A disaster creates disruption and threats to life and society, mental anguish, and leads to feelings of instability around such areas as security and safety. It causes suffering and requires assistance from experts within a structured and tested response framework. After 11 September 2001, the demarcation between disasters caused by natural hazards and terrorism virtually disappeared. The two now get treated concurrently, but there is a danger that anti-terrorism might hijack the agenda, overshadowing important work that must be done in the field of disasters caused by natural hazards. With this in mind, the Health Emergency Management Unit in South Australia was born. The unit was established for preparedness planning around the growing concerns of the potential for an impending pandemic caused by avian influenza. From those shaky beginnings, South Australia now has a dedicated and trained team. The unit provides a 24/7 health responses to planned events and unexpected incidents caused by natural or deliberate forces that may occur in the region. It also participates as part of the National Disaster Deployment Program. Currently, the unit is focused on risk reduction and increasing resilience by implementing a sound, comprehensive approach including all elements of prevention, as well as preparedness, response, and recovery strategies. The unit also provides an extensive education, training, and exercise program to health facilities across South Australia. This paper will describe the ongoing journey of the unit, how it works and interacts with all levels of health service staff and other emergency services, and some of the recent events and incidents in which it has been involved in within Australia and overseas.