dan blijft hij in zone 1. Als er een groot incident is, wat gebeurt er, de mensen
bellen dan de 112 centrale, dan komt de brandweer aan, die hebben meet apparatuur, maar dat is
niet echt hi-tech. Dan zullen ze zeggen ‘oei, hier hebben we een probleem met CBRN’ dan zal de
civiele bescherming worden opgeroepen, want we hebben speciale meetgroepen. Net zoals Hartmut
heeft, we hebben ook speciale meetapparaten voor alles wat we kunnen meten, dat zal zo gebeuren.
Wat zal er automatisch gebeuren, the witte colonne zal worden opgeroepen, je hebt de rode, de
witte en de blauwe en iedereen zal dan in alarm gedaan worden. Maar ik weet niet of wij bij ons
gespecialiseerde mensen hebben bij de geneeskundige kant om erbij te komen helpen, ik denk het
niet. Dat is zo’n beetje onder mekaar spelen, ik weet dat meneer Bodson daar mee bezig houdt, en er
is nog een andere dokter in ... die houdt zich een beetje bezig met CBRN, het heeft niet dezelfde
optiek als meneer Bodson. In het algemeen wie gaat er, politie, brandweer en civiele bescherming.
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Wat zal de civiele bescherming doen, ze hebben nog een officier daarbij, en er zal ook een
commandocel worden opgebouwd en in de commandocel zal ook een specialist zijn die in CBRN
gespecialiseerd is, een officier en die zal dan ook kunnen zeggen ‘OK, dat is dat product en dat zullen
de gevolgen zijn voor de mensen’ en dan zullen ze raad geven mevrouw renaars bijvoorbeeld. In het
algemeen gebeurt dat zo.
CG: en via mevrouw Renaars wordt het dan ook gecommuniceerd naar de bevolking?
MM: nee, dat is nog anders. In België... het is spijtig dat dat in het Frans is, ik heb het niet in
Nederlands. We hebben disciplines in België, 1, 2, 3, 4 en 5. 1 is de brandweer, 2 is de geneeskunde,
3 is de politie, 4 is alles wat logistiek is, de civiele bescherming, het leger en 5 is meneer thierry
brasseur, dat is alles wat communicatie betreft. En dat is ook iets wat we met de EMRIC groep, wat
we met Hartmut willen doen, dat bijvoorbeeld de informatie zoals die in Duitsland gegeven wordt,
dat die hetzelfde is als in Nederland en België. Dat is ook een beetje het probleem, dus wat gebeurt
er, het crisiscentrum wordt geopend bij ons in Luik, iedereen komt daar rond de tafel zitten, dus de
specialiteit van detectie dat is de civiele bescherming, die geeft dan informatie, ze krijgen dan
informatie binnen, dat is het product en wij moeten dan die gegevens aan mevrouw renaars
doorgeven. Zo gebeurt dat.
CG: en zo’n situatie dat de klachten niet overeenkomen met de stof, of er alleen maar klachten zijn
en niet bekend is wat er is.
MM: dat heb ik nog nooit meegemaakt in het crisiscentrum, ik heb altijd meegemaakt dat met een
speciaal product bijvoorbeeld een ongeval met een trein, de politie komt dan, die voelen zich niet
goed, dat wordt doorgegeven aan de brandweer, de brandweer komt dan met meetapparatuur en
die vinden dan het probleem, dat er niet genoeg zuurstof is ofzo. Die willen dan bescherming
oproepen, en ze komen dan met ons speciale apparaten aan. Het product wordt dan geïdentificeerd,
dan halen we zo’n affiche eruit. Maar wat we ook kunnen doen vanuit de brandweer uit Zwitserland,
daar kunnen we een privaat bereel bellen, daar hebben ze experts die kunnen we ook altijd bellen.
Maar wij geven de gegevens dan door aan de geneeskunde.
LS: oké, en zijn er ook verschillende manieren van handelen binnen Vlaanderen, Wallonië en de
Duitstalige gemeenschap?
MM: normaal gezien niet, waarom niet, omdat, dat is juist het mooie, de brandweer is regionaal, dus
dat hangt van een dorp, van een stad, van een provincie af. Vroeger was dat per stad, dus de stad
Luik had haar eigen brandweer. Nu hebben ze daar een vereniging van gemaakt met verschillende
gemeentes. Nu hebben ze eerst gezegd we willen dat provinciaal maken, toen zeiden de gemeentes,
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nee, waarom zou je dat provinciaal maken, ik heb mijn mensen, dat blijven mijn brandweermensen
en er zijn veel vrijwilligers bij. Toen hebben ze gezegd oké, dan gaan we zones maken, maar dat blijft
nog altijd provinciaal, gemeente. Maar de civiele bescherming, dat blijft nog altijd federaal, dus wat
wij in Chris nee doen, wordt ook in liedekerken gedaan. Het enige verschil is dat in brasschaap nog
altijd de mensen van de Nederlandse brandweer worden opgeroepen, dus de specialisten voor geval
van gevaren. En daar hebben wij in Luik de reactietijd niet voor om dat te doen. En ik denk dat dat
het probleem is omdat ze het product EMRIC+ nog niet kennen. En ik denk dat op het moment dat
we het EMRIC+ project goed kennen, dat dat in orde is en dat dat goed werkt, dat er een
overeenkomst is, dat is ook een beetje bij mijn werk nu, ik ben nu bij de THW in Luik, dat is
tegelijkertijd ook andere zaken die er dan bijkomen. Maar we werken helemaal zo nu. Hetzelfde wat
in Luik gebeurt, gebeurt normaal gezien ook in Vlaanderen.
LS: en hoe gaat de communicatie van data van wetenschappelijk tot de praktijk, hoe is dat,
bijvoorbeeld nadat alles gemeten is?
MM: de gegeven hoe die terug binnenkomen en hoe die verwerkt worden, hoe gebeurt dat? we gaan
ter plaatse meten, dat heb ik vroeger gedaan in mijn jonge jaren, die gegevens worden dan naar onze
commandocentrale gestuurd, in Chris nee dan. Daar hebben we een officier of een onderofficier die
gespecialiseerd is in CBRN en die gaat die gegevens analyseren. Dan wordt een rapport opgemaakt
en dat rapport gaat dan zo snel mogelijk naar het crisiscentrum, die gaat dan naar de kolonel toets en
hij krijgt die gegevens binnen en dan gaat hij die gegevens dan nog een keer nakijken en die worden
dan op kaart gezet en die gegevens worden dan verder verwerkt.
