Pandemic Preparedness & Response:  The Top 10

[June 17, 2009]

It is true.  I’ve switched teams.

I am no longer an employee.   I no longer hold the title of Team Lead or Director of such and such for a healthcare system.  I am now on the other team.  I am a vendor.   Our team provides disaster preparedness, information technology and healthcare management solutions.  Sound boring?  Not at all.  Passion, innovation and imagination are a must among the crew I work with whether we are in the same room together or 1000 miles away at a home office with bunny slippers on.

I love the buzz of conversation among my colleagues – players on both teams – and the camaraderie among those of us that love to share information for the common good.  So it is with a debt of gratitude that I share some of the information generously shared with me.  My hope is you will find it as useful as I have and that it advances your level of preparedness and response in the midst of the current H1N1 pandemic in the face of the upcoming 2009 flu season.

1.  Checklists, checklists, checklists

Checklists can be useful to guide the work of a large project such as the development and implementation of a public health emergency plan.  While there are many out there, I suggest if you haven’t begun any public health planning, a great tool, albeit an overwhelming amount of information if you are just beginning is the NJHA Toolbox, which is a series of modules developed by the New Jersey Hospital Association. 

2.  The Pandemic Plan

I probably rocked the boat a bit when I essentially refused to write a plan specifically for H5N1 avian influenza.  I was especially obstinate when required to write a Hospital COOP for pandemic.  I am less concerned frankly with what the risk or hazard is.  Do not interpret this to mean I do not support mitigation.  I do.  But at the end of the day, I like plans people can use, that are scalable depending on the impact regardless of the cause.  I don’t think we need a bio-terrorism plan, an infectious disease plan, a pandemic COOP and so on.  One plan will do.  I like plans that include influenza and scale based on impact or magnitude of the event.  For example, not every public health emergency will involve converting a space for cohorting infectious patients for triage and treatment, or the use of an alternate care site, but the plan should have the ability to scale in event it is necessary.  The public health plan template that we use is intended as guidance for an infectious disease event, whether terrorism or a pandemic.  We can then supplement it with documents such as our H1N1 table to provide disease specific information or this crosswalk to simplify a lot of information on one page. 

3.  Risk Communication

There are Six Principles of Crisis Emergency Risk Communication (CERC) per the CDC 

·         Be First

·         Be Right

·         Be Credible

·         Express Empathy

·         Promote Action

·         Show Respect 

If you haven’t developed a risk communication strategy and documentation go to our website for free downloads and check out the CDC’s CERC materials.

4.  Human Resources Templates

In the early planning efforts of pandemic preparedness, in many organizations there were several barriers to finalizing policies with respect to personnel.  Two of which include - the belief that the pandemic would not happen (which is no longer the case) and legal considerations.  If you haven’t already, establish policies that address personnel considerations during a pandemic.  Pandemics typically come in three waves so take the first wave as a learning opportunity and improve.  Another round of school closings and a more virulent strain are only two of the issues that we may face during the fall flu season.  For some templates go to our website for free downloads.

5.       Legal Considerations

For Legal Considerations, I would recommend two resources.  One is an article written by David Wirtz in the NY Law Journal.  If you would like a copy of the article, contact me.  The Journal does not make it available online.  The other is the Legal Module in the NJHA Toolkit referenced above.  If your general counsel is asking questions, start by directing them there.   

6.       Mental Health Considerations

The two primary strategies for coping with the emotional impact of a pandemic are:

·         Education:  Factual information about pandemic influenza and its impact;

·         Preparation:  Personal and family readiness for health emergencies

Here, are two documents to further assist you with the mental health considerations of your friends, family, colleagues and staff. 

7.       Social Media

If you like social media tools like Twitter and Linked In, you may be interested in the H1N1 Alliance or follow the tweets of the CDC or the WHO.  I’ve recently become a fan of FEMA on their Facebook page and a twitter follower of Big Medicine (of course!) 

