efore Disaster Medical Assistance Teams (DMATs) exist as they do today, the Commissioned Corps of the U.S. Public Health Service formed the first prototype DMAT's for the rest of the nation; one located in Rockville, MD and the other at the National Institutes of Health in Bethesda, MD. These first DMAT's, formed in the mid 1980's, were largely stabilization (triage) units, staffed with emergency room physicians and nurses, paramedics, and Emergency Medical Technicians (EMT's). But in contrast to the civilian DMAT teams of today, the PHS-1 DMAT and PHS-2 DMAT were structured to provide primary medical care, emergency community outreach, and preventive medicine. Therefore, they were also staffed with sub-units, containing mental health, laboratory, preventive medicine and dental expertise. These PHS DMAT's also included a fixed command structure with logistics and administration functions. These pioneering PHS DMATs, mostly staffed by USPHS Commissioned Corps officers, were a proof of concept for DHHS; that temporary volunteer teams could provide disaster response within a few hours in various places CONUS and OCONUS (outside the Continental United States). The two pioneering DMAT teams merged in 1993, forming PHS-1 DMAT, and eventually all other civilian DMAT teams that formed around the country. At that point, the National Disaster Medical System (NDMS) as we know it today, was part of the U.S. Public Health Service.
PHS-1 DMAT deployed and supported multiple missions, gaining experience and honing response technique. Among the many responses were Hurricanes Hugo (1989), Andrew/Iniki (1992), Fran (1996), and Georges (1998); Midwest Floods (1993), Northridge Earthquake (1994), Southeast Floods (1994), Oklahoma City Bombing (1995), Olympics (1996), G-8 Summit (1997), North Dakota Floods (1997), New York Ice Storm (1998), NATO Meeting (1999), Army support to the 85th Medical Battalion from 1985-1991, support to Army National Guard Units from 1985 - 1999 (MD, DC, PA, VA, MA, FL), Honduras (1993) and Guatemala (1999), Navy support to USNS Comfort (1991) and to the National Naval Medical Center (1998).
In 2003, the NDMS was transferred to the newly created Department of Homeland Security (DHS). This transfer created a situation that limited the ability of the PHS-1 DMAT to deploy because the PHS-1 DMAT was mostly comprised of officers of the Commissioned Corps who were not under DHS's direct administrative control. Despite this setback, the PHS-1 DMAT hung together through sheer force of will; its team members conducted monthly meetings and training exercises. This situation persisted until 2006 when the Tier-level Commissioned Corps response teams were formed. In order to form the first Rapid Deployment Force (RDF) teams, the Office of Force Readiness and Deployment (OFRD) essentially asked the PHS-1 DMAT to divide into two as-yet unnamed RDF teams in order to form an experienced core of leadership within those Washington, D.C. area RDF's.
The first two RDF's evolved as larger versions of the civilian DMAT's, containing the same preventive medicine and mental health capabilities as the original PHS-1 and PHS-2 DMAT's. At that point, Applied Public Health Teams (APHT's) and Mental Health Teams (MHT's) had not been formed. It seemed only natural to retain the "PHS-" prefix to honor the RDF teams' origins. Thus today, RDF-1 and RDF-2 hold true to this history by referring to themselves as PHS-1 RDF and PHS-2 RDF. The basis for doing so is also founded in the battalion-style unified command structure that influences present day response teams as numerically ordered sub-units. For example, Battalion 1 includes PHS-1 RDF, PHS-1 APHT, PHS-1 MHT, etc., and Battalion 2 includes PHS-2 RDF, PHS-2 APHT, PHS-2 MHT, and so on, through all five Battalions; -1, -2, -3, -4 and -5. Although most visible are the PHS-1 RDF and PHS-2 RDF, this naming convention does not set these teams apart as anything different or special; all teams may use the PHS-# naming convention. A few references to the OFRD's present day unit names are historically preserved in documents referenced here: Contacts Readiness and Response Program Engineer's Deployment Guide OFRD Deployment Roster OFRD Deployment Role and Response Team Selection/Application
Corps response teams are unique. No civilian teams address the universal need in any public health disaster to put well-rounded expertise on the ground within hours of a disaster. In fact, every disaster response should be considered multidimensional, where root cause analysis applies public health principles through a public health team to achieve the very best approaches to wellness, preventive medicine, mental health, triage, ambulatory care, clinical and long-term care.
-PHSChat recognizes CAPT Calvin Edwards, PHS-2 RDF, for his willingness to provide assistance with this article.