Studies of a Role for Communities in the Face of Catastrophe
By Paloma Dallas
Introduction
Over the last decade, the United States has been buffeted by a series of high-profile attacks and natural disasters, while the world has suffered numerous natural catastrophes.
While these incidents have prompted governmental and institutional responses, many Americans have little sense of how they can prepare if faced with these threats. Besides individually stockpiling canned goods, bottled water, and flashlights, citizens have little sense of what they might do in collaboration with others.
Some questions to consider as you read:
- What have the people in your community done together to protect themselves against, or recover from, catastrophic events?
- How can government agencies engage citizens to prepare for and responded to a catastrophe?
Article Text
Over the last eight years, the United States has been buffeted by a series of high-profile attacks and natural disasters: the September 11, 2001, attacks, the subsequent Anthrax scare, and the devastation of many Gulf Coast communities by Hurricane Katrina. There has also been the threat of a global pandemic, such as an avian flu or SARS outbreak, and the prediction that global warming will increase the incidence—and severity—of future natural disasters, both in the Unites States and around the world.
These threats, both realized and hypothetical, have prompted governmental and institutional responses. We have developed a Department of Homeland Security, and air travel will probably never be the same again. Research on vaccines and vaccine production has been ramped up. There have been investigations into both national and international public health protocols, and numerous congressional inquiries.
Yet many Americans have faced these threats with little sense of what they can do in anticipation, besides stockpiling canned goods, bottled water, flashlights, and perhaps duct tape. And they have had even less of a sense of what they might do in collaboration with others.
From the perspective of the Kettering Foundation’s work, this poses a threat to an understanding of democracy in which people see themselves as actors who, together, can engage the problems they face collectively. More pragmatically, it poses a challenge to responding to these threats.
The foundation has long identified what we refer to as “wicked” problems as those that cannot be addressed, let alone solved, by any one institution or agency. These problems—poverty, educational disparities, health conditions that are widespread in a community—all elude a purely technical solution. Regardless of the programs and initiatives developed to combat them, they will persist if the people of a community don’t also act.
It would seem that catastrophic events that threaten our collective welfare, whether they are natural disasters, pandemics, or intentional attacks, also require actions by citizens, not only as individuals, but also as a collective.
For this reason, the foundation has been intrigued by what seems to be growing attention to the role of communities in protecting themselves against these catastrophic events and in recovering as quickly and as fully as possible from them.
A March 2007 article in the journal Biosecurity and Bioterrorism argued that “Disasters and epidemics are immense and shocking disturbances that necessitate the moral courage, judicious action, and practical innovations of large numbers of people, not just those who serve in an official capacity.” The authors, the Working Group on Community Engagement in Health Emergency Planning, number more than two dozen and include scholars and professionals in emergency preparedness from across the United States and Canada.
A Web site for the Nicasio community in Marin County, California, has a link for their local disaster council. The page begins: “In the event of a major disaster in the area, such as an earthquake or major wildland fire, the county emergency services may be overwhelmed and our community may need to be self-reliant for a matter of days.” The Web site outlines the community’s disaster plan—which includes the establishment of neighborhood liaisons, a disaster command post, an assembly point (for disseminating information), a first-aid post, and an emergency shelter. In advance of a disaster, community members are invited to fill out forms detailing their property and the emergency skills they have to offer.
An article in a 2006 edition of Rural Realities notes the role Community Emergency Response Teams (CERTs) can play in helping “rural areas that are under social and economic stress respond more effectively to disasters by building capacity before disaster strikes.” And the Institute for Community-Based Research at Delta State University in Mississippi has a project in “Disaster Relief, Recovery & Redevelopment.” The project Web site is “intended to serve as a resource for people interested in conducting, applying and disseminating community-based research to understand disasters and inform redevelopment.”
In an article for Foreign Affairs, Stephen E. Flynn, a senior fellow for National Security Studies at the Council on Foreign Relations, argues that “when it comes to managing the hazards of the twenty-first century, it is reckless to relegate the American public to the sidelines.” The most likely targets of a terrorist attack will be civilians, he writes, and “most city and state public health and emergency-management departments are not funded adequately enough for them to carry out even their routine work.”
The federal government is also recognizing a role for communities in preparedness. The Department of Homeland Security is offering workshops for faith-based, community, and other nongovernmental organizations in a “strategic partnership to develop a national culture of preparedness.” And the Department of Health and Human Services has launched a Web site, www.PandemicFlu.gov, that includes information on federal and state planning, but also individual, workplace, school, and community planning in the case of a pandemic flu.
While all of these identify a role for communities or the public to play, it is not at all clear whether everyone is on the same page as to what that role is.
From the institutional side, there are questions about what it means to engage communities. Are people involved in creating plans and identifying problems, or are they simply being asked to help implement plans developed by government agencies or service organizations? And from the community side, how widespread are these initiatives? How well received are they within communities? And from both perspectives, how are disagreements about what to do dealt with?
Monica Schoch-Spana, senior associate with the Center for Biosecurity at the University of Pittsburgh Medical Center, is the chair of the Working Group on Community Engagement in Health Emergency Planning. I contacted her with some of these questions because I was struck by the way the working group described the relationship between professionals and the public in their March 2007 article:
The prevailing assumption is that a panic-stricken public, blinded by self-preservation, will constitute a secondary disaster for authorities to manage. Some emergency authorities also have mistakenly interpreted citizen-led interventions in past and present disasters as evidence of failure on the part of responders. In reality, government leaders, public health and safety professionals, and communities at-large have complementary and mutually supporting roles to play in mass emergencies.
