Tuesday, November 21, 2017

What I learned in Puerto Rico

There’s an old saying in emergency management, “There are no new lessons learned in emergency management, just new people learning the same old lessons.” Hurricane Maria in Puerto Rico was the 21st hurricane response in which I had participated, the first being Hurricane Opal striking Florida in 1995.

A much younger Michael Whitehead at the State Emergency Operations Center in Tallahassee during the Hurricane Opal response in 1995.
I traveled to Puerto Rico as a part of a Red Cross contingent mixed in on a charter flight with a Disaster Medical Assistance Team from Arizona. We landed at a darkened San Juan Airport at 2 AM on September 23, a few days after the storm struck the island. I was the second Red Cross person to arrive at the federal and state operations center in the San Juan Convention Center.

September 22, 2017: Red Cross volunteers and staff in Atlanta boarding a FEMA chartered flight for San Juan, Puerto Rico.
Many people asked me what I learned as a result of my participation in the initial response. On the spur of the moment I made a quick list of takeaways from my time in Puerto Rico. And I'm not speaking here about the Red Cross response in Puerto Rico, but about the overall response by the federal, state, local, and nongovernmental organizations that were involved.

This response was so unique and different from the others that I learned some new lessons while re-learning some of the old ones:
  •        There was no power, no communications, no water and no sewage almost anywhere on the Island when I arrived. In a situation where resources are in such short supply and distribution is a challenge the mass care Priority #1 is to resource the shelters. The shelters then become a Point of Distribution and the local community comes to that location to get food and water.
  •          “We were stuck on Day 2 of the response.” By days 3-4 in most responses power starts coming back on and the influx of outside resources catches up with demand. In PR we couldn’t get past Day 2 – the power didn’t come on and the terrible logistics of an island response kept FEMA from getting enough food and water on the island. In fact, in much of PR we are still in Day 2 of the response.
  •          The lack of communication was unprecedented in my experience. We had difficulty emailing or even making a cell call in the San Juan Convention Center where the Joint Field Office was established. At times, we couldn’t email or call someone on another floor or even across the room! We took pictures of each other’s pieces of paper, or their computer screen or their iPhone to capture the information that we needed.
A picture that I took of a piece of paper in order to capture the addresses because our email was limited.
  •          Large earthquakes like the New Madrid and San Andreas will create islands like PR, filled with millions of people unable to get power, communication, food or water. And with the bridges down, they will be unable to leave. Ironically, the many lessons learned from this response will apply to large earthquake responses.
  •          With populations this large (there are over 3.5 million people on the Island), we cannot bring enough shelf stable meals and bottled water on the island fast enough to meet demand, much less get it distributed in an equitable manner. We needed water purification tablets, straws and large Units capable of producing water in bulk, which is what they started bringing on the Island. Then they brought in containers for the populace to carry the water. And propane cooking stoves so that they can distribute food boxes with food that can be cooked.
  •          And finally, more of the responders got traumatized than in other disasters. I was.

Traumatized? Me? Yes.

I've traveled and been and seen things like this before. I was in a war zone for a year. I arrived in southern Mississippi 3 days after Hurricane Katrina slammed into Bay St. Louis and Waveland and Biloxi and all the other towns that were devastated. I spent 2 weeks in Manhattan after Hurricane Sandy. I've seen acres of carbonized homes with solitary chimneys left standing in mournful protest after wildfires.

But Puerto Rico was different.

I didn’t travel about the Island. Like during Katrina, I was working long hours so I missed all the terrible television images that many of you saw. For 3 weeks, I sat at a table that was one of many identical tables on the 3rd floor of the Convention Center. In the first weeks that I was there a parade of people with problems and questions for the Red Cross came to see me and my partner. Sometimes they were lining up to see us. Some of these problems and questions we were able to resolve. For most of the problems and questions we had no ready solutions nor answers.