CG: wij hebben bijvoorbeeld de voorlichting richtwaarde, alarmering grenswaarde en de
levensbedreigende waarde voor op het incident qua concentraties.
MM: ja, dat doen wij ook.
CG: dezelfde waarden?
MM: nee, dat hangt van ieder land af, ik heb een oefening gedaan met Europa. Dat is het probleem,
ik weet het echt niet, dat moet ik eens nazien met Hartmut, dat gaan we eens goed nazien. Dat ga ik
van de namiddag navragen aan Kolonel Toets wat onze waardes zijn, bijvoorbeeld in radiologisch
bereik, hoeveel microcifers mogen wij hebben, Ik denk dat wij er maximaal 50 mogen hebben in een
keer en in sommige landen mag het 20 zijn. Bij 50 moeten mensen hun akkoord geven, normaal
gezien is het 20. Maar er zijn landen waar het minder is en waar het meer is. Dat is ook een probleem
bij grensoverschrijdende interventies. Daarom is er ook een discussie met hartmut en met andere
mensen om te zeggen wie het bevel moet voeren. Er moet iemand van het land bevel hebben van de
54
interventie, maar een officier van bijv. België die naar Nederland komt, maar een officier mag alleen
bevelen geven aan zijn eigen mensen,want hij weet wat hij mag. Dat is het grote probleem denk ik.
CG: en ook opzich heb je het letterlijke taalverschil, dat vind ik ook wel een hele belangrijke. Los van
het Nederlands, Engels, Duits, de taal in het veld. Als wij andere grenswaarden gebruiken dan Belgie
en Duitsland, dan heb je het verschil.
MM: dat is ook een beetje het probleem met Emric, Emric moet dat gereed krijgen.
CG: ja, precies, ik denk dat dat een van onze doelen moet zijn, dezelfde taal spreken in het vakgebied
MM: ik ben op iets aan het werken bij ons, dat is in Chris Nee zelf, ik ben een nieuwe groep aan het
opbouwen daar en dan heeft de kolonel gevraagd, zo’n task team, technical assistance support team.
Dus die mensen zijn nu 4 maanden een opleiding aan het doen op het moment, ik heb er zeker 2 jaar
voor nodig voor die mensen goed zijn. Ik heb dat wel geleerd. Dus al die informatie wordt
automatisch op een kaart ingegeven zoals jullie al doen in Nederland. Dus we weten dan die mannen
gaan daar heen. We hebben contact gehad met mensen uit Israel, die hebben gezegd hoe doen jullie
dat in Belgie. Ik zeg dat die man zoals een sigaar. Dat is niet juist zegt die Israeli, dat is zo in een veld,
maar niet in een stad. Toen heeft die man een website gegeven en een wachtwoord, het is wel in het
hebreeuws, maar je kunt wel naar de plaatjes kijken, maar die doen dat in een rechthoek. Hij zegt de
wind in de straten dat is niet zoals een sigaar, de wind verandert. Hij gaf een heel ander beeld en hij
had daar gelijk in. Dus in de toekomst kan die groep dit soort werken doen. Die gegevens gaan
automatisch, neem aan dat er iets speciaals gebeurt in zeldewaard, dan worden er 2 mensen
ingestuurd en die mensen die doen alleen maar kaarten gereed maken, informatie nemen en die
doorgeven. Bijvoorbeeld de gevarenstoffen en de symptomen automatisch op kaarten ingeven. Dus
als de kolonel van Luik of de civiele bescherming of de burgemeester kan die informatie krijgen.
CG: en die houden dat ook bij in de tijd, dus als er iets verandert dan...
MM: ja ja, die zijn daar ter plaatse, dus een ploeg is ter plaatse en een in het crisiscentrum en als de
GSMs niet meer werken, dan gaat het over de satelliet. Mensen zullen ook altijd communicatie via
internet krijgen. Ik wist zelf niet dat dat bestond, maar met astra 2, ik heb daar testen mee gehad en
dat werkt perfect.
CG: en toen ik gister bij een overleg zat, hadden ze ook zo’n computer model zoals jij net verteld
hebt, bij chemelot, de DSM fabriek. Vanuit mij gezien, als je vanuit gezondheid daarnaar kijken wat
dan nog mooi zou zijn is als je de klachten kunt invoeren. Dat kon daar nog niet, maar dat zou wel
mooi zijn, dan kun je meteen kijken of de klachten wel overeenkomen met de stoffen. In een crisis is
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er natuurlijk heel weinig tijd om dat dan ook nog eens een keer te doen, maar dan zie je ook komt de
wolk die we berekenen ook overeen met de klachten die we krijgen en dan kun je al die lijntjes in een
oogopslag zien.
MM: dan willen we ook de tactische tekens weer naar boven brengen. Dus dat is een
gevarendriehoek met mensen die zijn geëvacueerd, want in het algemeen wat doen we, we tonen
een kaart met daarop de troepen en dan begin je met het overzicht. 72 mensen zijn daar, 80 mensen
zijn daar, maar dat kun je niet gemakkelijk op een kaart zetten. In Duitsland gebruiken ze nog altijd
de tactische tekeningen en die ben ik nu aan het ombouwen naar de Belgische civiele bescherming,
maar de tekeningen zijn hetzelfde. Dus als een Duitser of als die hier in Nederland dat ook
bestuderen, dan zeggen we, we weten dat een vierkant of een rechthoek of een cirkel is, die kleur
dat wil zeggen dat is brandweer, die kleur is politie, die kleur is civiele bescherming of THW of zoiets.
En dan kunnen we zeggen dat teken met 20 erbij, dat wil zeggen dat er 20 mensen geëvacueerd zijn.
Dan kunnen we op die plaats dat product aangeven, we kunnen er ook tekeningen in maken en dan
kun je dadelijk op een kaart de volledige situatie zien. Dat is een beetje voor begin volgend jaar, dan
moet dat in orde zijn. Dat is ook de communicatie dan, het probleem dat ik gemaakt heb tijdens
verschillende interventies, we hebben astrid, de brandweer heeft een folder die ze gebruiken die ik
niet heb. Dus dan slechte communicatie en wat is ook communicatie, spreken, dat kan een probleem
zijn, dan kun je het niet zien, maar als je een beeld door zou kunnen sturen, dan gaat dat veel sneller.