8.        Virtual Medical Director

If you don't have a corporate medical director, MedPrep Consulting will be your medical director. Their Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. You can find them at www.MedPrepGroup.com 

9.       BCPWHO H1N1 Survey & Webinar

In the spirit of full disclosure, I am on the Board of Directors for BCPWHO.  Nonetheless it is on the top 10 because of the expected value of the H1N1 Preparedness Hotwash survey we are conducting.  It will be invaluable in identifying issues and processes that must be addressed before the Fall flu season. For those who have not yet had a chance to complete the survey, please take a few minutes to do so.  There are only 15 questions and most can be answered very quickly.  The more responses received, the better quality of data we will have to review to develop a strategy for future planning.  The deadline to complete the survey has been extended to July 3, 2009.  The link again is:  https://www.surveymonkey.com/s.aspx?sm=c9MMy6FTByCic9eHbhBtQQ_3d_3d. 

The results from this survey will be shared through a webinar being scheduled in August.  Stay tuned for more details.   

10.   Business Continuity

Last but not least – business continuity.  I’m sure there are lots of new and improved templates out there, but I continue to refer people to a document developed in New Zealand.  It has some great nuggets regarding the management of employees who are ill, workplace cleaning and other information for workplace policies.  I certainly invite you to share with me other examples that are favorites of yours, but for now, this is one of mine. 

A pandemic presents increasing challenges for private industry, especially if we face a more virulent strain this fall.  And I remain concerned about the impact on the healthcare industry.  I certainly hope that the information shared here assists you in your own preparedness and if we must, leverage the upcoming flu season in the midst of the recently declared pandemic as an incentive to do so.  

 ~Angela is Managing Partner of Wakefield Brunswick, Inc., President of Mahila  Partnership and serves on the Board of Directors of BCPWHO and EMPOWER.  She can be reached at adevlen@wakefieldbrunswick.com.

Mahila Partnership is launched

[Sep 16 2008]

Dear friends & colleagues,

As many of you know, Nicole Mason and I co-founded a non-profit this year - Mahila Partnership www.mahilapartnership.org. We are a grassroots organization dedicated to serving vulnerable populations and working on projects related to education, community and disasters. Most recently we have partnered with UMASS Boston's Center for Rebuilding Sustainable Communities after Disasters. As their NGO Partner we will be working with them on their November 2008 International Conference on Rebuilding Sustainable Communities for Children and their families after Disasters.

You are invited to contact me directly to learn more, volunteer or learn about sponsorship opportunities. Please share this information with anyone you feel would be interested.

In support of the work at Mahila and initiatives at Caritas, I have been participating in projects related to women's issues and disasters. Here is an article authored by Jennifer Mincin (posted to the NEMRC Briefs site) that I had the privilege of contributing to-scroll down to see the domestic violence & disasters piece: http://www.nemrc.net/monday.aspx.

Also very exciting to me, (the amateur photojournalist that I think I am!!) I will be profiling issues in healthcare as well as the lives of women & their families as a result of our work through writing and photography. You will see my work on Big Medicine and other online & print publications. A new article will be posted on Big Med soon!

My work at BCPWHO and in healthcare in the areas of disaster management, domestic violence, vulnerable populations and emergency medicine will continue.

If you would like to learn more or have projects that you believe may benefit from some of these initiatives, you are invited to contact me.

Kindest regards,

Angela

Angela Devlen
Emergency Management, Caritas Christi Healthcare
President, Mahila Partnership www.mahilapartnership.org
Director, BCPWHO www.bcpwho.org
www.bigmedicine.ca/angeladevlen.htm
www.linkedin.com/in/angeladevlen 
adevlen@mahilapartnership.org
 

PARTNERSHIP TO REVOLUTIONIZE REBUILDING AFTER DISASTERS
 

Mahila Partnership Partners with UMASS-BOSTON Center for Rebuilding Sustainable Communities After Disasters
 

[Boston, September 16, 2008] - The University of Massachusetts Center for Rebuilding Sustainable Communities After Disasters (CRSCAD) and Mahila Partnership have established a partnership, working together to strengthen communities locally and internationally; focusing on sustainable rebuilding after disasters, and decreasing the impact of disasters on women and their families with a focus on particularly vulnerable populations such as those experiencing domestic violence or poverty.
 

