Health Incident Management During Floods Essay Example

Floods, Healthcare Incident Management

Introduction

Floods can cause many challenging issues for public health with both immediate and long-term implications. Drowning, contagious infections, and post-traumatic stress disorder are some health scares associated with flooding. Floods constitute the most frequent catastrophic risk factor, significantly increasing death and morbidity globally. The location, terrain, population makeup, and infrastructure determine how floods affect the local human population (Paterson, Wright, & Harris, 2018). Healthcare incident management takes a risk-based approach comparable to the efforts invested in dealing with natural emergencies like floods. Floods require the deployment of comprehensive or complex emergency management, including preparedness, recovery, response, and overall readiness. Like many other medical emergencies, flood management employs an integrative, people-focused strategy (World Health Organization, 2019). This research paper focuses on the fundamental principles of healthcare management as applied to incident management during floods, including triaging, handling vulnerable groups, and interagency cooperation.

Floods and the fundamental principles of healthcare incident management

The stabilization of the disaster scene, protection and preservation of life, and protection and preservation of property are the three fundamental principles of emergency management. Healthcare professionals comprehend the first principle instinctively and conceptually (Cooper, 2010). They also understand that the third principle is crucial to the first since they cannot carry out life-saving procedures without the necessary facilities, tools, and resources. The second principle, nevertheless, might be less apparent because an organized crisis response can only take place within the framework of a stable workplace, which is challenging to accomplish in the moments immediately after a catastrophic event when chaos is the norm, even in a remarkably intricate workplace like medical facilities that are highly self-regulated. So, to organize the chaos associated with emergencies such as floods, an emergency management system is required.

In flood events, the incident command structure should be defined by the three fundamental tactics—unity of command, the span of control, and clarity of text—that must underpin all incident orders. Open communication among all individuals participating in the emergency response is crucial because of unity of command. To maintain the strength of the hierarchy of command, these people nevertheless follow official commands and submit regular reports to a designated superior (Cooper, 2010). The concept of span of control states that no line manager can efficiently coordinate the work of a particular number of subordinate employees in a high-stress setting.

Clear communication is vital to guarantee that everyone participating in the relief efforts is aware of the strategic framework of the incident response blueprint and the Special Techniques used to counter the tragedy (Cooper, 2010). The clarity of text alludes to the principle that all written and verbal correspondence must be conveyed in the most straightforward and concise, basic vocabulary conceivable, seeking to avoid using phrases or colloquialisms that are likely beyond the comprehension of many emergency personnel.

Floods fit well into these principles since they call for the emergency operations strategy, which includes emergency triaging, to be implemented and activated at the hospital. The facility’s command center must be activated to guarantee the safety of both patients and personnel during floods. It deploys the entire hospital staff and generates a demand for more medical specialists. Even healthcare executives skilled in deciphering complicated organizational charts and clinicians used to diagnosing and treating complex medical issues may find it challenging to comprehend the incident command system used during emergencies like floods (Cooper, 2010). The fundamentals of incident command, nonetheless, are the same since everyone involved in the catastrophe response is accountable for their immediate responsibilities, communicating with others, and, most importantly, their protection and safety. In a nutshell, in the event of floods, there will be various efforts geared toward these principles – to protect human life, to stabilize the situation, and to protect property.

Issues would make triaging victims a challenge during floods.

Accurate and quick triage is the cornerstone of effective performance in accidents and emergencies. During emergencies like floods, triage becomes challenging for various reasons related to the immediate impact of the floods or emergencies. For instance, triaging implies that nurses and other healthcare workers can correctly offer early assessment procedures to the affected people. However, amidst the chaos caused by the floods, affected individuals may not be able to access the services of a nurse due to broken or unusable infrastructural systems such as roads and bridges. The lack of reliable infrastructure delays the affected people’s access to facilities and healthcare professionals for immediate evaluation and assistance.

Another primary cause of challenges in triaging during floods could be poor communication. As explained under the fundamental principles of healthcare incident response, precise and reliable communication is a core component of emergency operations. However, floods can adversely affect communication, as they may affect the power supply that supports the communication networks (Jha, Bloch & Lamond, 2012). It becomes challenging to connect the people needing help with the triage nurses and other healthcare professionals on the response teams, in addition to communication affected by the floods. Studies have proven time, and again that hierarchical structures slow down communication, which would ultimately affect other parts of the response efforts, including triaging.

Ultimately, it is a matter of common knowledge that hospitals receive numbers beyond what their capacity can ordinarily handle during floods and other emergencies of the same magnitude. With a more than ordinary population visiting a healthcare facility, the resources will become overwhelmed, and the human resources trend in triage may not be sufficient to serve the victims effectively and in a timely fashion (Mort et al., 2018). In a nutshell, those factors that pose severe challenges to the dredging process are directly associated with the immediate impact of the disaster.

Types Of Injuries Most Likely to Occur

More people die from floodwaters than any other calamity. A hospital needs to be prepared to treat patients who have spent much time outside before they can be saved (Paterson, Wright, & Harris, 2018). Puncture wounds, hypothermia, and trauma from falling objects are just a handful of the wounds a hospital may treat during a flood. The primary injuries include:

  • (i) Vector-borne illnesses could include hemorrhagic illness, dengue, yellow fever, and malaria.

