The after-effects of a disaster

[Cyclefrance]

Mentioned on another thread yday how 3 Carnival cruise ships had been chartered by the US Givt to provide temporary accommodation and decent shelter, food, etc. Seems that the company and comradery that places like the Superdome generate are preferred. Goes to show what is more important to the humans suffering - a sense of identity and purpose leads over better conditions:

Survivors spurn cruise ship plan
JOBS and money - not cruise ship berths - are what Hurricane Katrina survivors want as many spurn federal government efforts to relocate them once again to three vessels chartered from Carnival Cruise Lines and one from Scotia Prince Cruises. The Federal Emergency Management Agency had hoped to move 7,000 people from shelters to provide them with beds, private rooms and hot food aboard the vessels Ecstasy, Holiday, Sensation and Scotia Prince. But takers for the plan are few as many refugees want to get back to work and others are hesitant to go anywhere near a ship on the water after escaping New Orleans' floods. Nearly 26,000 evacuees at Houston's Astrodome, Reliant Center, Reliant Arena and convention centre were talking about the proposal yesterday, Coast Guard sources tell Fairplay. "Many feel the first certainty in their lives since before the storm," one officer said of the cots stretched across the dome's athletic fields. The mantra "the dome is home" has been heard from many, he said

[wolf]

I, myself, would be reluctant to get on a cruise ship in the gulf with several more named storms already formed ...

They have also apparently had trouble getting people to leave the Astrodome as they feel they have a better chance of reconnecting with their families if they stay closer to the area.

[tw]

Originally Posted by wolf

They have also apparently had trouble getting people to leave the Astrodome as they feel they have a better chance of reconnecting with their families if they stay closer to the area.

What would they have you doing, professionally, if you were called to assist these people? What really are the most important things these people must be provided for such an event? Are there mental exercises or physical activities one should perform to restore equilibrium? Will that many require medication? Or is it mostly filtering the few who really have problems from a more resilient majority?

[Cyclefrance]

I think you are right Wolf, plus there are other reasons as well, such as the thought of being moved again and back towards the area that has caused you the problems, and then there is the common bond that will have been struck between 'neighbours' at the Dome.

When I first read the news that cruise ships were to be offered I thought that everyone would be jumping at the chance to have a proper bed with washing facilities and also regular quality food and care, but that was the calm thinking of someone who has not been so traumatically affected by events. Who can gauge the reaction of the victims, and how exhausted both mentally and physically they are. Decisions they make and take will be on a totally different basis.

[wolf]

The majority of people affected by a disaster are actually pretty resilient. Meet their basic needs for safety, food, water, and shelter, and they do well. It's unlikely that folks who didn't need medications before the hurricane struck will need them in the aftermath. It's mostly about supportive counselling, in some cases specialized grief counselling, and doing things that will normalize the experience for them. Understanding stress reactions actually does a lot to help people through such experiences. Dealing with a natural disaster is actually easier than a terrorist event, but even that has it's own challenges. Lots of folks have a significant crisis of faith under these circumstances, but that's why we have Chaplains on the team who are specifically trained in disaster response. (A lot of well-meaning, untrained preachers say a lot of dumb things in the face of something like this ... particularly given that it was Gomorrah on the Gulf that got wiped off the face of the Earth.)

Excerpted from a much longer email from the International Critical Incident Stress Foundation

3. Once deployed, effective mental health response should follow the hierarchy of needs described by Abraham Maslow:
a. Meet physiological needs for shelter, food, water, clothing.
b. Meet basic needs for safety, security, and medical care.
c. Meet basic needs to re-establish family and other interpersonal connections. Reuniting families must take priority over all other such support. For rescue and recovery personnel, the establishment of "peer" and mental health support should be emphasized.