Dus de ploeg heeft ook een fototoestel met GPS en een elektronisch kompas, dus ze nemen een foto
en automatisch, dat is allemaal gratis op internet, allemaal mensen die bij de brandweer geweest zijn
hebben dat uitgevonden. En dat heet Georef en dat geeft je de hoek waarin je de foto genomen
hebt, en de plaats waar je hem genomen hebt. Dat is automatisch, je moet gewoon het kaartje in je
computer steken en dan gewoon dat beeld met print screen doorsturen. En dat gebeurt zo.
CG: voor de beeldvorming is dat handig.
MM: ja en ik heb nu de prijzen gehad en dat kost zoveel niet. Ja, wat is 100 euro tegenover 20000
mensen die in de problemen zijn, dat heb ik ook tegen kolonel Toets gezegd. Het probleem met
communicatie is nu dat de brandweer heeft nu wel in geval van catastrofe dezelfde folder. Dan
moeten we weer een groep veranderen en die moet ook naar dezelfde folder gaan. Dan kan de
brandweer van Luik en de civiele bescherming van Luik en de brandweer van een andere plaats,
kunnen we allemaal tezamen gaan.
CG: oké, een soort LCMS..
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MM: ja, alleen het probleem is, we spreken dezelfde taal af en toe niet. De brandweer zegt a vous of
a toi, normaal gezien is dat over, wacht is wait. En dat is een beetje verloren gegaan en dat zijn we nu
weer een beetje aan het opbouwen. Dus als ik nu met iemand uit Duitsland spreek, ja in Duitsland is
dat sprechen, dat is ook niet wait en over en al die zaken. Dus dat is een beetje ook aan het
opbouwen. Dus een groot probleem is dan wel die communicatie.
CG: als je met zo’n tekening kunt samenwerken, met visualisatie ben je al goed op weg.
MM: ja, dat gaat heel snel. Normaal gezien gaat dat, in de EU bestaat dat, dat heet een task team.
Die hebben een koffer, zo’n grote pelikanenkoffer en als een team naar het buitenland gaat, het
maakt niet uit waar, in Pakistan of China. Ik moet naar Brussel telefoneren, het probleem van die
man is kunnen bellen met spreken. Dat team moet iets kunnen geven waar je mee kunt bellen, dat is
satelliet of internet of GSM, dat is zijn probleem, hij moet spreken en de ander moet dat geven en
dat zijn we ook aan het opbouwen. Dus als er iets gebeurt gaat dat team erheen. Dat nu een
brandweerman mij dat vraagt. Ik heb er met meneer fanuel over gepraat, die werkt op de
alarmcentrale in Luik. Die heeft tegen mij gezegd, als jij mij dat kunt geven, dat ik op ieder moment
internet heb, dan zul je iedere dag op interventie gaan, omdat zij de mogelijkheid niet hebben. Het
voordeel daarvan is dat we gespecialiseerde mensen hebben, dat is hun beroep.
CG: en dat is bij de civiele bescherming?
MM: dat zijn vrijwilligers.
LS: Wat vindt u goed aan hoe Belgie incidenten met schadelijke stoffen afhandelt, wat zou Nederland
van België kunnen leren?
MM: ik denk dat België eerder dingen van Nederland zou kunnen leren.
LS: ja, maar misschien zijn er sommige gebieden waar Nederland wat van zou kunnen leren.
MM: Sommige materialen en nieuwe technieken omdat we iets nieuw aan het opbouwen zijn. Dus
wat was de civiele bescherming vroeger? Hetzelfde als de Nederlandse civiele bescherming voor de
koude oorlog. Toen is de koude oorlog een beetje afgebouwd geweest en toen hebben ze gezegd
wat kunnen we nog met de civiele bescherming doen? Dat wil zeggen we waren met 9000
vrijwilligers in ’81, we zijn nog 1300, dat is niet meer reëel, reëel is dat we nu zijn met minder dan
400, dus dat is echt goed afgebouwd. Dan hebben ze nog gezegd dat we toch een civiele
bescherming nodig hebben, want de brandweer is van de snelle opdrachten, de civiele bescherming
is meer in tijd. Dus dan moeten er meer mensen zijn zoals de THW in Duitsland. Dus dat is een beetje
op elkaar gericht. Wat is er gebeurd, nu hebben ze gezegd dat sommige opdrachten alleen voor de
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brandweer zijn. Alles wat snelle redding is, is brandweer, alles wat brand is, is brandweer. Alles wat
lange opdrachten zijn op lange termijn of gespecialiseerd, is de civiele bescherming. Dus CBRN,
schadelijke stoffen zal de civiele bescherming dan doen. Dus ze zijn het aan het opbouwen, met dat
opbouwen zijn er mensen die les hebben, die naar scholen gaan. Wat ik persoonlijk vind is dat er een
lijn is getrokken in België, zo onder Voeren en die gaat zo langs de taallijn door. En dat voel ik echt
goed, want Nederlandstaligen die gaan meer naar Nederland toe, Franstaligen meer naar Frankrijk.
En dat heb ik tegen de officier gezegd, luister, in Duitsland hebben ze iets moois om de analyses mee
te doen, en dan zegt hij, maar in Frankrijk... ik zeg, ben je weer met een paard onderweg? Dat
bekijken ze maar aardig. ‘maar Michel, wij spreken geen Duits’ ik zeg, ik wel. En we spreken Engels,
zij spreken Engels. ‘maar wij spreken geen Engels’ ik zeg ga naar school. En dus wat ik wel vind is dat
die zijn zaakjes aan het opbouwen en dat modern materiaal, dus materiaal dat nu wordt aangekocht
is ultra modern. En daar wordt ook veel scholing in gegeven, maar ik volg dat echt niet meer op, dat
moet ik een beetje meer aan een officier vragen. Vroeger hadden we ploegen, detectieploegen en
dan hadden we 2 keer in de maand les en dat was vooral gericht op oorlog, niet op dagelijkse
gevaarstoffen, dat was voor de brandweer en nu gaat alles naar de civiele komen. Maar ik denk nu
wel dat België kan meer leren van Nederland. In de contacten die ik nu heb met Emric, dan zie ik
toch dat Nederland verder is. Niet dat als er iets gebeurt in België, dat we het dan niet aankunnen,
we kunnen het wel oplossen. Maar er zijn andere zaken die ik hier veel beter vind dan in Duitsland.
LS: en wat denk je dat speciaal verbeterd zou kunnen worden aan het systeem in België
MM: hoe zeggen ze dan, zoals Hartmut kunnen binnenkrijgen, dat is AGS, dat hebben we bij ons niet,
dat bestaat niet. De officier bij ons die doet alles, die doet brand, die doet hoog water, die doet alles.