  • (ii) Waterborne illnesses

  • infected wounds.

  • (iv) Orthopedic injury and hypothermia are two common types of injuries resulting from flooding.

  • (v) West Nile virus transmission by mosquitoes After a flood subsides and stagnated rainwater is present, fever frequently occurs (Bartholdson & von Schreeb, 2018).

Issues that may uniquely affect the vulnerable populations

Children and the elderly are among the most vulnerable groups in any community. Floods may negatively impact older people’s health in several ways. The spread of infectious diseases and mental illnesses, made worse by the devastation of facilities, houses, and livelihoods, are two of the longer-term effects of flooding on health, in addition to the instant harm and death, they cause. According to a meta-analytic assessment, older people were 2.11 times more likely than younger ones to exhibit manifestations of PTSD and 1.73 times more likely to suffer adjustment problems after being subjected to catastrophic events (Bukvic et al., 2018). Many areas with more significant senior populations have additional characteristics that significantly influence this age group’s susceptibility, including aging housing stock, disability, and household earnings, which frequently vary across rural and urban surroundings. Children’s wellbeing is impacted by several variables, such as the loss of important personal and household belongings, social ties, intimately familiar environments, and schooling; feelings of sheer terror, stress, economic hardship, separation, unequal treatment, breakdown, mental anguish, and insecurity; a lack of sleep and recreation; diminishment in diet, living quarters, and housing quality; and a complete absence of flood educational opportunities for students and staff as a whole (Mort et al., 2018).

Public Health issues that may ensue and mitigation strategies

In terms of public health, flooding can have either direct or indirect consequences. Communities’ direct responses to flooding might be categorized as immediate, intermediate, or late. Floods have acute negative implications on health that manifest immediately or within days (Okaka, & Odhiambo, 2018). At this time, there is a great deal of anxiety about mortality from injury and drowning in floodwaters. The likelihood of drowning is typically based on the possibility of either a storm surge or a flood with a slow beginning. People lose their lives by drowning in their cars and houses or being swept away by floods. Severe hypothermia is another acute condition that may develop.

The initial impacts are those that appear within ten days of the disaster. At this point, there is a severe danger of infection from secondary infections and cuts and bruises. Antifungal therapy may not be necessary if proper wound care, extraction of foreign objects, and removal of damaged tissue material are performed (Okaka & Odhiambo, 2018). Typhoid, cholera, and viral gastroenteritis are all possible in places with low sanitation and hygiene standards. Hepatitis A and E, for example, could happen.

Depending on the region, the likelihood of vector-borne diseases like dengue fever and malaria increases the longer the flood waters remain in place. Mortality can result from a lack of accessibility to medical care services and medications to treat noncommunicable illnesses like hypertension and heart problems (Yu et al., 2020). Mental health illnesses like post-traumatic stress are among the other issues that are frequently disregarded. The damage to the transportation infrastructure that makes it harder for the disaster response to reach the flooded areas and assist impacted populations might indirectly impact health. In addition, the destruction of agriculture and food stores increases the risk of famine and hunger in the populace.

Compared to the acute health effects of floods, psychological issues, which can develop later, are frequently disregarded and not as thoroughly explored. It is currently known that experiencing a flooding catastrophe can influence people immediately following the occurrence and occasionally for years to come. Some typical psychological health issues that develop during a flooding disaster include anxiety, panic, post-traumatic stress disorder (PTSD), hallucinations, and sleeplessness.

Another potential health effect of flood catastrophes is malnutrition or malnourishment, and there is evidence to support it. Victims frequently lack access to a regular food supply and have been reported to eat very little during or after flooding (World Health Organization, 2019). Flooding can also seriously impact food production, including agriculture. This may affect the availability and caliber of food, resulting in undernourishment and malnutrition.

How interagency cooperation and local collaboration can be effectively utilized

It takes a network of affiliated institutions and entities to safeguard and advance public health. While government healthcare agencies are ultimately responsible for preserving the public’s health, interagency collaboration with communities and cooperative stakeholders is crucial for a quick and successful reaction to public health disasters and emergencies (Baskin et al., 2021). These organizations include many that may not be considered a component of the general health system, including local health departments (LHDs) and some that are typically thought of as such.

Collaboration across entities is characterized as a procedure whereby organizations accept risks, duties, and incentives to exchange information, modify actions, work collaboratively, and improve one another’s capabilities for mutual advantage and a common goal (Baskin et al., 2021). Associated agencies value collaboration for a variety of reasons. As operations and initiatives may be integrated and finances can be consolidated, combined projects can give partnering agencies results that may not have been possible independently.

These results may improve advocacy and capacity, increase awareness and recognition, offer a more systematic approach, and provide more possibilities for new projects. Collaborative efforts may also prevent agencies from working in duplicate. Successful collaborations foster teamwork, a feeling of ownership, and a setting that offers all the tools necessary for success.

