Primera Destreza de apoyo psicosocial: “obtener información y establecer las prioridades, identificar las destrezas para afrontar la necesidad”

Joseph O. Prewitt Díaz, PhD, LPC

Asesor de Salud Mental en Desastres

Región de la Capital Nacional

Washington, D.C.

Queridos todos y todas,

Me encantaría compartir esta información con ustedes mirando sus ojos y contestando preguntas mientras bebemos café Yaucono en la plaza de Cayey. Desafortunadamente los tiempos y circunstancias no lo permiten. Por tanto he decidido ofrecer un taller de apoyo psicosocial a través de este medio. Reciban un fuerte abrazo solidario, de este que desde lejos, los recuerda y los quiere mucho.

El sábado en la noche (18 de octubre 2017) me tome la libertad de escribir un articulo donde compartía con ustedes seis pasos sobre como administrar el apoyo psicosocial comunitario en la próxima fase de la recuperación después del Huracan María.

Decidí darle seguimiento con unas explicaciones adicionales para cada uno de los objetivos. De manera que los próximos seis “Post” en Facebook explican el método de acercamiento de la estrategia que sugerí.

Al establecer contacto con un grupo de vecinos debemos llevar a cabo tres tareas: (1) identificar las necesidades, (2) establecer prioridades sobre los pasos a seguir, y (3) elaborar un plan de acción.

Identifica las necesidades actuales. Al comenzar el contacto debemos observar cuales son las necesidades inmediatas y que acciones tenemos que tomar para resolver la necesidad. Estas necesidades deben  estar dirigidas a re-establecer la seguridad personal y/o resolver problemas que impactan nuestra salud psicosocial.

Desarrolla una lista en forma de priorizar las necesidades. Una vez el grupo ha establecido la lista de necesidades, repita cada una en voz alta, y  indique cual es su  entendimiento de las necesidades, preocupaciones y posible soluciones. Establezca una listo prioritaria de necesidades, desde la mas urgente hasta la que pueda esperar unos días.

Elabora un plan de acción. Determinamos cual de las necesidades podemos resolver entre nosotros, cuales necesitan mas tiempo, cuales debemos referir a las agencias pertinentes. El plan de acción debe esta identificar as destrezas que debemos exhibir para afrontar la necesidad. Por ejemplo: (1) manejar nuestras reacciones ante las secuelas del Huracan María, (2) mostrar pensamientos positivos, (3) desarrollar conexiones sociales positivas, (4) resolver la necesidad – ya bien lo hacemos como grupo de vecinos y/o referimos nuestra necesidad a las agencias pertinentes.

Psychosocial support is an important need during recovery from Hurricane Maria

Joseph O. Prewitt Diaz, PhD

Center for Psychosocial Solutions

Alexandria, VA 22310

Hurricane Maria has been a very stressful event.  That stress will linger on for a long time after the vegetation has grown, the mud washed away from the roads, the water in the creeks, the rivers has receded, and the government services are back on line.  As the time goes by improving or is improving very little of the recovery, will exacerbate, people’s psychosocial needs.

Rationale for a long-term psychosocial support

Everyone is likely to require continuing psychosocial support. Often, people’s experiences, which reflect the personal and social meanings of the event for them, and the understandings and meanings they derive from it, have more influence on the psychosocial impact of the event than the event itself. Recovery from distress after disasters, including Hurricane Maria, is characterized by adaptation to circumstances that have changed and by rebuilding communities.

Hurricane Maria has impacted the psychosocial well being of children, young people and older people may be more vulnerable than are adults of working age because they are dependent on adults’ responses to the floods that affect families. Parents’ wellbeing, for example, affects the quality of their parenting; people’s direct experiences and those that affect their caretakers may, separately and in interaction, either protect them or intensify the negative effects on children, older people and those with functional needs.

The extended timeframe of the impacts of Hurricane Maria on people, their homes, neighborhood and their communities are such that the effects of secondary stressors are highly important because they prolong the welfare, physical and psychosocial impacts. Recognition of the longer timeframe in which, psychosocial and mental healthcare responses are required is an important lesson that has been learned from major disasters in the past.

Action steps for the recovery

The response to Hurricane Maria in the recovery phase will require the following action steps:

·      Adoption of a community led multi-sector approach to promoting psychosocial wellbeing and recovery.   Family and community assets are vitally important to maintain and promote personal and collective psychosocial resilience.

·      Reliance on social cohesion community activities must be considered. These activities  have a significant effect on psychosocial expressions of distress and encourage  recovery

·      Introduce psychological first aid as a first order intervention.

·      Place based psychosocial support activities should be initiated immediately, and planned well into recovery.

Establish alliances with government and non-government, faith based, and community organizations, to support their psychosocial resilience and emotional wellbeing of the survivors.

Summary

The action steps proposed herein, support the a psychosocial support approach that comprises both universal and targeted plans and interventions, which are well with adequate, timely access for people in need.

Understanding Hurricane Maria in these terms should give direction to the response from service providers as well as from the affected communities. This applies to initial emergency responses, as well as recovery and reconstruction.

