This summer I took part in Anticipate, Plan & Deter Responder
Resilience: With Listen, Protect & Connect Training, here in the East
Bay, sponsored by Alameda County. The training took place in Fremont at the
firehouse, which is very near the BART station. Keeping in mind Occupy Sandy,
Rebecca Solnit’s A Paradise Built In
Hell: The Extraordinary Communities That Arise In Disaster, and events in
the Middle East including Occupy Turkey, I felt that when the next big one hits
the bay area, Occupy Oakland should be on the ready for a pro-active response. There
are way way too many active fault-lines in California, Tsunamis are a very real
threat, flooding, landslides, and forest fires are a consistent threat to us,
and more tornados, a phenomena of the mid-west and south has begun to grace
California with alarming regularity. For the record I have no professional
interest in this kind of training outside of something definitively Occupy, on the other hand, you never know when
it’s going to go down.
Merritt Schreiber[1]
has a PhD in Disaster Medicine, works for various agencies including the Red
Cross. Merritt has traveled the world over and has professionally approached
many disasters. He studied in Irvine, and he is the kind of guy that sits by a
phone late at night with the news on during a storm so to speak. He spoke an
accelerated discourse to a mostly over qualified audience, and I think that sometimes
when he does this class elsewhere he is likely more patient and not so much
streamlining his efforts. Specifically in attendance were mostly EMTs and fire
fighters, two ‘pro-active in the community,’ Berkeley ladies, and myself. Twice
I told him to read Rebecca Solnit’s book Paradise,
and naturally I mentioned Occupy Sandy and my concern for Occupy involvement in
the round robin hello state your name and purpose introduction. I was likely
the only socialist in attendance, although obviously not the only liberal. One
EMT in particular was extremely brilliant, and Merritt called him on it, his
profound sense of logic was so right on it was obviously a shame that his
mindset wasn’t part of disaster training one hundred years ago, his ideas might
have changed the world. Seriously. Nice to see gears turning in the minds of 30
somethings. Full biography: http://www.cdms.uci.edu/cdms-bios.asp
.
Apparently the US military would not
allow him to put a team on the ground in New Orleans for an undue extended
period of time during Hurricane Katrina. I did not interview him. During this
session Haruki Murakami’s book about the Sarin Gas terrorist act aboard Tokyo
subways came to mind, many books that I have read for college and outside of
studies regarding transnationalism, all of that came to mind. A good example of
what went on at the seminar is online at; http://www.integratedtrainingsummit.org/presentations/2011/main_training_summit/43_-disaster_mental_health_surge_tools_and_resources-ss.pdf
In 2011 he attended an ASAP conference in San Diego
and spoke to transnationalism and disaster; The role of
EM and psychosocial consequences of disasters in global health,
Merritt
Schreiber. https://cme.ucsd.edu/asap/program.html. What’s really amazing is
the topics of this particular conference seem very similar to academics
regarding what Naomi Klein refers to as Disaster Capitalism. Transnationalism, which
is in my professional opinion is a systemic sociological disorder derived from
capitalist oligarchy, is getting much more difficult to ignore in the
professional world of international medicine and international disaster relief.
Almost anyone can tell you so in the academic community. My interests at the Listen,
Connect and Protect were very obvious to me anyway; I thought of the photographs of Richard
Misrach, I remembered the Loma Prieta Earthquake here in California back in
1989, so much in mind during the seminar.
Essentially agencies bring a
group of professionals to a staging area where they build an intake triage.
This is the long and short of it all. If you study the integrated training
summit website, and following websites, you can see exactly how this is played
out. The point is to see what is needed for mental health issues during a
disaster, and any other issues that may also overlap. Supplies need to be
gathered in a place nearby, but conveniently enough away from the medical
triage. If you have read Solnit’s Paradise, you
would know that during 9/11 civilians secured a dock warehouse near the World
Trade Center and were eventually permitted by the US Military to continue their
grass roots efforts at quarter mastering the disaster. The US Military
admittedly reported that they simply had to get out of the way of volunteer
efforts there. In Solnit’s Paradise, she
also explains how many anarchists converged on New Orleans during Hurricane
Katrina, likely within the efforts of the Common Ground Collective, which
was founded by activist and Black Panther members. I have heard about volunteer
responders that some were successfully able to sneak past US Military blockades
and were further able to give aid in restricted areas. I am to imagine that
information must have been from CCC. The point being that anarchists are adept urban
specialists that can maneuver between the cracks, give supplies to people,
direct medical aid, send messages across boundaries, and give relief when
Nazi’s like Bush commit genocide. I guess what I’m saying is you don’t have to
be well read; you don’t have to have your first aid training certified every
year, although you should at least know what to really do in a real disaster. For
teachers here is his teacher / student disaster guide; http://www.ready.gov/sites/default/files/documents/files/PFA_SchoolCrisis.pdf. There is another for
children and parents; http://www.ready.gov/sites/default/files/documents/files/psychological_firstaid[1].pdf.