4. The principles of psychological first aid are useful guidelines for planning support services beyond that mentioned above:
a. Assess need, assess impairment
b. Stabilize (try to prevent further deterioration of psychological/behavioral functioning through meeting basic needs as described above)
c. Assess need for further support
d. Offer information, education, reassurance, as indicated
e. Connect with sources of continued support
f. Diagnostic and traditional "psychotherapy" functions are not included herein, but are considered as later points on an overall continuum of care.

It's pretty basic stuff as far as crisis services goes ...

One of the biggest tools that are at "our" disposal is the distribution of information. Not knowing what's going on breeds fear and uncertainty. There's a segment of what I do called a "Crisis Management Briefing" which gives accurate factual information about the event, as well as education on expected reactions ... basically teaching people that they are having NORMAL reactions of a NORMAL person who has been exposed to an ABNORMAL event.

The training I have was originally developed for use with emergency services personnel. It includes "pre-incident education" (knowing about this stuff going in can help you deal with your reactions), "demobilization" (talking to people as they are coming off a duty shift or off a disaster ground), "defusing" (a structured group discussion within 24 hours of the event, talking over what happened, but prepping people for what they might likely experience) and "debriefing" (also a structured group discussion that focuses on more on what they have been thinking/feeling since the event).

There are other segments that deal with children families of the emergency service workers, as well as spiritual support.

The same process can also be used for civilians.

Right now I don't know at which point I might be called in for assistance, but am prepared to go down South if my team is requested to do so.

[Cyclefrance]

I suppose it does come down to the basics when you think of it - get the fundamental needs satisfied and that must do a lot to influence a person's thoughts about where he is best off. The cruise ships under such circumstances would represent an unknown compared to what may have been achieved/received so far and instead of providing extra security as the authorities expect the choice for the individual isn't so clear-cut as he would be removed from the present comfort zone and that isn't going to be attractive.

Do wonder where this will all end. Last night's news on UK TV concentarted on the massive pollution in the area - water mixed with harmful chemicals, rotting food, corpses, sewage, etc, causing the whole area to need to be evacuated and a first estimate of at keast 3 months to clear up. Add to that, this morning we heard that 25,000 body bags were being sent to the area - irrespective of the current number of assessed fatalities. Really leaves you with heavy mixed emotions at the scale of the disaster.

[tw]

Originally Posted by wolf

The majority of people affected by a disaster are actually pretty resilient. Meet their basic needs for safety, food, water, and shelter, and they do well. It's unlikely that folks who didn't need medications before the hurricane struck will need them in the aftermath. It's mostly about supportive counselling, in some cases specialized grief counselling, and doing things that will normalize the experience for them.

I am rather surprised in that list of actions, that psychological triage does not appear to be part of the process. I would have expected 'psychological triage' to be implemented as part of a system when disasters were large. Or is such triage really inherent in the response?

[wolf]

If you tell people that they are going to a psychological triage station, or that there are psychologists or mental health people or something like that, they tend to head very quickly in the other direction.

We do that, but we're sneaky about it.

In addition to "normalizing the experience" we are on the lookout for signs and symptoms of something more going on.

[xoxoxoBruce]

This link is a friend of a friend's house after the flood in Mississippi. It doesn't look that bad at first glance but the water was almost up to the roof so the drywall is toast and the mold is rampant. It's funny the fences are almost intact but the washer and dryer moved around inside the house.

[Elspode]

Was this the result of storm surge flooding? My god, what a mess. The fact that their houses are still standing and essentially intact belies the destruction, because the molds will make their homes uninhabitable. They'll have to be gutted, sterilized, and refitted.

[LabRat]

[quote=xoxoxoBruce]This link [quote]

that album has been moved...

[xoxoxoBruce]

What? Where? Who? How?
The link I posted in post #9 still works.
What moved?

Originally Posted by xoxoxoBruce

What? Where? Who? How?
The link I posted in post #9 still works.
What moved?

I believe Labrat is referring to the link you posted in #14. That set of photographs has been removed. Interesting...

[bigw00dy]

This says alot!!!

[Trilby]

BigW00dy---I've seen people like that in the ED of our local hospital. Really.