The Joint Field Office on the 3rd floor of the San Juan Convention Center where I worked for 3 weeks responding to Hurricane Maria in Puerto Rico.
What follows is a brief but representative collection of the information that came to me by message, phone or in-person:
  • Search and Rescue reported finding dead bodies and live people in the same house.
  • A request for assistance from a nursing home, saying that they had no food or water for 2 days.
  • The Puerto Rican Red Cross volunteer who burst into tears mid-sentence as she was talking to me and sobbed, “I have been trying to bring food and water to my family, but I can’t.”
  • The man from Dominica who saw my Red Cross hat and stopped me as I left the Convention Center. He said that he had been living at the airport for 3 weeks trying to get home. I could see the desperation in his eyes.
  • A family of tourists in a hotel who needed food for their children because they had run out of cash and no store could take a credit card.
  • A family who needed a generator because their child would not survive without electricity.
  • Hospitals that couldn’t get diesel for their generators because the tanker drivers were afraid of being hijacked.
  • A message: “I have not heard from my elderly parents for a week. Can you tell me if they are okay?”
  • A message: “My father lives alone and needs insulin. Can you help me get him a resupply?”
  • An overheard conversation:
“These two elderly women live near my house. How can they get some food and water?”
“They need to go to the point of distribution for the municipality.”
“That’s a 30-minute walk from their house and we live on top of a hill.”
“You need to talk to the Mayor of the municipality.”
“We never know when the distribution site will be open. And by the time we get there everything is gone.”
“You need to talk to the Mayor of the municipality.”
“Isn’t there any other way to help these people?”
“This is the system that the Puerto Rican government has established. Go talk to the Mayor.”

We had lots of electronic communications devices but very little communications.
  • There was the young guy in the nice, blue U.S. Public Health Service uniform: 
He was on the Disaster Mortuary Team. “Red Cross workers in the field discovered some dead bodies,” he said. He wanted to make sure that if we discovered any more that we recorded the precise location and passed the information on to him. “We need to pick up the bodies,” he explained, almost apologetic. “It’s our job.”

There were more stories. Many more. I can’t remember them all, but I can’t seem to forget enough. The daily onslaught of messages from desperate people who I knew would die or suffer greatly if we could not help them, and we could not help all of them, took an emotional toll. I didn't need to travel to the cities or the shelters to know what was going on. I had enough disaster experience to know what the conditions were like on the island based on the reports I was seeing.

I think that I was traumatized by the fact that I traveled to the Island to help but I found out when I got there that I was unable to help everyone. In the other disasters I felt like we were behind but we were catching up and eventually we would get to everyone. In Puerto Rico, standing on the 3rd floor of the San Juan Convention Center, I didn't feel that way. I felt like I was in an alternate disaster universe, or in the disaster version of Groundhog Day, where we performed the same tasks with the same unsatisfying results.

I was deeply saddened by this knowledge, and still am to this day. I did the best I could. In fact, I think that I did one of the best jobs that I've ever done in any disaster. And I'm so very sorry that it wasn't enough.

Saturday, June 17, 2017

"Reflections" on student life from 1981

I was reminded of when I was a columnist for the Independent Florida Alligator, the student newspaper, during my long ago graduate student days in 1981. One of my columns, which I have excerpted below, will give you younger folks some perspective on the great issues of the day that we have discussed, are discussing and will discuss.

Mike Whitehead in 1981  with his graduate student "look"

Excerpt from my "Reflections" column in the Independent Florida Alligator in 1981:

UF has changed from 1975, when I left on a six year sabbatical, and last August, when I returned to enter the wasteland of higher education. The debate over Vietnam has been replaced by the debate over El Salvador. But, whereas the argument over El Salvador has just recently reached the stage where rhetoric overwhelms all fact, by 1971 the debate over Vietnam had passed that stage by about three years. Of course, like everyone else, we had our riots. In spring of 1972, Nixon decided to coax the enemy to the bargaining table by mining the harbors of Hanoi and Haiphong and bombing the hell out of whatever was left of North Vietnam. The UF campus, which had slumbered peacefully through the Tet offensive and the invasion of Cambodia, suddenly sprang into life. The local anti-war leadership, defeated and dejected after beating a dead horse for six years, was overjoyed that they could finally break out their microphones and chant their slogans to a crowd of more than 10 people.

The brave students seized 13th street in front of Tigert Hall and waiting gamely for the enemy to arrive, which they shortly did. A weak attack by a fire truck spraying water and then a tear gas grenade was easily repulsed by the students (they threw the grenade on top of the fire truck). The enemy retreated, the students cheered, and then settled down to a game of Frisbee. Meanwhile dark clouds were gathering as, unbeknownst to our heroes, every red-neck sheriff and policeman for five counties was called to Gainesville for the counterattack, which took place just after dark.

