Tribal members representing 23 American Indian tribes attended training at FEMA's Center for Domestic Preparedness (CDP) recently. This was the first all-tribal course taught at the CDP where members from 10 different states participated in a single course focusing on a mass casualty healthcare response.

After more than seven months of planning, the 56 students joined in training at the CDP's Noble Training Facility (NTF), the only hospital in the nation solely dedicated to preparing the healthcare, public health, and environmental health communities for mass casualty response to a catastrophic natural or man-made disaster.

"I'm impressed with the model used in training here," said Tom Dressler, tribal leader and council member representing the Reno Sparks Indian Colony in Nevada. "This training can be applied in every situation not only during a crisis. I wish there were more of these courses geared for tribal people—it is very important that we protect our safety. There is value here."

Tribal members and personnel attended the Healthcare Leadership for Mass Casualty Incidents (HCL) course. During the four-day class the students trained on providing a realistic medical response in an actual treatment facility. The NTF provides the perfect setting to mirror an emergency department surge and the activation of a hospital's command center.

"It is very important that I know this information so I have an idea of how to operate a [Command Center] and what Indian Health Service can do to support a crisis," said Myles Jones, chief executive officer of Lockport Indian Health Services from New York. "The training here is realistic and it seems like the event is really happening. I have no doubt that what we are learning will actually make a difference."

Organizing a tribal-specific delivery of the HCL took seven months to arrange. Gina Marotto, acting director for the Inter-Tribal Emergency Response Commission in Sparks, Nev., helped coordinate. She was asked to come on board by two colleagues at the Reno Sparks Tribal Health Center who had completed CDP training more than a year ago. Marotto notified tribes and tribal organizations nationwide about the possible training and learned that the interest was very high.

"I want tribal leadership to support Emergency Management (EM) training efforts," said Marotto. "I hope they support training. Emergency Management in Indian Country is in the intermediate phase. Some tribes have nothing; others have phenomenal [EM] departments. Structured training such as this -- with a facility to practice all positions and coordinate in a position we may not be comfortable with -- is key to any sort of effective training. I hope these tribes recognize they are either not prepared, or they recognize that their level of preparedness may need improvement."

The students did make suggestions and noted areas for improvement during the 32-hour course. The training scenarios did not fully resemble a tribal community. Incidents that typically occur in urban America may not fit into the infrastructure found on a reservation.

"We are going to relook how our scenarios are developed and consider changes that resemble a crisis event Native American responders may experience," said Chuck Medley, assistant director of Training and Education. "The CDP's hands-on training and realistic scenarios are popular among emergency responders and if we can tailor an exercise or classroom lecture to better suit the needs of tribes, we will look at every possibility and we welcome all suggestions for future course deliveries from the tribal community."

"The fact that our class is dedicated to tribal is immeasurable," said Michael Youngblood Konkle, from the California Tribal Emergency Response and Relief Agency. "The Native American community is getting more involved and it is nice to see the [Federal] government sharing this training with us. The scenarios could include more Indian titles and maybe use casinos [in place of shopping malls] or something relevant to tribes; but, this is more complete than any other training I've experienced."

Several of the students from the various tribal nations have already expressed an interest in scheduling training for members of their tribes on a regular basis, according to David Hall, CDP's Western Region Training Coordinator, who participated in the training coordination.

"If an organization does not take advantage of the training they are missing out on a great opportunity," said Garrica Bateman, a nurse with the Muscogee Creek Nation in Oklahoma. "I gained a lot of good information we can use when I get home to finish up our plans. This is an extraordinary feat to get all these tribes here for a single course."

"All we can do is prepare," said Jessica Tsingine, Safety Officer at Tuba City Regional Health Care Corporation located in Tuba City, Ariz., on the Navajo Reservation. "We can't prepare for everything, but we can be a little more ready. Preparation for emergencies will protect not only our people, but will protect our land as well."

CDP training is fully funded for tribal, state, and local response personnel. Round-trip air and ground transportation, lodging, and meals are provided at no cost to responders or their agency or jurisdiction. The CDP plays a leading role in preparing tribal, state, and local responders to prepare for and respond to manmade events or major accidents involving mass casualties. To learn more about the Center for Domestic Preparedness, visit or call 866-213-9553. Visit the CDP on Facebook at