{\rtf1\mac\ansicpg10000 {\colortbl;\red255\green255\blue255;\red0\green100\blue17;\red0\green0\blue212;\red2\green171\blue234;\red221\green8\blue6;\red252\green243\blue5;\red242\green8\blue132;\red0\green0\blue0;} \margl1440\margr1440\vieww9000\viewh8400\viewkind0 \f0\fs24\cf0 \ JACK BEALL: Good morning and\ welcome to 2011 Integrated\ Medical Pubic Health\ Preparedness and Response\ Training Summit. My name is\ Jack Beall. I'm the director\ for the National Disaster\ Medical System (NDMS). I\ shall serve as the master\ of ceremonies for this opening\ session. Before we begin, I\ would like to ask that all\ cell phones, pagers and any\ other audible\ communication device be\ turned off or placed in\ quiet mode. Second, in the\ event of an emergency or\ activated fire alarm in this\ facility, please walk, do\ not run to the nearest exit\ that is safe and free of any\ signs of smoke or flames. An\ announcement will be made\ via the hotels public\ address system regarding the\ situation and what action to\ take if necessary. Ladies\ and gentlemen, will you\ please rise for the\ presentation of the colors\ by the Grapevine Fire\ Department Color Guard and\ remain standing for the\ playing of the national\ anthem and until the colors\ have left the room.\ \ \ \ JACK BEALL: Please be seated. It\ is my honor to provide a\ special welcome to the\ following individuals: The\ Surgeon General Dr. Regina\ Benjamin. Deputy Assistant\ Secretary, Dr. Kevin Yesky.\ Department of Defence, Col.\ Lee Raybine, Department of\ Veterans Affairs, Mr.\ Michael Feezer. Department\ of Homeland Security, Dr.\ Michael Zanker. Before we \ begun with introductions, we\ would like to ask for moment\ of silence for all\ employees, members and\ volunteers who have passed\ away in the last year. Will\ you please rise.\ \ JACK BEALL:\ Please be seated. We will\ start this morning with\ words of welcome from those\ who are convening this\ Integrated Training Summit.\ This training summit is\ focused on the integration\ of four Department of Health\ and Human Services Programs\ that provide health and\ medical resources during\ times of disasters and other\ public health emergencies\ both nationally and\ internationally. It's my\ pleasure to introduce to you\ Capt. Rob Tosatto , director\ of the Office of Civilian\ Volunteer Medical Reserve Corps.\ \ CAPT. ROB TOSATTO :\ Good morning. Good morning\ and welcome to this 3rd\ Integrated and Training\ Summit. We're definitely\ building on the success of\ the first 2 summits and each\ year we get stronger and I\ hope more integrated. Let's\ start just with some\ thoughts I had for the last\ few days. Like many of you,\ I'm sure you were thinking\ about the announcement on\ Sunday about Osama Bin\ Laden.\ Well my first thoughts\ were about pride.\ \ CAPT. ROB TOSATTO: My first\ thoughts were about pride in our\ military and intelligence\ counter parts who carried\ out the mission and also the\ leadership that you made\ this happen. But I think\ there are also lessons that\ we can take to heart from\ this as well. The first is\ persistence. It took 10\ years to happen but the\ mission, the goal was\ accomplished. And I think\ all of us can keep that in\ mind. That persistence as we\ get frustrated sometimes by\ the challenges we face.\ Things like budgets and\ legal protections and other\ challenges but again, keep\ at it. Also the importance\ of planning, I mean the\ operation had to be\ meticulously planned and we\ all have to keep that in\ mind as we go about our\ efforts. The need to have\ defined goals, objectives,\ you know the action steps\ needed to accomplish those\ goals. So that's the\ importance of strategic\ planning for ourselves and\ for our units. Also, the\ importance of preparedness.\ Because really we don't know\ what's coming next so it's\ so important for each one of\ us to be prepared. That\ personal preparedness but\ also making sure our family,\ our friends, and our\ communities are prepared.\ Making sure our units, our\ teams are prepared as well.\ That includes trainings.\ Trainings are big part of\ preparedness. That's one\ reason why this integrated\ training summit is so\ important. I want you to\ keep those in mind. It's\ important that we continue\ to build this summit and do\ the integration. It's\ important for us to continue\ to breakdown the silos\ between the various programs\ and learn to work together,\ learn together, so that we\ work together better to\ improve the health and\ safety of our communities,\ our states and our nation. I\ want to take a few minutes\ to share some of the\ highlights about the MRC\ over the past year. First\ there are 941 MRC units\ around the country in all 50\ states and several\ territories and just under\ 210,000 volunteers now. The\ awareness of the MRC is\ growing every day. That's\ great. But we can't stop\ there. We need to keep at it\ because there are still\ communities that are not\ served by the medical\ reserved corps units and\ there are still volunteers\ out there that don't know\ about the MRC that we need\ to recruit and bring in to\ MRC. We continue make great\ advances in our integration\ and in our partnerships.