Although military systems serve only a small portion of the population, they are relevant to biosurveillance because outbreaks can be centered in military facilities. Most military bases have their own 911 call centers; some are tied into civilian systems. For example, Fort Belvoir, Virginia is served by Fairfax County's 911 system. A caller who is located on the base dials 911 and reaches a Fairfax County PSAP operator. That operator acts as the base' dispatcher, alerting military police, fire or EMS workers as needed (U.S.Army Military Police, 2005).
The National Emergency Number Association considers military bases to be underserved by 911 when compared to civilian jurisdictions. The majority of emergency services on military bases in the United States are equipped with at least Basic 911, but there are still many locations, which require callers to dial seven or ten digit numbers to reach emergency services. The 911-equipped centers are not uniformly equipped with CAD technology. A particular 911-equipped base may have E911 with CAD, or it may have Basic 911 with Automatic Number Identification and Automatic Location Identification, or Automatic Number Identification only. When callers must dial all 7 to 10 digits, the dispatcher may be able to display the originating telephone number, and may also be able to manually retrieve an address (but this information would not be available online). Often, base services are all dispatched centrally, meaning an incoming call is handled by one PSAP, and the same dispatcher will initiate and coordinate the response of military or DoD police, fire, and medical services as needed. As is the case in the civilian world, E911 and CAD functions are not yet available for callers using cellular phones. However, some military and Department of Defense personnel can also reach 911 via the satellite phone network operated by Iridium.
Iridium's phones, built by Motorola, use a constellation of 66 satellites in low orbit. The phones offer automatic 911 localization via satellite-based triangulation. Iridium® phones are not compatible with cellular systems, and must rely on a terrestrial wireless switch to connect a satellite phone user with landlines or cellular callers. The location of an Iridium user cannot be determined by cellular tower triangulation. This means that locating military callers in real time (and placing this information in Automatic Location Identification) using Iridium is more difficult than locating civilian callers using satellite phones when they can access the cellular phone network.
Military call centers can potentially play a sentinel role in biosurveillance if sufficient numbers of them can store information and provide the same access that civilian centers offer. For the moment, military centers remain less immediately useful, especially in regard to early detection.
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