Disaster recovery

{***Pause/Music***}

{***Amie***}

Coming up on Harvard Chan: This Week in Health…

Shifting from saving lives to recovery in the wake of Hurricane Harvey.

{***Eric McNulty Soundbite***}

(When you get to recovery, the media goes away, the donations begin to flow less freely, and you can begin to figure out, “Okay what are we going to do here?” There’s some long range decisions that need to be made. So it’s not just, “Let’s save those people,” it’s “How do we build this community so this won’t happen again?”)

In this week’s episode: The priorities and challenges as Texas prepares to rebuild.

{***Noah***}

Plus—What’s the best way for you to help storm victims?

{***Julia Brooks Soundbite***}

(A lot of the stuff is simply not what’s needed. After the Asian tsunami people were sending ski gear to a tropical island.)

One expert explains why it’s always better to send money in the wake of a disaster—instead of clothes and supplies.

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{***Noah***}

Hello and welcome to Harvard Chan: This Week in Health. It’s Thursday, September 7, 2017, I’m Noah Leavitt.

{***Amie***}

And I’m Amie Montemurro.

{***Noah***}

In Texas the focus this week is shifting from saving lives to recovery in the wake of Harvey.

The storm is being blamed for at least 64 deaths—and forced tens of thousands of people in the Houston area from their homes.

Harvey also caused severe flooding in Louisiana—and the damage across the region is estimated to be in the billions of dollars.

{***Amie***}

Last week, Richard Serino of the Harvard Chan School’s National Preparedness Leadership Initiative—or NPLI—said the recovery from the storm could take years—saying that people in Texas will face a quote, “new normal” after the storm.

{***Noah***}

So what will that recovery look like?

In the first part of this week’s episode you’ll hear from Serino’s colleague Eric McNulty, director of research and professional programs at NPLI.

And in the second half of the episode we’ll speak with Julia Brooks, legal research associate, at the Harvard Humanitarian Initiative about why it’s best to send money—not clothes, toiletries, or other supplies—in the wake of a natural disaster.

But first—our conversation with McNulty—who we spoke to over the phone.

He began by explaining why the recovery phase is likely to be long and difficult.

{***Eric McNulty Interview***}

ERIC MCNULTY: The challenge now will be that this recovery is a much longer process. And in the case of the Harvey impacted area, that’s going to be years. And so you’re looking at funding, there are certain funding mechanisms in place. When do they kick in? What does Congress do in terms of approving funds? To begin to do that, how familiar are people on the ground with the guidelines for how they can spend that money? And then, of course, there’s all the private insurance that will come into play here as well.

I think one of the biggest challenges that’s faced by the people who are involved throughout this is that in the response you’ve got all the media attention, the donations are flowing in, there’s a lot of unity of effort. Everyone can really see the goal. When you get to recovery, the media goes away, does come back periodically. The donations will flow less freely. You’ll begin to figure out what are we going to do here? There’s long range decisions to be made. And so it’s not just, let’s save those people. It’s how do we build this community so this won’t happen again.

NOAH LEAVITT: So you mentioned one of the factors right now is this idea of Congressional funding, getting federal funding for recovery efforts. I mean, in previous disasters is the federal government pretty willing to open the checkbook so to speak, or is that likely to be a problem going forward in terms of getting the necessary funding for this long term effort?

ERIC MCNULTY: I think they’re going to get the initial funding. I mean there have been problems in the past. We saw after Sandy, there were some Congressional representatives and senators from, more budget conscious, shall we say we’re not in favor of releasing extra money for the Sandy recovery efforts. In this case those are the states have been hit. Some people who voted against Sandy have now been the ones asking for money. And I think that the devastation has been so clear and so pronounced that at least for the initial funding, they will get that approved. As you go forward and you’re looking at a bigger and bigger bill, then people will begin to ask about tradeoffs.

So what does this mean relative to what we wanted to do with the border wall is the most obvious example that pops up. What does this mean relative to the deficit? When they begin to think about more tradeoffs and negotiating it, so it gets trickier over time.

NOAH LEAVITT: You mentioned that kind of one of the challenges is that over time the attention kind of goes away. There’s less media attention. There are fewer donations coming in. So as people who are kind of on the ground leading the recovery effort, what are some things they should be trying to do to ensure that the momentum isn’t lost in the months and years ahead?

ERIC MCNULTY: The first thing I would do if I were on the ground is be reaching out to the people who’ve done this before and done it well. So there’s a lot of work put in post-Katrina in terms of how to rebuild a community in a smarter way. Think of Joplin and post-Sandy as well. A lot of effort was put forward by urban planners, architects, other people who were involved who could help think about how to rebuild the physical infrastructure in a way that it’s more able to withstand future events like this.