Dan moet daar nog CBRN bij komen, ik vind dat dat niet mogelijk is. Dat moet zijn job zijn, alleen dat
doen. Ik ben ook voorzitter van de vrijwilligers en ik heb ook contact met de algemene directie en ik
moet een project binnen leveren voor het eind van december om een voorstel te doen en een van
mijn voorstellen zal zijn om burger mensen, dus specialisten die bij een chemisch bedrijf werken
aannemen als officier bij ons, maar als expert, dus die kan alleen opgeroepen worden als er
problemen zijn met gevaarlijke stoffen. Hij trekt een uniform aan met veel sterretjes erop, want
anders luisteren ze niet naar hem, maar hij mag geen bevel geven, alleen advies. En dat zal een
beetje meer in de toekomst zijn en ook veel meer gespecialiseerde mensen.
CG: dat zie je in Nederland ook, die mensen werken heel ergens anders en die draaien mee in zo’n
pool en op het moment dat ze dienst hebben en er is iets met gevaarlijke stoffen, dan komen die in
actie.
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MM: dat gaat nu gebeuren bij ons. We zullen ploegen opbouwen alleen met vrijwilligers, die alleen
dat zullen doen, dus die zullen echt gespecialiseerd worden.
LS: oké. Weet u nog van speciale wetgevingen op dit gebied?
MM: die zijn ze aan het veranderen heb ik gehoord. Er bestaat een wetgeving van seveso, dus die
fabrieken waar de problemen zijn en ik heb gehoord dat de zaken aan het veranderen zijn voor
bijvoorbeeld terroristen. Dat is een nieuwe wet die uitgekomen is, ik heb die nog niet gezien. Ze
hadden gevraagd of ik daar aan mee wilde werken, maar ik had geen tijd, dus bij ons is er een officier
heengegaan. Ik weet niet of die wetgeving al uit is, maar daar was iets speciaals aan de hand.
LS: oké, wat ik van meneer Bodson hoorde was dat er vaak veel regels en wetten zijn, en dat door die
regels mensen belemmerd worden in hun snelle handelen, dus als zij zich echt aan al die regeltjes
zouden houden, dat het dan te langzaam gaat.
MM: Dat zijn regels... bijvoorbeeld in België mag een dokter geen antigasmasker dragen, geen
gasmasker, want als je een gasmaker opdoet, dan sterf je. Die mogen dat niet dragen, dat is
verboden en ook in België mag een geneeskundig team nooit de rode zone binnenkomen en ook in
de decontaminatie tenten zullen we nooit een dokter binnenkrijgen omdat die niet getraind zijn en
dat is een probleem met wetgeving en daar ben ik ook wel een beetje voor aan het vechten sinds
jaren en dat zal ik nooit gereed krijgen. Misschien zal ik daar met Geert Gijs eens goed over spreken,
maar het probleem is ook, daar zijn verschillende ministeries binnen. Het ministerie van
binnenlandse zaken en in dat ministerie zit ook nog de brandweer, de civiele bescherming en de
politie. Daar zijn altijd bazen boven, die willen dat en die willen dit. En niet alleen dat, dan is er ook
nog geneeskunde, dat is volksgezondheid en dan wordt dat een beetje concurrentie van elkaar. Ik
mag die niet op z’n tenen trappen want dan gebeurt dat. dan hebben we nog het leger, defensie die
er nog bij wordt genomen. Ik vind dat een beetje veel. Er is een die kan zeggen ‘nu ben ik de baas’ en
dat is nog niet gebeurd. Daar heeft meneer Bodson wel een beetje gelijk in, hij heeft veel ideeën,
speciaal af en toe met een helikopter daar, oeh.
CG: hij had het ook speciaal over alle shows die gegeven worden, ook met het decontamineren. Altijd
heel mooi, maar wat er in de praktijk daadwerkelijk verbeterd is, dat is werkelijk nul.
MM: het probleem van de praktijk is vaak dat we een oefening moeten maken, maar met een
oefening moeten we mensen hebben die willen spelen en dat zijn niet burgers die dat moeten
spelen, maar mensen zoals ik die slachtoffer moeten spelen. En de problemen zijn logisch. Kijk maar
naar wat er in Tokio gebeurd is, net zoals in Londen in de tube, mensen wachten niet tot dat de
brandweer daar was.
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CG: ja, dat was zijn punt ook.
MM: in Frankrijk die hebben dat al gezien, die hebben in elk ziekenhuis ongeveer de SAMU daar. Dat
is service d’aide medicale urgente. Dat is de MUG ongeveer. Dus ziekenwagens met dokters en die
zijn allemaal getraind, die mogen ook met antigasmasker werken en die mogen ook in de rode zone
gaan. Die zijn ook getraind om in ziekenhuizen decontaminatie te doen. Dus in de aankomsthal van
de ziekenwagen is al voorzien van decontaminatie, die moeten gewoon nog het plastic in orde
brengen, maar de douches zijn er al en die zijn daar wel voorzien.
CG: dat was zijn punt ook heel duidelijk, decontaminatie bij de eerste hulp en bij de ziekenhuizen,
want daar gaan alle mensen naartoe, die wachten niet.
MM: nee, die wachten niet op de brandweer of de politie. Wie zal er eerst aankomen? De politie en
die is dan ook al besmet. Dan komt de ziekenwagen aan, 9 van de 10 keer is de ziekenwagen eerder
dan de politie. En die nemen dan mensen mee naar het ziekenhuis, dan is het ziekenhuis besmet en
zo kun je nog wel meer scenario’s bedenken.
CG: Dat is wel interessant, misschien voor jou ook wel, dat je iets meer met decontaminatie doet,
daar zijn bepaalde regels voor. Een slachtoffer dat besmet is, kan bepaalde hulpverleners besmetten,
dus daar zijn hele protocollen voor, maar inderdaad wat meneer Bodson zegt, het staat heel mooi op
papier, maar in Praktijk gaat het allemaal niet zo goed.
MM: zelfs op papier is er nog niks geschreven.
CG: bij ons dan in Nederland. We hebben het wel heel mooi op papier staan dat hulpverleners wel in
de warm zone mogen omdat daar in principe de slachtoffers al gedecontamineerd zijn voor 80%, ze
hebben de kleding al uit en ze staan boven de wind. Dus op zich is dat een redelijk veilig gebied en als
ze dan een bescherming opbouwen, kunnen ze daar best wel handelen, maar bij ons willen ze dat
niet omdat ze bang zijn. Op papier ziet et er heel mooi uit, dat we zeggen het is veilig, jullie kunnen
erin, maar de mensen durven dat niet. Daar moet nog kennis en opleiding bij komen.