\ Integration like this\ training summit with our\ partners, with ESAR-VIP. The\ integration is working great\ at the state level. About\ 60% of the individuals in\ the state based registries\ are MRC members. That shows\ that it can work. We are\ also working together with\ our Public Health Service\ and NDMS colleagues. I'm\ hoping to get MRC members\ involved in some of their\ field training exercises. We\ have great partnership with\ the American Red Cross. This\ year we released\ building block document\ with guidance to local Red Cross\ chapters and MRC units on\ how they can work better to\ collaborate and cooperate at\ the local level better. One\ of my passions is engaging\ youth and so this past year\ we have continued our great\ relationship with HOSEF,\ future health professionals\ and I think that is just\ something we need to\ continue to do is get more\ youth involved. More young\ people involved in MRC. So\ we're gonna continue to do\ that. MRC Units had been\ very active this year. For\ example, right now in\ Alabama the project Health\ MRC at the Birmingham has\ about 1200 MRC volunteers\ involved helping their\ neighbours whose lives were\ up ended by the recent\ tornadoes. MRC volunteers\ have assisted in Boston,\ Chicago, and a host of other\ marathons and sporting\ events and large public\ gatherings helping out to\ those instances. MRC units\ are helping to reduce\ vulnerabilities in their\ communities recognizing the\ importance of reducing you\ know reducing that\ vulnerability in advance\ emergency, recognizing that\ healthier people before\ disaster are likely to be\ healthier during a disaster.\ I encourage all of you to\ come to the opening session\ tomorrow where Dr. Marchime\ will talk about disaster\ risk reduction and how it\ applies to all of us. Many\ MRC units have also joined\ in the efforts to combat the\ epidemic of obesity in our\ nation, taking on the\ Surgeon General's vision for\ a healthier and fit\ lifestyle and the first\ lady's "Let's move"\ Initiative. As I talk about\ the importance of health you\ know I think that is\ something that all of us\ need to take to heart as\ well. It's not just enough\ to be personally prepared,\ all of us as responders\ needs to be personally\ healthy as well, a healthy\ as we can be. Last year at\ Integrated Training Summit,\ the MRC hosted blood\ pressure screenings for the\ attendees. We're gonna do\ that again this year so I\ hope all of you will take\ part. Get your blood\ pressure screened. Some of\ the results last year of\ about 200 people that had\ their blood pressure\ screened, 29% are in the\ normal range, 43% were in\ the pre-hypertension range\ and 28% in the hypertension\ range. Again, this is\ something that we can do\ here to help you understand\ where your blood pressure is\ so do take part in the\ screening. We're also\ supporting two healthy\ events at the training\ summit here. The first is\ actually on Thursday\ morning. I hope you'll join\ me at 6:30 in the morning\ for the "Let's move Yoga\ Session". It will be - we\ have a changed location, we\ will have it outside but\ because of all the rain but\ the change location to the\ Texas C and D Ballroom. And\ then tomorrow morning at\ 6:30 sharp, I hope all of\ you will join me for the\ "Elizabeth Fitch memorial 5k\ walk, run". As many of you\ know Elizabeth Fitch was our\ national level technical\ assistance coordinator for\ the MRC but she was also a\ strong member of this\ planning committee for this\ summit. Unfortunately, she\ lost her long battle with\ cancer earlier this year.\ Because of her passion,\ because of her planning\ expertise and her\ leadership, the planning\ committee for the summit,\ the partners decided to\ create an award in her\ honor, Elizabeth Fitch\ Memorial Leadership Award.\ We're going to announce the\ recipient of that award\ tomorrow morning at the\ opening session or at the\ general session. I want to\ take a moment to give\ special thanks to the units\ and volunteers from the MRC\ that are helping out with\ this summit. I hope many of\ you have the chance to stop\ by the booth down by\ registration. If you have\ any questions about the\ local area, I'm sure\ there'll be more than\ willing to give you some\ help or advice. I encourage\ all of you to make the most\ of this summit. Take the\ time to really learn from\ the sessions. Get into the\ training sessions and meet\ with each other. It's really\ important now that you meet\ so it's not at the time of\ deployment. So thank you for\ attending and good luck.\ Have a great week.\ \ JACK BEALL: It's my pleasure to\ introduce to you Capt. Dan Beck,\ acting director of the Office of\ Force Readiness and\ Deployment, the acting\ director of the Office of\ Reserved Affairs, Capt.\ Beck. \ \ CAPT. DAN BECK: Good\ morning. It is once again a\ great privilege and pleasure\ of mine to be able to\ welcome you to another\ integrated training summit.\ This summit in my\ involvement in how this has\ evolved and grown continues\ to amaze me in how we are\ moving this summit on in\ what this summit truly\ means. I've had the great\ privilege over the past year\ to serve as the acting\ director of the Office of\ Force Readiness and\ Deployment and the 41\ response teams in 3500\ additional officers\ roistered in our response\ system. I'd like to talk\ very quickly just a little\ about a little bit about our\ yearend review in what we as\ one of seven uniform\ services in our mission to\ protect, promote and advance\ the health and safety of\ this nation, the role that\ the 41 response teams play\ in fostering that mission.\ This past year, one of our\ newest team types the\ services access teams\ successfully proved that\ proof of concept in the\ field and we started to see\ again that the expansive\ groove the ability to not\ only think in terms of\ response but to look at the\ broader spectrum of health\ and medical care and the\ provision of care and\ services can continue to\ grow. In services access\ teams had given us the\ opportunity to take that to\ another level of providing\ important services to\ underserved & vulnerable\ populations. Last year many\ of you who were attending\ the conference in Las Vegas\ heard me speak about our\ plans to conduct innovative\ field readiness training to\ change the manner in which\ we as commissioned officers\ will train our teams and\ train our personnel in the\ field. I'm very pleased to\ say that that was and\ continues to be one of our\ most successful activities.