Roy was my partner for most of our deployment with Red Cross on the Disaster Mental Health Team in Texas. We spent many hours on the road mostly on our own, with the exception of “ride to the office” or “back to the shelter” caravans, which could be quite crowded as there were few available cars to ferry us all from the staff shelter to Headquarters for the day.
Conversations stayed rooted mostly in the present, even with kids occasionally Face-timing us in the car when a signal would pop up. I know that he’s been a social worker since 1970 and that he has been married nearly as long. Getting to know each other on a disaster mental health deployment is a different way of knowing someone, but knowing them well regardless. Similar relationships are built with the people you sleep a couple of feet from in the staff shelter.
Roy: “Wasn’t there a band people used to like called the Dead Heads? People liked them but I think they’re dead.”
Roy, In response to a question about breakfast: “Right I’ll give you another rotten orange in the morning.”
Kristie: “No thank you; that coffee was sufficient.”
“Roy, just go ahead and get in the wrong lane again for this right turn.” (Texas “turnarounds” can be a nightmare).
There was the normalcy of the city center recovering, demonstrated through open shops and Home Depot’s parking lot was nearly at capacity. Starbucks opened, there was a carafe in HQ for one of the lucky teams.
Vulnerability and exploitation were visible not far from the city center. Compounding issues plague those who struggled prior to the disaster. Living paycheck to paycheck when there is suddenly no paycheck creates a domino effect of financial disaster. You can only call the companies to beg for mercy if your phone works, if there are enough bars available to connect you. The smell is rising in neighborhoods, and the question, “What is that smell?” was more frequent today. Mold grows rapidly, and you can smell it from the street. Weeks have passed since the initial disaster, but it is just beginning to unfold for many people do not have flood insurance.
I ended up making a call to the Attorney General’s office regarding landlords who are refusing to remediate damage and demanding rent from those who cannot pay (or live in their home), with the threat of their things being sent to the dumpster. The police were empathetic but said that it’s a civil issue and in a disaster needs to go to the AGs office. So the wet carpet stays with children living inside, and they lack healthy food- maintaining on what looks like a vending machine diet.
There are contractor company scams that further exploit the exploited, and many workers are being brought in from surrounding areas without protective gear (notable lack of face masks) and clearly without reasonable hours or meal contracts.
On the other end of helplessness and anger, I felt in awe of all of the volunteers and what they do. They respond at the crack of dawn to Headquarters to work with a team using colored post it’s on the wall to map progress and hot spots for the day. Knowing that it’s likely that at the end of the day, they will have gotten sidetracked from the need that was directly in front of them, feeling regret for not making it back to the places they know are in desperate need but are now blocked by factors beyond their control.
Headquarters experienced an evacuation- someone screamed, “Get out! Get out of the building!” It turned out to be some off-gassing cones, but everyone went right back to work outside while standing outside the building waiting for clearance entirely unfazed.
Volunteers will talk it out with each other back at the shelter late at night, eating cold leftovers from the ERV (feeding) vehicles. Informal meetings run from their cots which will make a difference the next day in how resources are allocated because drivers are sleeping next to mental health, nurses, and those doing communications assessments. If you end up both eating and securing a space in line at the shower trailer behind the civic center before it’s too late, it’s something of a miracle. With a lot of contamination and illness going around, it’s best to just throw away the shoes on your way out.
As for the people we served, we realized the depth of desperation that is held for those in areas without good water. Your clothes were washed away or were contaminated, and even if you could wash them, you can’t because your washer and dryer is flooded (one family had some kind of snakes in theirs) as is the laundry mat down the road.
We brought restaurant workers wearing their last items of clothing and shoes serving people in the only community restaurant to open back up in Port Arthur in a certain radius, knowing that those clothes too, would soon be dirty. So what then? How long will this all take? While you may see signs of recovery in the city center, it’s clear that this is going to take so much longer for others, and the rural areas are barely touched by “helpers”.
