In honor of human capacities in West, TX and Boston, MA

There is no way to explain the emotional toll of so many man-made disasters in the last week. The immediate response is to feel overwhelmed, helpless, and hopeless. Fortunately, with the passage of words, reframing your thought process from the events from terrible things to small miracles and the exhibit of resilience of the human spirit. Two elderly people come to my awareness. The first one was a 78 year old who was blown away by the bombing in the finish line at Boston. One would have thought that this man was hurt, yet he managed to get up complete the marathon and participate in a TV interview a couple of hours later. The other was an older fellow who experienced that silo explosion last night. When he came on TV this morning he was bloodied and seemed that he had just experienced a horrible experience, which he did, about an hour ago he came back on TV, composed, shaved, and with the assurance that all was well.   

We have been taught about these types of reactions. These two old guys were doing the best they could do, to re-assure the public that all was well. They were bringing a calming effect to the situation. Altruism and compassion are two behaviors that we saw in both explosions (Boston and West). Everyone was helping each other as much as they could. Allowing the community members to actively participate in their own recovery is a very healing activity. It builds up the resilience of the individual and the community. I would be interested in following up on some of that population that seemed victimized by these two explosions a year from now. I am sure and assured, by my religious beliefs, that they will be victorious!!!

Reaching Resilience

A new manual entitled Reaching Resilience (www.reachingresilience.org) is a “must read” for those persons engaged in planning long-term recovery. The book includes eight key points on how to collect data, engaging stakeholders and designing flexible interventions. Each key point is divided into three sections: (1) Why it is important?, (2) Action Points, and (3) Pointers. The publishers of this manual are CARE Nederland, Groupe URD and the Disaster Studies of Wageningen University. By reading this manual and experimenting with the tools it provides, after contextualization, you can’t go wrong. 

Non-qualified immigrants are unseen and unheard after Hurricane Sandy in New York: Let my people be heard!!!

FEMA and other federal and state agencies only provide assistance to holders of Social Security Cards. These cards are issued after a person that is a (1) noncitizen national or a  (2) qualified aliens.  After Hurricane Sandy the primary source of disaster relief: the Individual and Household program and/or the Small Business Administration, was not available people that were not holders of social security cards, the so called non-qualified immigrants. (http://www.fema.gov/news-release/2013/01/22/who-qualifies-fema-disaster-assistance).

On Staten Island,  residents were surveyed (MRNY, 2012) in South Beach, Midland Beach, New Dorp Beach and Oakwood. These neighborhoods were located in New York City’s Zone A evacuation zones during Sandy. They experienced significant damage during the storm. According to the 2010 Census, 18% of residents of Midland Beach and 15% of residents of South Beach were born in another country.

On Long Island, residents of   Brentwood, Central Islip, Bayshore, Babylon, Patchogue and Long Beach were surveyed. Long Island’s immigrant population has more than doubled in the past few decades to just over 465,000 residents, accounting for more than 16 percent of the general population. According to the 2010 Census, more than 68% of Brentwood residents, 52% of neighboring Central Islip residents, and more than 29% of Patchogue residents were Latino or Hispanic.  For further information see MRNY (December 2012). Unmet Needs Superstorm Sandy and Immigrant Communalities. New York.

Most of the non-qualified immigrants are Latino’s from Central, South America and the Caribbean Island of Dominican Republic. In Long Island there is a cohort of Puerto Ricans 9although they qualify for assistance because they are U.S. citizens by birth).

The finding suggest that (1) people have lost their home, source of employment, or transportation that would take them to the place of work, and that the assistance provided by NGO’s is not sufficient to satisfy their long term needs. (2) there are strains, and emotional outburst amongst neighbors having to do with who received assistance and who did not, and (3) willing to participate in cash for work programs.

Alegria et al (2007) suggest that one of the ingrained qualities of the Latino population is the social connection. They are frequent participants of civic activities and show a willingness to help neighbors in times of need. This is the case after Hurricane Sandy except that this group is neither seen or heard by the decision makers. They are clamoring for a place in the table, where they can have a say on their future and the future of their families.

The literature on community based psychosocial support and Latinos suggest that lower-income Latino’s have been found at lower-risk of psychiatric disorders (Alegria, Canino, Simson, &Grant, 2006). Other studies (Breslau et al., 2006 and Gonzalez, Haan, & Hinton 2005) have found higher depressive symptom that may be caused by acculturative stress.