MM: en vooral de contacten, want ik heb contact met de europese lessen daar en iedere keer komt
dat op tafel. ‘wat is uw specialiteit?’ ‘ja, decontaminatie’ ‘ah, hoe doen jullie dat dan?’ ‘wij doen dat
zo’ daar zijn landen die werken heel anders dan ons. Ik denk dat het land in Europa dat het beste
voorbereid is, is Frankrijk. Ja, Frankrijk en Noorwegen, Zweden, Denemarken, die zijn echt goed
voorbereid. Dat is ook altijd... hoe doen we dat? Meneer Bodson wil dan de wagen nemen en dan
kleren uit en die op de weg gooien en dan wegrijden en dan als ze aangekleed zijn... ik zeg ‘oei oei oei
oei’. Nee, je kan dan wel zeggen van zou het gebeuren.
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CG: in een crisis gebeurt het dan toch altijd wel net iets anders dan hoe het in theorie gaat. Maar
toch wel goed dat daar over nagedacht wordt.
MM: ja, dat wel. En Canada en Amerika zijn ook goed voorbereid, en Engeland, die zijn ook zeer goed
voorbereid, die Engelsen. Daar ben ik verwonderd van, dat is ook, die hebben nog geen keer een
probleem gehad.
CG: nee, maar dat komt vast nog wel.
LS: maar als er iets is, dan zijn ze voorbereid.
MM: nee, dat zal nooit gebeuren.
CG: laten we dat hopen.
LS: dan heb ik nog een paar vragen over grensoverschrijdende hulp. Weet u of er officiële
overeenkomsten zijn op het gebied van grensoverschrijdende samenwerking?
MM: nee. Ik heb dat gehoord, de overeenkomst van Mainz, van Koblentz. Dat wist ik ook niet, daar
heb ik de laatste hoge venen brand interventie, toen hadden we helikopters nodig van de Duitsers en
dat was zo’n groot probleem. Toen hebben we een keer gereed gekregen dat we die helikopters
mochten krijgen op basis van dat verdrag. Een andere overeenkomst, ik denk... nee, dat zijn meer
mondelinge overeenkomsten, geen schriftelijke overeenkomsten. De enige schriftelijke
overeenkomst, dat is met de THW, de brandweer van zuid limburg, noord limburg, de
brandweerkazernes die daar aan de grens bij nord rein west falen zitten, die hebben daar een
schriftelijke overeenkomst, dat weet ik. Die heb ik wel thuis staan, maar dat is mijn job om dat nu
voor België ook gereed te krijgen, maar echt schriftelijke, dat weet ik niet.
LS: ik weet zelf dat er wel een paar zijn, bijvoorbeeld die van Madrid.
MM: ja ja, maar ik denk meer nu over Belgie en wat daar bestaat, maar dat Europese, dat ken ik van
buiten. Euregionaal, ja, ik weet dat er soms een mondelinge overeenkomst is tussen de brandweer
van Eupen en van Aken, maar echt schriftelijk op papier, nee, dat denk ik niet.
LS: en heeft u ook een voorbeeld van iets dat dicht bij de grens gebeurt is en hoe is er dan
gehandeld?
MM: ik heb er meerdere, de hoge venen bijvoorbeeld, die brand. Dat was een dennenbrand, de hoge
venen in Belgie, en dat is echt speciaal, want dat gaat tot diep in de grond, tot 2 meter diep in de
grond en dan moet wel snel ingegrepen worden. Daar waar ook Nederlandse brandweermensen die
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paraat stonden of die zijn misschien gekomen. Hoe gebeurt dat dan? Dat gaat naar het crisiscentrum,
sommige fasen zoals de hoge venen, die worden automatisch door het crisiscentrum geholpen waar
meneer faurait, de gouverneur komt. Ik heb het geluk of de pech gehad om daar bij te moeten
komen. Ik heb echt de beginfases gezien. Hoe gebeurt dat? er wordt contact opgenomen met het
crisiscentrum en er wordt een commandocel opgebouwd ter plaatse. Alles wordt gezamenlijk
besproken. De officier ter plaatse mag sommige bevelen dadelijk uitvoeren, andere bevelen worden
door de gouverneur gedaan. En toen heb ik gehoord dat ze meteen de brandweer van Aken hebben
opgeroepen, want Aken heeft dan Herzhogenrat die dichterbij zijn erbij geroepen. En wie is daar dan
nog bijgekomen? De THW, de politie uit Duitsland en Nederland. Wat heb ik nog meer meegemaakt?
Gasexplosie in coqruilles sambe. Ziekenwagens kwamen uit Nederland en Aken en helikopters uit
Nederland en Aken. Toen met die schutter zijn er ook ziekenwagens uit Nederland gekomen
LS: en dat ging allemaal soepel of waren er nog problemen?
MM: ik denk dat het soepel ging, maar het probleem is weer de communicatie, daarom wordt ook
ons team opgebouwd. Dat team dat gaat niet zeggen dat gaat alleen gebruikt worden als civiele
bescherming. Het objectieve doel zal zijn, iedereen bij mij, we spreken ten minste 3 talen,
Nederlands, Engels en Frans en ik ben de enige die daar ook nog Duits bij spreekt, maar de rest
spreekt allemaal 3 talen, dat is een heel groot voordeel, die weten ook hoe ze moeten coördineren.
Ik denk dat het probleem ook is dat we elkaar niet kennen.
CG: ja, dat is het grootste probleem, het scheelt al heel veel als je elkaar kent.
MM: ik kan naar de THW gaan, want ik ken die al 25 jaar, maar ik kan niet naar de kazerne van
Maastricht gaan, want ik ken daar niemand. Vroeger kende ik daar iemand, maar dat was niet in
Maastricht, dat was in Kerkrade. Nu begint dat weer een beetje op te bouwen. Maar ik ken mensen
uit Luxemburg al 10 jaar, ik ken de mensen in Frankrijk sinds meer dan 20 jaar, ik ken die mensen, ik
weet wat de civiele bescherming kan doen en ik weet nu wat de THW kan doen. Daarom heeft de
THW mij graag bij hen, omdat zij mij kennen. Ik vind dat een heel groot voordeel, vooral de mensen,
de bevelhebbers moeten weten wat er in Nederland kan gebeuren, dat is belangrijk.