The depth of this disaster isn’t something that we are used to covering, Katrina taught us a few things that are applicable, but each disaster is its own, and this scale is unimaginable. Puerto Rico is now unfolding as we watch on our screens, in some sort of mass denial of scale.
Most of us can sit comfortably behind our devices and all caps “GET TRUCK DRIVERS!” and while I can personally imagine the barriers that they have in distribution as we just experienced them in Harvey, you just can’t know unless you’re there and are using all of your five senses.
Roy Pence Kristie Holmes Red Cross Texas Rose City
How Social Workers Play A Role In Disaster Relief
Federally declared disasters have increased by 40% over the last 15 years, according to the Clinical Social Work Journal, and internationally, those numbers are higher. Over just the last two decades, natural disasters have doubled.
In the past, the term “disaster” was poorly defined, leading to emergency response plans that were a one-size-fits-all solution to multifaceted problems. This approach left survivors with fewer options for critical care, especially in the area of mental health.
The National Center for PTSD recently redefined disaster as “a sudden event that has the potential to terrify, horrify, or engender substantial losses for many people simultaneously.” It went on to further define disasters based on type, differentiating between natural and man-made disasters. If more widely accepted, this definition opens the door to opportunities for mental health care in these urgent situations, giving social workers a vital role in relief, recovery, and community resiliency.
Responses in Disaster Relief Social Work
Social workers can offer a variety of mental health services in the immediate aftermath of disasters. Traditional psychotherapy performed by therapists is known for its long-term approach involving session work and trust building, allowing patients to share their trauma narratives. However, when social workers are called up for active disaster relief, their critical and immediate intervention skills are far more necessary for psychological triage. Among them are:
- Psychological first aid (PFA): PFA assists those in crisis in the aftermath of disaster. It relieves initial distress in an effort to promote short- and long-term coping. This sometimes includes crisis intervention and counseling.
- Family care: Family social workers help families during crisis. They aid survivors in locating the services they need to overcome post-disaster challenges and repair their lives.
- Mental health media communications: This field provides voices and vital points of view for under-represented or disadvantaged populations.
- Resilient community capacity building: This includes creating response plans for various groups.
Above all, the pledge to “do no harm” is the first aspect of every skill.
Assistance During Disaster
Disaster relief programs typically consider the short-term needs of survivors in order to identify the best allocation of resources and promote beneficial coping in the aftermath of tragedy. Social workers assist in these programs in a number of ways, including:
- Case management: Social workers locate appropriate resources for clients, making sure they receive the services they most require.
- Case finding: Case finding involves providing survivors with information about the programs available to them. Many are unaware that such services are available or fear stigmatization for participating in them.
- Outreach: Social workers performing outreach increase program locations in order to allow services to be more accessible.
- Advocacy: Using connections within various relief organizations, social workers advocate on behalf of clients to qualify them for additional services.
- Brokering: When acting as a broker, social workers link client systems to the resources they need, fulfilling client needs throughout a multiplicity of programs.
Ultimately, all these methods allow social workers to disseminate information, refer clients to services, and assist them in qualifying for resources in disasters.
Disaster Relief Social Work in Practice
In the U.S., the American Red Cross and the Crisis Counseling Assistance and Training Program have provided almost half of all social workers participating in disaster relief programs. Depending on the type, duration, and severity of disaster, the challenges and requirements of social work change. When preparing ahead of an impending calamity, social workers may be identifying and organizing supplies, assisting with area and hospital evacuations, or even determining which patients can or should be moved.
During an actual emergency, the needs of the afflicted tend to take precedence over one’s own needs. Moment-to-moment changes in operational requirements contribute to the notion that social workers must remain flexible. They must be able to go where they are needed when they are needed there. The following are some real-world examples of social workers in the midst of disaster.
The residents of Beaumont, Texas, were witness to devastation on a massive scale. In the fall of 2017, Hurricane Harvey descended on Texas and Louisiana, and with it came ruined homes and wrecked lives.
