The following is a guest post from Whitney Zatzkin, Policy and Advocacy Manager at the American Association of Colleges of Pharmacy. A member of the Coalition for Health Funding, she attended a Congressional briefing on the role of public health in disaster recovery on September 12, 2011. More information on this and future events is available through the Coalition for Health Funding.
Disaster Recovery – After the Cameras Leave
The public was captivated when news crews descended upon New York City for the September 11 attacks, the Gulf Coast for Hurricane Katrina, Joplin, Missouri for the tornadoes and, most recently, along the East Coast for Hurricane Irene. But what happens after the cameras leave?
On Monday September 12, 2011 the Coalition for Health Funding hosted its seventh annual Public Health 101 briefing. The event featured Dr. Isaac Weisfuse, Deputy Commissioner for the New York City Department of Health and Mental Hygiene, Clayton Williams, Assistant Secretary for Public Health for the State of Louisiana Department of Health and Hospitals, and public health systems researcher, Dr. Jerry Suls, Professor and Collegiate Fellow at The University of Iowa.
“Gadgets only get you so far, staff is critical.”
So much of disaster response and recovery is fast adaptation and planning for the unanticipated public health response needs. Dr. Weisfuse spoke of the flames, days after 9/11, shooting 20+ feet in the air as workers moved beams for clean-up and of the health cleanliness recertification developed for restaurants and delis to address the places where breakfast was left on the table for weeks. Many anthrax scares followed 9/11 but the first case wasn’t confirmed until October 12th 2011. This slide from Dr. Weisfuse detailed that confirmed anthrax case – tracing the letter through NBC studios in an investigation that revealed that the NYC subways were, in fact, that dirty. And who knew they used fax machines for cleaning exposed documents for disposal? He closed emphasizing the significance of training, education and multi-layer communication for all stakeholders and highlighted the critical role for public health staff saying, “gadgets only get you so far, staff is critical.”
“We need a solid base in public health. That means people, and that means money.”
Mr. Williams brought the conversation to the recovery tasks following the BP Oil Spill, establishing seafood safety strategies and creating “the MOST certified seafood out there!” through the work of his team in Louisiana. His efforts there focused on “Rescovery,” merging response and recovery programs so disaster recovery programs (exposure screenings) are hosted INSIDE the established local response facilities (community health centers or shelters). Furthering the comments from Dr. Weisfuse, Mr. Williams cited that protocols in New Orleans once detailed that only the Public Health Director was left in the government health offices in its disaster plan. That one person was not enough when response was needed particularly post-Katrina when many colleagues within the Department of Health met the Public Health team for the first time. Emphasizing the important investment needed to build solid relationships with key stakeholders before the disaster happens, not after the incident, he commented, “We need a solid base in public health. That means people, and that means money.”
“We need money for research, staff and for outreach [programs].”
Closing the panel, Dr. Suls reflected on the important research around mental health and the challenges of rebuilding feelings of positivity in a community following a disaster. Not surprisingly, the biggest sources of stress following a disaster are employment, parenting and finances. Research demonstrates that people become more pessimistic following a disaster and they turn to pessimism-boosters, like alcohol and smoking, to find quick stress relief. Dr. Suls further explained that when pockets of optimism exist post-disaster, the feelings are often rooted in the idea that something like that would never happen to the community again and result in an increased number of people that stop being prepared for future events. In some cases, the optimists will even go so far as to not respond to local alerts and warnings to evacuate during the next hurricane or ignore alarms to seek shelter during a tornado. “If you have an immunization for something and no one uses it, you didn’t make an impact,” he said, adding, “We need money for research, staff and outreach [programs]” to make an impact.
Innovation in Public Health and Recovery Response
New York City was overwhelmed by the outpouring of support after 9/11. Volunteers flooded the area and officials sent the volunteers to donate blood when they found themselves over staffed. Quickly, blood donation centers were overwhelmed with donors and volunteers were left standing. The public health community developed new strategies to inform national volunteer deployment strategies and created the Medical Reserve Corps, to verify medical volunteers and deploy them successfully following emergencies.
Evolution in Public Health and Recovery Response
In her Congressional Statement for the Record this past May, Heather Blanchard, co-founder of CrisisCommons, cited the findings of an American Red Cross report and new levels of expected disaster response, “during an emergency… 55% [of respondents believed] help would arrive in less than 30 minutes if they posted a request for help on a social media website.” At the hearing, those in charge of disaster response stated how tweets and other web reports were an unmet need during past responses and that staff training, as well as new communications and new solutions, were needed. The public health and first responder communities are testing tweet-based deployment response and HHS and FEMA worked with Health 2.0 to issue an Application Developer Challenge to create a Facebook application to track a community following a disaster, communicate needs and verify safety. The need is growing for mobile platforms and effective response after an emergency, yet many agencies not only do not have the staff to support new media use but often staff cannot even access the websites.
Despite funding reductions at federal and state levels in recent years, the federal expectations and demands for public health emergency preparedness and response has increased.
In a letter to federal appropriators on August 25th, 70 member organizations from the Coalition for Health Funding asked Congress to recognize the needed investment in public health funding, detailing the 44,000 state and local professionals already removed from the public health workforce after recent budget reductions while citing the strong ROI of public health programming. Furthering the need, people in need are expecting and demanding more from government agencies and national response units to coordinate relief when disasters happen and turning to new resources and new communications to ask for help, expecting response.
We need to strengthen the capability of public health disaster preparedness and response now, before the next disaster, through staffing, training and research. Only then can we take efficient, effective programs to the places people are already turning to for help and offer recovery support.