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.
NASW Puerto Rico Chapter Sends Message Detailing Dire Situation on Island
This message from the National Social Work Association (NASW) Puerto Rico Chapter was sent to Mark Nichols, NASW manager of chapter services, in a series of cellphone text messages during the afternoon of Oct. 3. It has been slightly edited. We wish to share it with members and the wider social work community.
NASW will convey this message to members of Congress who are social workers and soon give information on how we can assist social workers in Puerto Rico:
Thank you for your support. Our main concern is there are no communications. There are no cellular phones that work well. All the island is without power — there is no water and little produce.
President Trump came today and just said we are costing too much money for the United States government. The suicide rate is too high triggered by the suffering from lack of basic needs. During this period about 12 persons committed suicide (and there are likely more that are not confirmed).
We are citizens of the United States of America, we defend the principles of democracy, we fought in World War I, World War II, Vietnam, Korea, Afghanistan and Iraq.
Our people went to Vietnam without any preparation. Most of those who were drafted were only 17 years old and had no understanding of the English language. We fight very bravely with no support. Even the Congress recognized the 65th Infantry Regiment as an important part of (American) history. The man who planned to rescue the Americans who were hostages in Iran by the Carter administration, he was a Puerto Rican.
Actually, we need support from the federal government, not just 4,000 soldiers around the island. We need to repair the electricity. We need water and food. There are people in the shelters without hope. Simply, there is no place to go.
Mr. Nichols let the social workers know about our situation. Let the newspapers describe all the justice we need. I trust our nation and I strongly believe that a call to the Congress will help make the effort to help not a political issue, but a social justice issue. As I explained, the communications (are very bad). Thank you very much.
For information contact Greg Wright, NASW Public Relations Manager, at 202.336.8324 or by email at [email protected]
Rescue to Recovery Stages in a Red Cross Disaster Deployment
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.
Facebook Introduces a New Center for Crisis Response
Facebook announced that their crisis response tools, including Safety Check, Community Help, and Fundraisers, will be accessible in a new center on Facebook called Crisis Response. Beginning today, people will also be able to see more crisis-related content, such as links to articles, photos and videos posted by the Facebook community, from crises around the world where Safety Check has been activated.
Since the first Safety Check tool in 2011, Facebook has continued to develop a number of crisis response tools to better serve its community. When there is a crisis, people use Facebook to let their friends and family know they’re safe, learn and share more about what’s happening, and help communities recover. People will be able to access Crisis Response on Facebook in the upcoming weeks from the homepage on desktop or from the menu button on their phone. They will see the following tools when they’re on a crisis page:
- Safety Check: an easy way to let your friends and family know you’re safe. It will continue to work the same way it does today and will be featured at the top of each crisis page if you are in the affected area.
- Links to Articles, Photos and Videos: crisis-related content from public posts can help people learn more about a crisis.
- Community Help: people can ask for and give help to communities affected by the crisis.
- Fundraisers: let people create fundraisers and donate to support those affected by the crisis and nonprofit organizations helping with relief efforts.
As part of the single resource hub, Facebook will also include links to articles, photos, and videos from public posts so people have access to more information about a crisis in one place. Safety Check activations and related information may also appear in News Feed to help provide additional details about a crisis.
Facebook strives to continuously provide people with helpful information to keep them safe and help communities to rebuild and recover.
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