Supportive relationships rely on each participating party’s involvement to achieve the partnership’s objectives and capitalize on each participant’s assets. The effectiveness of cooperation is improved when all parties involved are conscious of each other’s capabilities and areas of specialization (Nkwunonwo, Whitworth & Baily, 2020). This enhances the efficacy of combined effort. Partner organizations must trust one another for continued cooperative efforts to be successful because reliable, dependable partners carry out their commitments, have common purposes and objectives, and are ready to be transparent and straightforward. Effective partnerships, which comprise routine, continuing, open discussions, teamwork, and planning, require trust and practical talks.

Emergency preparedness initiatives may start with collaborations between LHDs and other affiliate organizations. Numerous school systems now have health-related initiatives in place, such as campaigns to promote a healthy lifestyle, promote quitting smoking, and in some cases, raise awareness of STDs and illnesses (Bell et al., 2018). Developing collaborative preparedness measures for LHDs and school systems might benefit from building upon current partnerships and activities. Collaborations on preparation projects might take the form of co-writing plans, carrying out emergency drills and rehearsals, and equipping schools to serve as shelters or distribution points in times of need.

Pre-and Post-incident Pitfalls

People should be warned not to consume stormwater runoff after it has passed, nor should they use it to clean their dishes, brush their teeth, or prepare foodstuff. Affected individuals should wait until city officials have deemed it acceptable to return home following the evacuation (Yu et al., 2020). To determine whether their water is suitable for drinking and showering, everyone should abide by the local authorities’ water advisory notices. Furthermore, consumers must only consume and cook with purified, hot, or bottled water during a water warning. Traveling through flooded regions and stagnant water should be avoided as it might be problematic.

Conclusion

Floods pose a severe public health threat because they affect communities in diverse ways that ultimately impact their wellbeing and quality of life. This paper has reviewed some of the ways in which floods impact health directly. One significant health risk in the event of a flood is illnesses and epidemics. Waterborne infections, or those brought on by ingesting or coming into touch with polluted water, are one possible type of these. Diarrhea, cholera, scarlet fever, and leptospirosis are a few examples. The paper has effectively described some of the considerations unique to floods when assessed from the public health perspective.

References

Bell, J. E., Brown, C. L., Conlon, K., Herring, S., Kunkel, K. E., Lawrimore, J., … & Uejio, C. (2018). Changes in extreme events and the potential impacts on human health. Journal of the Air & Waste Management Association, 68(4), 265-287.

Cooper, A. (2010). Healthcare Incident Management Systems. Health care emergency management: principles and practice. Sudbury, MA: Jones & Bartlett Learning, 21-45.

Nkwunonwo, U. C., Whitworth, M., & Baily, B. (2020). A review of the current status of flood modeling for urban flood risk management in developing countries. Scientific African, 4(4), 785-792.

Paterson, D. L., Wright, H., & Harris, P. N. (2018). Health risks of flood disasters. Clinical Infectious Diseases, 67(9), 1450-1454.

Okaka, F. O., & Odhiambo, B. (2018). Relationship between flooding and outbreak of infectious diseases in Kenya: a review of the literature. Journal of environmental and public health, 4(5).

Bartholdson, S., & von Schreeb, J. (2018). Natural disasters and injuries: what does a surgeon need to know? Current trauma reports, 4(2), 103-108.

World Health Organization. (2019). Health emergency and disaster risk management framework.

Baskin, C. R., Barry, M., Cohen, R. E., Condren, C., Crosley, S., Dickhans, C. D., … & Schmidt, S. (2021). All Hands-on Deck: Local Public Health Agencies Leveraging the Incident Command System During Crises. Health security, 19(4), 364-369.

Yu, D., Yin, J., Wilby, R. L., Lane, S. N., Aerts, J. C., Lin, N., … & Xu, S. (2020). Disruption of emergency response to vulnerable populations during floods. Nature Sustainability, 3(9), 728-736.

Bukvic, A., Gohlke, J., Borate, A., & Suggs, J. (2018). Aging in flood-prone coastal areas: Discerning the health and wellbeing risk for older residents. International Journal of Environmental Research and Public Health, 15(12), 2900.

Mort, M., Walker, M., Williams, A. L., & Bingley, A. (2018). Displacement: critical insights from flood-affected children. Health & Place, 52, 148-154.

Jha A. K. Bloch R. & Lamond J. (2012). Cities and flooding: a guide to integrated urban flood risk management for the 21st century: a summary for Vietnamese policymakers. World Bank.

Healthcare Organization Assessment Essay Example

The role of healthcare organizations is providing treatment and preventive care services to patients and communities to improve their health. This can be achieved if healthcare services are delivered efficiently in organizations. Hence, Hence, healthcare organizations contain structures, rules, and regulations that enable efficient provision of healthcare services to populations. This essay aims to evaluate a healthcare organization based in the United States (US) and discuss its readiness for the future, strategic plan, potential challenges, and recommend an effective organizational model. Regular assessments help organizations prepare for the future since they enable them to discover current trends and incorporate them into strategic planning.