In the end, the storm caused over $125 billion in damage and took 107 lives. The end of the storm was nowhere near the end of the damage. Long-term psychological trauma is a reality for many survivors, especially children. According to a recent survey in the aftermath of a hurricane, nearly 3.4% of respondents were found to have suicidal thoughts. The assessment, response, and counseling of suicidal behaviors were critical concerns that social workers on the ground were able to address.
In September 2017, the USNS Comfort, a hospital ship, was deployed to Puerto Rico in the wake of Hurricane Maria. The crew included social workers and mental health providers for inpatient and outpatient mental health services. These providers developed protocols to educate the ship’s staff in treating psychiatric patients in addition to treating patients on board.
NORTHERN CALIFORNIA WILDFIRES
The Wildfire Mental Health Collaborative was established in Sonoma County after the devastating Tubbs fire to offer survivors tools for dealing with trauma. In the wake of the fires, The Guardian reported that many social workers were funded by grants from FEMA, which allowed them to connect with nearly 70,000 people in Sonoma County alone. These social workers were able to identify and refer thousands to much-needed mental health services.
Further study of the impact of disasters on the mental health of survivors is critical to the practice of disaster relief social work. The National Association of School Psychologists (NASP) has emphasized that children are especially vulnerable in disaster conditions, as they take their emotional and behavioral cues from adults.
Anxiety and startle responses, typical symptoms in children that have survived hurricanes, require therapeutic activities to help them cope in healthy ways. According to NASP, other disasters can prompt separate trauma responses. Tornadoes can cause survivor’s guilt due to their suddenness, whereas wildfires, given their advance warning, can cause anxiety. Negative effects stem from displacement, property destruction, and the concerns associated with biological threats to one’s health.
Work Together to Prepare for the Next Big Storm
Year by year, hurricanes are growing stronger and more frequent. We are witness to these changes as we watch two catastrophic storms devastate the southeastern United States in as many weeks.
This month, Hurricane Michael slammed the Florida Panhandle, southern Virginia, and the Carolinas. The massive storm killed at least 16 people, flooded cities, highways, and rivers, and reduced much of the region to rubble.
Barely two weeks ago, Hurricane Florence killed at least 36 people in three states, forced thousands to evacuate their homes, dumped record floodwaters on North Carolina, created power outages for hundreds of thousands, and killed millions of farm animals. The most recent damage estimates put the economic toll at a staggering $100 billion, once accounting for property damage, medical costs, and lost wages.
Natural forces emboldened by climate change continue to overwhelm our outdated stormwater management practices and inadequate urban planning, putting us in a precarious position. Short-term economics have often driven development where considering long-term environmental impact was needed instead. When it comes to handling the effects of more storms, we’re not as prepared as we think.
As we assess the damage done by Michael, Florence, and other storms, the shrewdest move is to prepare for the next big storm — and the one after that. Municipalities, businesses, and individuals can brace for the next storms by focusing on the following areas:
Additional Pollution Prevention
Florence and Michael disrupted two of North Carolina’s biggest industries: coal power and hog farming. This created environmental trouble and the potential for health problems. Duke Energy officials in North Carolina said slope and landfill erosion caused stormwater with coal ash — containing heavy metals such as arsenic, lead, and mercury — to spill into Sutton Lake. Watchdog groups have expressed concern about the effect on water quality.
Floodwaters also breached multiple hog lagoons, designed to keep solid waste from polluting sources of drinking water, in at least two North Carolina counties, causing varying degrees of damage. The North Carolina Pork Council says the state’s other 3,000 hog lagoons are holding up, but the state’s Department of Environmental Quality will have to perform inspections.
The landfills, dams, and lagoons containing pollutants need to be stabilized and reinforced. Cities can reduce landfill washout by using gravel stabilizers, terracing, drainage diversions, and other measures to safeguard their slopes against erosion. To avert overflow of detention ponds like hog lagoons, companies can add pond depth, secure the perimeters, and place impervious barriers around the site.