Guerrilla war ensued when the students realized that the policemen were prevented from entering the campus. The students began to launch forays into enemy lines as the policemen, like Marines on a firebase, waited doggedly for the next assault. The students would drag a bench onto University Avenue in front of Murphree Hall, wait for a squad car to respond, and then pelt the officers with rocks when they arrived. Reinforcements were called, tear gas was fired, and the students would retreat into Murphree Hall until the next round. All this came to an abrupt halt when a tear gas grenade (accidentally?) landed in a first floor stairwell and smoked everyone out.

I watched all these proceedings, quite safely, from the roof of what is now Goering's Book Center. This not only looked like the movies, it bore a remarkable resemblance to the evening news of the last few years. So this is college life, I thought.

So this is college life. Unfortunately for these students, the war ended in a year and they had to return to more mundane things like studying. Today's freshman has no such mission or sense of purpose to guide his life. Oh, he has the environmental movement and the anti-nukes, and El Salvador is beginning to have possibilities, but nothing to offer him full commitment. Maybe Reagan will send the Marines into El Salvador. Wouldn't that be great? Then the old megaphones could be dusted off and the never ending battle for truth, compassion and justice could be continued against the Gainesville police, just like in the days of old. Who wants to study anyway?

Monday, May 29, 2017

My memories on Memorial Day

I first met Bob Zangas in Kuwait at the start of the war. He was a Marine Corp Lieutenant Colonel, a Reservist, and part of the civil affairs contingent for the First Marine Division. He and I were waiting in Kuwait while the invading army sliced through the hapless Iraqi Army on the way to Baghdad. We worked on a project together and I got to know him. After I moved to Camp Babylon Bob moved to the provincial capital of Al Kut. I was able to see him a few more times before he rotated home in September 2003 with the rest of the Marines.

I first met Fern Holland at the Coalition Provisional Authority (CPA) South Central Office at the Hotel Babylon in Hilla in the fall of 2003. Fern, a lawyer from Oklahoma, was assigned to the office to promote women's rights in the south central region of Iraq. Fern came across to me as a very attractive, very intense young woman. We were going in different directions during the day so I rarely spoke more than a few words to her, and that was mostly in passing, in places like the dining facility. Such a woman, assigned to perform such a mission, caused some eye rolling among some of the men at the Office. But, since the promotion of women's rights in Iraq was a priority for Ambassador Bremer and the CPA, such editorial comments were limited.

Salwa Oumashi was an Iraqi translator who worked for Fern. According to a 
New York Times article on these two women, Salwa had lived in the United States. One evening, during a social function on the third floor of the Hotel Babylon, I was able to have a nice, long discussion with Salwa. I took away the impression that she was very committed to her job.

In December 2003 I was standing in the CPA compound when I saw Bob Zangas, dressed in civilian clothes. After Bob completed his initial tour and the Marine Corp Reserve returned him to civilian life, Bob volunteered to return to Iraq as a civilian employee of the CPA. He was assigned to our South Central Office with the task of building the capacity of the Iraqi media. Although I could not imagine volunteering to return to Iraq the act seemed to go along with the boundless enthusiasm Bob had for his new job and the unlimited optimism he had for the future of the Iraqi people.

The CPA South Central compound where I worked from October 2003 to February 2004 was comprised of primarily civilian employees of CPA or Kellogg, Brown & Root (KBR), the contractor responsible for providing our logistical support. Most of the cooks and servers in our dining facility were Pakistanis who lived right there in the compound. The men who protected our perimeter and guarded us while we slept were contracted Nepalese, former Gurkhas in the British Army.

Other than a small contingent of Military Police, my Team of five civil affairs soldiers were the only other soldiers on the compound. This became important because we were armed, and could provide our own protection, and we traveled frequently to the five provincial capitals in our area. KBR would often check our schedule and ask if we would escort truckloads of supplies to one of the outlying CPA offices. I didn't want my job to be escorting supply convoys, but I saw no reason that we couldn't occasionally lend a hand.

So it was that one day in January 2004 Bob Zangas came to me and asked if he could accompany us to Ad Diwaniyah and would we stop by a dairy in the area? The dairy was a beneficiary of a CPA project, and Bob wanted do a media story on the project. I thought the task supported the war effort and I agreed to help. In February 2004 Fern asked if she and Salwa could ride 
.along with me on a trip to check on the progress of the construction at the Karbala Women's Rights Center. Later that month Ambassador Bremer came to Karbala to the inauguration of this center.