Cleveland Clinic Health System

Cleveland Clinic was founded in 1921 to operate as a nonprofit healthcare organization in the US. The organization is based in Cleveland, Ohio, but has other hospitals and healthcare centers in other states like Florida, Nevada, and Toronto. Furthermore, the organization has expanded to other states like the United Arab Emirates (UAE) and Canada. Cleveland Clinic has about 11 hospitals and universities in the US that train nurses and offer additional courses in medicine (Cleveland Clinic, 2022-a). It serves nearly 8 million patients in a year. It is ranked one of the best hospitals in the US because it improves healthcare outcomes. Cleveland Clinic is committed to enhancing the well-being of people living in America. It provides a range of healthcare services to patients and engages in community project to improve the health of populations in America (Cleveland Clinic, 2022-a). The organization supports diversity and inclusion by including healthcare professionals from minority communities into the workforce team. In addition, it supports research and innovation to foster improvements in healthcare.

Readiness Assessment

Readiness assessment is conducted to determine if an organization is ready for the future. The healthcare industry is expected to change because of the emerging trends. Therefore, healthcare organizations should be ready to tackle the incoming changes. One expected change in healthcare in the future is increased population diversity. Cleveland Clinic is ready to provide care to people from diverse groups because it fosters inclusion and diversify (Cleveland Clinic, 2022-b). The organization has also employed workers from diverse groups who will provide culturally competent care to people from minority groups.

Another trend in the healthcare industry is increased demand of healthcare services. A large proportion of the current population consists of aged people who require quality care because they are more likely to get infected. The organization is ready to address the increasing demand for healthcare services because it has employed enough healthcare professionals to provide quality patient care (Cleveland Clinic, 2022-d). It also supports nursing education to facilitate the training of future nurses who will meet the demands of populations.

Furthermore, there is rapid advancements of technology in the healthcare industry. In the coming years, hospitals will be using modern technologies to provide patient care to improve health outcomes and reduce medical errors. Cleveland Clinic is prepared to adopt new technology because it has invested in research andand innovations to facilitate improvements of technology (Cleveland Clinic, 2022-c). The use of modern technologies in medical care will improve the quality of healthcare services.

The other anticipated change in healthcare is the increasing cost of healthcare products and services. Healthcare costs are increasing overtime, and hospitals are forced to incur additional expenses to provide quality care. The organization is ready for the increasing cost of healthcare. It has adequate finances to serve large populations in the future (Cleveland Clinic, 2022-a). This, Cleveland Clinic is prepared for the future.

Strategic Plan

Strategic plans are important because they help organizations achieve their goals and solve challenges. Cleveland Clinic requires an effective strategic plan that will enable it to improve healthcare delivery in the country. The first strategic plan of the organization should be to increase its network. Organizations with more extensive networks can serve larger populations and establish partnerships with other organizations easily. The organization will increase its network if it expands its services to other regions (Cleveland Clinic, 2022-d). It will also provide a wide range of services to reach more people and increase its network.

The other plan of the organization should be improving nursing staffing There is a need to improve nursing staff in healthcare organizations because they is a high demand for healthcare services. Therefore, the organization needs to enforce measures to improve nursing staffing to prevent shortages and increase healthcare accessibility. To achieve this goal, the organization will support nursing education by providing sponsorships to encourage students to pursue nursing careers. Nursing education helps to increase the nursing workforce to meet the healthcare demands of populations (Beitz, 2019). In addition, the organization should establish a committee to ensure nurses are hired when the demand for healthcare increases.

Cleveland Clinic needs to work on improving patient satisfaction. Patients require safe and quality care to improve health outcomes. The organization will get more clients if it enhances the quality of its services to improve patient satisfaction. The organization will use modern technologies to provide care to improve patient satisfaction. Modern technologies like telemedicine improve patient outcomes because they help nurses to monitor patients after discharge (Ramaswamy et al., 2020). It will also hire qualified healthcare providers to achieve this goal.

Furthermore, the organization should include resource management in the strategic plan. There is a need to plan how resources are used in healthcare organizations because they are inadequate. Resource management will also ensure equal distribution of health resources in communities. In addition, it will improve human resource management associated with improved performance in organizations. (Gile et al., 2018). Cleveland Clinic health organization will ensure effective leadership and management in hospitals to regulate the distribution of health resources.

Potential Challenges Facing the Organization

Organizations in the healthcare industry are prone to challenges because of the ongoing changes in the system. An issue that is likely to affect Cleveland Clinic healthcare organization is the shortage of nursing workforce. The demand for nurses is expected to increase in the future because healthcare needs are increasing in populations (Beitz, 2019). Also, nursing roles are changing and nurses have to be enough in a hospital setting to perform all roles effectively. This problem can hinder the organization from improving patient satisfaction. Therefore, the healthcare organization should train and hire more nurses to meet the demands of populations.

Organizational Theory

For Cleveland Clinic healthcare organizations to implement it’s strategic plan, it should use an effective organizational theory to govern its structures and employees. The appropriate organizational theory that the company can use is classical organizational theory. This model uses a scientific approach in management. It emphasizes on division of labour to improve productivity (Helbig, 2018). It also emphasizes authority and responsibility. The managers at the top positions enforce rules and assign tasks, and employees at the lower positions execute the commands from above. This organizational model will help the organization address the shortage of nurses by ensuring a division of labour in hospitals to meet the demands of the population. Besides, it will improve leadership and management in the organization. This, Cleveland Clinic should adopt the classical organizational model.

