Wednesday, January 30, 2013
By Dr. Irwin Redlener
Director, National Center for Disaster Preparedness, Mailman School of Public Health, Columbia University and Co-Chair, NYS Ready Commission
As we move beyond the immediate response to Hurricane Sandy into a long phase of recovery, many new questions arise: what have we learned? What could we have done better? What must we keep in mind in planning for and responding to future disasters?
These were among the questions Governor Cuomo posed when he created the New York State Ready Commission, charged with finding ways to ensure critical systems and services are prepared for natural disasters in the aftermath of Hurricane Sandy.
These were also the questions that leaders from the newly established Center for Disaster Philanthropy explored as they gathered at Philanthropy New York in early January 2013. Having just delivered our preliminary recommendations to the Governor, I discussed a number of issues that came up during the course of the Commission’s analysis:
1. Evacuations. Evacuation policy during Hurricane Sandy was generally ineffective. More information and planning are needed to effectively prepare for and implement general evacuations as well as critical, complex evacuations from hospitals and health care facilities. Key questions include: who should be evacuated and when? Who are the “evacuation messengers” and what exactly is the message? Do we endanger vulnerable people by evacuating them versus sheltering them in place?
2. Citizen Preparedness. In the post-9/11, post-Katrina environment, data show that many people are concerned about future disasters. However, few citizens have taken the recommended steps to ensure their own safety for such an event. In order to create a culture of readiness, we must better understand the dynamics of changing attitudes and behaviors regarding preparedness.
3. Vulnerable Populations. Children, the frail and elderly, and people with chronic illness face unique challenges in coping with events like Hurricane Sandy. We still have much to learn about how to protect the lives and well-being of people with complex need in a time of crisis. They are our litmus test; until we effectively protect the most vulnerable, we are failing at the overall task of disaster planning.
4. Incident Command and Coordination. The federal government has developed a National Response Framework that offers guiding principles for disaster preparation and planning, and much has been written about the role of incident command systems in disaster management. However, during and after Sandy, information sharing and coordination fell short. This must be addressed. We need better after-action analysis and more research in order to ensure sound strategy, policy and decision-making.
5. Mental Health Concerns. With lives, property and neighborhoods harmed or lost by this storm, it may be years before many individuals and families can return to a sense of normalcy. The psychological toll of displacement and destruction from Sandy may be far-reaching and long-lasting, particularly for children and people with pre-existing psychological or behavioral problems. Study and systemic action is needed to ensure quality psychological first aid is available to all who need it during and after a major disaster.
6. Training. Government at all levels has drastically reduced support funds for disaster training, curricula development, drills and exercises. This, coupled with an aging and diminishing public health workforce, spells serious trouble for ongoing efforts to improve our ability to plan for or respond effectively to calamitous events.
7. Recovery. The larger the event, the more complex the recovery. Buildings and infrastructure must be brought back, hopefully better and stronger than before. But the physical rebuilding must be coupled with emotional restoration. By addressing psychological fragilities and focusing on getting those affected—especially children—back to a state of stability and normalcy as soon as possible, we can bolster our most critical asset: people.
Optimizing disaster prevention, readiness, response, mitigation and recovery is essential if we are to save lives, protect property and reduce the long-term impact of events like Hurricane Sandy. And we must act now, since the reality is that persistent climate change and a highly deteriorated infrastructure create conditions for increasingly frequent and severe disasters in the future.
But, while our forecast calls for more Sandys, we need not feel helpless or overwhelmed. Entities like the Center for Disaster Philanthropy and their partners are taking bold steps to raise awareness about and funds for additional training, better organization and research that is translatable into effective practice. By following this lead, we will someday look back at Sandy not simply as another disaster or harbinger of those to come, but as an event that catalyzed the formation of a stronger and more resilient society.
Dr. Irwin Redlener is the Director of the National Center for Disaster Preparedness at the Columbia University Mailman School of Public Health, which works to understand and improve the nation’s capacity to prepare for, respond to and recover from disasters. He is also President and Co-Founder, along with singer-songwriter Paul Simon, of the Children’s Health Fund, a philanthropic initiative created to develop health care programs in some of the nation’s most medically underserved communities.