An expert on influenza pandemics and other public health disasters had to cancel his talk at the South Dakota State Medical Association's annual meeting Thursday because he was busy responding to one of those emergencies - Hurricane Ike.

As the director of the Public Health Readiness Office of the American Medical Association's Center for Public Health Preparedness and Disaster Response, Dr. Italo Subbarao was in Texas dealing with the aftermath of that storm this week instead of at the state medical association's convention in Rapid City. But physicians from throughout the state still got an update on what South Dakota is doing to better respond to a large-scale public health disasters, as well as an overview of the state of disaster medicine in the United States.

The annual meeting of the state medical association continues through Friday, Sept. 19, at Best Western Ramkota Hotel and Conference Center in Rapid City. This year's theme is "Acting Now for a Healthier Tomorrow."

Ever since the terrorist attacks of Sept. 11, 2001, the arena of public health preparedness and disaster medicine has become increasingly important in America, said Dr. James James, director of the AMA's Center for Public Health Preparedness & Disaster Response.

"I like to say that every physician has a second specialty, and that is public health," James said.

Research shows that although 80 percent of U.S. physicians say they want to volunteer in a disaster, only 20 percent feel they have the training necessary to do so, he said.

In South Dakota, the Statewide Emergency Registry of Volunteers, or SERV SD, is the mechanism to organize a systematic approach to medically-trained disaster volunteers, according to Dr. Matthew Owens, a Redfield family practice doctor who is a lead physician for the state health department's Office of Public Health Preparedness and Response.

SERV SD is a collaborative effort between the state Department of Health, the state medical association and the Sanford School of Medicine. It was created in response to the 1998 Spencer tornado that destroyed an entire town, which illustrated that a systematic approach to medical volunteers was needed. SERV SD is now in its fourth year of operation.

Although the odds of a terrorist attack or a hurricane are remote in South Dakota, any large public health crisis - a pandemic of influenza, or large numbers of trauma patients caused by a tornado, flood or train derailment - requires a similar approach, Owens said. "No matter what the disaster is, the framework for responding to it is the same," he said.

In addition to doctors, SERV SD also trains first- and second-year medical school students to mobilize in the event of a disaster. Beginning in 2009, that training will be extended to the state's nursing students, physician assistant students, pharmacy students and other medical-related fields, providing a pool of more than 1,500 volunteers that could be rapidly deployed in the event of a public health emergency, Owens said.

In the event of a flu pandemic, the students are trained to give immunizations and to treat anaphylaxis - an allergic reaction to a vaccination - as well as how to operate an emergency radio.

James praised South Dakota's efforts to train and coordinate disaster volunteers. He said that seven years after Sept. 11 and three years after the federal government's poor response to Hurricane Katrina, federal disaster preparedness still has a long way to go.

"We are not working together well, still," he said. "A lot of responding agencies still have tunnel vision."

The goal of SERV SD is to have volunteers pre-trained and pre-registered before a disaster strikes, Owens and James said. A series of online trainings and a database of certified volunteers is the key.

"We want doctors to develop an expertise in a discipline that we hope they never have to use - disaster medicine," James said.