Conclusion

Cleveland Clinic delivers long-term care to patients in all parts of the country. The readiness assessment reveals that the organization is prepared for the future because it promotes inclusion and diversity in its institutions and fosters the development of new technologies. Besides, the organization is training more nurses to increase its workforce to address the increasing healthcare demands in the future. Cleveland Clinic will succeed if it uses the classical organizational theory in leadership and management.

References

Cleveland Clinic. (2022-a). About Cleveland Clinic.https://my.clevelandclinic.org/about

Cleveland Clinic. (2022-b). Office of diversity and inclusion. https://my.clevelandclinic.org/about/community/diversity

Cleveland Clinic. (2022-c). Research and innovations. https://my.clevelandclinic.org/research

Cleveland Clinic. (2022-d). Quality & patient safety institute. https://my.clevelandclinic.org/departments/patient-experience/depts/quality-patient-safety

Beitz, J. M. (2019). Addressing the perioperative nursing shortage through education: A perioperative imperative. Association of periOperative Registered Nurses (AORN) Journal, 110(4), 403-414. https://aornjournal.onlinelibrary.wiley.com/doi/abs/10.1002/aorn.12805

Gile, P. P., Buljac-Samardzic, M., & Klundert, J. V. D. (2018). The effect of human resource management on performance in hospitals in Sub-Saharan Africa: A systematic literature review. Human Resources for Health, 16(1), 1-21. https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-018-0298-4

Ramaswamy, A., Yu, M., Drangsholt, S., Ng, E., Culligan, P. J., Schlegel, P. N., & Hu, J. C. (2020). Patient satisfaction with telemedicine during the COVID-19 pandemic: retrospective cohort study. Journal of Medical Internet Research, 22(9), e20786. https://preprints.jmir.org/preprint/20786?__hstc=102212634.d5e31758ab40436fd3f14668be870bdf.1661323705118.1661323705118.1661323705118.1&__hssc=102212634.1.1661323705122&__hsfp=305935853

Helbig, J. (2018). Reengineering health care management. In Grand Canyon University (Eds.), Nursing leadership & management: Leading and serving. https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/#/chapter/5

Changes In Hellenistic Kingship Sample Assignment

Macedonian kingship increasingly changed in the period after Alexander the Great’s death, throughout the course of this essay Macedonian kingship under Philip II and Alexander will be discussed. Subsequently, an analysis will occur regarding the Diadochi and their heirs drawing comparisons and differences throughout the period. Particular attention will be paid to Ptolemy of Egypt, primarily due to his moves in becoming the first Diadochi to realise the future of the empire lay in smaller kingdoms.[1] This essay will also analyse the Macedonian army, its role in the stability of monarchical rule, as well as, its development into a body able to exert power even over Alexander.[2] The argument that will be shown throughout the course of this paper will be that; initially the Diadochi struggled to muster up power or authority able to resemble Alexander or Philip, however, throughout their reigns steps were taken to impose not only absolutism, but also divine rule. With further changes resulting from the abandonment of one ‘sown success upholding loyalty in the military a nd instead creating links to those proceeding in a bid to obtain legitimacy.

Philip and Alexander

The reigns of Philip and Alexander were exemplary, both not only expanded Macedonian holdings and wealth, but they improved and used their armies in a manner so efficient that they gained hegemony in the Hellenistic and Asian worlds respectfully. However, the two reigns although complimentary are quite different. Philip’s aims, and successes were modest, “his use of the League of Corinth was successful, basing it on the military force of the Macedonian kingdom, as well as on Greek diplomatic practices and inter-state agreements, which were familiar and acceptable to the Greeks.” Which in turn allowed Alexander to retain control after his father’s death.[3] This shows not only Philip’s ability to exert force as efficiently as his son, but also the diplomatic skills that Alexander seldom used. Philip’s aims are somewhat contested, Historians have limited them to mere Greek subordination to prevent Athenian naval attacks, whilst others have attributed the release of occupied Greek polis in Asia Minor as his goal prior to his death.[4] Whilst an answer to this cannot be definitively stated one can agree he achieved a substantial amount whilst on the throne, arguably being the cause for Alexander’s capture of Asia, without the developments of Philip Alexander would have struggled financially and militarily in Persia. Philip unified Macedonia, which for centuries had been divided, he inflicted defeats on the Illyrian and Paeonian tribesmen to the west and north. Furthermore, he captured the Greek fortress of Amphipolis, which meant control of gold-rich Mt. Pangaeus. Philip’s objectives through this were threefold: Protection from Macedonia’s external enemies, increase wealth, and to give experience to Philip’s reorganized army, having established the first heavy infantry phalanx[5]

Alexander appeared to be continuing his fathers’ work, however, when Darius was killed and the Persian Empire seemingly in Alexander’s possession, his decision to continue Eastward appeared to be conquest for conquests sake, an opinion expressed by his men in their refusal to march further. This was to be the first time the Macedonian army challenged their king, but by no means the last.[6] Alexander’s death followed not long after this battle of wills, it is this situation that the Diadochi inherited their positions. In a period of unprecedented Macedonian success, but also in a time when army moral was low, and their opinion meant everything. Whilst Philip, similar to Alexander, did not leave a clear heir he at least had sons able to vie for the throne. Alexander, knowing the position of king rested on the army’s acceptance was able to invoke their support and remove potential threats to his position, including brothers.[7]