I
was surprised when Dr. Merritt mentioned that NORAD was part of the disaster
relief system, apparently NORAD or USNORTHCOM, the old dinosaur that scared me
as a child about WW3 took on disaster relief after 9/11 as part of the Bush
administration. It is about time that agency do something useful, although they
failed miserably at Katrina, largely due to directed misinformation. I’ve heard
some commentary about public or government agencies on public radio, and the
level of unpreparedness is unprecedented. The military doesn’t do the same job
as that of Dr. Merritt and his contemporaries either. FEMA in particular is
evidently extremely odious and incompetent. I would remind readers that in a
recent article by Keith McHenry in the Slingshot Newspaper. Keith admitted to
the incompetence of FEMA during Occupy Sandy, and that indeed, Food Not Bombs
fed FEMA workers. Also Keith remembered passing many FEMA related caravans on
the highway on the way to New York during the Sandy disaster, the emphasis
being that FEMA certainly took their time, and some of them likely ran out of gas,
or somehow lost track of their supplies. The military and some government
agencies such as FEMA are not state of the art, and the military also stopped
debriefing for disaster relief citing that all
facets are multi-action, or some such nonsense. [Cold war survivors might
remember the; confirm then verify
policy that was definitively US foreign policy regarding hostiles.] Finally due
to PTSD and insurance scandal the military has phased out early stage crisis
intervention during a disaster as such methods were deemed counter- productive.
In a very real sense I’m asking all Slingshot readers to take these facts to
heart and do what you can to learn disaster relief, and this is why.
The
US military does debriefing in battlefield as part of something referred to as
‘complete soldier fitness.’ Supposedly this supersedes the need for disaster
debriefing onsite. The idea of the ubër soldier came to mind, superman is
already killing a million dollars of tax payer revenue, so create more
complicity for onsite triage please! The problem here being that the line
between survivor and victim is blurred, there are normal reactions and abnormal
events that occur and this is PTSD, essentially. Of this abnormal/normal Dr.
Merritt stated, “As a function of the event contents being driven they are not absolute
as both embrace the full continuum of impact.” He might have been quoting the
US military on the subjectivity of abnormal / normal actions and events. He
said a lot of uncanny bullshit that someone in the top of their field might say;
this was the most difficult wording I think he came up with, although who knows
he sped along quite nicely. One stated fact was that 50-90% of transitory
disaster response is insomnia and / or fear of recurrence, this is a discrete
fact and not technically PTSD, and this is normal human function and
resilience. People bounce back[2]
eventually in a timely manner. If you Google the following: PsySTART Staff Self
Triage System, you receive a fact sheet from EMSA [Emergency Medical Services
Agency,] in Los Angeles. [Note: There are too many abbreviations in this field
of study. You’ve seen four or five so far, there are too many to count.] There
are seven similar PDFs on that Google search page, of about 3100 total indexes.
The bottom of my personal copy from the seminar reads: Monitor Stress during the
response and activate your coping plan early and revise accordingly to maximize
your resilience. Review 30 days post-incident, if not sooner. Dr.
Merritt says that any of the similar Los Angeles County pages are good, he
wrote them. He builds a stress pyramid, the apex being survivors with long term
symptoms, the next down is short and long term psychopathology, followed by
acute stasis disorders, there-after non-specific psychological distress, and
the base of which is concerning behavioral change. It’s based on a 9 million
dollar federal study, which I should assume came from the Obama administration.
The answers from your online PsySTART chart dictate the placement of the
individual on the pyramid, and numbers are tallied in an impromptu consensus,
this is a patented process actually. Disaster relief warrants a copy-write
patent if you can believe it. The Department of Homeland Security [HSPP8,]
selected mutual health tasks from the “universal task list,” which would be
similar to this process. The PsySTART system is simply designed to help with
onsite triage in the event of a disaster, there is a checklist of options. Danger to Self Or Others? Felt/Expressed
Extreme Panic? Around twenty disaster related types of stress to a specific
system. Tally that number, the high numbers are the top of the pyramid, the lows
at the bottom, people with the most extreme problems have the least resistance
to disaster stress. Once intake is completed, then you can group people
together for the purpose of treatment I am to theorize. Speaking as a
non-medical professional I honestly am not certain how that would work.
