The German approach to emergency/disaster management.

Disaster control and disaster relief in Germany are public tasks. But the government has shifted the responsibility of the administration of these tasks to the 16 states, the so called "Lander", because the EFG is a federal republic. The same is valid for the civil defense and the civil protection in the case of military or international risks. The 16 states are also responsible for the legislation of rescue service, fire fighting service and disaster control (natural and technical disasters). Counties and district-free cities are responsible for the organisation of these services. The German system is based on the principle of subsidiary between official and private institutions. A lot of official and private relief organisations are responsible for the execution of disaster relief tasks. In Germany the following organisations exist: Official (GO): Technisches Hilfswerk (THW/Federal Technical Support Service), Feuerwehren (Fire Brigades/professionals and volunteers) Academie of Emergency Planning and Civil Defense Private (NGO): Arbeiter-Samariter-Bund Deutschland (ASB/Workers' Samaritan Association Germany), Deutsche Gesellschaft zur Rettung Schiffbruchiger (DGzRS, German Lifesaving Association), Deutsches Rotes Kreuz (DRK/German Red Cross), Johanniter-Unfall-Hilfe (JUH/St. John's Ambulance), Malteser Hilfsdienst (MEID/Maltese-Relief-Organisation). ASB, DRK, JUH and MHD are specialised in the field of rescue, medical and welfare services and medical disaster relief. 80% of the German rescue service and 95% of the German disaster medical relief are realised by these NGO's. NGO's and GO's employ more than 1.2 million volunteers and appr. 100,000 professionals. Rescue service is carried out by professionals, disaster relief by volunteers. The German constitution allows to call the federal army in case of disaster, to support the disaster relief organisations (for example: flood Oder River 1997, train-crash "ICE" 1998). In all counties and district free cities disaster control staffs are set up by the administration. During disaster relief operations a operational command is on site. Most of the counties and district free cities, medical executives, rescue staff executives along with fire executive officers are responsible for the medical rescue organisation. All emergency physicians and medical executives have attended special training or a 520 hours-training-course (Paramedics). All volunteers of the medical service in the disaster relief organisations are trained in separate special courses (90 hours). Over the last years, civil protection, disaster relief and rescue services in the FRG have been reorganised. In 1997, the civil protection was reformed by a new federal act. Disaster relief of the "Lander" is supported by Federal Government with about 9000 vehicles and a budget for training. Emergency physicians have to take part in a (80) eighty hours lasting course on emergency medicine from an interdisciplinary point of view; they are only allowed to do rescue missions after having proved basic experience in emergency medicine as well as having completed a (18) eighteen-months-postgraduate training period at least. Senior emergency physicians receive and additional (40) forty-hours-lasting theoretical and practical training-after three years practice in rescue services as a minimum. There are special training courses offered for Medical and Non-Medical Personal to cope with disaster situation by different institutions and organisations.