The Diadochi however were unable to adhere to the model of kingship illustrated by Alexander and Philip, with none able to present themselves as a dominant enough figure to claim the empire nor coerce their contemporary’s loyalty to them.[8] What was left then was an empire in turmoil, an army facing an identity crisis and a plethora of potential heirs both familial and not hoping to lay claim to the conquest of Alexander. The situation was made worse by Alexander’s inability to leave an idea of who he wished to rule, his unborn child was a possibility, however, it may have been born a girl. Although it was not, I would still need a regent until it matured. His brother, later to be Philip III was mentally defect, whereas Antipater had a substantial support base in Macedonia, Craterus had 10,000 veterans on their way home, as well as the army’s loyalty, whilst Perdiccas possessed alexander’s signet ring.[9] What is being shown here is the confusion and nearly insolvable problem of inheritance in 323BC.

What this culminated in was a generations worth of fighting and an eventual seventeen years before any of the Diadochi would proclaim themselves king, of which Antigonus was first, with the rest following suit. Before this occurred, however, Alexander’s empire had been divided and his family killed leading to a new period of Hellenistic monarchies which despite numerous geographical changes were similar to Alexander’s model of kingship.[10]

The Macedonian Army

Regarding the army, after Alexander’s death they imposed their rule over the successors gaining a dual monarchy between Alexander IV and Philip III, of which the army supported the latter. Furthermore, despite Perdiccas’ favourable position in 323, by the end of his disastrous campaign in Egypt he was killed by his own troops. What is interesting to note is not only Ptolemy’s use of financial incentives to win over Perdiccas’ troops loyalty but also that this event marked the culmination of army discontent into a developed mutiny ultimately changing the balance of power in the Hellenistic world.[11] The model of Macedonian kingship under Philip and Alexander was based on military support, this too was true for the Diadochi, what changed however was the army’s perception of itself. During the reign of Philip, the army was a national body, intensely loyal to king and country. [12]However, throughout the conquest of the Persian Empire this changed, the troops were far away from home with most never to return. Furthermore, many had married Asian wives or were Asian mercenaries themselves, this led to growing individualistic, not nationalistic, views among the troops, without the personal charm of Alexander nor his impressive feats to remind the troops why they follow him Perdiccas was unable to retain control and paid for it.[13] A fate Eumenes would also suffer due to the military changes throughout the 4th century B.C.E. Further exacerbated by his failure to protect his troops baggage train, leading to the Silver shields, a battalion of Macedonian veterans to lose faith in his command, eventually capturing him and handing him over to Antigonus. Therefore, as Edward’s notes “by Triparadeisus the army assembly had evolved from its traditional role as a means for the monarch to disseminate information to a body choosing kings, condemning traitors, appointing regents, and even on occasion making policy decisions”[14]

What can be concluded thus far is that the Diadochi similar to Alexander and Philip needed the support of the military to ascend to the throne, what is different however, and which is something the Diadochi could not control is that the army’s perception on its role changed, they were not only willing to remove support, but they were willing to kill those who fell from favour, intensifying the already difficult position in the Diadochi’s attempts at power snatching. Where they failed in regard to Philip and Alexander was to unify a region or achieve feats that were astonishing or beneficial enough to the troops to command their respect in the way Philip and to a less successful extent, Alexander was able to do.[15]

Limited Aims

As noted, the differences between the Diadochi and Alexander’s kingships were cemented when each successor realised they would not rule over the entire empire of Alexander, although the Seleucids did certainly attempt it. Ptolemy was the first to establish limited aims, contenting himself with Egypt, perhaps the wealthiest and most self-contained region in the Empire. Furthermore, in choosing Egypt Ptolemy placed himself in a region were royalty and divinity was intertwined, whether he travelled to Egypt with Alexander is uncertain, although likely, regardless it is probable that Ptolemy’s acquisition of this region was to cement the view he was semi-divine, a goal he arguably obtained from Alexander and Philip, this, however, will be discussed in depth later.[16]

Evidence for Ptolemy’s limited aims, and in turn his divergence from the model of kingship developed by Phillip and Alexander, was in his reluctance to take Perdiccas’ position after his death. Instead at Triparadeisus he merely sought total control over Egypt.[17] Furthermore, any action taken to expand his holdings was for the betterment of his kingdom, not the reunification of the Empire, with Syria and Cyprus being his two areas of contention throughout the period before Roman annexation of the peninsula.