If acculturative stress is compounded by the traumatic stress resulting from the displacement, and fears generated by Hurricane Sandy, then there are long term needs for psychosocial support amongst this population that (1) focuses on (community and individual interactions that provide disaster affected people a web of social networks perceived as caring and available in times of  need, (2) targets weaving the connections among family, friends, and place that will strengthen the mechanism of social connections, and (3) provide psychosocial support activities, that serve as stress-buffering for post disaster secondary stressors.

Finally alleviate the fear of people coming forward and actively participating on the planning tables of FEMA, and other NGO’s by granting a moratorium on migratory status. Their contribution is very important for the future of our nation.

RELOCATION MUST BE CLIENT CENTRIC, AND COGNIZANT THAT IN CIRCUMSTANCES SUCH AS HURRICANE SANDY PSYCHOSOCIAL SUPPORT MUST CONTINue AS PART OF LONG TER RECOVERY

This weekend of spoke with one of my colleagues that is currently in New Jersey. The call came out of the blue, so I asked, ”how is it going”, after a long pause he shared his feelings for a while. I asked what were the three basic problems disaster affected people were facing: (1) lack of appropriate housing, (2) upper respiratory injections due to the mold, and (3) mental health issues to deal with secondary stressors. “It is so bad that whole families are impacted now and will be impacted for life”. “The sad part is that we don’t have protocols in place to deal with all the small issues that are turning into insurmountable mountains for these people”

Recovery must consider the psychosocial context and well being of the affected families. Such is the case with displaced people not recognized by FEMA such “as non resident aliens”. Relocation is an acute and short-term life events; except for those without government assistance it becomes a long-term life event. It imposes a considerable amount of stress because when the disaster affected people are forced to move because of an impending catastrophe, they know they will loose everything they had. This perspective minimizes the dynamic quality of mobility and ignores the longer term health and behavioral health consequences of the relocation that unfold gradually as the disaster affected families moved from the shelters to temporary housing, to living with relatives and hopefully back in their place.

Based on our experience and the existing research we propose that there are deleterious health and mental health effects caused by disaster related relocation, not only the immediate circumstances surrounding a move, but also the broader context of the individual’s residential history, the perception of well being in place, the current situation, and the aspiration for the future.  

Psychosocial Support and Disasters: THE VOICES OF DISASTER-AFFECTED PEOPLE MUST BE HEA...

Psychosocial Support and Disasters: THE VOICES OF DISASTER-AFFECTED PEOPLE MUST BE HEA...: Re-establishment of the built or natural “place” is more important to disaster-affected people than the areas emphasized by the govern...

THE VOICES OF DISASTER-AFFECTED PEOPLE MUST BE HEARD

Re-establishment of the built or natural “place” is more important to disaster-affected people than the areas emphasized by the government, i.e., mitigating damages and fostering resilience.  This point was clearly made by residents of the Rockaways in New York, which was devastated by Hurricane Sandy. In a meeting with federal, state, and local politicians, these residents voiced their desire to be heard. Moreover, last month, John Corri,[2] the co-founder of Friends of Rockaway Beach, was emphatic and clear when he indicated that his neighbors have expressed their concerns that they simply want their voices to be heard.  “We are talking about the future of Rockaway, and this is not the time for outside agencies to be dictating what’s best for us. This is our town and we want a seat at the table when it’s time to plan out our future.”[3]

Moreover, other New York residents are seemingly at greater peril. Make the Road New York (MRNY) a New York community-based umbrella organization conducted a study of Staten Island and Long Island amongst “non-qualified aliens,” i.e., non-qualified immigrants that have been barred from receiving monetary assistance from FEMA or unemployment benefits. Some within this group have children who are US citizens, but they are afraid to apply for services because they fear the possibility of deportation.[4] The umbrella organization has been able to document that thousands of families have lost their safety nets and community networks and are currently relying solely on their own emotional strength. Their needs include but are not limited to the following: (1) housing and the ability to re-establish their “place,” (2) supplemental nutritional assistance, (3) opportunities to become engaged in the reconstruction of their communities in a “cash for work” program or other type of labor reform, and (4) inclusion by FEMA and partner agencies (i.e., to actively seek out the people in need and provide psychosocial support for all those in this cohort).[5]