Together, along with other international partners an inaugural conference, “Rebuilding Sustainable Communities for Children and their Families after Disasters”, will be held at CRSCAD November 16-19, 2008.

“The central objective is to provide an intellectual forum for scholars and practitioners around the globe to explore how rebuilding of communities after war or disasters can be carried out in a way that promotes social justice, economic and political sustainability, and the full participation of all stakeholders,” CRSCAD Director Adenrele Awotona said about the conference, which began to take shape after a successful conference he held at the University of Massachusetts-Boston on rebuilding in Iraq.
 

Experts participating in the November conference include:
 

Grace Oyebola Adetula, Nigeria, “Female Ex-Child Soldiers: Case Studies for East and West Africa”
 

Ashfaq Ishaq, USA, “Rebuilding After Disaster: A Child-Centered Approach”
 

Tutty Alawiyah , Indonesia, “Rebuilding sustainable communities for children orphaned by the 2004 Aceh Tsunami: The Case of As-Syafi`iyah Special Boarding School for Orphans”
 

Kai T. Erikson, USA, “Lessons from Katrina” (tentative)
 

Diane Levin, USA, “Understanding the Impact of Disasters on Children and
Helping Them Heal and Thrive Afterwards”

More information about the conference can be found at: http://www.rebuilding.umb.edu/rsccfd/

In addition to the conference, together Mahila Partnership and CRSCAD will work with vulnerable populations to develop and promote sustainable methods of community rebuilding after disaster, with a focus on the issues of domestic violence and poverty, both of which make women and their families even more susceptible to disaster. “Along with CRSCAD, we will work with our partners to support sustainable redevelopment of communities affected by poverty, violence and disasters,” says Mahila Partnership co-founder Nicole Mason.
 

About The University of Massachusetts-Boston Center for Rebuilding Sustainable Communities After Disasters (CRSCAD)
 

CRSCAD works in close collaboration with practitioners, academics, researchers, policy makers and grassroots organizations in their search for the most appropriate and sustainable ways to rebuild their communities after disasters (both natural and man-made). The work of the Center includes applied research, early childhood education and family support, communications and intellectual outreach to academic experts, other research groups and policy think-tanks. It organizes and hosts seminars, workshops and conferences on various aspects of post-disaster reconstruction in partnership with public and private sector agencies in all the countries of the world.
 

About Mahila Partnership

Mahila Partnership is a grassroots organization dedicated to serving vulnerable populations by promoting self expression through the arts; fostering awareness through educational initiatives; working to end domestic violence and poverty; and training women and their families so they are better prepared for, and more able to recover from disaster. Together with our partners, we create and support innovative projects to reduce vulnerability, promote dignity, and strengthen communities through long-term, sustainable measures.
 

Crisis

[Feb 4 08]

It’s a different sort of crisis. It isn’t global in scale. But it is a crisis and two things about every crisis that ring true every time, ring true this time. Every crisis is local and it’s leadership in the face of that crisis that makes a difference.

Not enough time has passed to look back and reflect on the lessons learned and exactly what principals of leadership made the difference. We are still in the midst of this. But what I have witnessed and had the privilege of being a part of in the past couple of weeks has been inspiring, and has renewed my faith in power of community and unity and the difference that is made when there is a shared common goal.

My daughter attends public school in Salem, MA. We have been impacted by an unexpected financial crisis resulting in a 4.7 million dollar deficit. This was going to result in layoffs of teachers and other school staff in the middle of the school year. On February 1st, our teachers' jobs were reinstated before they were scheduled to finish their last day of work. This would never have happened if not for leadership. This leadership was demonstrated in a number of ways but there are two words that repeatedly come to mind that sum up the ways in which that leadership was exhibited over the last couple of weeks - commitment and empowerment.

The commitment to achieve a specific outcome, in this case - save every job - has generated an outpouring of generosity from every corner of our community as well as actions by our school and political leadership. So far we’ve prevented the loss of about half of the jobs slated for cuts and several more fundraisers are scheduled to save the rest.

