Chapter 18 – Communications

Abstract

Hospitals and the healthcare systems are dependent upon reliable and redundant communication systems. Communications is the most common failure complaint following a disaster. When these systems fail, as they often do during a disaster or other event that puts an overload on normal ways of conducting business, there needs to be an ultimate, reliable fall-back solution. Volunteer communications experts, known as Amateur Radio operators can provide communications and hold things together until the commercial phones and radio systems can recover.

Chapter 18 Communications

Marina Zuetell

Executive Summary

What is Amateur Radio?

Amateur Radio is a technical hobby that teaches people how to use two-way radio to communicate. Many people use the hobby to acquire new friends, contest, talk to the space shuttle, bounce signals off the moon, and experiment with radio and other technical aspects of the hobby. The Federal Communications Commission (FCC) has granted the Amateur Radio Service access to a wide variety of the radio spectrum, with the stipulation that it be used to develop new radio technologies and provide emergency communications (www.access.gpo.gov/nara/cfr/waisidx_04/47cfr97_04.html). The term “amateur” denotes that the operators are unpaid volunteers, not that they are unprofessional or unskilled. They are also called “hams,” although the derivation of that term is lost to history.

There is one aspect of the hobby that serves a more serious mission – that of emergency communications. Amateur radio operators use their hobby to provide backup and emergency communications during disaster situations, and when normal communications fail. They like to communicate, and they volunteer their skills and interest by helping the agencies and organizations who rely on communications to fill the gap when things go wrong. Hurricanes, floods, earthquakes, tsunamis, and other geological events can cause complete or partial failure of the normal phone, cell phone, and commercial radio systems. So do man-made events such as the collapse of the World Trade Center towers or a large terrorism or bioterrorism event, where regular communication systems are overloaded or compromised.

There are two commonly known groups who provide these emergency communications. One of these is sponsored by the ARRL (Amateur Radio Relay League) (www.arrl.org) – the national organization for amateur radio; and the other is sponsored by the federal and local governments, an offshoot of the old Civil Defense system. Different operating requirements and restrictions apply to each:

ARES®: Amateur Radio Emergency Service – Public service communications have been a traditional responsibility of the Amateur Radio Service since 1913. In those early days, such disaster work was spontaneous and without previous organization of any kind. In today’s amateur radio, disaster work is a highly organized and worthwhile part of day-to-day operation, implemented principally by the Amateur Radio Emergency Service (ARES) and the National Traffic System (NTS), both sponsored by ARRL (www.arrl.org).

RACES: Radio Amateur Civil Emergency Service is no longer referenced or supported by FEMA, although individual teams still exist within some local jurisdictions. Their primary mission is to provide communications support for local government jurisdictions. Other communications support activities are left to the ARES and ACS (Auxiliary Communications Service) groups.

Emergency service is one of the basics of the Amateur Radio Service and there is sometimes confusion about ARES, the ARRL branch of emergency services, and RACES, the government arm of amateur emergency services. ARES is activated before, during, and after an emergency. Generally, ARES handles all emergency messages, including those between government emergency management officials. As an example, the ARRL recruited ARES team members from all over the country to provide communications in response to the Katrina and Rita hurricanes. They supported field kitchens, mobile meal delivery, shelters, and wherever else they were needed, around the clock, for about six weeks. RACES, on the other hand, almost never starts before an emergency and is active only during the emergency and during the immediate aftermath, if government emergency management offices need communications support. RACES is normally shut down shortly after the emergency has cleared. Radio operations are limited to one hour of training per month, and team members can only be called upon by a government agency when there is a formal emergency declaration.

What Motivates “Hams” to Volunteer Their Time, Skills, and Equipment?

It is significant that Part 97 of the Federal Communications Commission’s (FCC) Rules and Regulations states, as the first principle under “Basis and Purpose,” the following: “Recognition and enhancement of the value of the amateur service to the public as a voluntary non-commercial communication service, particularly with respect to providing emergency communications.” (www.access.gpo.gov/nara/cfr/waisidx_04/47cfr97_04.html). Amateur radio operators are encouraged to provide community and public service responses to various agencies and organizations, in return for the use of the radio spectrum they utilize.

There are only about 15–20% of licensed amateur radio operators who take this to heart and volunteer their time and belong to and participate in the activities of the ARES and RACES teams in their communities. Those who do usually spend a lot of time training and preparing for that big event when their services are really needed. The recent hurricanes on the East Coast are a perfect example of this. Amateur radio operators came from all over the country, at their own personal expense, to provide communications for the beleaguered government and non-government organizations.

External Hospital Communications

Hospitals need to be able to communicate with a variety of organizations and agencies without interruption. When these communication systems fail or are overloaded, it places a huge stress on the facility’s ability to serve its patients and provide safe and effective healthcare. During a routine business day, hospitals have a variety of means for communicating internally and with other hospitals, emergency medical systems (EMS), vendors, suppliers, and health departments, as well as patients and their families. If this is disrupted, because of a large mass casualty incident, a natural or man-made disaster, or even just a technological failure, communications become a huge problem. Building communication redundancy and flexibility into the hospital response system is a vital necessity. There are a variety of ways to do this:

1. Most hospitals already have a variety of radio communication systems, in addition to the normal land-line and cellular telephone systems. Sometimes these radio systems can take up the slack, but often they become overloaded as well. The HEAR (Hospital Emergency Administrative Radio) system is relatively common across the United States in hospitals and EMS units. It is often used for EMS units to notify hospitals that there are incoming casualties or patients. This system was developed in the 1960s and not much has been done to modify it, although there is some newer equipment available, which has improved the operations and ease of use. The technology is old enough that it is unlikely that it can ever be brought up to current inter-operability standards (APCO-25).
2. Other radio systems, in addition to, or replacement of, the HEAR system include UHF, VHF, 800 MHz, and others commonly used by public safety agencies (fire, EMS, police). These are used day-to-day to communicate with the hospitals, but often become overloaded when some unanticipated large-scale event occurs. Many facilities have satellite phones as well.

UHF/VHF/HF – These terms indicate various bands of the radio spectrum, each with its own characteristics for distance, penetration, and inter-agency communication. Ultra-high frequency (UHF: 300–3000 MHz) has shorter wavelengths, but greater penetration within a building; very-high frequency (VHF: 30–300 MHz) has somewhat longer wavelengths and distances, but works less well within the facility compound. High-frequency (HF: 1.8–30.0 MHz) is used for long-distance communications – across state or national boundaries, depending on the frequency band and antenna used (www.ntia.doc.gov/osmhome/allochrt.html).

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