Unmet Need for Information during Emergencies

"Difficulties are meant to rouse, not discourage" - William Ellery Channing

One thing you can count on during an emergency is terrible communication. During the NorthEast Blackout of 2003 I listened to a radio in my office in New York City to learn if Metro North train service was restored. I slept at the office and again waited the next morning for news of trains running. My wife was more reasonable. She called to say her friend could see trains moving with people. She instructed me to forget the "official reports" and get my butt to Grand Central Terminal and take any train leaving the city. I did and found that although GCT had no power, diesel trains were running and conductors were informing people which trains went where via megaphones. I got home but not with any help from news reports.

On another occasion I played a victim in a drill for a Sarin gas attack. Boom, the pretend bomb goes off. Then we wait and wait. Firemen come and go. Two persons in Bio hazard gear peak in a window but never say a word. Two hours after the bomb we can see shelters being raised and much activity but no one has gives the victims any instructions except for "say put". In real life those of us who could move would have fled the scene by then.

"Disaster victims need information about their options in order to take any meaningful choices about their future, " according to a recent article by the BBC World Trust Service. As the physical and psychological needs of disaster survivors change over time, information needs change also.

First Stage - Survival

1. Victims need to know what happened
2. How to get immediate survival needs satisfied
3. What has happened to family members and friends?

Providing these answers decreases panic and increases survivor capacity to take action. But the infrastructure for radio, television, and telephones has been destroyed. So how do you get information to those who need it most??? There are no easy answers.

Second Stage - Short Term Relief

1. Survivors look for availability of fresh water, shelter, and medical attention.
2. Expectation management is vital as relief may not fulfill needs as quickly as desired.

People who have knowledge of issues such as when and where food will be distributed, the amount of allocated rations per person, and how to cook the rations to maximise nutritional value, can help manage logistics, reduce corruption, and improve health and mental well being.

Third Stage - Long Term Recovery

1. People want to know what relief services are available and to what they are entitled.
2. They need to know about recently implemented policies that affect them, such as housing reconstruction guidelines or victim compensation policies.
3. What are the government and relief agencies accountable and responsible for?
4. Safety instructions (boil your water, etc) must be communicated.

Unmet communication needs can lead to further trauma and stress. "In particular, psychosocial studies increasingly note that information deprivation actually causes stress and exacerbates trauma..."

Bottom Line

Information is essential to give people "a sense of power and purpose over their own destiny" during a disaster. It is a "critical issue." The providing of information becomes a form of aid and deserves prioritisation through the development of effective and properly resourced communication strategies. If you are an Emergency Manager please read the BBC report for communication recommendations.

Emotional Stress for First Responders

“If you had to define stress, it would not be far off if you said it was the process of living. The process of living is the process of having stress imposed on you and reacting to it.” - Stanley J. Sarnoff

In yesterday's blog I discussed the emotional issues that disaster survivors may face during recovery. In addition, people who serve in the various emergency services, such as police, fire, EMS and other rescue personnel are at a heightened risk for traumatic stress and other powerful emotional reactions in the wake of a major disaster. During an emergency responders try to suppress their fears and emotions and deal with calmly with a not so calm public. After hours or days of control, these bottled-up emotions need to be released and dealt with.

The CDC (Center for Disease Control) has a series of slides and a pdf on surviving field stress for first responders, http://www2.cdc.gov/phtn/webcast/stress-05/. Field stress impacts one's ability to think clearly, to concentrate, and to think quickly. There is an increased risk of making a dangerously wrong decision.

A recent TV show on PBS described the efforts of firemen to rescue pets from a burning animal shelter. The firemen did not want to leave the burning building and abandon the pets to certain death. The fire chief had to order them out for their own safety. The sorrow and grief and guilt over death can be overwhelming.

Ways to Manage Field Stress

1. Have experienced officers supervising
2. Provide on scene briefings for new personnel
3. Limit caffeine and sugar
4. Ensure adequate rest and rotation of personnel
5. Provide mental health counselors for debriefing

Common Aftereffects of a Response

1. Anger or Sorrow
2. Dreams and nightmares
3. Distracted by frequent thoughts about what happened
4. Strains in family and work relationships
5. Difficulty sleeping

Severe effects can include depression, anxiety disorders, and post-traumatic stress disorder.

BOTTOM LINE
Disaster field stress and aftereffects are normal and nothing to be ashamed of. It helps to talk about what happened. Check the Internet for first responder support groups in your area where you can share stories and grief together.

Emotional Recovery

"The sun will come out tomorrow" - Annie the Musical

Today's blog is taken from the Red Cross website "Picking Up the Pieces after a Disaster". While the physical destruction after an emergency is plain to see, the emotional damage is equally important to recognize and address.

You may be surprised at how you and others may feel after a disaster... People may experience fear concerning their safety or that of a loved one, shock, disbelief, grief, anger and guilt. Memory problems, anxiety and/or depression are also possible after experiencing a disaster.

Children, senior citizens, people with disabilities and people for whom English is not their first language are especially at risk. It is important to talk with children and elderly people in a calm way and let them know that you will help them find a safe place to stay.

Children become afraid that the event will happen again and that they or their
family may be injured or killed.

Young children do not understand the notice of replay on TV. When they see pictures again and again of a tornado or storm, they think the event is live and reoccurring. In NYC on 9-11 many children were terrified by frequent reshowings of a plane hitting the World Trade Center and the towers collapsing. For them the event kept rehappening.

Some basic steps you can take to meet physical and emotional needs

• Try to return to as many of your personal and family routines as possible. For children this can mean having a favorite stuffed animal to hold and familiar pajamas to sleep in.
• Get rest and drink plenty of water.
• Limit your exposure to the sights and sounds of disaster, especially on television, the radio and in the newspapers.
• Focus on the positive.
• Recognize your own feelings.
• Reach out and accept help from others.
• Do something you enjoy. Do something as a family that you have all enjoyed in the past.
• Stay connected with your family and/or other support systems.
• Realize that, sometimes, recovery can take time.

BOTTOM LINE

If you observe unusual behavior in your children, which you think may be caused by a reaction to the disaster, contact your local Red Cross chapter, child's counselor or community professional for additional information and help. The Red Cross can also arrange for you to talk with a member of its disaster staff who has special expertise in dealing with disaster stress.