I’ve often thought that American children don’t appreciate the education that they are so fortunate to receive. But in the last two weeks I have been proven very wrong by the children here in Salem. It is remarkable what children are capable of when empowered to do something. They have been as much a part of the solution as anyone, raising money on their own by going door to door requesting donations and perhaps the most touching (for me), a fundraiser led by my six-year-old daughter, where children brought in their very own pennies, dimes and quarters to try and save the jobs of their teachers, librarians and para-professionals.

In addition to the difference the money makes, parents are proud, teachers feel valued and our children know they have done something that makes a very big difference in their world. That is leadership in action and by young children no less.

This is not to suggest our crisis is unique. There are schools around the country facing similar issues. There are schools around the world facing far worse. The point here is to share one point of view about what has made a difference for my community and my daughter.

It is also a story about how it isn’t the crisis that dictates an outcome but rather how the people touched by that crisis deal with it.

It’s amazing what can happen when people come together. I’m thrilled to know it is for a common cause-education. Because education really is the key to our children’s future-in every community and every corner of the world.

HOW YOU CAN HELP

Attend our Fundraiser - Knights of Columbus Hall on Salem Common between the hours of 2 PM and 10 PM on Saturday, February 16. There will be entertainment and an auction.

A volunteer/donation number has been established. Call 978-750-1110 for information on volunteering time or to donate materials or money for the auction.

Donations that can be mailed should go to SOS, C/O 5 West Terrace, Salem, MA 01970. All others should be brought to the front desk at Salem High School between 7 AM and 3 PM until February 14. If those times are not workable please call 978-744-3856 for assistance.

Donations can also be made directly to "The Salem Education Fund" and mailed to: The Salem Education Fund, P.O. Box 4125, Woburn, MA, 01888 or can be made online at www.salem.com.
 

The Fourth Generation

[Jan 2 08]

The Salem [MA] Fire Department [May 1 07]

The child of every firefighter is terrified their parent will die in the line of duty. I know because I am one of those children. I know because I cried the day the towers fell knowing my worst fear came true that day for all the children who lost parents on 9/11. I know because I watched with horror as two homes in the Salem Willows neighborhood burned one April night and other children’s daddy’s with hoses in hand ran into those houses engulfed in flames and worked relentlessly for 5 hours to put that fire out. I know because they were putting their lives on the line that night for me and 11 other people who called those burning houses home. But putting out fires is what they do. They put their lives on the line every day. Yet there is so much more that so many do not see or appreciate.

My daughter, now 6 has visited the Salem Fire Department Headquarters on Lafayette Street with her school at least once a year for the last 3 years. Each year as part of a public education program-one of the first departments in Massachusetts to start a program like this in schools-firefighters enthusiastically show her and her classmates around.

Then one day last summer when walking past the firehouse we approached one of the firefighters on duty asking if we could get a tour. And as if we were the first people to ever ask, he showed us around with pride and enthusiasm—the kind that someone has when they have begun something new and exciting. We all know that feeling. Only this firefighter has been on the job for more than a decade. It takes that kind of passion to do this job. My father still has it after 30 years. They take every opportunity they can to give a tour, educate another citizen, to share their passion.

Whether it is through their union charity account, their leading 10-week Juvenile Fire Setter Intervention Program or public education, their community commitment is clear. Lt. Peter Schaeublin shared examples of how their local grassroots charity holds fundraisers to meet community needs such as giving away wheelchairs to those who may not otherwise be able to afford them, distributing turkeys at Thanksgiving, and countless other identified community needs. The money they raise in its entirety is for the community instead of themselves even though funding for the department has been scarce.

When asked about the night of the fire at my house, firefighter Bob Cook who is also a Salem Willows resident and on the first responding truck that night told me, “I remember that night”, he said, “The second ladder truck usually isn’t in service. That night it was. It made all the difference. We could have lost the entire neighborhood.” Cook wasn’t the only one to remember that night. I heard more than once among the men who were there that night that it could have been the night a neighborhood was lost. I can’t help but wonder how much having that second ladder truck in service made the difference. But the department is only staffed at about 80% of what it needs. Having the trucks is one thing. Without the enough funding to hire firefighters to work them, they sit idle. The risk to our community is not lost on me, nor is the risk to the firefighters.

