In 2011, entire sections of the city of Joplin, Missouri, were leveled by a tornado. As the storm approached, hospital employees dragged patients on mattresses into the hospital hallways and away from the windows. It was the night of the senior prom, and a mother was sucked out of her car while getting pizzas for the after-prom party. There was very little warning. There was no place to shelter or hide. It was all too horrible.
That tornado was one in a series that spread over the southern United States and killed 562 persons over 24 hours. There were few tornado shelters that could withstand the immense power and size of that particular storm. An inner wall collapsed on school children in Oklahoma, killing nine. Tractor-trailer trucks were blown off interstate highways like sandbox toys. In the midst of the storm, an African American woman and her family were turned away from shelter at an all-white church in Alabama.
After the storm, spiritual care professionals from all over the country traveled to Joplin to support the community. The staff of the Joplin hospital had to relocate large numbers of surviving patients, in addition to taking care of their own families. Many of their homes were damaged or destroyed in the same tornado.
How does one comfort those killed, injured, or displaced by a tornado or hurricane? While many of the techniques discussed earlier in this book still apply, there are some aspects of these types of tragedies that are unique to natural disasters.
Natural disasters can be described as acts of God for some people, but for many scientists and others, what occurs in nature has a rational, nonbiblical explanation unless “to every season” means hailstorms and brimstone. Floods, tornadoes, hurricanes, earthquakes, volcanic eruptions, tsunamis, and forest fires all are products of nature and may influence climate and, even, wipe out civilization. Destruction from the Japanese earthquake and tsunami in 2009 combined with a nuclear power plant meltdown rendered entire regions uninhabitable and destroyed.
Climate change and global warming have produced more intense hurricanes and storms and with increasing frequency.
There is little comfort in a category 5 hurricane. In the aftermath of the storm, there may literally be no evidence that life existed before the storm, except for a concrete pad where once a home or business existed. Schools, parks, and downtown commerce areas are devastated. In Mexico Beach, Florida, everything was destroyed down to the sand.
The upper Midwestern dream of getting a houseboat and cruising the Gulf of Mexico in retirement can become a nightmare as there are more storms, with greater intensity, than ever before. There is little comfort in exposure to the extreme elements of heat and humidity that is scientifically related to global warming. Whether or not you are a believer in climate change is cold comfort when your home and business is lying in ruins.
I grew up in the Midwest. I was familiar with tornado warnings in the late summer and where to hide in the basement if a funnel cloud was seen. I am very familiar with the Wizard of Oz except that houses and beds do not automatically stay together in a tornado like they do in the movie.
In the 1950s, fallout shelters that would protect us from radioactive clouds of a Russian nuclear bomb that could be used if you were away from home when a tornado “hit” were built in many communities.
There were floods in the Missouri River valley caused by remnants of hurricanes blowing themselves out after landfall, but folks had time to prepare and get to higher ground. Old-timers could remember the flood of 1931 or 1957. Now it seems that every year there is a 100-year flood. Levees can’t be built high enough or strong enough to withstand the pressure from extreme rainfall.
Floods also traumatize relatives of those whose loved ones are buried in cemeteries where flood waters expose coffins after a severe flood. There is little comfort in knowing that your loved ones are not “resting in peace.” Heavier rainfalls, early ice melts, and more intense thunderstorms all can be traced to climate change.
The top ten costliest hurricanes according to the Weather Channel have occurred since 2004, with Katrina topping the list. Harvey, Irma, and Maria also made the list. Just like there are storm chasers for tornadoes, there are those who try to ride out a hurricane with a party and a video camera. First responders have put out the message that they will not endanger personnel attempting rescues of those who do not heed the warnings. Disasters are not entertainment.
Oceans are warming and that impacts weather. More intense hurricanes and typhoons are anticipated and have already occurred. Climate change is a natural disaster happening rapidly in some corners of the world and more slowly in other places. It is scientific fact and there is little comfort in anticipating what may occur.