On February 28, 2004 I left CPA South Central to return to Kuwait and eventually an airplane ride home. With our departure Fern, Salwa and Bob were forced to decide whether they could do their jobs inside the compound or be forced to travel outside, unprotected. I had already observed by their actions that Fern and Bob were prepared to take more risks than I was. Any risks that I took, of course, subjected my soldiers to the same risk. Bob was responsible only to himself. Where ever Fern went she was accompanied by Salwa. I was not privy to any conversations that these women had about the risks that they were taking.

Some could argue that they were braver than I was, or more foolish. Others would say that both sides of the argument are correct. The net result was that on March 9, 2004, ten days after I left Iraq, while returning from a visit to the Karabala Women's Rights Center, Fern Holland, Salwa Oumashi and Robert Zangas were ambushed and killed in their vehicle by a hail of AK - 47 bullets.

February 2004. The Women's Rights Center in Karbala. I am showing the ladies a picture of my family. Fern Holland, far right and Salwa Oumashi, second from right, pointing to the picture, were killed in Iraq in March 2004.

In a commentary in last week's Wall Street Journal  entitled "They also serve who contract out," Peter J. Woolley said that an estimated 3,200 individuals, most of who were American nationals, have died in either Iraq or Afghanistan since these wars began. I know that Memorial Day is to honor fallen American soldiers, but whenever I think of someone who was killed in Iraq Fern, Salwa and Bob come to mind. They and their families sacrificed for this war. 
January 2004. I am translating the Spanish spoken by the Iraqi policeman to my right into English for Bob Zangas, seated to my left. Bob was killed in Iraq in March 2004.

Not a Memorial Day has gone by that I don't think of them.

Saturday, July 30, 2016

Mass Care in Richwood, West Virginia

A frontal system got stuck over the hills of West Virginia the night of June 23, 2016 and caused historic flooding over the central and southern counties of the state. Twenty three people were killed, including a 2 year old who's lifeless body was found by search and rescue workers on the Greenbriar golf course. On June 24 the American Red Cross, in response to the flooding, deployed me from my home in northern Virginia to Charleston, West Virginia.

I worked on the response for 2 weeks. I spent almost half of that period in the little town of Richwood. I want to tell you a little about what happened to me there and, more importantly, what I took away.

The sign at the limits of the city of Richwood.
Dr. Bob Henry Baber was sworn in as the Mayor of Richwood five days after the storm. According to the business card he gave me, Bob Henry (as he likes to be called) is a "Poet, Novelist, Environmentalist, Speaker, Creative Writing Teacher and Mosaic Arts Instructor." He also told me that Richwood was a town of 2,000 souls in which 99% of the children were on free or reduced school lunch.

The flooding happened on a Thursday night and into Friday morning. I arrived in West Virginia that Friday night. When I reported to the Disaster Relief Operation (DRO) on Saturday morning the number of staff assigned to the operation had more than quadrupled from the day before. By Monday morning the staffing number had tripled again, and by Wednesday had doubled again. Ultimately, over 700 staff and volunteers were working on the operation. All of the volunteers came knowing that they would be sacrificing their 4th of July weekend.

Of the 1500 or so homes judged destroyed by the flooding, the most were in Kanawha County (598), followed by Greenbriar County (460). Nicholas County, in which Richwood resides, had the third highest total, 141. Through the misfortune of geography Richwood was more inaccessible than the affected towns in the other counties.The homes in Richwood were just as flooded. There just weren't as many of them, and the town wasn't as easy to get to.

On June 29th the DRO divided the response into 4 Districts and I was assigned as the Mass Care Lead for District 3. That day I drove from the DRO headquarters in Charleston to the District headquarters in Beckley, just south of the Fayette County line.

The division of the affected counties in West Virginia into Districts by the Red Cross Disaster Relief Operation.
The morning of Thursday, June 30th I rode north on US 19, a four lane divided highway that I came to know very well in the next week. Just south of Summersville we turned East on WV-39, a twisting, turning, harrowing, 8% downgrade that led to the Cherry River valley and the town of Richwood.

Viewed from a mountainside the Cherry River Valley and the town of Richwood are pretty. The damage is hidden.
At first glance flood damage is not as dramatic as that created by hurricane or tornado winds. With a few exceptions, like the mobile home in the picture below, the damage is hidden inside the structures. By looking at the high water marks and the topography of the valley I could tell that much of the city had been affected.