Schoch-Spana went on to further clarify in our interview, “Our working group wanted to articulate a different vision of the citizen role in preparedness, so it was less about individuals hunkering down with their stockpiles in the middle of a crisis and more about the active contributions they could make in advance of a crisis.” There is a “collective wisdom” in the community, she said, and while “it’s wonderful that we value volunteers’ physical contributions during the crisis . . . their mental and moral problem-solving skills remain untapped in the planning period long before and after the crisis.”
Not only will communities often be on their own in the initial aftermath of a crisis, she continued, but there are decisions that governmental and other institutional responders will have to make that will have profound impacts on a community. For instance, there are many decisions that require the input of the community to ensure policies are “feasible, socially acceptable, and fairly applied across the population.”
In the case of a pandemic flu, vaccines are often not immediately available. So there are choices to be made as to who should receive the first vaccines or who should have priority in receiving antiviral drugs. And in fact, the Centers for Disease Control have already held some public forums around the country asking people to weigh in on precisely these kinds of questions.
Another example Schoch-Spana gave concerns the suggestion that schools shut down for a significant period of time in the event of a pandemic. Because children are known for transmitting diseases, shutting down the schools is thought to make containing an outbreak easier. Yet closing schools would have economic and social consequences and put a heavier burden on some—particularly those whose work hours are inflexible and who wouldn’t be able to find alternative child care. Only the people of the community can determine what would be in their best interest by weighing the benefits of closing the schools against the challenges that this would create. And, she pointed out, different communities will probably reach different conclusions about what is best for them.
If communities have no role in the development of a plan or strategy, they may be more resistant to its implementation. Policies and plans developed by agencies and organizations unfamiliar with a community may also fail to take into account the community’s particular assets or challenges. A 2006 paper titled “Community Wildfire Events as a Source of Social Conflict” finds that the greatest conflicts often occur between community “insiders” and “outsiders” in the aftermath of a natural disaster. Community insiders are often frustrated by everything from the “evacuation process and experience” to the failure to adequately take advantage of local capabilities.
But the question of how community outsiders and insiders collaborate, or perhaps more specifically, how those charged with responding to a disaster collaborate with the people in the community affected by the disaster, can be challenging. Part of the difficulty is because our health-care system is a constellation of government agencies and private and public hospitals that don’t always collaborate with each other, much less with the public. “Right now, our health-care system is not set up to solve community-wide problems,” said Schoch-Spana.
She explained:
In a local community, your hospitals are pretty much competitive economic units. They don’t really have incentives to work together to address population health problems. But in the context of something like pandemic flu, how they behave as a group is going to have a profound impact on the mental and physical well-being of the community. So there are some large-scale issues, such as if hospitals can only take in a certain amount of people . . . how are those large-scale triage decisions going to be made? And that is not just a medical decision. That really is about how one uses a community’s entire set of health-care resources to protect the health of people and the confidence of the population. We don’t have the infrastructure it takes to have those kinds of collective decisions right now because health care is considered to be the purview of technical experts. And because health care is also in the private sector, there is little way in which a city’s residents can engage with and have a conversation with the leadership of hospitals.
Many hospital administrators are recognizing that they will not have the capacity to respond to these threats alone. So some have begun to try to build coalitions with public agencies and even with community organizations. When I asked how the group’s recommendations had been met by professionals in the field, she said that by and large, health-care and emergency response professionals recognize that they need to interact differently in the public sphere. They are daunted, however, by the resources—both in financial and personnel terms—that they think would be needed to adopt the joint problem-solving approach suggested by the working group.
Right now, the most common approach to engaging the community is through mass marketing. Marketing a series of policy recommendations to people raises all of the previously discussed concerns about the failure to engage them in the decision-making process. Marketing threat messages raises the more basic challenge of getting people to respond, especially given that many Americans are suffering from what Schoch-Spana called “threat-fatigue.” Some communities that regularly face natural disasters, such as the Nicasio community, which regularly confronts wild fires, may see a reason for organizing. But for many others, the threat of an emergency is either too distant or too abstract to prompt action. So some community groups have found a different way to engage communities.
Âna-Marie Jones, a member of the working group and executive director of CARD (Collaborating Agencies Responding to Disasters) has been working with vulnerable populations in California since the late 1980s. “They don’t respond to scare stories about how their lives are going to be torn asunder by epidemics or disasters; what she has found is there’s been more of an affinity to what she calls a prepare-to-prosper approach, which is more of a positive community development/economic development model to preparedness,” said Schoch-Spana.
The approach draws on the literature of “community resilience,” such as that by Fran Norris and colleagues. These researchers identify four factors common to communities that are best able to weather disasters and bounce back. The factors—economic robustness, a sense of collective efficacy and shared decision making, strong social ties among people, and a strong communication system within a community—would probably be included in almost any measurement of a generally “strong” or “good” community. And they suggest any number of ways that the people of a community might become engaged in not only preparing for a disaster but also improving their community’s overall health.
The appeal is similar to an argument for exercise: although being fit may help you fend off an attacker, it has all sorts of other general health and social benefits as well.
The notion of community resilience also speaks to the argument that Schoch-Spana and others have made that those most devastated by a catastrophe will usually be the most socially and economically vulnerable populations. “People are more [vulnerable] or less vulnerable to the effects of disasters; social class, ethnicity and race, gender, and social connected-ness are factors that often determine the extent of harm,” wrote Schoch-Spana in a 2005 piece, “Public Responses to Extreme Events: Top Five Disaster Myths.”
The idea of focusing on the health of the community or the strength of the body politic as a strategy for preparedness has a lot of resonance with other lines of the Kettering Foundation’s work. We think it holds promise for revealing more about the conditions in communities that allow people to take charge of their future. Since it is an area the foundation is just now beginning to explore, we encourage readers of this Connections to share with us what they know about other agencies and community organizations that seem to be experimenting along these lines.