This limited position was somewhat unanimous after 306BC with each successor actualising themselves as kings it was no longer an attempt to regain the lands of Alexander but simply a bid to gain internal support and expand lands and wealth when available, with no figure emulating the skill or conquests of either Alexander or Philip. Rather, each Diadochi contented themselves with their holdings after Ipsus, and the Epigoni continuing this tend and cementing their fathers, as well as their own, claims to the new Macedonian kingdoms.[18]

Concluding this segment, it was intelligent of Ptolemy and his contemporaries to focus on smaller regional kingdoms, the price of admission to the throne, indeed any throne, is success. By limiting one’s concern to a smaller region, particularly one as self-contained as Egypt allowed Ptolemy to streamline his internal affairs, increase the grandeur of his capital city and conquer modestly when he could. Indeed, Ptolemy’s reluctance to enter combat frequently is perhaps a key component to the longevity of his dynasty. What this means, however, is that the expansive and aggressive policies in Philip and Alexander’s kingships was not continued by the Diadochi nor the Epigoni marking a decisive end to the model set forth by the formers actions.[19]

Divinity

The analysis of divinity will concern Alexander, Philip and the Ptolemaic dynasty with each figure taking controversial as well as public steps to connect themselves to the Gods, if not presenting themselves as one entirely. Whilst Philip was somewhat subtler in his portrayal of his divinity, he most certainly took steps to denote his connection to the Gods.[20] Prior to his death Philip’s ceremony seen him stand among the twelve Gods of Olympus, with the sacrifice given to them in turn being given to him. This desire for divinity also fuelled alexander, believing himself to be a descendant of Hercules, and later accepting the title of son from the oracle of Zeus Ammon. Whether throughout his intensely successful campaign Alexander believed this or not is difficult to distinguish, he did, however, introduced the practice of Proskynesis, a custom which to Greeks symbolised divinity, but to the Persians merely showed the prostrating individual’s lower rank. Whether this was Alexanders attempt to actualise his divinity is questionable with him refusing to enforce it upon his peers due to the negative reception it received.[21]

What is certain is that after Alexander’s death whether divine or not his body was symbolically important enough to illicit conflict between Perdiccas and Ptolemy. Where Alexander sought to be buried is unknown and to a large extent irrelevant. He was buried in Egypt and through this the Ptolemaic dynasty was able to associate and legitimise itself with Alexander’s remains, legitimately obtained or not, the army and followers of Alexander were aware he rested in Alexandria and that gave Ptolemy credibility. Taking steps to convert Alexandria to the capital (moving it from Memphis) further cemented the ties between the two dynasties. Furthermore, being the first Diadochi to place Alexander’s head on a coin, a place typically reserved for Gods, enhanced the position of Alexander and with it the son of Lagos.[22]

Regarding Ptolemy’s divinity, this cannot be attributed to himself, rather his son and grandson. The Egyptian Epigoni took great steps to convey Alexander and Ptolemy as Gods. What is important to note, however, is Ptolemy’s divine standing amongst his Egyptian subjects, the actions taken by Ptolemy II and III were for the benefit of their Greek subjects. In 280 BC Ptolemy II instituted an official worship of his father as a God and established the notion that the king became a God after death. “Ptolemy had now established the final principle that the king was during his life officially the god of all his subjects, both Greek and Egyptian; after this each succeeding Ptolemy was officially a god during life, and each royal pair became incorporated in the State worship, with Alexander at its head.” What occurred then was the actualisation of Alexander’s goal, divinity actualised, and the connection of Ptolemy and Alexander. [23]

What this meant for the Epigoni in Egypt was that they had somewhat abandoned the model of Macedonian kingship of Philip, Alexander and even the Diadochi. Whilst the former two reigned and obtained based solely on their own success, the Diadochi, particularly Ptolemy relied on Alexander as well as his limited success at expansion to reign and succeed in legitimising his reign.[24] Where the Epigoni diverge is the removal of their own personal successes and limited expansion abroad, relying on the leaders of old and connecting their rule to the will of the Gods not on the success that was essential for the people and the army in particular to follow Alexander and to a lesser extent the Diadochi.[25]

What is interesting is that this practice was not ubiquitous. In294 BCE when Demetrius seized the Macedonian throne he did not invoke the memory of Alexander but rather Antipater who had served the Macedonian people loyalty whilst Alexander sought personal glory in Asia. What is essential to note is that Alexander left Macedonia at the age of twenty-two, with him he took the physically fit men of the country, the backbone of the countries economy, impacting it irreconcilable.[26] What Alexander had done to Macedon was not gaining it international recognition but to weaken its economy divide families and eventually leave it in turmoil and repressing expensive wars with Greece after 323BC. As Bosworth notes “. The hero of Macedon was Philip, who had built his country’s supremacy. His son had squandered that inertance”[27]

Conclusion

As has been illustrated the Macedonian kingship did indeed change throughout the reign of Philip, Alexander, the Diadochi and the Epigoni whilst Philip was a uniting figure having gained the support and adoration of the Macedonian people which Alexander used initially and expanded upon both developed the army and aims of the Macedonian people. What the latter did, however, was to push the army too far both geographically and emotionally, he created an aggressive army willing to stand up to those in charge and remove support haphazardly to better themselves. What this established was a difficult situation for the Diadochi to contend with each other, creating limited objectives and a return to smaller kingdoms working to retain success to keep their thrones, this success however did not mean conquest but stability. With the Epigoni done was bastardise the lives of their fathers, with the Ptolemaic dynasty turning men into Gods to cement their legitimacy at the expense of seeking success which was the model of kingship of the reigns of old.

