Centers Unite! COE and CDC link resources across geographic and bureaucratic boundaries

By Gary Rhyne & Robin Hayden

“No one is better than CDC at disease prevention and control,” says Dr. Joel Selanikio, Medical Epidemiologist and a Lieutenant Commander in the U.S. Public Health Service’s Commissioned Corps. “The resources brought to the table by the Center [of Excellence] in the field of disaster management and its involvement in humanitarian assistance are also unparalleled. When you bring together this expertise, I think that’s good…it’s what we are striving for…”

Since March 1997, the Centers for Disease Control and Prevention has partnered with the Center of Excellence to expand its own horizons in the Asia-Pacific region. It supports the Center’s efforts in providing world-class scholarly and operational expertise through conference facilitation, training programs, curriculum development, operational research and information brokering. This joint endeavor focuses on complex humanitarian emergencies, disaster mitigation and response, and civil-military operations in Asia, the Pacific, and worldwide.

The strength of the partnership lies in its ability to draw upon the extensive resources and expertise of both organizations to serve its constituents. In fact, the original agreement and collaboration between CDC and the Center has proven so successful that in Fiscal Year 1999, the two organizations jointly funded a third public health position. Based at CDC headquarters in Atlanta, GA, this disaster medical specialist position allows CDC full flexibility in providing the Center with the appropriate subject-matter expertise to respond to any public-related issue arising in the Asia-Pacific region. In addition to Dr. Selanikio, CDC employees assigned to the Center are Gary Rhyne, CDC/COE Project Manager, and Mark Keim, Disaster Medical Specialist (see end of story for biographies).

In June 1999, the Center reorganized its management and program structure to include a Public Health Unit as a distinct program. This event was the culmination of efforts initiated the year before by the Director of the Center, Dr. Frederick (Skip) Burkle and the concept was embraced by Kent Gray, Chief of the Emergency Preparedness and Response Branch of the National Center for Environmental Health at the CDC.

The mission of the Public Health Unit is to increase public health expertise and operational capability related to disaster and humanitarian assistance through innovative and creative solutions to current needs. Since its creation, the Public Health Unit’s mission statement, operational objectives, personnel and resource allocation, timeline development, management, and coordination of strategic planning goals have been galvanized into a operational plan that spans Fiscal Year 2000. It has begun to address the underlying public health concerns common to all disaster situations. In addition, it has developed avenues by which both parent organizations may benefit from collaboration in areas as divergent as natural disaster mitigation and bio-terrorism.

The Public Health Unit is composed of the three CDC employees, and LTC Patricia Hastings, Deputy Director of the Center of Excellence, who serves as co-director of the Public Health Unit with Mr. Rhyne.

The Public Health Unit team will explore three exciting projects in FY2000. The two research based projects will explore and test hand-held data collection technology for use in health-related assessments in austere field conditions. Developing and refining this technology has a potentially unlimited use and benefit for public health assessments and data collection not only in the Asia-Pacific region, but worldwide.

The third project examines how we develop and use current disaster health assessment tool methodology. The Health Unit will test these concepts in American Samoa and the Federated States of Micronesia during a disaster-related health assessment commissioned by the U.S. Health & Human Services through the Office of Pacific Health & Human Services, Region IX. The successful completion of these projects offers the potential of revolutionizing the way field assessments are planned and conducted, and the data used.

Mr. Rhyne believes a new paradigm in health assessments is necessary. While these evaluations are routinely performed around the world to meet specific needs, very often these tools are created on the spot, with limited consideration of the big picture.

“The idea of this assessment process is not to just go take yet another look at an island’s health capacity to respond to disasters,” says Rhyne, “but to develop a collaborative tool that can be utilized by anyone—the Centers for Disease Control and Prevention, US Pacific Command or one of its subordinate commands, the World Health Organization, the Health Department for the State of Hawaii or local health officials across the Pacific.”

In Rhyne’s view, health assessment data must be collected so that it can be woven into a larger tapestry of information, combining not only the threads of health-related data, but compatible data derived from other tools.

“If we develop the assessment tool correctly,” Rhyne continues, “the data can be seamlessly merged with a myriad of other data sets that ultimately will provide a matrix of information that covers the entire Asia-Pacific region. The usefulness of this type of information base—which is not being duplicated by every assessment team that conducts similar assessments and provides useful information to the organizations who sponsor them—would clearly be welcomed as part of any comprehensive tool.

“You can see the implications for collateral involvement by other Center program areas in this effort—specifically, if our research concludes that the integration of the assessment tool into hand-held technology is practical. To my knowledge, this has never been done before.”

