Risk and Value
One of the major shifts occurring in our lifetime is the increasing risk of being a victim of a disaster. Adapting to these new, changing conditions presents a classic challenge because day-to-day survival is generally taken for granted. The conveniences of technology and superb engineering infrastructure have cushioned much of the population from considering the constant threat of death that historically characterized human existence. Survival used to depend upon individual fortitude and extreme cooperation within communities – everyone knew this and acted accordingly.
It may become true again that survival will depend upon individual preparedness and the tightness of your immediate community in planning together how to respond to a disaster. Trained professionals are stretched to encompass a vast range of knowledge, skill, and experience in their discipline (fire, policing, medical, etc.) and beyond. Now, First Responders must also
- be skilled in communicating with diverse communities (there is no one-size-fits-all language),
- understand the precisely relevant needs of unique individuals (rather than assuming everyone is exactly the same as everyone else), and
- comprehend and use new technologies of social media.
Although amazing improvements have been made throughout the field of emergency management since 9-11 and Hurricane Katrina, recent natural disasters around the country continue to expose weaknesses and gaps. Invariably, many these gaps revolve around expectations that volunteers will miraculously appear and take care of all the ragged edges.
Interoperations: Self-enclosed or Interactive?
Of course there are, and always will be, spontaneous volunteers during acute stages of a disaster. Some good samaritans will also gut out the long haul. But vital services for vulnerable populations such as the elderly and medically ill, transportation for people with mobility disabilities, language support services for people fluent in languages other than English, childcare, pet and service animals husbandry, and a host of other specific functional and access needs are not going to materialize out of nowhere. Adequate emergency response now and in the future is going to be measured on the basis of casualties among people in these groups. Just as recent disasters have illustrated that professional First Responders are not yet capable of anticipating and responding properly to every individual situation, the inadequacy of relying on volunteers to respond effectively and efficiently in caring for the most vulnerable populations is also blatantly obvious.
The entire system needs to evolve.
The District of Colombia’s Mayor’s Office of Volunteerism, Serve DC, is taking steps to build relationships between trained volunteers and professional emergency responders. On Saturday, April 14th, more than two dozen previously-trained Community Emergency Response Team members were given a taste of what it would be like to deploy as ‘first responders’ to a scene involving multiple victims. This first-time event for the District put volunteers in the field to be coached by fire personnel and emergency response consultants. On a beautifully sunny day, a well thought-out “high wind event” disaster scenario challenged these would-be rescuers to work in teams, coordinate with each other both within and between teams, and demonstrate their ability to stablize wounded people while awaiting more highly trained medical personnel.
It was my first experience with moulage, the realistic display of severe injuries. I spent most of the time observing the Incident Commander and considering the communication dynamics. There are some tough inter-role dynamics to sort out. By role, I mean the different categories of function that need to be performed by designated individuals. Roles are distinguished by tangible criteria such as amount of training and experience, and are performed according to less tangible personal qualities of the individual. For this CERT exercise, the primary roles were professional First Responders (acting as coaches) and volunteers – including the victims (talk about a role that requires patience!). While the actual exercise was focused on intra-role communication (among and between CERT volunteers), the practical test of CERTs is going to be how and when they are integrated by the professionals into the response effort.
This will require some adaptation on both sides: volunteers need to learn to confirm to hierarchies of command that are fairly rigid, and professionals need to accept more variation in the communication of significant information.
A Resilience Regime
One of the most telling indicators of the quality of human social organization are the lines drawn around paid and unpaid labor during emergencies. I have already begun to argue the necessity for a new, temporary designation for professionals and paraprofessionals who respond during a disaster. Minimum levels of training would need to be established, along with Standard Operating Procedures (SOPs) for alert and notification, issuing safety equipment, deployment, administration for billing and reimbursement, and access to post-disaster services such as trauma counseling and medical care.