\ The nature of that field\ training is to take it\ beyond the perspective\ solely of training our\ personnel but to take the\ important opportunity to\ provide care and services in\ the course of conducting\ that training. It also gives\ us the greater opportunity\ to work hand and hand with\ the very communities, the\ very governments, the very\ officials, leaders and\ citizens where we may need\ to come out and respond. As\ a result of that field\ training last year, one of\ the sites said we\ participated that was in\ Pikeville Kentucky. In only\ weeks after our training\ activities in Pikeville\ Kentucky, Pikeville and Pike\ County was struck by a\ devastating flood. As the\ direct result to the\ interactions that took place\ during that training, Pike\ County had a better\ understanding of how to\ utilize the entire emergency\ response system. How to\ actually reach out to the\ state in a more efficient way\ and what assets the federal\ government in a broader ESFA\ support structure had to\ bring and what they could\ bring to better that issue.\ And as a result of that\ field training, they were\ able to quickly get recovery\ assets moved into Pikeville.\ Assets that they are\ familiar with, were\ comfortable with, and felt\ as if they were truly\ partners with to greater\ effect the recovery of their\ location. I think as we\ continue to grow and evolve\ those training programs,\ we're gonna find that the\ bang for the buck we're going to\ get when we the collective\ whole of us continue to\ participate in that\ training. That the\ preparedness activities that\ we will conduct by preparing\ each and every one of us and\ also continuing to build the\ preparedness of our\ communities. As I looked\ back on the past year, I\ realized that in years past\ we've spent much time giving\ ourselves accolades in looking\ back on the good work we did\ in response to crisis. I was\ struck by what a remarkably\ low operational tempo we\ seem to have in the past\ year, right? We were very\ lucky and very fortunate to\ not have numerous large\ scale responses. Large scale\ federal responses going out\ there but I was struck even\ more as I looked back to\ find it wasn't because there\ weren't a multitude of\ disasters, emergencies,\ public health crisis that we\ were presented with. We need\ look no further but simply\ the events of the last\ couple of weeks and the\ severe storms that have\ affected the south,\ devastating storms that\ affected the south but not\ the kind of large scale\ federal type of intervention\ response you would expect.\ And as I realized that, I\ realized that it's not so\ much that we hadn't had a\ large scale of events. It's\ that we are collectively\ better able to respond to\ these events. The very\ resiliency of the\ communities has grown so\ that we are really changing\ the way in which we have to\ think about response and\ think about preparedness.\ Right? That very activity is\ what this training summit is\ all about. It's not just\ about getting together and\ meeting with colleagues and\ friends, it's truly building\ that important resilience\ and preparedness. In the\ corps, at our officer basic\ course, all of our new\ officers go through officer\ basic course and they were\ taught basic sets of tenets\ and those form around 4R's -\ concept of resilience and\ readiness and understanding\ roles, responsibilities and\ resources. I think when we\ look at those 4R's, you can\ take that concept with you\ for the rest of this\ training summit and build,\ and continue to use this\ Summit & these opportunities\ to build the resilience of\ your communities, the\ individuals, your teams, to\ be able to truly leave this\ conference more prepared\ better ready to respond to\ the events that we are\ preparing for. To understand\ first-hand what your roles\ and what our each of our\ unique roles and\ responsibilities are and to\ really take advantage of\ what a remarkable resource this\ training summit truly is. So\ with that, thank you again\ so much. Have a fantastic\ training summit and I look\ forward to working with each\ and all of you. Thank you.\ \ JACK BEALL: Now, my pleasure to\ introduce to you Dr. Kevin Yesky\ Deputy Assistant\ Secretary for Preparedness\ and Response, Dr. Yesky.\ (People Clapping.)\ DR. KEVIN YESKY: Good morning.\ People: Good morning. \ What a great day. It\ just inspires me to look out\ and see so many people\ attending this conference\ and the collective wealth of\ experience and knowledge\ that's out there to help us\ in our preparedness and\ response and recovery\ activities. I like to start\ off by just thanking the\ planning staff and the\ people who made this\ conference possible. This is\ a great site. This is a\ great agenda. This is a\ great curriculum and I just\ like to get them a round of\ applause for their work and\ dedication\ putting this together.\ (People Clapping.)\ DR. KEVIN YESKY: I have a couple\ of minutes just to talk about\ some things related to NDMS and\ ESAR and maybe talk a little bit\ about a way ahead and where\ we're going. We're building\ a system. You are all part\ of that system. I think for\ system to work most\ effectively, it pays for you to\ have a wider view of what's\ going on around you and\ where we wanna go with the\ system and how we wanna take\ preparedness and response.