Services, food, water, rest, bandages, suddenly the next step is very real and
unclear. Food is included; sometimes a meal is an important first step in
debriefing, get a full stomach and then relate your difficulties to the
responder. He did mention that asymptotic panic was something that might test
the fidelity of the responder system as a model, directly to say that the responder
system might not help everyone. One thing about the pyramid is the base should
be paraprofessionals: trained volunteers, listening to people, friends, family,
neighbors, spiritual leaders, and connectedness, higher up would be Mental
Health Professionals. Researching the pyramid system / PsySTART one might be
able to deduct that care should be considered in a zone kind of system,
different kinds of care should be conducted in different kinds of zones within
the emergency relief triage area of activity. The fidelity of the model is a
relevant concern regarding this system. Debriefing amounts to psychological
education or first aid, it’s not what you see, its’ how you cope. Regardless to
stress inoculation or mass casualty pre-event sociology corresponds to a
psychological first aid model, including social support, triage, and any
further necessary treatment thereafter. Apparently there is a golden hour, and
a golden month in which to take effective care, effective care could be a
disaster relief Federal Stafford Loan for example. Another PDF I’m referring to
is online from the Red Cross; http://www.cdms.uci.edu/pdf/psystart-cdms02142012.pdf.
Regarding PsySTART and the above PDF, please
take the doctor’s word for it. I think anyone actually interested in disaster
relief should study this particular PDF specifically and the PsySTART. At that
point you aren’t an expert, although you would be somewhat better prepared to
begin disaster stress triage. Stay calm, keep rubber-neckers, the media, and
tourists out of the emergency response area, and see what you can do to help
victims of disaster. Meanwhile there is real danger to this effort also. Among
other kinds of related problems, there is a 9% PTSD rate by disaster relief
responders and for military personnel that number is 20%. I want people to be
cautious yet if you follow the online sites mentioned in this article you might
be able to anticipate stress / scenarios that can help reduce calamity, and
possibly help people. Most important to note is the fact that the mental health
implications for victims usually outweigh other dangers of disaster. The
previously noted online pdf has an interesting tid-bit from the Hospital
Preparedness Program Coordinator from Los Angeles County:
“The
damage to nuclear reactors in Japan has understandably lead to concerns about
the safety of individuals throughout the world, including here in Los Angeles
County. This concern can lead to many individuals seeking medical care and
particularly requesting prophylactic pharmaceuticals such as Potassium Iodide.”
The
letter from the coordinator to Los Angeles hospitals also requested
participatory voluntary data to help create risk assessment strategies.
Realistically
it is difficult to determine whether or not Occupy Oakland will be needed for
any type of disaster beyond that of economic inequality, lack of government
intervention, and the disabling effect of poverty on the community at large. We
should assume we need to be prepared. The Bay Area is blessed with a fairly good disaster preparedness system which is on
par with some of the best in the world. Other locales might not be so lucky
however, and we can never know what we will be hit with next. People power is
always a relevant structure to achieve great goals, so perhaps this article can
help inspire individuals to achieve their own directed study. At the very least
an Occupy medical triage is not a bad idea for activists concerned with
disaster stress be that by way of police brutality, panic, or other presently
indiscernible calamity. I was a boy scout, and I have been trained for first
aid, and I can see that I clearly need to be recertified. On the other hand I
have been in some of the hairiest fucking riots in the east bay in the last
some odd years, and I feel that in certain situations that I am likely over
qualified – and that’s probably a really good thing. Be safe out there people.
How to be supportive: Disinhibit reluctance to be supportive, not everyone
is touched by crisis similarly. Keep in mind risk factors, although don’t
panic. Take breaks and be effective, avoid repetition when it becomes
inhibiting or tiring.
List of symptoms / steps: Listen, protect, connect, and use direct assistance.
Listening is a metaphor for the totality of observation. Keep in mind a
consensus model during first response activity [think on your feet as a group
sometimes.] Hydrate often. Use the PsySTART.
The FEMA model: First aid, categorize via something similar to
PsySTART, first aid data should lead to a referral to other agencies, like a
hospital or official crisis center / county services. It’s a good model,
despite the organizations best efforts otherwise.
The next and final URL
recommendations by way of Dr. Merritt; www.nyc.gov/citizencorps, and
nyc.gov/311, apparently all cities have something like this. The department of
education is limited, and there are many federal websites and numbers. Share
your information, create mental health awareness! Don’t Panic!
[1] http://iom.edu/Global/Directory/Detail.aspx?id=0020021141
[2] www.bouncebacknownyc.org,
essentially a self-help website for disaster relief as designed by MUSC, the
Medical University of South Carolina, you have to register.
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