There is so much anxiety and so many citizen helpers. So many citizens who own boats and rafts and kayaks for recreation have now repurposed them for survival. One foot of water and politicians are running for reelection sometime in the near or distant future. There was a peacetime armada in a war against water.
There were videos of catching fish by hand in a living room and alligators floating in the front yard of townhouses. There were vacant stares and looks of compassion and concern. There was a diabetic and a hoarder. A methadone user and a pregnant citizen. There were garbage trucks and the National Guard. There were Coast Guard helicopters and news agency drones. There was so much to be said and not a dry place to say it. And there were pets. A nation’s wealth in poodles in puddles. There were bedsheets in windows and evacuations in the middle of the night. Dams that overflowed and responses that underwhelmed. There were people there from dry places in Washington and Connecticut, and people sending love from California. There was pluck and verve. There were many reporters doing repetitions of the same story only different. There were many survivors in pontoons.
There was much information and reassurance. There was comfort and coffee, diarrhea, and soon, pneumonia. There were piles of donated dry clothes and lines waiting for ice. There were so many children and people milling around. There were smartphones and waders; closed highways and power outages; people shivering and those too shocked to sob. There was so much pain everywhere. There were children comforting adults. There was clarity and confusion.
The sky may not be falling, but new meteorology models can predict where major hurricanes are going to make landfall. The combination of science and technology has revolutionized weather forecasting. I can go online and see fairly accurate weather predictions for Orlando for the next ten days, and the same for Omaha and Oakland. Those in emergency preparedness know they must plan for the next “Big One” as well as smaller, everyday disasters like house fires and auto accidents. EMTs need to be prepared for all types of situations and be able to ramp up in size and scale as quickly and seamlessly as possible, as local events may expand and become state and national emergencies.
Oftentimes, first responders and other emergency response personnel have practice drills for anticipated catastrophes like an earthquake in the center of the country wiping out Chicago, St. Louis, and Memphis. These disaster scenarios may feature “the destruction of all bridges over the Mississippi” and the ability of comfort and care to arrive in time to save millions. There sometimes is a little too much glee in the room when the disaster scenario features the destruction of Washington, DC. But these staged enactments are deadly serious and have probably, more times than we know, saved lives.
These emergency response personnel live constantly on call, twenty-four hours a day, seven days a week. Pretraumatic stress may be a constant in the lives of first responders. Emergencies and natural disasters are inconvenient and do not happen between nine to five, but generally at the more inconvenient time of 5 a.m. on a Sunday morning. In the case of the Pulse nightclub shooting, which happened at 2 a.m. on a Sunday morning, there were limited available first responder resources available for those who needed to be called to respond. After ten years with the Red Cross, I suffered from alert fatigue. I could not watch the news or the Weather Channel without imagining the worst possible outcome. It took me several years to be able to watch media without hyperventilating. Even today I find myself limiting my media exposure to the news and the weather as a method of self-care. Speaking with colleagues, I know that this is not a unique reaction to long-term exposure to disasters.
There is compassion fatigue that many experience in the helping professions, and there is alert fatigue.
Alert fatigue also becomes an issue as disaster responders may be bombarded with hyperbole about the next “mega disaster” that will be bigger and worse than anything mankind has ever experienced. At times, it seems like a constant threat. That is why there are so many rehearsals and disaster drills to keep responders sharp and everyone knowing their job and the command hierarchy. Knowing what to do and when to do it and who’s going to do it is somehow very comforting. An incident command system details the responsibilities for everyone. By rehearsing and knowing what is expected, anxiety is lessened when the actual flood or hurricane or shooting sadly comes to occur.
One never expects to die in a natural disaster. Tidal waves are extremely rare. Floods can be fast rising but there is always higher ground (in theory). Tornadoes and forest fires all give some warning. It may not be the same with earthquakes and volcanic eruptions, depending on an area’s warning systems. It seems like there will always be time to jump up and get under a desk or door frame. Smoke on the horizon or a line of dark clouds can be an advance warning to find an escape route—but it’s not always enough.
No one wants their last words to be, “I should have heeded the warnings.”