\ Also, I like to say that a\ couple of years ago we\ talked at the integrated\ summit about an\ international component to\ NDMS and the international\ component response at ESFA\ and we had a pandemic, we\ had Haiti and then we had\ the Japan earthquake tsunami\ and nuclear reactor crisis\ all of which we deployed\ assets and resources to\ assist in the response. I\ think this year let me just\ post the thought about this\ is an integrated public\ health preparedness and\ response training summit and\ I think in future years\ we're gonna have to add\ recovery to that title and\ to those activities. You\ know we have an\ international track now for\ this summit and I think as\ we grow this we need to be\ more inclusive on how we\ build this system. So some\ of the advancements we had\ and we've had many over the\ last couple of years with\ regards to NDMS and\ ESAR-VIP, I just want to\ name a couple that are\ memorable because they\ illustrate the strength of\ the system and the\ responsiveness of the system\ we're building. We had\ considerable work on patient\ movement. 2008 there were --\ we got the opportunity to\ test the patient movement\ piece of our ESFA response\ and it didn't work as well\ as we wanted it to. Some of\ it is execution some of\ those planning. But we had a\ group of people in Arkansas who\ said it didn't work\ very well and you need\ to know that and we'd like\ to help you fix it. And over\ the course of time we worked\ with them to, as Dan talked\ about service access teams\ and we had a joint patient\ tracking system. We have a\ number of different things that\ we collectively through a\ partnership with DOD, and VA,\ FEMA and DHS as well as our\ state partners and our\ private partners to fix that\ and make it better. Make it\ work for our end users, the\ people who actually are\ caring for our patients and\ are moving the patients and\ all that. I'm really proud\ to announce because I think\ this is a big accomplishment\ among the many things we've\ accomplished with patient\ movement. We signed or we've\ got -- we have signed now\ from the inter agency\ partners a new and I think\ improved hospital NDMS MOU\ that we hope to get out\ there shortly. I think\ that's a big accomplishment\ and I think it's really --\ I'm proud of it because we\ worked with our state and\ local partners as well as\ our federal inter-agency\ partners to get that across the\ goal line. So I think that's\ really important. I think on\ the ESAR-VIP side, again just\ watching the integration of\ ESAR with the Medical\ Reserve Corps and how that\ had worked well and how that\ blossoming to be really have\ a synergistic effect on our\ state local preparedness and\ they are making them more\ resilient and better able to\ handle those incidents that\ don't rise to the level of\ national declaration and\ require ESF8 involvement but\ yet they are very\ significant incidents in\ those states and the states\ are better prepared and more\ resilient. And then ESAR\ worked on their volunteer\ play, how to bring on\ volunteers quickly and\ effectively and how to\ manage them. I think those\ are significant\ accomplishments and I'm\ really proud of those. But\ the work is not yet done,\ we're building a system and\ we need as we've seen in the\ last couple of days we've\ seen how setting of vision,\ setting a goal and being\ persistent maybe through\ some hard times pays off. I\ think that's where we are at\ right now. We need the\ vision and we need the\ persistence that all of you\ demonstrated over the years\ to achieve this goal and a\ couple of things had\ happened and I think it\ gonna help frame and shape\ how we move forward in the\ next couple of years. Most\ recently as a national the\ presidential policy\ directive, the PPD8 this\ describes national\ preparedness. PPD8 does a\ couple of things. It says we\ need a national preparedness\ goal that has to be\ measurable, has to be\ measurable and we need a\ national preparedness\ system. Some of this sounds\ familiar to many of you on\ the room because that's what\ we've been working for over\ and over for decades in the\ NDMS and ESFA. We have to\ have integrated guidance,\ programs and processes. We\ have to have integrative\ planning framework. National\ preparedness is not just\ federal preparedness, its\ national preparedness where\ everyone has a shared\ responsibility and\ individuals as well as\ governments and private\ institutions and other\ organizations all have a\ responsibility in this. And\ all have a role in this and\ we need to be inclusive in\ that. It has to be\ capabilities based. We need\ to say what we want to do,\ how we want to prepare and\ then how to get there and\ this is all of nation\ approach. Again it's not\ just a government approach\ it's an all of nation approach\ with a shared\ responsibility. We have to\ be able to measure our\ operational readiness of\ national capabilities with\ clear quantifiable measures.\ Okay, so we need to be able\ to say "This is where we're\ going and this is how far we\ are to getting there." So\ that there's more to come.\ There's gonna be\ implementation plans set out\ of this and a bunch of\ activities and this is all\ available on the web and I\ would recommend everyone in\ the room that you go take a\ look at this. Just google\ PPD8 and it will come up.\ It's a good read, its 8\ or 9 paged document. Take a\ look at that because that's\ gonna define how were gonna\ move forward with this. I\ think there are some other\ things that are out there.