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Emergency Management

Lessons in the Current Puerto Rican Disaster

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A man tries to repair a generator in the street after the area was hit by Hurricane Maria in San Juan, Puerto Rico September 25, 2017. REUTERS/Alvin Baez

Those who have worked in disaster areas know that coordination and transport can be difficult, but with the USS Comfort leaving Puerto Rico after admitting less than 300 patients when there is unmet need isn’t a great sign of success. Hurricane Maria made landfall on September 20, 2017. The Comfort, which is essentially a floating specialty hospital arrived in Puerto Rico on October 3rd.  November 8th, the Comfort was restocked with supplies but then departed shortly thereafter for “no apparent reason” after providing outpatient services to somewhere around 1500 patients, according to the DOD.

…”I know that we have capacity. I know that we have the capability to help. What the situation on the ground is … that’s not in my lane to make a decision,” he said. “Every time that we’ve been tasked by (Puerto Rico’s) medical operation center to respond or bring a patient on, we have responded (Captain of the USS Comfort to CNN).”

The death count is still hazy, and there is difficulty in confirming how many died during- or as a result, of the disaster.  One group is doing a funeral home count because information is difficult to obtain. CNN has found through a recent investigation that the death toll appears to be more than 9 times the official government report. 

Coordination on a micro, mezzo and macro level must come from multidisciplinary sectors to problem solve. There are many good people working to rebuild Puerto Rico, but there is far too much apathy, throwing up of hands, and of course, corruption.  Many of the Social Work Grand Challenges are highlighted in Puerto Rico alongside the UN Global Goals.

The Whitefish linemen are making $41-64 per hour to restore power to Puerto Rico’s Grid, but the US government is being billed for more than $319 per hour. Whitefish just called a strike because they have not been paid. This, of course, is having a terrible impact on those who are in the most need.

Where do you come in?  We tend to think of trauma on a psychological level: family members and friends who are missing, grief, anxiety, and depression due to home and job loss as well as connecting with those close to you, each processing the trauma differently.

On the mezzo level, we are working with smaller groups and institutions, of which there are many in disaster or mass casualty events.  Local churches, schools, nonprofits and local chapters of larger scale organizations attempt to unite in the local area to help speed services to those that need it most.  Often this is where many of the challenges lie.  Each organization has their own protocols which may not match up with larger scale efforts of the government or international organizations.

On a practical level, resources are often short on a disaster scene- there are not enough clinicians to meet with clients individually, at least not for more than a few minutes at a time. We revert to what the American Red Cross refers to as “Psychological First Aid”.  Human networks through nodes (like shelters) provide a sense of community and belonging when all is lost, with individuals acting as brokers between networks that previously didn’t have ties.

Ground efforts can be supported by a drone equipped with a camera to see if there is a possibility of reaching a scheduled neighborhood by car, saving countless minutes that matter.  The aerial shots from 3 days ago may no longer be relevant. The water may have receded but now a home has landed there, blocking road access.

The volunteers mapping from satellite images can instantly beam their work from anywhere (tracing homes, schools, possible military vehicle parking areas or temporary helipads) while teams on the ground stare at a water covered road, unsure of what is beneath. Life saving choices are made with options and all levels working together. This is how neighborhood Facebook groups saved lives- they were the eyes on the ground in their own neighborhood that identified who was in the most danger.

Facebook may no longer be the hippest new technology (we are nearing the decade and a half mark) but it is arguably the most ubiquitous and well supported (crashes rarely). Many survivors could make a post but were unable to call or text from the same device. An important component to the multi-level view is the understanding that macro tools like mapping serve micro and mezzo levels.

Being a survivor in an active disaster can quietly morph into anxiety, depression and survivor’s guilt.  Being able to participate in practical support efforts can boost the well being of survivors as well. Friends of friends of friends and influencers in social networks have proven to be incredibly powerful.  It’s what happens when “mixed networks” collide.

As we move to a macro level, there’s a realization that there is a great deal of organic movement in even the best planned days for rescue effort workers.  Do you stop here where the need is great (and went unreported) even though it’s blocking you from reaching the mapped area that your team has already scheduled? This is where technology for good can make the difference.  Depending on your training and background, you may make a different choice.  Who is in charge of the government response, and how do we help change course if it is failing?  How do we know if the efforts match our resources?

The simple answer is that we are there to communicate it with others, on all levels—including the virtual one. This may mean volunteering for rescue efforts, collecting tampons in your hometown, or using your own technology for good by mapping for workers on the ground that are not sure what lies beneath—you are helping to ensure their safety and mental well being.  In turn, you get to pass that knowledge into your own networks.

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Kristie Holmes, PhD, LCSW, specializes in topics related to global health, gender and media, as well as technology’s impact on relationships. She has spent a significant amount of time in the past eight years working on projects related to the United Nations Sustainable Development Goals with the United Nations.

          
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