Interestingly, the federal government tends to agree with this community and its members. A report released by FEMA (2011) indicates “recovery can be successful only when it is locally driven, and the community [place] takes ownership of the process. The visioning process should be inclusive, reaching out to all stakeholders in the community for input [emphasis added].”[6]

In this instance, we have the following stakeholders: (1) a disaster-affected people from the Rockways clamoring to be heard regarding their thoughts about the future of their own built and natural place amidst the plans presented by external stakeholders for the recovery of that place; (2) a population of disaster-affected people from Long Island and Staten Island who have not received the full complement of services because of their immigrant status but still need to re-establish their places and four identified steps to improve their recovery process, and (3) a government agency and their respective partners who seem to agree that disaster-affected people must take ownership of their recovery and their place and be given the opportunity to provide input on the visioning for the future of their respective place.

However, the situation is missing a schematic of service delivery. The International Convention of the Protection of the Rights of Migrants and their Families and the International Standards proposed by the SPHERE Project propose a path that could resolve the existing situation. A gestation period during which disaster-affected people are given opportunities to express their frustration and share their dreams for the future is necessary; this is important in the immediate future due to the efforts to develop action steps moving forward, and it is necessary as a preventive method to reduce mental health issues that could arise a year from now.

Using psychosocial support as a platform, a non-governmental agency (NGO) would become responsible for meeting disaster-affected people in their respective places to identify their geographical space and outline their needs, hopes, and aspirations related to re-establishing their place. Community people would then be trained to weave pre-existing networks, develop new ones, and provide psychological first aid (i.e., provide an opportunity for people to voice their experiences and desires, thus generating calmness and contributing to visioning for the future). The NGO would then identify protective factors and challenges, prioritize potential projects to improve place (e.g., clean-up campaigns for the natural and built spaces and neighbor to neighbor projects focused on reconstructing housing) provide funding for these work projects, and provide children with emotional and educational assistance through after-school programs. 

Every activity focused on recovery is possible by maintaining a nimble posture; encouraging wide participation by the disaster-affected people in their own recovery process; becoming partners with the residents in their visions, dreams, and aspiration; and promoting the goal of enhancing resilience and well-being.

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[1] Dr. Prewitt Diaz is the recipient of the 2008 APA International Humanitarian Award and the CEO of the Center on Psychosocial Support in Disaster in Alexandria, VA.

[2] CNN iReport (March 13, 2013). Rockaway residents demand say in Sandy recovery plans. (http://ireport.conn.com/docsz/doc-946322?hpt=us_bn3).

[3] Ibid, p. 2

[4] Make the Road New York (MRNY) (December 2012). Unmet needs: Superstorm Sandy and immigrant communities in the metro New York area. p. 5

[5] Ibid, p. 10

[6] FEMA (2011). Lessons in community recovery. Washington, D.C.: Department of Homeland Security. p. 2. 

Hurricane Sandy and client centric services

Since Hurricane Sandy I have written and sent out to several journals and shorter articles to newspapers addressing two points: (1) the need for psychosocial support for all the disaster affected people and (2) the importance of engaging the disaster affected people in the recovery process and ultimately planning for their future. This morning I received the sixth note of rejection. The issues are not related to the theoretical basis of the argument but to “grammatical errors that may district the reader”. I shouldn’t feel in angst, I have lived in this country long enough to realize that outsiders are not really welcomed, especially if they have an accent or if they don’t have a mastery of the written language.

Let me try one last time to articulate what I am trying to say based on more than thirty years of experience working disaster response in over 32 countries in the world.

1.     Recovery process doesn’t belong exclusively to the external stakeholders. If the recovery plan is not viewed positively by the affected people it may not work well. Acceptance by both groups will dictate the level and quality of participation that has to take place in the development of the recovery plan if the final goal is “a resilient and healthier community”.

2.     If resettlement is necessary in areas with large number “undocumented residents”, then develop an appropriate level of assistance, have the disaster-affected people involved in designing and implementing of their recovery, and minimize adverse psychosocial negative impact.  

3.     Articulate interests and needs so as to reflect the complexity and multi-dimensionality of the recovery process. Have patience, steps toward resilience must be nimble, the gestation period with all stakeholders will strengthen the social fabric of place, neighborhood and community networks.