And then also the community. And again Joplin I think is a great case here, where that community really came together and for a good year after the tornado came through, worked together in really exemplary ways to make sure that they supported each other, they took care of each other, and they got the community back on its feet. So as a leader, one of the things you really, again, the mental shift here is from short term to medium term to long term. And being in the right zone there as you’re making your decisions is really critical.

NOAH LEAVITT: So I know one of the things that’s a big focus of NPLI is this idea of connectivity and inter-agency cooperation. So you know, we got a sense last week of what that looks like during the immediate kind of storm response. But what does that kind of cooperation and connectivity look like over this long term recovery?

ERIC MCNULTY: There are a couple of challenges that come up. One of them is common and one of them is a bit unique to our current situation. So the common one is how familiar are the various people involved with the statutory requirements, the things that are already in place for a legal and regulatory point of view of how you go about doing this, how you get the funds, how you make sure you flow in properly, and you get to use them. And so you know that is one that this is a region that is used to responding to natural disasters. I have a feeling that they are pretty well versed in this.

Brock Long at FEMA, although he is new in the job there, is from the region, and he’s had a lot of experience around these things. So that should work pretty well. I think the challenge we’re going to have is there’s still a lot of empty chairs in this administration at that second, third, and fourth tier level of appointees. And so how stretched they get, how well they can maintain focus, when you’re not just talking about the top people in that first team, but the people who are really going to need to carry on over time. And particularly where you’ve got Irma bearing down upon us, and so you may be dealing with a second response right after the Harvey response, which will stretch things.

NOAH LEAVITT: And that segues well, because I wanted to ask with Irma looking like, as of right now, it could impact Florida, how does that complicate what’s going on in Texas and Louisiana? I mean I’m guessing that one of the biggest impacts might just be federal funding. But how else does that kind of complicate things?

ERIC MCNULTY: Well, you’re going to have to begin, they probably already have begun, moving resources from the Harvey area toward Florida, just as the prepositioned things before Harvey, they’re going to preposition before Irma. And I think one of the big differences here is if you’re talking about the same people, they’re going to be tired. They’ve been working really hard in the Harvey response. Now with barely a chance to take a breath, they’re going to move into Irma.

Now a lot depends on Irma, with where it hits landfall. If it hits Miami square on, that’s a very different and worse situation than if it hits a less populated area somewhere else in the state or goes up, it may be up to the Carolinas. The other good news is that those states are used to hurricanes. They do them well. And this can be a very big storm, so it’s going to test everybody.

But they’re familiar with this. So the state resources, the local resources, they should be well prepared for this. I think that it is unfortunate, but it will be very interesting from a research perspective to see Irma coming right on the heels of Harvey. One of the things that people in disaster planning have been talking about for a number of years now is dealing with simultaneous or near simultaneous multiple disasters. And fortunately, we’ve not seen that. We’ve not had to experience that.

This will be our first chance or as close as we’re going to get to that right now. And see depending on where Irma hits, how well the system responds. I’m confident they’re going to do well. But it’s going to be stretched very thin. And that’s going to be where we’re really going to need the patience of the public and the participation of the public to really help out the first responders who we know are going to give it their all.

NOAH LEAVITT: Just a quick follow-p there, I mean I imagine that there was a lot of conversation with Harvey about how much did climate change play a role in making this storm maybe worse than it would’ve been. Is that also kind of something that’s in the back of the minds of people as you know, we might be seeing, because of climate change, we might see more severe storms more close together more often?

ERIC MCNULTY: That seems to be what the science suggests is going to happen, that, in the case of Harvey, was we’ve already had higher sea levels and warmer oceans that contributed they say to more rainfall and to a greater storm surge. That’s going to become an increasing factor that you may see these, just the intensity of it, and when you get the intense rain, you know the Houston infrastructure, there’s no place in the country that could have taken the rain that the Harvey impacted areas got and come out unflooded. I mean it really was an enormous amount of rain.

So if we get these really intense storms that dump a lot of water in a short period of time, there are going to be places in the country that aren’t used to dealing with flooding, and have to figure it out in a hurry. So that’s one. And I think that from a first responder perspective, they don’t want to have to get into the whole climate change debate because it is still politically fraught. They just want to get through the event and have people come out you know as well as they can come out. But I think is it from a planning perspective, absolutely, this is something to be worried about.

NOAH LEAVITT: What would a successful recovery look like and I guess, how can that be measured again, with this realization that it will take years for a full recovery to happen? So what would a successful recovery look like and then how can that be measured in a way?

