Since the early 1980s, Associate Professor Griggs has been involved directly or peripherally in the medical response to a number of mass casualty events/disasters. All of these have led to 'lessons learnt' and, more importantly, lessons subsequently applied. The National Crime Authority (NCA) bombing in 1994 was an unexpected early brush with terrorism. A circus stand collapse in Cleve, in rural SA, in 1996 initially produced the challenge of dealing with '200 casualties' in a remote location. The first Bali bombings in 2002 exposed major gaps in our national plans, requiring ad hoc responses. These first bombings also indirectly resulted in the creation of the National Critical Care and Trauma Response Centre in Darwin, which has developed a leadership role in training, standards, and response internationally. By the second Bali bombing in 2005, the lessons learnt documented from the earlier bombing largely served as a template for the response.

The magnitude of the Indian Ocean tsunami in 2004 created a new level and set of challenges and produced another set of learnings. In 2009, some of these lessons were applied in the Australian support to another tsunami, which struck Samoa. In the meantime, various international organisations, including the World Health Organisation, the United Nations, and the International Committee of the Red Cross, have developed international standards and systems to improve coordination between governments and NGOs. In particular the cluster system has proved vital. This integration was evident in the recent response to Vanuatu following Tropical Cyclone Pam. However, a new issue that is just appearing is a possible loss of flexibility as plans become more and more complex.