Disaster Preparation, a multi-media retrospective.

            As this post is being written, a storm that is being called “the most powerful typhoon ever” has made landfall in the Philippines, while the Midwest is cleaning up from a band of deadly tornadoes.  This blog will not debate the link between climate change and hostile weather patterns, rather it will attempt to discuss some of my personal experiences with my recovery efforts following two large natural disasters. 
          While there are obvious steps that can be taken to prepare for any disaster, we cannot stop the wind, water, fire, and hatred from taking their toll.  I have found that what we really need to address is the actions that we as caregivers provide once the storms have passed and the victims are left to pick up the pieces of their lives.

My Disaster Relief Background

            I was touring the country with an automotive group when Hurricane Katrina decimated the a couple hundred miles of Gulf of Mexico coast land. A couple of weeks after the storm we were setting up our show in the Atlanta convention center,  when we were told that 100’s of buses filled with evacuee’s from all over the coast would be arriving there in the morning.   Our small group of corporate trainer-types were overwhelmed by the massive triage effort and lack of resources that were in place to provide support for this huge wave of stone faced victims who were now hundreds of miles from their devastated homes.

            As soon as this tour was over, I loaded my car full of tools and a tent and drove down to Mississippi with no actual destination.  My rationale included the fact that I had just bought my first house, and if some big wave smashed it to bits, I would love to see someone come help me out.  Four weeks after the storm, The Red Cross was not accepting volunteers who they had not trained, and Habitat for Humanity was not ready to make a move because the damage and the chaos was still too overwhelming for them. 

Importance of the POD in the disaster area.

In cases where a large area of the infrastructure has been damaged, i.e. downed power lines, the establishment of a Point of Distribution or POD is of paramount importance.   The POD can be defined by the needs of the scenario, but the main purpose is to get urgently needed supplies to victims in a timely manner.

I found two women and a man running an independent POD in a strip mall that had the only electricity remaining in the area.  I asked them if they needed any help, and they accepted immediately. "The Line" that they were operated was open early and stayed open until 5:00 each day. Cars drove into their parking lot that was filled with military tents and semi trailers, and if we had what the locals asked for, they were given it. Bleach was a hot item for killing black mold, there were also giant pallets filled with diapers, crates full of tampons, cat food, batteries, you name it, people were in need.  This video was created about five weeks after the storm, we edited during the night once the POD shut down, and the response was more than we could have expected. By the time this was posted, the rest of the country thought everything was "back to normal" in the gulf, and it was anything but.

 If you see a need, fill it.

            A very tangible roll of a nurse is the provision of care and support following a natural or man made disaster that may not have resulted in loss of life, but wide spread property damage.   While my original intention was to help with construction, as I had no interest in any sort of “patient centered care” at that time, I soon found that doing something as simple as listening to these peoples “storm stories” was providing some much needed patient care.  Finding yourself in a disaster area provides the perfect outlet for critical thinking as the needs, the people and the environment and the politics are constantly changing.

       The possession of some"situational awareness" (SA) that is required in these scenarios is a great benefit to the individual hoping to find the best fit for his or her abilities.  One night I saw a man stalking around the closed POD and I could see that he was carrying a weapon, but I could tell by the way he was carrying himself, he was not intending any harm.  When i approached him and asked if I could help him out and if he was aware of the sundown curfew, he identified himself as a cop, and he was only looking for diapers and some formula for his newborn.

Environmental Dangers:

      45 days following Katrina’s landfall people were still dying, all over the place. We heard of a mother who had returned to the site of her home to pick through and collect any belongings. This young woman apparently scraped herself on some debris and the resulting infection killed her less than a day later.  While initially we assumed this was just rumor, this sort of fungal infection again began appearing in Joplin after the F5 tornado of 2011, striking down several relief workers who were injured while clearing debris. (CDC, 2013).

Dexter Michigan lost 68 homes in about 10 minutes.

Angela Cesere | AnnArbor.com

       When you see someone filling a gas can, make sure that they know not to put their portable generator in the garage.  When you see someone with a chainsaw, make sure to tell them to use chaps and eye protection.   When the Dexter tornado arrived in 2012 I took an afternoon to go clear downed trees and debris with my little chainsaw.  What I learned about storm-twisted, yet still-standing timber was that this type of tree is very unpredictable and dangerous to cut.  The winds put a tremendous amount of torque on the trunk, and providing the relief with the saw is a very hazardous task.  There was a father of two was missing for a few days after Katrina.  He was last seen heading back to his home with a chainsaw to clear some of the fallen trees.  After two days with no word from him, some friends went looking for him only to find him dead beneath the first tree that he was trying to cut down.

