Direct Relief engages in significant emergency preparedness and response efforts related to hurricanes and other natural events. The following list addresses several of the questions that often arise in hurricanes regarding who is most vulnerable, what to look for during, and background on the organization’s preparedness and response activities.
1. Different risks arise from the natural environment, the built environment, and demographics – and the intersection of all three. A hurricane in an unpopulated area with no infrastructure is an event of nature. A hurricane becomes an emergency when it occurs in a populated area, where critical infrastructure exists, where substandard housing, levees, or other such items in the built environment are present.
Because risks stem from different causes, mitigating them requires different actions. Zoning and building codes guard against building in high-risk areas or with techniques that won’t withstand likely natural events. Preparedness for health emergencies through such means as stockpiling the appropriate medications or supplies depends in part upon knowing what types of medications and supplies are most likely to be needed by people in a community – the difference between, for example, a college town and a retirement community.
2. Food, Water, Shelter, and Medical Services are the four basic immediate concerns in a hurricane or other emergency situation to safeguard people.
3. The storm isn’t the only health risk. Preventing injury and loss of life from storm-tossed debris, electrocution, exposure, or being caught in floodwaters are priorities for first responders and emergency personnel during a hurricane. Evacuations, as were ordered or recommended during Irene, relate to geographic areas. But some people can evacuate easier than others. People who lack mobility or have other disabling physical or mental conditions have greater difficulty simply leaving their residences, as do those without transportation or with very low incomes.
Evacuations and damage to infrastructure – such as roads and power lines – affect the flow of information and distribution channels. This can present health risks for people with chronic health conditions such as diabetes, hypertension, or asthma if they forget to bring their medications with them and cannot obtain a new supply. People with chronic conditions can quickly find themselves in a health crisis without access to their medications. (Direct Relief’s Hurricane Prepositioning Program with community health centers and clinics is designed to reduce such risks.)
4. Social Vulnerability: Who is at Risk, Where, and Why. Not everyone within a hurricane’s path is equally at risk. Extensive research by Dr. Susan Cutter of the University of South Carolina regarding past hurricanes and other emergencies has identified over 30 factors that affect communities’ vulnerability in such events, including an area’s natural and built environment, its rural or urban character, and the demographic composition and income levels of the population. In general, vulnerability is greater among people at age extremes (young and old), with low incomes, members of minority populations, and those with special health or medical needs.
5. Financial losses can be extreme and long-lasting. Hurricane-caused real and personal property damage or destruction is often readily apparent. Less readily apparent are both immediate and long-term economic losses for individuals and businesses, which result in extreme hardship that escapes official damage estimates. Lost sales and wages, uninsured losses of personal and real property, crop and capital-equipment losses, reduced property values, business failures, and even large-scale relocation of people from an area have a compounding effect upon each other. Social vulnerability research confirms common sense intuition – including that people with low incomes often have a smaller cushion of resources to fall back on during and after a hurricane and greater challenges bouncing back.
6. Before, During, After (Preparedness, Response, and Recovery.) Hurricanes are indiscriminate, and their effects are felt by individuals, families, communities, schools, businesses, health facilities, and governments. Preparedness at each level, from the individual to the government, enhances safety, reduces losses, and also helps target response activities during an emergency and recovery efforts afterwards.
For response activities, the principle that good information is needed to make good decisions is amplified. Among the challenges in emergencies is the need to make rapid decisions to deploy resources – equipment, personnel, money, food, water, shelter supplies, and health resources – occurs just as current, precise information becomes harder to obtain and distribution channels become damaged. A “fog of war” analog exists in emergencies; Direct Relief’s preparedness and response efforts focus on building information channels, working consistently with the nonprofit health centers and clinics that serve vulnerable people in high-risk hurricane areas, pre-positioning essential health resources in the areas, and building a robust distribution channel to infuse additional resources as circumstances warrant.