Bibliography

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  3. Bosworth, A.B. (2005) The Legacy of Alexander: Politics, Warfare and Propaganda Under the Successors, Oxford: Oxford University Press.

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  14. Lewis, D.M. ‘The Cambridge Ancient History’, 2(6): The Fourth Century BC (Cambridge, Cambridge University Press,1994), p 37

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  17. Samuel, A.E (1988) ‘Philip and Alexander as Kings: Macedonian Monarchy and Merovingian Parallels ‘, The American Historical Review, 93(5), pp. 1270-1286.

  18. Tarn, W.W. (1928) ‘Ptolemy II’ The Journal of Egyptian Archaeology, 14, (¾) pp. 246-260

  19. Walbank, F.W. (1982) ‘Sea power and the Antigonids’, in Adams, L.W. and Borza, E. N. (ed.) Philip II, Alexander the Great and Macedonian Heritage. Washington: University Press of America, pp. 213-236.

  20. Wheatley, P (1995) ‘Ptolemy Soter’s Annexation of Syria 320 B. C. ‘, The Classical Quarterly, 45(2), pp. 433-444.

  21. Worthington, I. Philip II of Macedonia (Yale: Yale University Press, 2000), p. 13

[1] A.R. Burn. (1959) Alexander and the Hellenistic Empire, London: The English University Press.p.254.

[2] M. Edward. (1991) ‘The Evolution of the Macedonian Army Assembly ‘, Historia, 40(2), pp. 230-247.

[3] S. Perlman. (1985) ‘Greek Diplomatic Tradition and the Corinthian League of Philip of Macedon’, Historia, 34(2), pp. 153-174. P.174.

[4] Ellis, J.R. (1982) ‘Phillip and the Peace of Philokrates’, in Adams, L.W. and Borza, E. N. (ed.) Philip II, Alexander the Great and Macedonian Heritage. Washington: University Press of America, pp. 43-59.

Samuel, A.E (1988) ‘Philip and Alexander as Kings: Macedonian Monarchy and Merovingian Parallels ‘, The American Historical Review, 93(5), pp. 1270-1286.

Burke, E.M. (1983) ‘Philip II and Alexander the Great ‘, Military Affairs, 47(2), pp. 67-70. P. 67.

[5] Burke, Philip and Alexander, p.70.

[6] E.M.­­­­ Anson. 2013) Alexander the Great: Themes and Issues. QCAT [Online]. Available at: http://encore.qub.ac.uk/iii/encore_qub/record/C__Rb2064135__Sanson__FffacetavailabilityzzOnline__P02__Orightresult__U__X4?lang=eng&suite=qub (Accessed: 14th April 2018). P.230.

[7] Samuel, Philip and Alexander as Kings, p.1273.

[8] A.B. Bosworth. (1986) ‘Alexander the Great and the Decline of Macedon ‘, Hellenistic Studies, 106(1), pp. 1-12. P.3.

[9] A.B. Bosworth. (2005) The Legacy of Alexander: Politics, Warfare and Propaganda Under the Successors, Oxford: Oxford University Press.

[10] Errington, R.M. (1970) ‘From Babylon to Triparadeisos: 323-320 B.C’, Journal of Hellenistic Studies, 90(1), pp. 49-77. Pp. 62-73.

[11] King, C.J. (2013) ‘ALEXANDER’S DIADOCHS AND THEIR DESTRUCTIVE WARS ‘, The Classical Journal, 108(3), pp. 362-368.

[12] Worthington, I. Philip II of Macedonia (Yale: Yale University Press, 2000), p. 13

[13] Ellis, Ptolemy, p.125.

[14] Errington, Babylon, p.76.

[15] Lewis, D.M. ‘The Cambridge Ancient History’, 2(6): The Fourth Century BC (Cambridge, Cambridge University Press,1994), p 37

[16] Fredricks-Meyer, E.A. (1990) ‘Alexander and Philip: Emulation and Resentment’, The Classical Journal, 85(4), pp. 300-315. Pp. 313-315.

[17] Cuthbert, L. (1917) ‘The Diadochi and the Rise of King-Worship ‘, English Historical Review, 32(127), pp. 321-334. Pp. 330-332.

[18] Bosworth, Legacy of Alexander, p.136.

[19] Ellis, Ptolemy, p.88.

[20] Burke, Philip and Alex, p.69.

[21] Anson, Themes and Issues, p.101.

[22] A. Erskine, (2002) ‘Life after Death: Alexandria and the Body of Alexander ‘, Greece and Rome, 49(2), pp. 163-179.

[23] W.W. Tarn, (1928) ‘Ptolemy II’ The Journal of Egyptian Archaeology, 14, (¾) pp. 246-260. P.248.

[24] P. Wheatley, (1995) ‘Ptolemy Soter’s Annexation of Syria 320 B. C. ‘, The Classical Quarterly, 45(2), pp. 433-444. Pp. 441-4.

[25] F.W. Walbank, (1982) ‘Sea power and the Antigonids’, in Adams, L.W. and Borza, E. N. (ed.) Philip II, Alexander the Great and Macedonian Heritage. Washington: University Press of America, pp. 213-236. P. 222.

[26] Erskine, Life after Death, p.172.

[27] Bosworth, Decline, p.11.