\ One is the national health\ security strategy. That came\ out about a year or so ago\ and the implementation plan\ will be out shortly. Again\ the two major goals of that\ are community resilience and\ enhancing our response\ capability and capacity. So\ we're gonna be looking at\ how we do that with a set of\ priorities underneath that\ and goals and objectives.\ And let me just finish up\ here by talking a little bit\ about hospital preparedness\ program another program\ that falls in my office.\ Again this has been a\ program over the last 10 or\ so years that has put out\ funding for hospital and\ healthcare preparedness.\ This is made marked\ improvement in hospital\ preparedness over the last\ 10 years but now in light of\ all the other things that\ are going on the PPD8,\ National Heath Security\ Strategy, it's time to move\ that program forward. Number\ 1 in the spirit of\ integration is making sure\ that our grant because FEMA\ has preparedness grants,\ CDC has preparedness\ grants, ASFER has prepared-\ ness grants. First step of\ integration is aligning\ those grants making sure\ that we cover the waterfront\ with the content of those\ grants and making sure that\ there is minimal duplication\ and maximum content in every\ area that we need to cover\ with the capability we cover\ with those various grants.\ The other thing is making it\ end user friendly. Instead\ of having multiple\ applications process with\ multiple reporting periods\ all that kind of some making\ it user friendly. I think at\ the end of the conference\ we'll gonna have an MOU\ signed across between HHS\ and FEMA on making sure that\ interagency spirit we align\ those grants. And again\ we're working with other\ components along within HHS\ to make sure that those\ grants were aligned. That\ will seem like a small thing\ but it's really important to\ our end users, it's really\ important as we look at what\ we have to cover in our\ national preparedness\ mission that we cover those\ areas. The other thing you're\ gonna see at the end of the\ week here is that we're\ gonna release a report on\ state preparedness based on\ our hospital preparedness\ program. I think that's the\ first time we've done that,\ it's really gonna give us a\ snapshot of how states have\ prepared. You know some\ people will say that they\ haven't prepared enough. But\ this is a good new story.\ This is really good new\ story. States have become\ enormously well prepared in\ their ability to provide\ surge capacity, alternate\ care sites, communications\ all those things these\ capabilities that you would\ want when there is an event\ going on to help take care\ of the vast number of\ injured patients with some\ of these scenarios provided\ some of these real life\ events had provided. And the\ growth that the states have\ made and the improvement\ that the states had made\ again is the success story\ and that's part of the\ system building - taking\ their shared responsibility\ using their resources,\ becoming resilient, becoming\ somewhat independent of just\ having the federal system\ come in and take over and\ manage the response. The\ states have assumed\ responsibility and did an\ incredibly good job that\ becoming resilient in\ managing their events there\ is they can within the\ state. So I look forward to\ that. That will be a web\ based document that should\ be coming out shortly but\ hopefully we'll get a\ release here by the end of\ the week. So I'll stop\ there. You know I could talk\ literally for hours on the\ accomplishments we've had,\ the improvements we've made\ but again understand, we're\ building a system and I'm\ not building the system,\ ESAR is not building the\ system, Medical Reserve\ Corps is not building a\ system. We're building it\ together and I think\ everyone has a role in this.\ Everyone has an important\ role in this. Contributing\ to our component of this but\ when you go back home,\ taking what you learned\ here, putting it back to\ your local communities,\ putting that back into your\ individual preparedness and\ your family preparedness and\ your neighbourhood\ preparedness. That's all\ important and there's a role\ for that and pretty much\ every presentation you will\ attend here. Something to\ take back home, integrate\ that into local community\ and build your preparedness\ one step at a time. So I'll\ stop there I hope everyone\ enjoys the conference. It\ looks like it's gonna be a\ great week. Get out and\ enjoy Grapevine and I hope\ to talk to many of you on\ the halls. Thank you.\ (People clapping.)\ JACK BEALL: And now I would like\ to introduce our speaker,\ Regina M. Benjamin, MD, MBA.\ The 18th surgeon general\ United States Public Health\ Service. As a doctor she\ provides a public with the\ best scientific information\ available on how to improve\ their health and health of\ the nation. Dr. Benjamin\ overseas the operation of\ command of 6500 uniformed\ officers who served the\ locations around the world\ promote, protect and advance\ the health of American\ people. Dr. Benjamin has a\ BS in chemistry from Xavier\ University in New Orleans;\ MD degree from the\ University of Alabama\ Birmingham. An MBA from the\ Tulane University an\ eleventh honorary doctor.