Yet, survivors always talk about clinging to treetops or rooftops, running out into the street, digging oneself out of the rubble, or racing through a burning landscape. Sometimes there are inadequate warnings. Or there are none at all. The evacuation scenes from the Paradise wildfire are incredibly painful to watch as some had to leave their burning cars on the highway and just run.
We are all familiar with the Emergency Alert Broadcast (EAB) Network that holds monthly on-air tests on local television, radio, and, now, text messages. “This is a test of the Emergency Alert Broadcast Network. If this had been a real emergency, you would have received instructions of where to go and what to do.” I was in my backyard in Arlington, Virginia, when the plane hit the Pentagon, and I don’t remember if the EAB was utilized in the evacuation of Washington, DC, but this certainly would have been the time to use it. I was in shock when my neighbor told me to turn on the television and see the extent of the attack on the Pentagon and New York City. After calling my husband to ensure his safety and welfare, I made my way to Washington Hospital Center where hundreds of patients had been discharged to await a possible influx of casualties. In the end, I think we only received fourteen victims. My clinical training prepared me to work as a member of a team at the hospital covering all possible scenarios.
The problem is, we know that fully one-third of the population will not prepare for a storm. For some, it may seem like anticipating a disaster causes the disaster. For others, they feel God will protect them or that the government will swoop in at the last moment and rescue them. This last viewpoint has been largely discounted after scenes of desperate people on rooftops in New Orleans after Hurricane Katrina have been burned into the public consciousness. With over 80 fatalities in the California Paradise wildfire, it became evident that first responders can only do so much without the support of the public, and in some circumstances, disasters unfold so quickly and severely that rescue is not always possible. In modern times, no one thought that 1,700 people could die in a hurricane until Katrina. Or that the morning after Katrina, the streets of New Orleans would be dry before the levees broke. Or that anyone always checks for the nearest exit wherever they go, be it a nightclub, movie theater, or school classroom. Sometimes death comes instantly, and other times it comes after spending days in the attic of a flooded house in the Ninth Ward.
So, after the alert comes the next question—do we stay or do we go? And, why are more people choosing to stay in what they know may become “harm’s way.” For some, it is a privilege to evacuate, to have a car or other transport accessible, or the resources to buy gas and lodging in a distant place.
When Hurricane Rita hit Houston in 2005, two million residents tried to evacuate. Roads were overwhelmed, people ran out of food and gas, and twenty-four elderly nursing home residents perishing in a bus fire during the evacuation. Twelve years later for Hurricane Harvey, a decision was made not to evacuate so that there would not be a repeat of the chaos surrounding the Rita evacuation. But then scenes of trapped residents and a multitude of water rescues from flooded neighborhoods swamped the television networks for days. In the case of Harvey, economic resources did not play a role in who was impacted. The Cajun Navy, an ex-officio group of people with pontoon boats, take it upon themselves to self-deploy wherever a storm with possible flooding is anticipated. In Houston they helped to evacuate stranded people side by side with official search-and-rescue first responder crews. In this instance, rather than becoming a liability, these volunteers were actually an asset, helping supplement a sometimes strained local rescue force. Government, as we will see later, cannot do everything.
Which causes more harm? Staying or going? Often, it is hard to know.
A chaplain colleague at one of the hospitals in New Orleans spoke of the ordeal of evacuating patients from a hospital. When the power was lost, heroic staff continued to manually compress air bags, keeping their patients alive until they could not do it any longer. Some patients did not survive. Some patients were evacuated only to have a “second” death, dying in a distant hospital in a different region of the country without family, without the option of dying at home. The true statistics of Katrina’s dead do not include residual deaths that can be related, but did not technically occur in New Orleans. Elderly evacuees died in distant cities. Maria’s death toll in Puerto Rico arose dramatically to 3,000 people when expanded storm-related causes were considered.
We know that hurricanes can form two weeks before landfall, but there are so many calculation models for where it will make landfall, and how fast it will travel. We don’t know whether it will strike Texas or Florida or both. We don’t always know whether it is better to evacuate or whether more people will die or be injured in an attempted or failed evacuation.
