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After Hurricane Maria hit, Luis David Rodriguez saw the same look on faces all over Puerto Rico: Dazed. Overwhelmed. Disheartened.
Touching down on the island of Grand Abaco, in the Bahamas, the Direct Relief staff member noticed similar expressions on the faces of people waiting to evacuate or receive medical attention. So many, he said, displayed signs of “the powerless feeling that…there’s nothing you can do but just wait for help.”
Rodriguez had spent nearly two years working to facilitate recovery on his native island. When he reassured Bahamians who’d lost everything, he spoke from experience. “We’re still recovering in Puerto Rico, but it’s definitely something that will get done,” he’d tell them.
The aftermath of Hurricane Maria – a storm that caused the deaths of nearly 3,000 Puerto Ricans, created an estimated $100 billion in damages, and left many without power for up to a year – is widely cited as worst-case example. Experts point to everything from insufficient preparation to a halting response as contributing factors to a calamity that continues to affect nearly every facet of Puerto Rican life.
No one would claim that Puerto Rico and the Bahamas are neatly comparable. The damage in Puerto Rico was widespread; in the Bahamas, it was catastrophic, but confined.
Nonetheless, catastrophes bring a few universals to the places they hit: Widespread damage. Isolated, unwell people and communities. Urgent calls for supplies and aid. The threat of disease outbreaks. And the aching need to get back to everyday life, as quickly as possible.
The days after a hurricane like Maria or Dorian are marked by heartbreaking loss and dramatic rescues, international attention, floods of donations – and breathless media attention.
And then, within a few days or weeks, the world’s eyes turn elsewhere. “The public attention, the drama… dissipates, and for the agencies and people that remain after the TV cameras have gone, the challenge of getting attention and getting resources can be really overwhelming,” said Irwin Redlener, a disaster preparedness expert and professor at the Columbia University Mailman School of Public Health.
The first few weeks after a disaster are spent dealing with the most immediate needs: rescuing people who are trapped and disabled, evacuating the gravely injured and ill, providing on-the-ground emergency medical care, and distributing supplies of food, water, and other necessities.
The recovery process, by contrast, takes place over years. Houses need to be rebuilt, infrastructure shored up, schools reinstated, clinics rebuilt. People “don’t understand how long and complicated and expensive that recovery is, in part because we don’t have that kind of narrative in the media,” said Samantha Montano, a self-described “disasterologist” and professor of emergency management and disaster science at the University of Nebraska-Omaha.
For example: In the days after a hospital is catastrophically damaged, doctors will often fly in from all over the world to provide much-needed emergency medical care. Days later, they return home.
But after they leave, the community’s need for a reliable source of long-term healthcare remains. The process of renovating or rebuilding that hospital, replacing its medical equipment, outfitting it with a reliable solar system so it won’t lose power, and recruiting permanent healthcare providers to replace those who leave is an intensive, long-term process.
“We need to think long-term from the start,” said Andrew MacCalla, Direct Relief’s vice president of emergency preparedness and response. He imagines an aid group, rather than rushing in, deciding that “We’re going to wait; we’re going to deploy in two or three months; we’re going to focus on the needs of people who have been displaced.”
It may not be where most donors imagine their money going. But staying for the long haul is essential to helping a community regain equilibrium.
Focus on Local.
International NGOs get a lot of attention. And while there’s good reason for that, Montano said, local groups are the ones who really understand the impacted community and its needs.
“A lot of those bigger organizations are doing good work, and they have very specific disaster expertise, which is really valuable,” Montano said. “But many of those larger organizations don’t have that local knowledge piece.” To mount an effective long-term response, Montano said, you need both.
In the wake of Hurricane Maria, the electrical grid was severely damaged. Hundreds of schools were shuttered. Health centers and clinics were damaged. Domestic violence rates shot up at the precise moment that shelters were operating at decreased capacity.
None of these seem directly connected to disaster response, but for Puerto Ricans, they’re essential concerns. A functioning electrical grid, open schools, working clinics, and effective protection for those threatened by domestic violence are all vital to community health.
The result? Some groups had more medicine than they could use, or a huge volume of donations they had no time or resources to organize.
Over the long term, an effective response effort will involve listening to, and following the leads of, the people who live in and serve affected communities.
Prepare for a Next Time.
When it came to Maria, Redlener said, “pre-disaster planning was not anywhere near what it should have been.” The island lacked well-positioned supplies, so people in isolated or heavily damaged areas had trouble getting food, water, medications, and personal care items. Health centers with no electricity or clean water struggled to provide care. Many Puerto Ricans, accustomed to hurricane warnings, didn’t stock up.
According to Redlener, Maria needs to be warning for governments and hurricane-prone communities. He’s worried it won’t be.
“We keep calling these things wake-up calls, but in reality they’re more like snooze alarms,” he said.
The problem is that, like long-term recovery, future proofing is an intense, time-consuming process. Supplies need to be strategically placed. Emergency plans need to be thoughtfully developed and repeatedly updated. Housing and infrastructure need to be designed to withstand strong winds and extreme flooding. Everyone, from government agencies to local groups, needs to know their designated role.
“We’re definitely thinking about that all the time with Maria. Everything the team does there is about ‘Is this going to make it better next time?’” said MacCalla.
That means funding generators and solar panels, stationing Hurricane Preparedness Packs, and helping health centers build mobile units that will allow them to reach patients in the case of a future disaster.
And in the Bahamas, Direct Relief has plans to help renovate Rand Memorial Hospital in Freeport, on Grand Bahamas. “We’re already shifting to getting hospitals and clinics back up and running,” MacCalla said.
The organization is also weighing options to help the island nation be more prepared for future disasters.
“I could see us putting four or five [Hurricane Preparedness Packs] on different islands; I could see us doing solar energy on the healthcare center,” said MacCalla.