Who is my leader? A case study from a hospital disaster scenario in a less developed country

SummaryIntroductionA paucity of literature exists pertaining to the role of leaders during the health response to disasters. The minimal published literature regarding disaster leadership suggests that health leadership in a disaster should adopt an approach similar to that of professions such as law enforcement, military and freighting.AimThis paper aims to describe observations pertaining to disaster leadership during a mock disaster scenario.BackgroundThis case study is set in Surkhet, Nepal, a small city prone to disasters such as earthquakes and floods. This case presents a mock disaster scenario of an earthquake set at a nongovernment health facility.MethodsObservations were made of the performance of responders in establishing triage, treatment and command centers.ResultsInstitutional leaders among the responders struggled to apply the disaster plans in the face of spontaneous disaster leadership.ConclusionsBoth the recognised leadership of an organisation, and those who in a disaster may step up as disaster leaders need to be confident in implementing the disaster contingency plans. Leadership in disasters must have a clear distinction between incident controller and ‘clinical leader’ roles.Discussion and recommendationsThis paper provides recommendations that may have applicability to leadership in real world disasters.