CG: en wat de bevoegdheden zijn, dat was nu in Luik met de schietpartij een beetje misgegaan, er
was wel een Nederlandse ambulance, maar in Nederland hebben we geen dokter op de ambulance,
maar wel verpleegkundigen die de bevoegdheden hebben. Maar ze mochten in België niemand
helpen, ze waren daar wel, maar ze mochten niemand redden terwijl ze het wel kunnen. Als men al
wist van Nederlandse verplegers zijn bevoegd en getraind om dat wel te doen, dan hadden ze wel
kunnen helpen.
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MM: in Frankrijk is dat hetzelfde als bij jullie, maar in België niet.
CG: ja, dat zijn van die kleine dingen. Als je het van elkaar weet is dat geen probleem, maar als je het
niet weet.
MM: ja, maar het grote probleem is wel de taal. Dat vind ik persoonlijk, voor mij is dat geen
probleem, ik voel me goed daarbij. Maar dat zijn de taalproblemen, Frans, Nederlands.
CG:en vooral het Franse gedeelte, tenminste voor ons dan.
MM: en de Fransen zeggen Nederlands... pfoe. En dat is het grote probleem en daarom in mijn
team, iedereen spreekt bijna wel Nederlands.
LS: zijn er ook nog regelingen voor uitwisseling van data met andere landen?
MM: ja, dat was een project, ik weet niet of dat in orde is geweest, door de vroegere
brandweercommandant van Aken. Die had een programma, dat werd betaald door de EU, het was
een Italiaanse firma die dat opgebouwd heeft. Dat wilde zeggen op het moment dat er door de 112
een oproep binnenkwam, bij heimaten, dat kan naar Nederland gaan, naar Luik of naar Aken. Dan
ging dat automatisch naar Aken en dat was dan een probleem. Nu met dat programma kun je
automatisch zien dat er iets gebeurt. Het probleem is ook de taal. Van Luik weten we dat er iemand
is die Nederlands en Duits spreekt bij de 112, maar neem eens aan dat die aan de telefoon is. En door
dat programma werd dat automatisch vertaald. En dat begint automatisch, hij neemt de telefoon op,
voert dat in op de computer en drukt op een toets, dan gaat dat automatisch naar de
alarmeringscentrale in Maastricht en in Luik. En als dat dan in Duitsland gebeurt, dan komt dat in het
Nederlands en in het Frans aan. En het antwoord dat in Luik gedaan werd, werd automatisch
omgezet naar het Duits en naar het Nederlands. Ik weet niet waar dat programma is.
CG: en dat is niet operationeel, dat is gebouwd maar...?
MM: het bestaat en ik weet niet of dat aanvaard is. Ik weet in België hebben ze een nieuw
programma in Luik waar ze tekeningen erop kunnen doen en alles.
LS: vindt u dat er een behoefte is aan meer samenwerking in de euregio?
MM: ja! Ja, ik vind dat echt persoonlijk. Er moet meer contact zijn, want de contacten zijn nog niet
genoeg. ik ben in 2 landen, België en Duitsland. Met Nederland hebben we nog niet veel contact,
want die zijn zich langzaam aan aan het opbouwen door het euregioproject emric en emric+ ook. Ik
ga dat van de namiddag vragen, de brandweer van Maastricht heeft contact opgenomen met de
kazerne bij ons en die zijn ook verleden week naar Maastricht gekomen naar de 112 centrale. Maar
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het probleem is weer de taal, maar hier in Maastricht spreken veel mensen Frans. Maar ik zal daar
meer over weten na deze middag. Maar niet genoeg samenwerking, we kennen elkaar niet goed
genoeg. het is niet gewoon om elkaar te spreken, we zullen een oefening moeten doen. Een moet
naar de kazerne komen, we moeten routines doen, met de wagen elke maand 50-60 kilometer
rijden. Ja, 50-60 kilometer, dan zijn we naar Maastricht heen en terug. Dus gewoon 6 man in die
wagen, en tot aan Maastricht rijden, daar gewoon een kopje koffie komen drinken en een beetje
praten. Dat zal dan veel beter gaan en dan kennen we elkaar ook.
LS: ja, dan heb ik ook nog een paar laatste vragen. Hoe denkt u dat de rampenbestrijding van
schadelijke stoffen eruit gaat zien in de toekomst? Ziet u dat het goed gaat of dat er meer aan
gedaan moet worden?
MM: in de toekomst met het emric+ programma, zie ik dat echt positief in. Ik voel dat persoonlijk zo
en dat heb ik ook al aan de mensen van Emric+ gezegd, ook tegen Hartmut, ook tegen mensen van
de brandweer, tegen Ivan ook gezegd toen, ik weet hoe het hier in Europa gaat, dus ik zie dat een
beetje groter. Dat dan mensen vanuit België naar Spanje of Slovenie moeten gaan, wat we moeten
doen, maar het probleem is ook een Belg zal nooit aanvaarden om bevel te krijgen van een Duitser.
Of een Nederlander zal het nooit aanvaarden om bevel te krijgen van een Belg. En dat zal een beetje
aangepast moeten worden, ik denk dat als we zo’n groep gereed kunnen krijgen met Emric+, dan is
dat top. Ik heb eens gehoord, ik weet niet meer wie dat tegen mij gezegd heeft, ‘mijn zoon is
geboren’ ‘ah, waar, in Luik?’ ‘nee, in Aken’ ‘waarom in Aken?’ ‘ja, we zijn commissies gaan doen en
toen reden we naar huis en ze kreeg haar krampen. We hebben moeten stoppen in Hauset, we
hebben 112 gebeld en in een keer stond er een Duitse ambulance voor ons.’ Want wat hebben die
gedaan, het was echt nodig dat ze zo snel mogelijk naar het ziekenhuis ging en Aken was veel dichter
bij dan Eupen. Dus hun zoon is ter wereld gekomen in Aken. En toen heb ik gevraagd ‘en hoe is dat, is
dat aardig?’ ‘het enige aardige is dat hij in Aken geboren is, ik vind dat speciaal, maar dat er dan een
Duitser is die een beetje Frans probeert te spreken tegen mij... maar ja, mijn vrouw is geholpen
geweest en die dokter sprak ook een beetje Frans en alles is goed afgelopen en dat is het
belangrijkste.’ En ik denk dat dat met het Emric+ project, als dat zo verder gaat zoals nu, dan kan dat
alleen maar positief in de toekomst zijn. Want een wolk als die in Luik begint en die komt in
Maastricht aan, die hebben geen grenzen, die stopt niet. Als op dat moment specialisten van
Nederland al naar Luik kunnen komen, of Hartmut of anderen van Duitsland naar ons kunnen komen,
of andersom, wij naar de andere kant kunnen komen. Ik zie in de toekomst dat die grenzen zullen
verdwijnen en ik vind ook persoonlijk dat dat moet.