A mobile home washed against a bridge over the Cherry River in Richwood, WV.
After the flood waters receded the people of Richwood were inundated with a second flood: donations and volunteers. Different people and organizations stepped up to the task of receiving, sorting and distributing the thousands of items brought in on trucks, trailers and automobiles. The Moose Lodge, across from City Hall, and the 1st Baptist Church on Walnut St. were two such locations that I visited. The largest repository was the High School Gymnasium, a red building down by the river.

Donated goods at the high school gymnasium in Richwood, WV.
The Moose Lodge, untouched by the flooding, was a central location for feeding and donated goods and we initially established a fixed site for feeding there. Access to food was an issue in Richwood since they had no grocery store and the only restaurant I could find was a Dairy Queen, a few blocks from the Moose Lodge where I stopped when I wanted coffee.

Food pantries, supported by food banks, have the traditional role of feeding the hungry in blue-sky days. The food pantry in Richwood was by the river and was innundated by the flood. I worked with the food pantry and the food bank people to start the road to re-establishing this service. The Baptist kitchens and the Red Cross ERVs couldn't be there forever. In order to transition to long-term feeding we had to get the food pantry back in operation. I was able to start this transition process before I left.

Red Cross Emergency Response Vehicles feeding at the Moose Lodge in Richwood, WV.
A Type 1 Field Kitchen from the North Carolina Baptist Convention was assigned to support District 3 and operated at the Restoration Fellowship Baptist Church in Mt. Nebo, just off US 19 south of Summersville. I ate a lot of meals from that kitchen. The meals prepared by the kitchen were delivered into the 4 counties of the District by Red Cross ERV's. The meals are kept hot by insulated food containers called Cambros. You can see the Red Cambros stacked on pallets in the picture below.

Positioning loads for Red Cross ERVs at Kitchen #3, operated by the North Carolina Baptists, in Mt. Nebo, WV. 
We were fortunate to have a Team of Americorps Volunteers assigned to support us in Richwood. Many of the inhabitants of the city were elderly and didn't have vehicles. The Americorps Volunteers delivered meals from the ERVs to them. With the aid of a Red Cross truck and a supervisor, the Americorps Volunteers also loaded donated supplies from the gymnasium and delivered them into the community.

Mayor Baber was undaunted by the challenges his community faced and even thought that the disaster could be an impetus for change. The last time that I saw him, just before I left West Virginia, I told the Mayor about Pearlington, MS. I told him how Pearlington had been devastated by the passing of the eye of Hurricane Katrina over the town in 2005. I told him how the many people who came to Pearlington to help had left with a tiny piece of the city in their hearts.

Home in Pearlington, MS destroyed by Hurricane Katrina's wind, rain and surge.
Someone set up a website dedicated to the recovery of Pearlington and the people who had responded. On the first annual anniversary of the storm the city inhabitants had a celebration with a Low Country Boil of shrimp, crab, potatoes and corn-on-the-cob. Through the website they invited all the responders and I came.

I told the Mayor that Richwood should do the same thing. Have a celebration a year later and invite everyone who had helped. When I spoke those words I'm not sure that Bob Henry, a far-sighted a man as I think he was, was able to see that far into the future.

He did give me his email and maybe next year, when the months have healed some of the damage of that night, I might remind him. I'm not the only one who left West Virginia with a piece of Richwood in my heart.

Monday, May 30, 2016

At the National Response Coordination Center

The National Response Coordination Center (NRCC) is housed on the Mezzanine Level of FEMA Headquarters on C Street in Washington, DC. "When activated, the NRCC is a multi-agency coordination center located at FEMA Headquarters. Its staff coordinates the overall Federal support for major disasters and emergencies, including catastrophic incidents and emergency management program implementation." I've been in the NRCC many times but last month I got the opportunity to work in the NRCC when it was activated for an exercise.

The National Response Coordination Center.
Unlike the emergency operations center in Tallahassee, FL where I spent numerous hours over the last 18 years, the NRCC has a low ceiling. Like the State EOC in Florida, however, every chair in the NRCC is assigned to a role and the agency designated to fill that role. My job was to serve as the American Red Cross liaison to the NRCC. 

The State EOC in Tallahassee
FEMA provides the trained staff to operate the NRCC when activated. Most of the various federal agencies and nongovernmental organizations identified in the National Response Framework provide representatives to the NRCC so that we can perform the emergency management form of alchemy called multi-agency coordination. Because of the inevitable turnover in staff, and the fact that the NRCC is rarely activated, these agency representatives show up in the NRCC knowing something about their own agency but very little about how to operate in a multi-agency coordination center.