In less than three years the Centers for Disease Control and Prevention and the Center of Excellence have shown that solving complex issues in both the humanitarian assistance and disaster relief arenas can be accomplished by coupling the vast resources of the nation’s premier health organization with a small vision-driven organization able to respond to change quickly. In partnership they can bridge resources to solve common problems and provide the creativity, innovation and out-of-the box thinking necessary to move disaster management into the 21st century.

Mr. Gary Rhyne

After spending four years in the United States Marine Corps, from 1970-74, including a short detour to Bien Hoa, Vietnam, Gary Rhyne graduated with a B.A. in Criminal Justice from the University of Texas at Arlington in 1977. In 1980 he joined the CDC as a Public Health Advisor. For the next six years he worked with the Sexually Transmitted Disease Program in cities as diverse as New Orleans, LA; Houston and Waco, TX; and Fayetteville, NC before joining the National Immunization Program in 1987 as the Immunization Program Manager in Pierre, SD.

In 1989, Mr. Rhyne was chosen by the CDC to attend graduate school at Syracuse University, NY, where in 1990, he graduated with a Master of Arts in Public Administration. From 1990 to 1994, he served as a program/grant consultant with the National Immunization Program in Atlanta, with responsibility for six states in the Midwest. In 1994 Mr. Rhyne became one of only two full-time instructors for the National Immunization Program. During his two-and-a-half years as an instructor, he co-presented CDC’s nationally known Epidemiology & Prevention of Vaccine Preventable Diseases course over 30 times in 18 states.

In March 1997, Rhyne accepted a position with the CDC’s National Center for Environmental Health, Emergency Preparedness and Response Branch, and the Center of Excellence in Disaster Management & Humanitarian Assistance in Honolulu, HI.

With 20 years’ experience in public health management as well as experience in training and education, Mr. Rhyne is capable of wearing many hats. As CDC Project Manager, he is responsible for all CDC-related activities. He is Co-Program Manager for the Center’s Public Health Unit, and as Research Coordinator, he chairs the Research Evaluation Committee which oversees the Center’s research project development. Mr. Rhyne also serves as the point of contact for natural disaster-related activities.

Dr. Joel Selanikio

A former Wall Street computer systems analyst, Joel Selanikio received his M.D. from Brown University Medical School in 1992. Upon completion of a residency in pediatrics at Emory University, he accepted a position as Epidemic Intelligence Service Officer at the US Centers for Disease Control in Atlanta, and was later made a commissioned officer of the US Public Health Service. Since joining the CDC, he has led a number of high-profile international efforts, including:

Team Leader of CDC’s rapid assessment team in the US Virgin Islands after Hurricane Marilyn in 1995;

Co-Investigator of the epidemic of acute renal failure among children in Port-au-Prince, Haiti in 1996, Haiti that claimed over 100 lives;

Lead Environmental Investigator for an investigation of 31 unexplained deaths in Sarawak, Malaysia in 1997.

Dr. Selanikio has twice received the Department of Health and Human Services Secretary’s Award for Distinguished Service; the Nakano Citation of the National Center for Infectious Disease for “best peer-reviewed scientific paper;” and the CDC’s Mackel Award for “best investigation combining field epidemiology and laboratory work.” Dr. Selanikio provides frequent consultative services for the World Health Organization and the World Bank, and to other organizations.

In addition to his work in the field of public health, Dr. Selanikio practices pediatrics and pediatric emergency medicine, and retains staff privileges at several Atlanta hospitals. In August 1999, he joined the Center of Excellence as a Director of Public Health Research.

Dr. Mark Keim

The third and newest CDC employee at the Center is jointly funded and remains at CDC headquarters in Atlanta, GA.

Dr. Mark Keim is the Principal Medical Officer for the Emergency Preparedness & Response Branch at the US Centers for Disease Control & Prevention in Atlanta, GA. He is also an Assistant Professor of Emergency Medicine at Emory University in Atlanta. Dr Keim is a formally-trained Disaster Medicine Specialist, having completed a two-year joint fellowship at Emory University School of Medicine, the US CDC and the Emory School of Public Health.

Mark Keim has provided medical leadership in the management of 12 major disasters, such as Woodstock II in 1994; Hurricane Marilyn in 1995; the 1996 Olympics; the 1997 North Dakota Floods; the Montserrat volcanic eruption in 1997; and hurricanes Mitch and George in 1998. In post-terrorist events consequence management, his experience includes response to the World Trade Center bombing; the 1996 bombing of Olympic Centennial Park; the bombing of US Embassies in Kenya and Tanzania; as well as the management of over 50 recent bioterrorist threats.

Dr Keim is the author of numerous scientific presentations and publications of original research and he is a peer review consultant for several major medical journals. His press interviews have appeared on network television programs including CNN, PBS and the CBS Evening News.