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LS: ik heb nog een laatste vraag, heeft u nog interessante bronnen waarvan u denkt dat ze wel
interessant kunnen zijn?
MM: dan zitten we hier morgen nog. Over gevaarlijke stoffen? Ja, ik heb zoveel contacten met
Europa. Websites die kun je overal wel vinden, bij ministeries enzo, maar ik heb veel persoonlijke
contacten. Ja, wat kan ik erover zeggen? Er zijn dingen die gebeuren in Frankrijk, die gebeuren in
Nederland, in belgië, ja, in heel Europa. Ik word op de hoogte gebracht door de kennissen, de
persoonlijke contacten. Echt interessante zaken die vind ik in Canada.
CG: ja, dat is ook qua cursussen en trainingen heel goed.
MM: ja, Canada is echt de top en zelfs de Amerikanen.
LS: oké, dank u wel, en als ik verdere vragen zou hebben, zou ik die dan mogen stellen?
MM: je hebt mijn email adres, ik hoop dat het interessant was voor je.
LS: ja, zeker, bedankt.
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Appendix 3 – transcript interview Cindy Gielkens
Medical advisor HAZMAT
June 7th , 2012
CG = Cindy Gielkens
LS = Lisanne van der Schors
LS: ik zal meteen maar beginnen met vragen hoe je het systeem in Nederland vindt.
CG: en dan bedoel je gewoon als er een incident is dat opschalen en alles?
LS: ja
CG: nou, in principe denk ik dat het heel... ik ben nog maar heel kort in dat wereldje, maar op papier
werkt dat zeker heel erg goed, maar ik denk in praktijk dat er nog wel hele grote verschillen zijn
tussen de regio’s en de verschillende colonnes zeg maar, tussen de brandweer en de medische tak en
de politie, maar dat we zeker een stuk verder zijn dan in het verleden. Maar we kunnen door het
netwerk en het oefenen en noem maar op, daar nog wel heel veel stappen in kunnen nemen, maar
goed, het goede begin is. Vanuit mijn weinige ervaring denk ik dat het de goede kant op gaat.
LS: en wat zijn de problemen die je nu nog ziet?
CG: het hele systeem is bedoeld eigenlijk om multidisciplinair ook samen te werken en ik werk daar
nu als GAGS voor 5 verschillende veiligheidsregio’s en dan zie je wel goed de verschillen. In Brabant
koppelen ze bijvoorbeeld altijd nog wel terug naar de GAGS en hier in Limburg doen ze dat nog niet
of nauwelijks. Dus daar zijn nog grote verschillen om elkaar multidisciplinair op te zoeken terwijl daar
nog heel veel winst te behalen is.
LS: en wat denk je dat goed zou zijn om verbeterd te worden?
CG: ik denk dat het vooral begint bij de mensen te kennen, dus echt het netwerk. En als is het maar 2
keer per jaar, om toch met de mensen van de brandweer, van de AGS als mensen van de GHOR, van
de GAGS, om gewoon rond de tafel met elkaar de incidenten te bespreken, maar vooral elkaar even
in de ogen te kijken en elkaar leren kennen. Als er dan toch een incident is en je hebt elkaar aan de
telefoon, dan werkt het veel makkelijker. Dat is een eerste stap, dan kun je dan vervolgens nog de
procedures of wat er allemaal nog bij komt kijken als er een incident is, dat nog met elkaar beter
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afstemmen of aanscherpen. Maar ik denk dat het vooral begint met het stukje netwerk en elkaar
leren kennen.
LS: ja. En heb je ook wel eens ervaren dat je door de wetgeving belemmerd werd?
CG: nee, dat heb ik zelf nog niet meegemaakt.
LS: en dan heb ik nog wat vragen over grensoverschrijdende incidenten, heb je voorbeelden van
rampen dicht bij de grens en wat er dan gebeurde, watvoor problemen er waren, wat heel goed ging.
CG: vooral een paar voorbeelden op afstand, niet dat ik er zelf bij betrokken was, maar die er zijn
geweest. Die gifwolk van het DSM, die heb ik ook in presentaties verwerkt. Dan kwamen er op een
gegeven moment, een collega had die wolk zelf gezien, dan kwamen we erachter dat er een wolk
richting belgie trok van het DSM met ... dampen. Toen zijn we gaan bellen en hebben we met
mensen gesproken. De brandweer heeft de wolk gevolgd zo van; komt hij ergens op leefniveau uit?
Voor zover ik weet hebben ze ook met collega’s van de Belgische kant overlegd en gezegd dat er een
wolk aan komt, maar ze hebben er geen rekening mee gehouden dat in Belgie het leefniveau hoger is
dan hier en dat de wolk daar wel op leefniveau uitkwam en er ook mensen zijn geweest met
klachten. Uiteindelijk is dat allemaal wel goed afgelopen, maar de communicatie over en weer had
beter gekund en de inschatting van de situatie ook.
Een goed voorbeeld van samenwerking was, daar was ik zelf ook niet bij, de brand in een
parfumfabriek in kerkrade. En daar voor zover ik weet, kon er niet zo snel iemand ter plekke zijn
vanuit Nederland om metingen te doen en toen is meneer Prast uit Duitsland overgekomen met zijn
meetwagen om de metingen te verrichten. Dat is heel goed onderling afgestemd en teruggekoppeld
en daar heeft men een goed gevoel aan over gehouden.
LS: en zijn er ook nog problemen met wetgeving met communicatie, als er dan een ander land naar
Nederland komt om te helpen, want in Belgie had je natuurlijk dat met die ambulances van
Nederland die niet mochten helpen bij de schutter. Is dat in Nederland ook zo geweest?
CG: dat weet ik eigenlijk niet zo goed en zeker niet voor de CBRN incidenten, ik heb nog niet ervaren
dat daar problemen zijn qua wet- en regelgeving, het is gewoon dat er andere regels zijn.
LS: vind je dat er meer behoefte is aan samenwerking in de euregio op HAZMAT gebied?
CG: of er echt behoefte is.. ik denk dat we vooral even van elkaar moeten weten wat er is, en dat we
dan moeten bepalen of er behoefte is aan een concrete samenwerking. Een volgende stap is om over
een project te gaan nadenken, zijn er aanknopingspunten en hebben we behoefte om wat dichter bij
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elkaar te zitten qua incidentbestrijding. Ik denk wel dat het goed zou zijn, want nu is er helemaal niks.