ERIC MCNULTY: Measuring it is tough because, and you want to look and see how cohesive is the community? Yes, you want to look at the physical infrastructure and say, have they built back smarter than before? So in Houston’s case, have they thought about ways to mitigate some of the flooding for the future now that we’ve seen what happens. But then as a community, you want to see are they more cohesive? What’s the net inflow or outflow of people?

You know, you had a fair number of residents in Houston who moved there who were evacuated from Katrina and stayed. To people staying in Houston, it’s one of the fastest growing cities in the country so I assume it will and I assume its economy will bounce back. But, and I’m not versed in all the exact instruments you would use, but I would like to see, is the community cohesive? Is there a stronger bond there that has endured that endures throughout that recovery or are people fighting with each other and squabbling and those kinds of things?

NOAH LEAVITT: Are there any lessons that we’ve already learned from Harvey that can be applied to future storms, future disasters, or is that still too early to tell?

ERIC MCNULTY: No, I think we have seen some. And I think what we have seen is a culmination. I mean one of the great stories coming out of Harvey is that there was such broad participation, not just from the official first response agencies, but from the business community and nonprofits and ordinary citizens. So it truly was a whole community response. And that’s something that FEMA has been talking about for a number of years. Craig Fugate was a big champion of that. And you’ve seen it evolve, Katrina, where things were not good. And then you move forward again, incidents like Joplin, incidents like Sandy, many smaller ones, Irene that came up the East Coast.

You’ve really seen that evolve and that has almost come to a new level with the Harvey response. People really came out to see how they could help. And the more invested the community is in the response, the more they’re going to be constructive critics and participants as opposed to seeing themselves as victims and wondering when’s the help going to come for me. So I think as we’ve continued to see that evolve, and now we’ll see what happens with Irma, where they’ll be looking at two incidents right back to back, if that holds.

But I think overall we saw a very good connectivity in the Harvey response. Things seemed to be going very well from an external perspective. And there was a lot of cooperation of the different levels of government. So that’s really been something has evolved over about a decade, a decade or more , which was really great to see come forward.

I think in terms of Harvey, we’re more and more learning lessons as well about social media and the apps that can help people, that companies like Airbnb that volunteer there, can host, can keep people for free. There’s no fees due to them. Other companies in that short of sharing economy have begun to do things like that. So you have more stakeholders invested in and being very active in the response. And that was good to see in Harvey and it’s going to continue to go forward.

{***Noah***}

That was our conversation with Eric McNulty about the long recovery ahead in the wake of Harvey.

{***Amie***}

But what can you do if you want to help Houston rebuild?

What’s the best way to support the city’s recovery?

{***Noah***}

In the wake of the storm, there’s been an outpouring of support and donations—especially in the form of goods—things like clothes, toiletries, or diapers for babies.

And while those donating have good intentions, experts say it’s not the best way to help.

{***Amie***}

Instead—they recommend that people send money directly to aid organizations so they can use it where it’s most needed.

{***Noah***}

To get some perspective on this we spoke via phone with Julia Brooks, legal research associate, at the Harvard Humanitarian Initiative.

She recently wrote a piece for the website the Conversation, explaining why giving cash, not supplies is the best way to help following a disaster

{***Julia Brooks Interview***}

JULIA BROOKS: We’ve seen, you know, time and again that people want to help those affected by a disaster and this is great and should really be encouraged. And the message that we’re trying to get across is that it’s much better to donate cash money rather than goods. And the reason for this is that when you donate money to organizations that are working on the ground that are established, they’re the ones that are really best positioned to know what is needed, what goods people may be in need of, what services that money can be best allocated, whether to those affected themselves or in terms of helping communities more broadly. So it’s really better to rely on the organizations that are working on the ground and local communities to determine what is needed. And you can best supply that from afar with money.

NOAH LEAVITT: And is that guidance true of disasters, both here in the US some of the tornado or hurricane but also kind of disasters abroad? Does that same logic hold?

JULIA BROOKS: Yes, definitely. I think the same logic holds whether we’re talking about disasters in US or abroad and sometimes abroad even more strongly. We’ve seen this now nationally in the US with hurricane Harvey but also Katrina, Sandy in New York, and in terms of the international responses in the Haiti earthquake or the tsunami in Southeast Asia, Typhoon Haiyan in the Philippines, and many more cases that are especially in terms of sending international relief to distant places, it’s much more efficient and useful for humanitarian responders on the ground to receive financial support than to try to send goods across these long distances that may go unused. They may be inappropriate items. Or they may simply come at a large cost for transportation, sorting, warehousing, and distributing these goods once they arrive.

