Medical Preparedness for Disasters IN THE DECEMBER issue of this journal, Dr. Orient (1)

reviewed the planning in several countries for medical responses to disasters. In this thought-provoking article, the author illustrates an increased risk of incidents with mass casualties by referring to the recent Bhopal acci-dent. She points out that there has been little progress in our capacity to respond to medical disasters for many years. She identifies disaster preparedness as a component of civil defense programs. Her article then reviews the medical elements of the civil defense programs of Switz-erland and the U.S.S.R., describing in some detail how they were principally designed for war scenarios. The pa-per deplores the current state of American civil defense programs and appeals for an improvement in American efforts to prepare for disasters. There is no question that today's population densities have increased the risk of massive casualties accompany-ing accidents. An earthquake in Mexico City has oc-curred since Dr. Orient's paper was submitted for publi-cation, and as I write this editorial today's headline reads "Colombian Volcano Erupts, Killing Thousands " (2). The United States is not exempt from this risk. Some heavily populated regions are subject to substantial risk of earthquake, storm, or tidal wave. Industrialized areas of the United States are at risk of technologic accident, which varies according to their facilities, industrial feed-stocks, and ultimate products. However, we are a safety-conscious society. Stringent building standards, good engineering, hazard management, and progress in emer-gency technology (notably in fire service) have spared u