Reflecting again on the night of the fire, I remember the “mayday” called over the radio. The thought of losing a firefighter in the fire that took the place my daughter and I called home was terrifying. Firefighter Jack Rubin is a “salt of the earth sort of guy”, tough as nails and clearly admired by his brothers in the department. He is a Vietnam veteran with over 30 years on the job. Jack was the one who called that mayday. Few things makes a man’s blood run cold like the moment when they hear one of their own, one of their “brothers” call for help. Fortunately, Jack Rubin made it out alive that night.

Choosing a fire department most worthy of accolades is no easy task. They all have common traits and challenges. In my role as an emergency manager, I work with dozens of fire departments. I can use the same characteristics to describe all the firefighters I’ve worked with: Strength…Character…Bravery.

But for all that my local department has done for me, my neighbors, my daughter, her classmates and countless others, I must tell this story. It is not only my story. It the story of every daughter of a firefighter. It is the story of every person who’s been left homeless after a fire. It is the story of every firefighter. And it is a story of the Salem Fire Department.

In a time that often feels void of heroes, I need not look any further than my own back yard. Thanks to Chief Cody and the Salem Fire Department a community only lost 2 homes that night, not the entire street. We have a department dedicated to our community. We have local heroes my daughter can look up to.

For more stories about the heroism of firefighters and the work they do for their community go to web.firedog.com/acrossamerica/vote.aspx  and vote for your favorite essay.

Battered [Feb 1 07]

In addition to the risk of being murdered, there are many barriers to safely leaving abusive relationships that include but are not limited to:

• Children – victim’s often desire for their children to grow up with both parents.
• Control – victims often believe that they can control the violence by doing what the abuser wants. This is almost never true.
• Shame or embarrassment about their situation.
• Isolation – many abusers will cut off relationships the victim has with family and friends, leaving the victim to feel alone and with no control over the situation.  
• Fear – the perpetrator will often make threats of increased violence and even homicide if the victim threatens or attempts to leave.
• Financial concerns – victims of domestic violence often feel they have lost all control over money and feel hopeless about their situation. In their first year after a divorce, a woman’s standard of living drops, on average, 74%, while a man’s standard of living improves by an average of 42% (Action Notes, 1989).
• Deserve abuse – victims often have the false belief that the abuse is ‘deserved.’
• History of childhood abuse – victims with a history of being abused as a child or witnessing domestic abuse in their family of origin often believe that violence is a normal part of a relationship.

The act of leaving an abusive relationship is a process.

Source: The above information was adapted from materials provided on the following websites: http://www.houseofruth.org/; http://www.fvpf.org; http://www.ncadv.org  

Survivors experiencing abuse should contact their local domestic violence program for immediate support.  Check your local yellow pages or call the National Domestic Violence Hotline (operated by the Texas Council on Family Violence) at 1-800-799-SAFE to be connected to the program in your area.

-Know that no one is silent though many are not heard. Work to change this.  

Pandemic [Jan 7 07]

Over the past couple of years, H5N1 avian influenza has caused concern among public health officials and sparked debates around the globe about the significance of this virus, the likelihood of another pandemic and whether the threat is in fact imminent.  And like everyone else in my field I am planning for the influx of infectious patients on our hospital doorsteps and working out a strategy to treat them as effectively as we can knowing we may be short on everything-supplies, staff and space. 

·    Bring my daughter to my mother’s - a village in Canada where she may not become exposed.

·    Arrange for her to be cared for while I am at work recognizing I may not see her for days at a time and when I do go home, potentially expose her to the virus

·    Turn my office into a temporary residence, bring her to work with me and increase the risk of exposing her to the virus

We can do all the planning we want.  Even if we could somehow guarantee enough beds, nurses, and ventilators, there is still the human element, or what my colleague Dr. Gerald Lewis has coined the Human Factor.  We can’t predict that piece; we can only be prepared to respond knowing it is the unknown.  Certainly we can make some broad sweeping assumptions that I believe will be reasonable. 