NOAH LEAVITT: And so I wanted to ask about that because you touch on the number of goods in the article that I mean, they may go unused. It may be costly to deal with these. So what are some of the downsides of getting these things like clothes, toiletries, shoes, et cetera?

JULIA BROOKS: Yeah, I mean we’ve seen, especially in international disasters, but also in national ones, that a lot of this stuff is simply not what’s needed or it sits in warehouses and doesn’t get used. We’ve seen in the worst cases that disasters become a dumping grounds for stuff that people eventually clear out of their closets. like old clothing, high heeled shoes. So after the Southeast Asian tsunami, people were sending ski gear to tropical islands. So while people have an urge to help, it’s hard to make sure that those items reach those in need and that they actually are the proper items that are needed locally.

NOAH LEAVITT: Are there any good examples of disasters where we saw a better recovery because people just sent money versus disasters where people did send maybe inappropriate clothing or goods?

JULIA BROOKS: I would say that the positive lesson is that we see, more locally, when communities respond locally, there can be a useful role for providing goods, if you live for instance near Houston or in Texas, and you can reasonably provide goods that are being requested that you know are needed. Really the concern is shipping things over long distances that might be unused and then come at a cost and tie up resources for the actual response. So I would say if you are local to the area, if you’re a trained volunteer or professional that is working with a reputable organization and you know what’s needed, it can be very helpful to provide money and in some cases donations or even volunteer service. The concern is really doing that from afar and not knowing what’s needed.

 

NOAH LEAVITT: And so I mentioned then we heard from Eric McNulty earlier in the podcast about this idea that this recovery from Harvey could take months, probably will take years. From an aid agency perspective, I mean how important is cash in that context in terms of being able to sustain the recovery mission for that long period of time?

JULIA BROOKS: It’s really important to sustain that level of response over the long term because we know that recovering from disasters can take years. And especially for aid agencies, humanitarian agencies are often flooded with funding support in the initial emergency phase and have a much harder time sustaining that in the longer run. And they also have to switch to do emergency response in other situations in the longer. Run so it’s really important to keep these settings in mind and think about not just initial a week or two of emergency response, search and rescue, shelter, or things like that, but figure out how to get to Iroquois communities as they rebuild and recover over the longer term.

NOAH LEAVITT: And for people who are listening to something, OK, I want to take some money and contribute to an organization. what are some things people should keep in mind before they do make that donation?

JULIA BROOKS: Yeah, I think if you’re looking to give money and do the most good, there are a number of guides that are available online. A number of news services have put out guides for giving. A number of rules of thumb to keep in mind, is that it’s good to give to trusted organizations, especially those with established ties in the local area. Many organizations have been working on the ground long before these emergencies happened and will continue to do so.

It’s also good to give to organizations that are transparent about the money that they bring in and where they spend it, as well as organizations that are going to procure items locally, support local economies, and really integrate into the overall response effort, whether with local communities, local government officials, and others, so that it’s a coordinated relief effort.

NOAH LEAVITT: And so just a final question. I mean you touched on this fact, that in the media wake of a disaster, the donations flood in and everyone wants to help and has all the media attention. But is there anything I guess like in a preventative way that can be done be to position aid agencies and aid organizations kind of in a better position so that when disaster strikes they can respond a little more quickly and have a better financial footing?

JULIA BROOKS: Well I would say one thing there is that aid organizations do spend a lot of time between disasters trying to educate communities, to say, you know when things happen it’s useful to provide financial donations, not in-kind goods donations. Organizations also will frequently preposition staff and supplies when they know that something like a hurricane is coming. Or in longer term, emergency settings where they establish longer running programs. So I think that aid agencies are preparing for these types of disasters all the time, as are many local communities and governments. It’s just that during these heightened disaster periods, when there’s more international or national media attention.

{***Noah***}

That was our conversation with Julia Brooks about why it’s best to give money—not goods—in the wake of a disaster.

{***Amie***}

If you want to read her piece on the Conversation, we’ll have a link on our website, hsph.me/thisweekinhealth.

{***Noah***}

And coming up next week: New research is raising concerns about a popular brand-market

{***Elsie Taveras Soundbite***}

(Parents are looking for ways to support their schools, but in essence, what programs like Box Tops is doing, is leveraging poor school funding and caring parents to promote the purchase of poor quality foods)

How the Box Tops for Education program may be driving parents and kids toward unhealthy food choices—and what can be done to combat the program’s impact.

{***Amie***}

In the meantime you can listen past episodes of this podcast any time by visiting iTunes, Soundcloud, or Stitcher.