The challenge of explaining complex scientific actions in disaster response and humanitarian aid in a parochial environment: The case of the American Red Cross

Joseph O. Prewitt Diaz, PhD

Alexandria, Virginia

As I was driving this morning I heard in NPR that the GAO had completed its review of the American Red Cross[1], and that one of the members of the House of Representatives[2], had proposed the “American Red Cross Sunshine Act”.

The American Red Cross is one of a movement of 189 Red Cross and Red Crescent Societies from around the world with a Headquarters in Geneva. The existence of the American Red Cross is guided by seven fundamental principles: humanity, impartiality, neutrality, independence, voluntarism, unity, and universality.

 I was pleasantly surprised that the query of such a prestigious entity such, as the GAO would conduct a thorough investigation comparing apples with apples. As I reached home I looked up both reports. Then sadness set in.

The GAO detailed their research methodology, they indicate that they compared the American Red Cross several entities, types of disasters, national and international response, and other non-government agencies in the United States. I was taken aback to see that GAO had not compared the American Red Cross and its “modus operandi” at least “three national societies” from resource rich countries comparable to the United States. So in essence lacking that valuable information, the report is rendered useless. It is another report for those that have the miotic vision and the lack of universal vision to see that this organization brings a lot of well being to the image of the American people, especially from countries that are resource poor and who have felt the helping hand of the American people through the American Red Cross in their moment of need.

Secondly, to legislate the work of the American Red Cross, as suggested in the proposed legislation “The proposed American Red Cross Sunshine Act comes in response to a government report, also being released today, that finds oversight of the charity lacking and recommends Congress find a way to fill the gap” (quoted verbatim from the NPR/Pro publica news article).  To provide oversight to a member of an international movement is in effect a direct move to do away with the the mission of the American Red Cross, and the fundamental principles that its work embodies.

My  take is that  (1) monies given by the U.S. government or its representative to  an entity in order that they may perform a specific task should be placed under scrutinty. I also believe the scrutiny should be such that there is respect from the US Government toward the integrity of said organization; (2) establishing a law with the specific purpose to “rein-in” an organization is a an attempt to destroy the principles of independence, neutrality, and impartiality. This may not be very important to politician in Washington or others who unscrupulously seek to say “gotcha” without an unbiased investigative reporting that includes “here say” and also includes desk research, and experiential learning.

In addressing this issue I am fully aware that I will be considered a  “Vox clamantis in deserto”, but morally and with great respect toward those that have died in the past and present with the Red Cross vest providing humanitarian assistance, I couldn’t really be a bystander and keep quiet.

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[1] GAO. (September 2015).  American Red Cross: Disaster Assistance Would Benefit from Oversight through Regular Federal Evaluation. Washington, DC: United States Government Accountability Office.

[2]  Elliot, J. & Sullivan, L. (Sept 16, 2015). American Red Cross Sunshine Act’ Would Open Charity to Outside Scrutiny. Washington, D.C.. National Public Radio & Pro Publica.

American Red Cross and the NPR Report: Commentary on NPR program this afternoon

As I was driving this afternoon, I listened intently to the interview you had with Mrs Leslie Schaeffer from the American Red Cross. The reference for such interview was an article published by NPR/Pro-Publica related to Haiti. I re-read the report (Investigation) that NPR/Pro Publica had published on the American Red Cross. It is a report all right, but the credibility of investigative reports is questionable. It does not provide context for the disaster response by the American Red Cross or a timeline that could easily be followed by readers. Nor did it try to understand the international disaster laws, easily accessible in Internet, by which such responses are guided. According to the authors, the thesis statement has to do with the American Red Cross misusing funds in the Haiti response, probably because they lacked the background knowledge or the tempo of the response, and couldn’t explain it to their target audience.

Without discussing the value of the minutia let me reflect on some components that are missing in these reports:

1.     Did the American Red Cross have a pre-disaster agreement with the Haitian Red Cross, or a Haitian government entity to provide bilateral immediate response? The American Red Cross as partner, the International Federation of the Red Cross and Red Crescent, followed the guidance of said organization to plan their response.

2.     Were agreements in place with local banks for transfer of funds or mechanisms for hiring local personnel?

3.     Were the ports open to allow equipment being brought by American Red Cross to the country. Did Haiti exempt American Red Cross from paying entry tariffs? What would happen with that equipment once it was used in Haiti?

4.     When was American Red Cross given clearance to begin on-the-ground assessment? Had all the bodies been recovered and the debris removed from the public thoroughfare?

5.     Were there people either native or Haitian descendant that specialized in disaster response? If not, did the American Red Cross exercise the “Do no harm” imperative waited past the gestation period (a period usually between six month to a year) where assessments are conducted, local people are trained, work plans formulated and evaluation mechanism are in place?

I cannot answer those questions because I was not there, but the reporters, who were there, I am sure cannot answers the questions either.

It is easy to be an spectator that with the passing of time develops compassion fatigue, to develop a warped vision of reality. It is also very difficult for reporters to do in-depth investigative work without having a working knowledge of the science of disaster response, reconstruction, and development.

Paraphrasing Mrs. Schaefer, well said in the program this afternoon, the American Red Cross did what it was supposed to do, continues to do what was planned, and will remain on the ground until all the identified programmatic needs, now using trained local personnel, are no more.