\ She is formerly associate\ dean for rural health at the\ University Of South Alabama\ College Of Medicine in\ Mobile. In addition to 15\ years in state public\ health, Dr. Benjamin was the\ founder and former CEO of\ the Bayou La Batre Rural\ Health Clinic a small\ shrimping village in\ Alabama. The clinic was\ destroyed by hurricane\ Georges in 1998, hurricane\ Katrina in 2005 and a\ devastating fire in 2006 but\ she always reopened, often\ putting up her own money to\ cover the expenses. In 1998,\ Dr. Benjamin was United\ States recipient of the\ Nelson Mandela Award for\ Health and Human Rights. She\ received the 2000 National\ Caring award which was\ inspired by mother Theresa\ and in 2009 was awarded the\ MacArthur Genius Award. Dr.\ Benjamin.\ (People clapping.)\ DR. REGINA M. BENJAMIN: Good\ morning. People: Good\ morning. DR. REGINA M.\ BENJAMIN: What a big crowd,\ a great crowd. I am really\ honoured to be here today\ and I really like to thank\ the program partners for\ inviting me particularly the\ Chesapeake Health Education\ Program, the NDMS and of\ course the ESAR-VIP and the\ Medical Reserved Corps. But\ especially the United States\ Public Health Service Corps. So\ I would like all the\ commissioned officers in the\ audience to please stand and\ to be recognized.\ (People clapping.)\ DR. REGINA M. BENJAMIN: Thank\ you. Needless to say, I'm very\ proud of these officers who\ do so much work and you guys\ get to work with them a lot\ so you know how hard they\ work. You know using this\ summit to develop synergy in\ collaboration to the\ Department of HHS and other\ agencies and throughout the\ nation, it is really\ important that we start to\ come together and to\ breakdown some of those\ silos that we build up over\ the years. And seeing all of\ you here today is an\ outstanding example of what\ integration and cooperation\ can do. I actually had the\ opportunity to work with\ Kevin Yeskey as many of you last\ year during the Golf Oil\ spill along the Gulf Coast.\ That was an example of where\ all the work we've been\ doing over the last several\ years has started to come\ together. So speaking of the\ Gulf Coast, I thought I\ would tell you, many of my\ friends already know, but how\ I really got involved in\ community medicine and why I\ stay involved actually. When\ I was an intern, I attended\ the Medical Association of\ Georgia's annual meeting. And\ one of the intense issues that\ were being debated was that\ sexually transmitted\ diseases needed to be taught\ in the medical school. While\ I stood up on the room with\ maybe 15-20 people and I\ told them I never seen\ certain diseases except in\ the textbook. And I thought\ there was a need. The\ resolution passed and the\ Georgia delegation forwarded\ that resolution to the AMA.\ They sent me to the AMA to\ speak to the resolution and\ it passed. Within 6 months\ every medical school in this\ country was encouraged to\ include sexually transmitted\ diseases as part of their\ core curriculum. I learned\ that one person can make a\ difference. Whether it's a\ medical policy or medical\ practice and I learned that\ I can make a difference in\ medical practice when a\ National Health Service\ Corps sent me to Bayou La\ Batre. It's a pretty place\ but it's a poor place. I\ found the community of\ working poor. Too poor to\ afford medical care but too\ rich to qualify for\ Medicaid. I like the people,\ I like the community and I\ wanted to practice medicine\ there. But I quickly learned\ that practicing medicine\ wasn't just sewing up shark\ bites. I had to deal with\ the land sharks, the\ regulators, the reviewers, all\ that paper work that you\ have to do. And so I stayed\ involved in community in\ every organization I could\ try to get services to our\ community. You know we have\ people who didn't know how\ to read so it didn't matter\ if I wrote prescriptions\ that they couldn't\ understand the basics so\ adult literacy programs.\ Different programs we stayed\ involved with the United Way\ the Red Cross, Girl Scouts,\ Chamber of Commerce. And all\ of that proved to be\ helpful. In2005 when\ hurricane Katrina hit our\ town of Bayou La Batre\ bringing a 25 foot surge of\ water and Bayou La Batre was\ hit very hard. With the\ population of 2500 people\ and 2000 had no liveable\ homes and the economy of the\ town was destroyed, when you\ can see these shrimp boats\ left in the pine trees. Our\ clinic was destroyed as\ well. But because I did\ house calls anyway I went\ out looking for our patients\ but they didn't have any\ homes. So many of them were\ on the shelter in small\ camping tents on the ground\ and so we set up this make\ shift clinic on the stage of an\ auditorium that was serving as\ a shelter. And we provided\ the basic primary care. You\ know many people had lost\ their meds, their diabetic\ supplies, and their asthma\ machines in the storms. And\ so we didn't have anything.\ So I took copy paper and cut\ it in 4 pieces to make\ prescription pads and so the\ patients didn't really have\ any money so I just wrote in\ the bottom to our pharmacist\ to just bill me because we\ will get something later but\ they needed it then. The\ community came together and\ they helped each other. With\ volunteers just like many of\ you and many of you\ actually. I know personally\ many of you came to help the\ Gulf Coast rebuild. We\ restored our building and we\ actually moved in to our new\ building about 5 or 6, 3\ months or so later. And once\ again dried out all those\ charts and renovated the\ building to open a new year\ on the day after new year.