Caregiver strain

      As the weeks and months dragged on following Katrina, I could see the psychological and physical strain that this work was putting on the people that ran the POD.  The story cycle of the mainstream press will leave something as huge as Katrina behind in less than two weeks,  but the time-scape inside the disaster area seems endless, it is very blurred, where days run into nights and the workload becomes unfathomable.   As a nurse it is imperative to look for the signs that relief workers or volunteers have reached the point of exhaustion and may need some time back "on the surface" where they can reconnect with their families and normal life as we know it.
       While I would not consider it a clinical case of PTSD (post traumatic stress disorder), what I felt when returning to the normal nest egg that is Ann Arbor after three weeks in oblivion, was a feeling of deep guilt and depression.   I had a hard time with the transition (yeah, I went there) back to my "old normal", when what I knew to be going on down there was so far from being resolved.  I probably could have used some help getting my head around the entire experience, and in reality, none of it even effected me: my house was still standing, I didn't have strange acne-like welts on my back... I knew where all my "things" where, so why was I affected?   Its a mind-f*%k that I still revisit, even while writing this blog thing, eight years later.

      The residents themselves are in a state of shock that you may not be able to comprehend.  It is very important to not judge a home owner who is not willing to or able to pick up a tool to help you clean out, or even rebuild his or her own home.  The mental strain of "loosing everything" is often too much of a burden to overcome, and the assistance that a volunteer work force provides may be the only thing that brings this type of wounded survivor back from the brink.


Beware of Fraud:

   I got to camp in the yard of an elderly Mexican woman who’s home was thoroughly rinsed out, but not destroyed by the surge that flowed up the Pearl River. She was adamant about introducing me to a man who was running an volunteer operation a few blocks from her home, his name was Peter, and this was the operation he was in charge of.

        He seems like a nice enough guy, right?  Well, a few weeks after this video was posted Peter fled the Gulf with a large amount of the PDA's money. Not to be misunderstood, the PDA was and still is a valid charity doing good work, they just selected the wrong individual to run this particular camp. It was a little shocking how many strange goings on were unfolding once money started flowing into the area.
       One of the weirdest indicators of the money train that followed the subsiding water was the story of the I-Care village, erected by Merrill Osmond, yes, of the Osmonds.  I was sent there the first night I arrived on the scene because they had a place for me to stay, but before i could sleep, I hung a bunch of drywall inside of this massive circus tent-like structure.  The reason for this housing complex was not to shelter newly displaced locals, but to house volunteers that would be paying Donny Osmund's brother something like 20 bucks a night to stay in his massive tent.  Needless to say, about six months later, there was no sign of the Morrell Foundation's I-Care Village in Buccaneer State Park.
    The bottom line is, do your homework, and most of all, listen to your gut.  If the people your are working with seem weird, they probably are. The stories of non-profits taking advantage of generous gifts is sickening, like this one about "Camp Coastal" 

When the Dust Clears.
        As things slowly improve (and I cant emphasize how slow the progress can be), eventually it is time to rebuild and move past the devastation.   There are still plenty of opportunity's for an RN months and years into this rebuilding process, because just like a traumatic injury, the wounds that the people people you meet, be it mental or physical will need a great deal of rehabilitation and and attention.  When the volunteers start using power tools, and working on ladders, there are plenty of opportunity's for physical injury, as well as dehydration.
         One House At a Time, or OHAT was an upstart non-profit that wanted to start building small homes far earlier than Habitat for Humanity was willing to. I was drawn to Glenn Locklin and his struggle in Pearlington, and this tells a lot of that story.

    Team Rubicon
      Following the earthquake in Haiti, a group of veterans formed to assist in disaster relief much the same way that they would deploy for a military mission. Team Rubicon was named after an historic campaign of Julius Ceasar, when they ventured into Haiti against all warnings.  These guys are the real deal, and one of the main reasons that I pursued this RN degree, because they will only take trained professionals. Take a look at their flowchart and try to poke a hole in their philosophy!

 

courtesy of http://teamrubiconusa.org/about/

      So, in conclusion,  get a bag packed, and go help some poor bastards out, it will change your life.