Adjusted Damage Estimates
Because of climate change, we can count on heavier rain and shorter intervals between storms increasing flooding risk. Data is still being gathered for Michael, but we know that for Florence, greenhouse gas emissions and warmer weather made for more intense rainfall. When Hurricane Harvey hit Houston last year, the city matched its annual rainfall (typically 50 inches) in a matter of days.
Cities, businesses, and infrastructure planners need to set new damage expectations, as “500-year storms” arise with increasing regularity. Adequate planning and preparation may seem expensive overall, but it’s more expensive to deal with damage in the aftermath of flooding. It’s important to remember there’s no immediate fix or silver bullet. Instead, we need long-term solutions first acknowledging the problem and then planning for it.
Broader Public Education
Weathering the next storm requires a public education process that touches all sectors on the solutions available to help protect communities against floodwater. In my hometown of Houston, the community has come together with a discussion on the web, in public forums, and in community meetings.
The Houston Green Building Resource Center provides a public resource at the permitting building, providing engineers, architects, contractors, and homeowners with techniques on how to reduce flooding on the macro and micro levels, including information on building codes, permeable and sustainable materials, and engineering technologies to incorporate. Examples include elevated construction, or raising buildings above the rising floodplain, and permeable paving techniques that can reduce the extreme weather’s impact on the earth’s surface. Both are cost-effective improvements worthy of broader public education.
The intensity of storms like Michael and Florence raise the bar for planning and preparation. Governments, businesses, and communities must plan ahead and work together during the quiet times before the storm returns.
How Not to Be a Victim When Natural Disaster Strikes
How people on the East Coast fare as Hurricane Florence reaches landfall will depend in large part on what they have done to themselves to prepare in advance, says Beth Gazley, professor in the Indiana University School of Public and Environmental Affairs.
Disaster resilience begins, she said, by understanding how environmental change has kicked up the force of these storms, by making them bigger, slower and wetter.
“That means your past experience with storms — or your house’s past experience — may no longer be valid,” Gazley said. “Climate-induced hurricanes are a different animal.”
It also means residents should think in terms of elevation rather than just wind speed when they consider their risk. “Rain flows downhill,” Gazley said. “Most of Hurricane Harvey’s victims in Texas were flood victims. Evacuating low-lying areas, regardless of your distance to the coast, will be crucial.”
Disaster resilience also requires acknowledging our collective responsibility as citizens to prepare for major storms, said Gazley, a co-founder of Indiana University’s Environmental Resilience Institute.
“Ask any emergency responder what he or she wants from us,” she said, “and you’ll get the same answer: ‘Make a plan and assemble an emergency kit. We can help you best when you help yourself.’ Each of us needs to start that planning effort in advance of a storm. How are you going to charge your cellphone if the power is out for days and possibly weeks? Think through these questions in advance.”
One of the most active Red Cross campaigns, Gazley said, is about family and workplace emergency preparedness. The Federal Emergency Management Agency has excellent resources at www.ready.gov.
But even in the best of circumstances, and even when we implement good emergency plans, some people will need help.
“Fortunately it’s a natural human inclination to help others,” Gazley said. “So give. Give today, not next week — in fact, I just made a gift on the www.redcross.org website. Make an unrestricted gift so the charity can use it where it’s most needed.
“Then renew that gift next year, and the year after, even when a disaster is not happening. The most successful charities depend on long-term support. That kind of financial stability gives them the chance to train and retain the kind of experienced professional emergency response staff we all need.”
Gazley said people who don’t give to established charities like the American Red Cross because of their high reported overhead costs are making a mistake.
“For heaven’s sake, don’t give to the disaster charity with the ‘lowest overhead,'” she said. “The nonprofit research is pretty clear that charities with low overhead may fail to thrive in other important ways, like investing in fundraising or in experienced senior staff.”
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