\ But on New Year 's Eve the\ building burned down to the\ ground. All that equipment\ burned out charts and all\ that and we were devastated\ but what was really\ important is communities are\ resilient. Communities come\ together. My patients came,\ they came by and they cried\ and one elderly patient for\ example sent me an envelope\ by her daughter that they\ were standing out in smoke\ & embers and she sent me an\ envelope and in it had a\ note. Well it had 7 dollars\ in it and a note that said\ "to help rebuild the\ clinic." So I know that she\ can't afford that 7 dollars\ but if she could find it we\ would find the rest. And\ it is out of disasters like\ this that we organize our\ local MRC chapter. Because\ it was clear that when a\ major event like 9/11 or\ Katrina or the tornadoes\ last week, a community often\ needs help from others. But\ the outsiders they also need\ the help of the community.\ And so having a community\ leaders in place already is\ so important so it's really\ good to see so many of you\ here leaders in the\ government from the private,\ from the industry getting\ formal training on how to be\ prepared to work together\ should the need arise. It's\ also important to understand\ that the healthier the\ people are before disaster\ the less vulnerable and more\ resilient they will be in\ the face of an emergency.\ For example just being able\ to walk up a few flights of\ stairs or help a loved one\ out of a burning building\ can be so important. And so\ public health activities are\ key component when we are\ trying to do good disaster\ risk reduction in building\ our strategies. So I was\ kinda asked to talk to you a\ little bit about my public\ health priorities and they\ basically are to help us\ have a healthy and fit\ nation. That we could\ respond to anything we need\ to everything from being\ ready to go to school and\ learn to be healthy and\ prepared in an emergency. As\ surgeon general my\ priorities are focused on\ wellness and prevention and\ last year I was joined by\ Secretary Sevilla and the\ first lady Michelle Obama in\ a press conference to\ release my first paper, the\ surgeon general's vision for\ healthy and fit nation. You\ know there's perhaps no more\ serious challenge to the\ nation's health and\ wellbeing than that posed by\ obesity and overweight. You\ know these statistics that\ since 1980 obesity rates\ have doubled in adults and\ more than tripled in\ children. And the problem is\ even worst among black,\ Hispanic and native American\ children. We see the\ sobering impact of these\ numbers and the high rates\ of chronic diseases such as\ diabetes and heart disease\ and other chronic illnesses\ that are starting to affect\ our children more and more.\ Recently a study from the\ University of North Carolina\ School of Medicine reported\ that obese children as young\ as age 3 shows signs of\ inflammatory response that\ has been linked to heart\ disease later in life. So I\ was really pleased to join\ the first lady for the\ launching of the "Let's move\ campaign". Both my vision\ for healthy and fit nation\ and the first lady's "Let's\ move campaign" takes a\ comprehensive approach that\ engages the families and the\ communities as well as the\ private and public sectors.\ My vision for healthy and\ fit nation is an attempt to\ change the national\ conversation from a negative\ one about obesity and\ illness to a positive\ conversation about being\ healthy and being fit. We\ really need to stop\ bombarding Americans by what\ they can't have, what they\ can't eat, what they can't\ do. We really need to start\ talking to them about what\ they can do to be healthy\ and be fit. And so I like to\ congratulate the Medical\ Reserve Corps for recently\ launching their healthier\ MRC challenge and so if you\ haven't done so I encourage\ you to sign up for that\ challenge. I've actually\ been trying to set a little\ bit of example by doing\ Surgeon General Walks around\ the country. We did go to\ Baltimore. We were up in\ Boston with the Harvard\ doctors we call that one\ white coats and white\ sneakers. We walked in Los\ Angeles with 5000 fitness\ trainers and another place,\ I wouldn't call it a walk, I\ think I'll call it a hike\ was the grand canyon rim to\ rim. I actually walked 5000\ feet down 5000 feet up, 26.2\ miles across. But the point\ for that and I forgot to\ mention that a camera crew\ was following me.\ (People\ laughs.)\ DR. REGINA M. BENJAMIN: The\ point was that\ I'm not a big exercise\ buff but if I can do it,\ everybody can do it.\ And to have fun and to enjoy\ yourself being outside just\ appreciating what we have is\ really is enjoyable and to\ try to get people out. Our\ national parks are wonderful\ places to see and if you\ can't get to a national park\ your parks at home. Just\ walk in your own\ neighbourhoods and that's\ why it's important for\ government and our local\ leaders to make those places\ safe. Because I believe\ exercise is medicine. And so\ some people say medicate by\ movement. So just doing the\ exercises medicine program\ with sports medicine is\ really important. Hopefully\ you will participate in\ Elizabeth Fitch 5K run\ tomorrow. It's kinda early\ in the morning but usually\ you have a good time as well\ as the yoga the "let's move\ yoga session" on Thursday.\ It is important that you\ have fun have a good time,\ you dance and you play. Many\ folks around my age will\ remember that you know we\ used to disco and we go to\ dance and not because we are\ trying to do 30 minutes of\ aerobics we would do it\ because it was fun and we\ thought we look good.\ (People laughs.)\ So it really is\ important that you enjoy\ being health and being fit\ no matter what size you are.\ You know I have a lot of\ other priorities but I'll\ just mention some of them in\ addition to obesity is that\ we have a breast feeding\ report that came out. It's\ very important that we\ support women who want to\ breastfeed. (People clap.)