But at the end of the day, we are individuals and this pandemic, if it ever happens in my lifetime will affect each and every one of us on an individual level.  It is impossible for me to conclude exactly what I will do, but right now as wrong, controversial or selfish as it may seem I cannot envision shipping my daughter off to someone else knowing it may be the very last time I see her.

Cocoon [Dec 21 06]

The Butterfly…

There is recent evidence to show that this is possible.  A new initiative benefiting women and children in some of the most remote areas of the world is currently in development.  Through the values of social entrepreneurship and following the recommendations of The Huairou Commission the goal of this initiative is to facilitate the deployment of resources to some of the most remote (including mountainous) regions of the world. 

This is achieved through establishing relationships with grassroots women’s groups involving women and their communities in disaster preparedness and response.  This leads to long-term sustainable development by empowering local women with the resources they need. 

They can best determine local needs and get resources to those most in need, therefore establishing a local sustainable structure that strengthens local efforts rather than deplete or remove them. 

So what does this community rebirth, led by women look like?  According the Huairou Commission it looks like this:

• grassroots women gather
• they identify their problems
• they work together, with others in the community and with other grassroots groups to create solutions
• they negotiate partnerships
• they implement solutions
• they continue assuming new roles of leadership and responsibility
• they teach other groups what they’ve learned

(source:  www.huairou.org)

I am looking forward to supporting an initiative that will allow these women to find a safe haven in their “cocoon”, as they strengthen themselves and their communities…until they are ready to emerge as a butterfly.

The Fire [Dec 2 06]

It’s probably about 2 a.m., the day after tax day and I am watching a fire envelope not one but two houses. There are several people standing around with looks of concern and fear on their faces. It isn’t their house on fire but it may be.

This has been this close-knit neighborhood’s nightmare for generations. The houses built so close together. Winds blowing off the ocean. Flames licking at the side of two houses. Will it spread? Is this the fire that will wipe out the entire street…neighborhood?

I am beyond fear at this point. I have seen and heard of fires such as these many times before. I was a Disaster Action Team Member with the Red Cross for several years. My father is a Lieutenant on the Saint John Fire Department in Canada.

I recall red stickers on our windows to tell fire fighters where the bedrooms were, learning to crawl on our knees under the “smoke” and checking doors for heat before opening them. I recall seeing my dad three days before the evening of this fire.

I begin thinking about the next day and how tired I will be at all of my meetings if I don’t get some rest. It is April and I am cold standing outside. I go inside and can’t warm up.

Someone investigating the fire wants to ask me questions. I feel like a suspect of a crime and I am nervous. I am not sure suddenly if what I said I witnessed is the exact truth. It all happened so fast.

“There was an explosion…not a huge explosion, but a bang”, I say. “Then the flames raced up the side of the houses.”

“It was between the houses…no I don’t know what could of started it…no I don’t know what the explosion/bang could be…”

I am still cold.

Yes, I am beyond fear at this point. I am not worried whether it will be my house next or whether this fire will spread. The house on fire is mine. The irony of it all is not lost on me.

The Red Cross arrives.

“Oh my…one of our own volunteers”, they realize.

$75.00 they give me for food. Suddenly the work that I had done for 10 years with them seemed so inadequate now that I realized how much is lost by a family in a disaster and how little of that a bag of toiletries and $75.00 would cover.

Nonetheless, I appreciated that they were there for me. But then I am back to reality and next steps.

I am a single mom with a dog. Nobody rents to people with dogs. My family is hundreds of miles away. What will I do with $75.00? I am homeless with a little girl who just turned four the week before and a dog.

I am not alone however. Ten other people lost the place they called home that night.

Over a decade of disaster management experience did and did not prepare me for this. Certainly, I responded quickly and decisively. (Once I realized it wasn’t drunk teenagers banging outside my house). It was a multifamily house and there was another mom with 2 boys on the top two floors. Within seconds, I and a neighbor raced up to get them out of the house.

I immediately began thinking of the next days schedule and an upcoming business trip and how would I go about cancelling the next day’s meetings and at the same time borrowing clothes for the following week’s trip. Where would we live? Begin the process with the insurance company. (Adjusters are both a blessing and curse) Survive. Focus.

