Last revision: 11/09/2000  - js
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A Triage-based Approach to Resource Problem Classification

Robert W. Buddemeier

             Boldface links are to other atlas sections; italic items are linked to glossary definitions

Introduction -- what is "triage" and why use it?
Triage is defined (Webster's Ninth New Collegiate Dictionary) as "the sorting of and allocation of treatment to patients and esp. battle and disaster victims according to a system of priorities designed to maximize the number of survivors." Commonly this involves sorting casualties into three categories -- those likely to recover fully with routine, non-urgent care, those with a good chance of survival and recovery if they receive prompt or extensive attention, and those unlikely to survive or recover fully even with the maximum possible effort.

More generally, the term is used to describe the process of allocating limited resources for greatest effect in any situation where prompt action is necessary to minimize or limit serious loss or damage. In this sense, it is increasingly being used in with regard to natural resources and hazards. As one example, after the 1993 floods in the Mississippi basin it was recognized that some bottom lands could not be protected against all possible floods, and levees were not rebuilt. For another, conservation biologists are increasingly recognizing that natural habitat loss to environmental change and human population growth will inevitably continue, and suggesting that it makes more sense to do an effective job of protecting selected regions than to diffuse resources in a vain attempt to save everything.

Water resource applications
Water resources are an area in which the conditions for 'resource triage' are met -- at a basic level water is critical for the maintenance of life, and in more advanced settings, it is a critical factor in quality of life and in economic development. Worldwide, water is recognized as a limiting resource that appears to have a greater potential for generating future conflicts than land or oil. In Kansas, the crisis stage has not yet been reached -- but with demand growing, with most systems fully appropriated under present rules, and with groundwater inventories and reservoir storage capacities decreasing with time, the potential is clear.

The time aspect of the triage requirement deserves particular mention. Changes in supply and demand are barely noticeable on a year-to-year basis -- but accumulate to major changes on the scale of a decade or two, as can be seen from the projections in this study. Major natural stresses, such as droughts and floods, also have time constants of decades. When such extreme events happen they may cause major changes very rapidly -- but on average, natural processes are slow compared to human interventions; the depletion of the Ogallala aquifer that has occurred in a few decades of pumping would take centuries of natural recharge (with no pumping) to replace.

These time scales are important as human society pushes the limits of the hydrologic system, because effective societal approaches to exploitation of a complex and limited resource are by no means prompt or easy. To build a dam or a pipeline requires many years, and probably decades, to proceed from conceptualization through authorization, funding, land acquisition, design, and actual construction -- and there is no incremental benefit along the way, since the whole project has to be completed for improvements to occur. So-called 'soft' problem solutions based on management, regulation, or education lack the physical delays of engineered solutions, but can be even slower to move through the process of agreement, legislation, funding, and implementation because of the wide range of social, political and economic forces that tend to perpetuate the present status.

Implementation -- the Kansas approach
In this situation, 'triage' can be applied at several levels. The first and second are represented by this study -- a simplified, informed classification and assessment of potential problems, combined with a concurrent assessment of additional diagnostic needs. This information is input to the policy recommendation stage that develops informed action recommendations for the public and for legislative bodies, which then (in principle) have the incentive, the information, and the responsibility to take action "…to maximize the number of survivors."

Experience has shown, however, that the stages do not work well in isolation. The technical evaluators cannot pre-empt the policy recommendations -- but if they do not identify real scientific limits on societal action, or phrase their input in language useful and comprehensible to the policy community, they will have minimal effect. Similarly, if the policy bodies do not come to terms with the technical input and propose feasible responses based on realistic needs, those who legislate and implement responses will find it difficult to function effectively.

Effective assessment and action requires an unprecedented level of ongoing communication among the various groups and levels of operation -- unlike a field hospital, resource triage provides not only milestones but a basis for an ongoing process. This project attempts to address that need by close cooperation between the primary management and science agencies (KWO and KGS), by involvement of other relevant organizations (KSU, KDA, KDHE, the GMDs), and by effective use of both electronic and print media to facilitate access to and review of appropriate information. 'Appropriate information' in this sense is not limited to summaries or one-time analyses, but includes a wide range of background information (see the other sections of the High Plains Aquifer Atlas), explanations of methods and especially of confidence limits and uncertainties, an emphasis on key issues for policy consideration -- and above all, mechanisms for and an expectation of ongoing feedback and dialogue throughout the critical process of water policy review, revision, and implementation.

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Funded (in part) by the Kansas Water Plan Fund