My case was a little different. Because of my background and the fact that I had been in my new job less that 6 months I knew more about how multi-agency coordination centers operate that I did about the Red Cross. That was okay. It was an exercise. We were all there to practice and learn.

When I was at the State EOC my view of the disaster was like flying over in a helicopter. Working in the NRCC was equivalent to viewing the Atlantic Ocean from a transcontinental flight to Europe. We took the Long View of the Big Picture.

Most of our activities revolve around responding to resource requests (provided to us by the FEMA Region) from the affected state or states  and creating reports for the Big Bosses about What Is Going On. The information we collect is built into reports that inform decision makers like the FEMA Administrator and ultimately the White House. 

I enjoyed working in the NRCC. Part of the reason is that the exercise had an interesting scenario. If I had spent 3 days waiting for a hurricane that fizzled my sentiments would've been different. What was really interesting was the perspective that I got from looking down on the disaster from the transcontinental airliner and how this affected my opinion about how state mass care coordinators should act when faced with large or catastrophic disasters. And that is what I want to talk about.

Most normal emergency manager people when faced with an overwhelming event naturally focus on the part of the job that is familiar to them. They see the situation getting out of control and struggle to wrest it back. They work with the resources that they have available to get the situation back under control. In most disasters this is the correct course of action.

In a large or catastrophic event the resources available are inadequate for the tasks. Getting these resources deployed is important but an even more critical task is communicating the type, kind and quantity of resource shortfalls to those outside the affected area who are able to provide those resources. If you're at the county level you need to let the state know what you need. If you're at the state you need to concentrate on getting those Resource Request Forms completed and submitted to the right FEMA person as soon as possible. 

In other words, if your jurisdiction is affected then you need to direct more of your attention to those external agencies who are mobilizing to provide support. If you're not telling these external agencies what you want, when you want it and where you want it sent they aren't going to wait on you. And you may not be happy with what you end up receiving. 

After requesting resources the second most important task on the state mass care coordinator's list in a catastrophic event is to help ensure all the stakeholders have a common understanding of the situation - a Common Operating Picture. The way to achieve this common understanding is to get everyone with a need to know on the same conference call every day. The state mass care coordinator is in the best situation to do this.

The purpose of the state mass care conference call is to gather and share information with all the mass care stakeholders within and outside the State EOC. Holding this conference call daily with the right agencies is critical to an effective mass care response. I cannot emphasize this point to much.

Mass Care Conference Call
When I was the State Mass Care Coordinator in Florida I always held the call daily at the same time: 10 AM. This allowed everyone to adjust their own meeting and conference call schedules so that they could participate in the state call. I also developed a State Mass Care Conference Call agenda/report that I emailed to all the conference call participants before the call. This document identified who I wanted to report on the call and also contained the latest mass care information from the State EOC. That way precious conference call time wasn't used reporting on information that was already shared in the document.

After requesting resource shortfalls and ensuring that all stakeholders have a common operating picture the third way that the state mass care coordinator can help his/her cause is by working to establish the mass care priorities for the response. The best way to do this again is through the mass care conference call. The means to this end is not by dictating priorities but by soliciting input from the key stakeholders and then working to achieve consensus. This is a tall order but the state mass care coordinator is in the best position to achieve this goal.

The sooner that the state mass care coordinator can establish a mass care conference call in order to 1) determine mass care resource shortfalls, 2) gather and distribute a common operating picture, and 3) establish mass care priorities the better the response will be. Achieving these objectives will enable those of us outside the affected area (in the NRCC, the Regional Response Coordination Center and the Red Cross Disaster Operations Coordination Center) to do a better job of suporting the survivors on the ground in the midst of the disaster.

Sunday, April 24, 2016

Estimating mass care resources: the example of the Kumamoto earthquake

I've been trying for over 20 years to estimate the amount of mass care resources that would be required in a disaster. In 2004 when Florida was hit by 4 hurricanes in a 6 week period I had multiple opportunities to try and figure this thing out. One thing I learned pretty quick in the 6 weeks was that when someone wanted me to provide a mass care resource they wanted it RIGHT NOW. Or, preferably, yesterday.