Dat is ook wel de rode draad van het hele project, want incidenten houden niet op bij landsgrenzen,
dus als er eens een keer iets is, dan moeten we elkaar minimaal weten te vinden en weten wie we
moeten bereiken. Ik denk dat we allemaal op onze beurt de nodige expertise hebben en dat het
zonde zou zijn om daar geen gebruik van te maken. Maar het is een heel ambitieus doel om ooit een
HAZMAT team te hebben, maar ik denk dat we al een goede eerste stap hebben gezet.
LS: hoe zie je het in de toekomst, wat denk je dat er verbeterd zal worden en wat zal er ook echt
verbeterd moeten worden?
CG: ik denk dat het leren kennen wat ik zojuist aangaf, dat vind ik echt belangrijk en daar hebben we
al een goede eerste stap in gezet, maar dat zal wel echt onderhouden moeten worden, dat sowieso.
Dat er mensen zich toch verantwoordelijk moeten voelen om toch een paar keer per jaar iets te
organiseren dat je elkaar in ieder geval treft en dingen kunt uitwisselen. Je hebt toch ook nog wel de
taalbarrière denk ik, Nederlands, Duits en als daar Engels bij komt is het ook nog goed, maar ik denk
dat Frans voor de meeste partijen lastiger is. Ja, en gewoon, wat ik nu als volgende stap zou zien is
om gewoon een aantal incidenten praktisch te beoefenen, wat zouden jullie van jullie kant doen en
wat zouden wij daarvan kunnen leren. Maar de communicatie zal met name verbeterd moeten
worden en van daar uit kun je werken aan de inhoud.
LS: maar dat gebeurt nu ook al met het project nu. Zijn er nog andere dingen die al een beetje
begonnen zijn met verbeteren? Zoals je nu bijvoorbeeld de communicatie hebt.
CG: ja, ik denk vooral dat we in ieder geval nu langzaam weten wat ieder land wel of niet kan en hoe
het geregeld is en de echte winst zal daaruit moeten komen door het ook warm te houden en een
aantal keren echt met elkaar rond de tafel en wellicht nog andere personen. Ik denk dat we nog lang
niet alle mensen die er veel van weten gevonden hebben. Dus nu op dit moment is het dat we een
aantal contactpersonen weten uit de regio, we hebben al met ze om de tafel gezeten en we hebben
uitgesproken dat we er interesse in hebben om het samen te verkennen. Ik hoop dat dat een hele
grote eerste stap zal zijn, maar dat zal de komende tijd moeten blijken of het ook echt gecontinueerd
zal worden.
LS: en dan wil ik nog vragen wat je vooral heel erg goed vind aan het Nederlandse systeem, wat je
denkt dat andere landen nog van Nederland zouden kunnen leren.
CG: het is niet helemaal objectief, maar ik denk vooral de GAGS functie. Ook door gesprekken met
collega’s van beide andere kanten, die spinnen het web. Het is een beetje het linkende punt tussen
de leden van de brandweer, tussen de medische kant, tussen de landelijke instituten die wat roepen
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als er een incident is, dat dat wel een hele belangrijke sleutelfunctie kan zijn. Ik begreep dat ook uit
de interviews, dat mensen dat vaak aangaven, zo van de brandweer doet zijn ding aan zijn kant, de
medische kant doet zijn ding, maar daar missen nog een beetje de dwarsverbanden en dat dan de
functie van de GAGS, het kan ook heel iemand anders zijn, maar in ieder geval zo’n intermediair die
de verschillende lijntjes tussen de verschillende partijen kan leggen en onderhouden en de juiste
mensen met elkaar in contact brengen, dat dat aan de GAGS functie van de Nederlandse kant een
goede zaak is. En vooral ook als je vanuit medische-toxicologische kant naar het incident kijkt. Je hebt
op zich wel de echte artsen en verpleegkundigen die levensreddend werk verrichten op het moment
dat er een incident is. In Duitsland zijn die notarzen er gewoon bij de incidenten en kijken vooral naar
de levensbedreigende zaken, mijn eerste indruk van de gesprekken. Meer een stapje terug doen en
kijken van kunnen de effecten ook veroorzaakt worden door de stoffen, zijn er effecten waarvan je
eigenlijk verwacht dat ze door hele andere stoffen veroorzaakt worden, een beetje die invalshoek.
Dat is het voordeel van de GAGS functie aan de Nederlandse zijde en die ontbrak eigenlijk aan de
beide andere zijden.
LS: en heb je nog dingen gezien in Belgie of in Duitsland wat je heel interessant vindt en die je ook
door zou willen voeren in Nederland?
CG: nou, doorvoeren weet ik niet, maar wat ik wel, omdat ik weet dat in Nederland die discussie ook
heel actueel is, van doe je nu wel of niet biomonitoren, kun je bij mensen bloed of urine afnemen om
te zien wat de blootstelling is geweest. Er is in Nederland nu pas een richtlijn over verschenen, maar
daarmee ook het inzicht dat daar nog wel heel wat haken en ogen aan zitten qua privacy wetgeving
en ethische vragen. We waren bij de ATF in Keulen, die nemen standaard in een incident in hun
industrie bloed en urine af bij de mensen die daarbij betrokken zijn geweest en wordt dat op
verschillende stoffen getest. Ik weet niet of wij dat moeten doorvoeren, maar daar wordt er blijkbaar
gemakkelijker mee omgegaan dan in Nederland. En je zou er eens echt in moeten duiken of je daar
echt winst mee behaalt of je mensen eerder kon behandelen en of ze daar echt gezondheidswinst
mee hebben kunnen maken, maar dat zou je eens echt moeten analyseren. Maar op zich zit daar nog
wel een verschil waarvan ik niet zeker weet of dat in Nederland beter is dan in Duitse zijde. Op zich
zou daar ook wat voor te zeggen zijn als het wat gemakkelijker zou kunnen. Met betrekking tot Belgie
kan ik me daar even niet zo snel een voorbeeld vinden. Ja, daar zijn ze met decontamineren in
bepaalde gedachtes wellicht wat verder, zonder het te hebben over die dingen die opgetuigd moeten
worden, maar meer ook waar moeten ziekenhuizen op voorbereid zijn als er mensen aan komen
lopen die besmet zijn met het een of het ander. Ik denk dat er allemaal zaken zijn waar we van elkaar
zouden kunnen leren, en dat dat de meerwaarde van een goede samenwerking zou zijn in de
euregio.