How to cut risks of mass gatherings

Story highlights

  • Hundreds were killed Thursday in stampede at the Hajj pilgrimage
  • Pooja Agrawal: Mass gatherings are only safe when everyone prioritizes safety

Pooja Agrawal is an assistant professor of emergency medicine and the director of Global Health Education in the Department of Emergency Medicine at Yale University School of Medicine. She is also an affiliate faculty member of the Harvard Humanitarian Initiative. The views expressed are her own.

(CNN)I've seen for myself the devastating human impact of tragedies like Thursday's stampede in Saudi Arabia, which claimed the lives of more than 700 people and injured 900 others. Back in 2013, I was one of a team implementing an electronic medical surveillance system during a major mass gathering at the Kumbh Mela, a HIndu pilgrimage in India. There, I witnessed the aftermath of a stampede as pilgrims rushed to get on a train at the city station. A confluence of factors, including a last-minute change of the arrival platform, large and impatient crowds, a narrow footbridge, and general panic led to 36 people losing their lives, with many more injured.

The spate of tragedies occurring during this year's Hajj are even more devastating than what I saw. But while some deaths, including those caused by storm-related crane collapses and terrorist attacks on mosques, are less predictable, those caused by Thursday's stampede at Mina should not have been.
Pooja Agrawal
Sadly, human tragedies such as those that we've seen at the Hajj and other mass gatherings around the world seem to be an increasing, and almost expected, occurrence. This is perhaps not surprising considering globalization trends including ease of travel, the availability of information and rising international grassroots political and religious activism, all of which have made mass gatherings around the world more frequent and more accessible to ever greater number of people. Combine this with crowds that aren't always aware of possible hazards, and preparedness plans that are not sufficient to mitigate potential risks, and you have a recipe for disaster.
    The Saudi government, security forces, and faith-based organizations at the Hajj have all attempted to help manage crowds, yet the need for enhanced and adaptive planning has been overwhelming the ability of agencies to execute such plans.
    True, after attendance swelled to more than 3 million in 2012, the Saudi government imposed restrictions on attendance. But an estimated 2 million worshippers will still attend the Hajj this year. And, as evidenced by recurrent stampedes, simply reducing the size of the gathering is insufficient.
    Instead, disaster preparedness requires a plan that is appropriate to the population, yet flexible enough to adapt to changing circumstances, as well as multilateral support and personnel to attend to the physical structure, organization of people, security, and acute needs like medical, fire, rescue resources in the event of a disaster such as a stampede.
    In the case of the Hajj, at least, this kind of forward planning should be do-able. While spontaneous or transitory mass gatherings with temporary infrastructure are intrinsically conducive to stampedes, the Hajj occurs at the same location, with permanent structures and on a specified date, every year. This permanence should offer urban planners an opportunity to learn from previous experiences to prevent future tragedies from occurring.
    Restricting entry based on crowd size, as the Saudi government has done, is of course critical. But officials should also conduct drills, coordination exercises, and simulations of stampede response during non-Hajj times to allow personnel to act quickly and effectively when needed.
    Another way of reducing the chances of disaster is by establishing a proximate Incident Command Center, equipped with closed-circuit TV (already in place at the Hajj), with eyes and ears on the ground to help spot risky crowd movements quickly and allow for an immediate response and redirection of people when appropriate. In addition, keeping entrances and exits clear, with open places as offshoots for overflow, allows for potential crowd surges and provides a place to pull people from danger.
    But while a well-written disaster plan is necessary, it is not sufficient to successfully prevent stampedes and resultant injuries -- participants at events should also make themselves aware of what they can do to protect themselves and their families in large crowds.
    This was underscored during my experience in India, where we evaluated a religious pilgrimage of 80 million people who gathered for six weeks at the banks of the Ganges River. Yes, I saw the aftermath of a stampede, but the numbers hurt or killed could have been much higher than 36 if not for a number of personal measures that people took to reduce their own risk of injury. For example, many people seemed aware of emergency protocols and knew where exits and emergency personnel would be should trouble arise. They established rigidly unidirectional traffic patterns to avoid turbulence while walking. In addition, people were supportive of each other -- instead of simply protecting themselves -- to ensure that everyone had a safe experience. Engaging and empowering attendees to be active participants and partners in safety can help support safe environments.
    Ultimately, mass gatherings are only safe when everyone is committed to prioritizing safety. Organizations and administrators need to prepare for expected crowds, dedicate sufficient resources and create appropriate safe guards to protect the population. But attendees must also recognize the potential risks in their surroundings and take appropriate precautions.
    Too often, the thousands of lives lost in mass-gathering stampedes and other tragedies around the world are limited to a few lines on the back page of a newspaper or a fleeting online article. Instead, we need to dissect each mass gathering incident, to allow the opportunity to learn from our past and adapt future disaster plans.
    Most importantly, we need to tell the stories of these tragedies on the front page to broaden public awareness of safety concerns and ensure that such tragedies change from expected headlines to ever rarer exceptions.