I also learned that in the State Emergency Operations Center during a hurricane response we weren't able to do "right now." For certain things that were already in the State Logistics Staging Area (like bottled water) we might even be able to do "tomorrow." More likely it was going to be day after tomorrow. And if they wanted something that we hadn't already ordered it would be, well, days until they would get it. That is if the requester was lucky and everyone, including me, did everything right.

There was a lot of things that I remembered and a lot of things that I forgot after Charlie, Francis, Ivan and Jeanne paid us all a visit. My big takeaway was that we needed to be able to estimate mass care resource requirements before the damage assessments were completed and in some cases, before the event actually happened.

How in the world are you going to do that? you may ask. Think about it. If a Category 5 Hurricane is lined up on Miami and forecast to hit there tomorrow we don't need to say, "Well, as soon as the damage reports are compiled, probably a few days after the storm hits, we'll know what we need to order. We'll just have to wait until then to figure out what we need."

We have to do better than that.

The things we need to order are always the same: cots, field kitchens, shelter managers, bottled water. What we don't know are what numbers we need to put in the quantity blocks of the requisitions. What frequently happens are conversations like this:

MASS CARE GUY: I need cots.
MASS CARE GUY: I have no idea.
LOGISTICS GUY: "I have no idea" doesn't fit in the quantity block of the requisition.
MASS CARE GUY (MAKES UP A NUMBER): What about 10,000?

I've had those conversations during a disaster. More than once, I'm afraid to say. But what could I do? There wasn't a manual or instruction book explaining how to do all this stuff I was doing. I decided that there had to be a better way of doing things than making up the numbers.

After 10 years of talking, explaining and arguing with some knowledgeable mass care people we've come up with a process to estimate mass care resources. The process is crude and needs a lot of refining, but guess what? Doing it this way is better than making it up.

The demand for mass care resources after an event is based on three factors: population, intensity and vulnerability. The population numbers we can get from the Census. To estimate intensity levels we developed this chart:

Table to estimate event intensity.
What we do next is estimate the number of people who were affected by each intensity level. For hurricanes we have the Saffir-Simpson Scale.  The U.S. Geological Service puts out PAGER Alerts after significant earthquakes. The basis for measuring earthquake intensity in these Alerts is the Modified Mercali Intensity Level:

The PAGER system provides fatality and economic loss impact estimates following significant earthquakes worldwide. This information is usually available within hours of the quake and provides an immediate estimate of the number of persons affected.  The USGS put out a PAGER ALERT for the Kumamoto, Japan earthquake that happened several weeks ago. The PAGER looked something like this:

The PAGER showed estimates of the number of persons affected by MMI level. Using the Event Intensity Table I came up with the number of persons affected by High (194k), Medium (1,410k) and Low (2,865k) intensities. I entered these population numbers into the Mass Care Planning Tool spreadsheet that we've developed to estimate mass care resource requirements

Remember: the demand for mass care resources is a function of population, intensity and vulnerability. Using the Intensity Table and the PAGER we were able to estimate the population affected by intensity. From these numbers we need to estimate the % of people who need to be fed and sheltered, for each intensity level. The percentages would vary according to the vulnerability of the people.

In some places, for example, the percentages for sheltering would be 10% for High, 5% for Medium and 1% for low. There are different percentages to estimate the feeding numbers. I had no idea what %'s to use to make a shelter estimate for a Japanese earthquake so I used the 10/5/1 that I had. The estimate using those percentages for the Kumamoto earthquake was 118,550 persons needing shelter (see Table below). Then I waited for the off chance that I might actually be able to get an estimate of the number of persons requiring shelter.

Weather.com also reported that: “Local media reported that nearly 200,000 homes were without power and an estimated 400,000 households were without running water…[and] 180,000 are without shelter.”

Now that I had some actual numbers of people needing shelter I could see that the estimate of 118k needing shelter was low.  The 10/5/1 shelter percentages that I used weren't high enough, and probably should have been higher.  In other words, their vulnerability to the hazard was greater than I estimated.

As we socialize this estimation process in the mass care community and people start using it in disasters our ability to estimate these vulnerability percentages will improve. The conceptual framework for this estimation process has been included in the new FEMA L418 Course: Mass Care/Emergency Assistance Planning & Operations Course. This concept is also included in the new (soon to be released) Red Cross Feeding Standards & Procedures.

 Like I said, the process is crude and needs a lot of refining. But take my word for it: estimating mass care resource requirements this way is one HECK of a lot better than making up the numbers.