I am not the first person in disaster management to endure a personal disaster. I am grateful it wasn’t happening to me at the same time as the community around me.

Fate waited to deal me that blow a year later with the floods that hit the Northeast in May 2006. One disaster a year. Not bad! I am obviously not the only person to lose their home in a fire or disaster. I am grateful I had a great deal more to rely on than most…friends, colleagues, a great career and a steady paycheck.

But I learned something. We are all expected to pick up the pieces on our own. Granted, I received tremendous support. Fundraisers by colleagues and friends. My daughter's caregivers opened their home to us. Yet, the recovery is long.

People expect you to be back on your feet within days or a few weeks at most. But it was more than a year before the magnitude of the loss hit me. The cumulative financial impact.

Watching my daughter still mourn the loss of her “babies” in that fire. Looking for something that I just know I have and then realizing that, of course, I don’t.

Even for those of us where life is relished and opportunity embraced, the recovery is long. It reinforces how important it is that vulnerable populations not be forgotten in disaster and that women and children are often part of that group.

It also reminds me how so many people think the disaster is over once the media finds something else to cover. Obvious human suffering is newsworthy. The quiet suffering and private tears are not.

Disasters large and small have all the same characteristics by those impacted by them. The fire at my house made the front page of the newspaper the next day. The day after that it was forgotten by most.

For us, the work was just beginning.
 

Welcome to my rebellion [Nov 16 06] Hmmm...a column. That would be great fun I thought when it was suggested I contribute to Big Med. [The privilege also not lost on me].

My response to express my interest?

"...as a single mom of a five-year-old girl, working in emergency management in healthcare, with a background in private sector BCP/DRP...but started out as an EMT...not to mention my little side projects such as BCPWHO and gender issues in disasters [there is a feminist hiding not so deep inside me] and my passions for mountains, wine, cooking, gardening...well, one could argue I'm a little scatterbrained. I like to call it passion for life."

 

They say you should choose one thing and do it well. My column will be nothing short of a rebellion against that concept. As is my life. Of course, you can see that from my response.

So allow me to begin with all the issues that are important to me.

Women and children. I am a single mom. My five-year-old daughter is my primary inspiration and she teaches me every day. Sure, sure you say. Of course we'd all say that if we were writing a column mentioning our children. You may be right.

But I would argue she has experienced loss and life in a way that has taught her a great deal in five short years. She is an old soul and is wise in a way few people are, regardless of age. My daughter inspires me to be a better person and it provokes a response in me I can only describe as a desire to advocate for the safety and livelihood of our children.

Violence. Domestic abuse, crime, war, and disasters are common events resulting in violence against women and children. Empowering them through grassroots efforts at home and across the globe are key to addressing this issue.

Emergency Management. I have always had two jobs...at least. Currently I may be up to four. They weren't always all related to emergency management but at least one of them was either emergency management or healthcare. Currently, I have the great privilege now of leading emergency management at Caritas Christi Healthcare System in Boston and serving on the Board of Directors of BCPWHO www.bcpwho.org.

Mountains. I was in Costa Rice nearly five years ago. You can hike up into the cloud forests at over five thousand feet. You can go to the closest village in the valley and drink beer with the locals. You can walk up the mountain roads where the mountainsides were burnt, erasing the beautiful landscape of rainforests to make room to grow coffee. Also along these mountainsides are shacks that are built that the people live in but are frequently washed away during the rains.

Yet I love the mountains. I spend as much time as I can in the Northern Presidentials in New Hampshire. But the mountains can be dangerous. I think of that as I remember the families I met on the mountainsides in Costa Rice, or the man who fell in the ravine a couple of weeks ago when I was climbing Mt. Washington [he survived], or the families facing yet another Himalayan winter following last year's earthquake in Pakistan.

Where does this all lead? Is it truly possible to weave all of this together...a product stronger than the sum of its parts? Yes, it is. For me doing one thing is boring and does not mean you will do it well.

Imagine an effort that supports woman and children through mitigating the effects of disasters, preventing violence against them and supporting sustainable development projects - particularly in areas hardest to reach, like mountainsides.

Welcome to my rebellion.