\ Of course we have a tobacco\ report and the effects of\ cigarette smoke. I can talk\ to you for a couple of hours\ on that. I would love to\ sometime. HIV-AIDS\ particularly in women and\ girls is very important.\ Another priority is mental\ health and substance abuse.\ And by the way today is\ National Children's Mental\ Health Awareness Day. And\ under that comes the\ particular interest we have\ on violence. Particularly\ youth violence and we're\ gonna be coming out with\ some call to actions and\ some surgeon general's\ report on youth violence as\ well as I guess in a week so\ were gonna be launching a\ medication adherence\ campaign. It's really\ important that people to\ understand that they take\ the medications\ appropriately and how they\ should take the medicines.\ Also with youth the youth\ misuse of prescription\ drugs. So those are some of\ the priorities. Throughout\ all of that is we need to\ eliminate health\ disparities. You know the\ Affordable Care Act,\ provided us with a historic\ funding commitment to\ promote prevention and\ wellness. In a new law\ established a national\ prevention health promotion\ and public health council\ which I have the honor to\ chair. In this council\ includes 17 cabinet level\ members and their heads of\ agencies throughout\ government. It's not just HHS\ it's housing, HUD, labor\ commerce. We have 17 of\ them, the cabinet level\ members which shows the\ importance of it. The\ council will provide\ coordination and leadership\ at the federal level to\ ensure that the government\ is focused on prevention.\ We're going to develop the\ first ever national\ prevention strategy and make\ recommendations to the\ president and to the\ congress about the most\ pressing health issues\ affecting the nation and how\ we can change the federal\ policy to help prevent that.\ So with this council I hope\ to move us from a system of\ sick care to a system based\ on wellness and prevention,\ because just like many of\ you I've seen so many missed\ opportunities for prevention\ and heath care settings\ across this nation. If we\ truly want to reform health\ care in this country we need\ to prevent people from\ getting sick in the first\ place. We need to stop the\ illness and stop the disease\ before it starts. So in\ addition with the state of\ the art medicine, we need a\ new approach to promoting\ prevention and wellness in\ our communities. So staying\ healthy depends on other\ factors that influence our\ health like housing and\ transportation. Education --\ I lost you, sorrry. The\ availability of quality\ affordable foods, our work\ places and our\ environments. I really want\ to change how we think about\ health in this country. And\ that calls for a nation --\ (microphone stops working)\ (People laughing.)\ So there, okay. So actually in\ order to change the way we\ think about health in this\ country, we really have to\ take a more holistic --\ (microphone turns off again)\ you\ know that I'm doing -- I'm\ hitting to turn it off.\ (People laughing) \ It's me. I don't like what I'm\ saying.\ (People clapping.)\ That's\ what happened when you get\ nervous in front of a big\ crowd. I really want to tell\ you about making a nation of\ more holistic community,\ taking everything from safe\ highways and worksite\ wellness programs to clean\ air and healthy food. You\ know we really do want to\ get to a place where\ everyone understands that\ almost everything we do even\ though it's not labelled\ health or prevention really\ does affect the health and\ the quality and the length of\ life of all the Americans.\ And so I take that as a sign\ to wrap up so, as Americas\ doctor I really want to tell\ you that you are leaders and\ we really appreciate\ everything you're doing but\ it's important that you take\ care of yourselves that we\ need a healthy responder.\ When I came here on a plane\ yesterday,the flight\ attendant gave a safety\ warning and she said, put\ your own face mask on before\ attempting to help others.\ It is important that we take\ care of ourselves that we\ rest, we exercise, we have\ vacation, we have fun that\ at this meeting as much as\ you need to sit in a\ sessions and learn, is also\ a time to see old friends\ and make new friends. Start\ to build those relationships\ and those sustainability\ things that will keep you\ going because at times of\ disaster that's what you're\ gonna need. Finally the\ thing is that you wanna during\ flu season, to make sure\ you get your own flu shot.\ You know I want to end with\ a story that many of you\ heard me tell. All my\ stories re about water but\ there was a young girl who\ was jogging along the beach\ early one morning and then\ she was jogging, there was\ an older gentleman who was\ tossing the starfish in the\ water one at a time. And she\ run along the beach and he\ was still tossing the\ starfish and by the time she\ finished her run she just\ can't take it anymore so she\ went up to him and said "Why\ are you bothering to toss\ the starfish in the water\ one at a time? There are\ hundreds and hundreds of\ starfish along the beach. As\ soon as the sun comes up,\ it's gonna dry them all off\ and they'd gonna die anyway\ and it's not gonna make a\ difference. Why do you\ bother?" He looked at her,\ reached down and pick up a\ starfish and said "Because\ it will make a difference to\ this starfish." And he\ tossed it in the water.\ Enjoy the conference. Learn\ as much as you can and then\ go back home and then find\ your starfish and continue\ to make a difference. Thank\ you so much and have a great\ conference.\ (People clapping.) \ (end. Music playing.)\ }