And when does evacuation become a privilege? Often, those who have the resources to evacuate do leave. Having private transportation simply was not an option for many of Katrina’s poor, without the privilege of car ownership or access to emergency public transportation. This was the first time that it became a significant issue that finances could play a devastating role in who survives or not.
Sometimes providing shelter is a short-term problem: sheltering in place until an active shooter is apprehended or waiting until a hurricane passes and people are able to return to their homes. But sometimes, when housing is damaged, destroyed, or otherwise unlivable, shelter can become a longer-term concern. The scale is also different. While a bomb or plane crash may destroy a building or two, a natural disaster can leave hundreds or thousands without a place to stay. Shelters are for people who have no other place to go.
There are small shelters in church basements and mega shelters in convention centers and sports stadiums. Oftentimes, cots and food supplies are prepositioned before the landfall of a hurricane, thanks to modern tracking of storms. Shelters try to provide three meals a day unless resources and supplies are scarce. Shelters are for the general population and are not segregated by sex (unless it is a Muslim-run shelter). There may be a childcare area and a medical area for those with special health issues. Shelters are often located in schools or armories with shower facilities. The scale and scope of Katrina, with over a million people evacuated, had FEMA placing people in hotels and motels in what was described as FEMA hotels, and, therefore, to be placed in one became a FEMA “vacation.”
Sometimes the community donates clothes which need to be sorted and made available to those who arrived at the shelter with only the clothes on their back. Oftentimes clothing donations are discouraged because of the logistical problems of having volunteers available to sort and size the clothes. Generally, there are no laundry facilities in shelters, as they are seen as short-term housing solutions. Also, schools may be closed for students but open as shelters. After the storm passes, part of the transition back to normal is to re-open schools as schools. I visited a Presbyterian conference in Texas that was incorporating showers into the design of new church halls throughout the region, anticipating there being used as future shelters. This forward-thinking group also advocated for having industrial-size kitchens to help feed the evacuees.
Today, shelters have security, because arguments can become fights. The stress of the disaster and the shelter noise makes sleeping problematic for some. Shelters also have crisis counselors offering emotional and spiritual care to comfort those who may have lost a loved one in the flood or hurricane. But it all can be too much, too overwhelming. Everything is different. Nothing is the same. Shelters are temporary solutions to a new homeless situation.
When I would visit a shelter, what I would do is go cot to cot. People just want someone to hear their story, and I would sit and ask them to tell me theirs. Then to the next cot and start the conversation. This is known as psychological first aid.
Finally, shelters must also think about people’s pets. I can’t imagine leaving our dogs, a corgi and a poodle mix, to fend for themselves in our condo or releasing them outside to survive as best they can. One of the lessons of Katrina was the awareness of how important and central to our lives are our pets. (See chapter 9 for more information about pets and disaster.)
Not everyone goes to a shelter after a natural disaster, but survivors still need to be fed. There are those who camp out to protect their property after a storm or return to work on their home sites. After Florida experienced four major hurricanes in 2004, there were food trucks stationed in devastated neighborhoods. Who was served by these mobile canteens? The poor, the elderly, the mobility challenged, and rural inhabitants who gratefully welcomed the meals that were brought to them by disaster volunteers. I embedded disaster spiritual care chaplains into mass care and feeding vehicles very successfully, not only to support the disaster victims one encountered but also to keep morale up for those who were delivering and handing out the food.
This was very successful because for a chaplain feeding the hungry is also sacramental.
Oftentimes in a disaster, during the first week people don’t have the option of choices on what to eat. It is still important, though, to remember cultural considerations. In a predominantly Jewish neighborhood, well-meaning volunteers passed out ham-and-cheese sandwiches, not realizing Judaism prohibits eating pork. After Hurricane Maria, and the desperate need on the entire island of Puerto Rico for food, star chef Jose Andres brought his chefs and kitchen workers to the island and served thousands of hot meals every day in makeshift kitchens and schools. The psychological value of warm food, and the emotional and spiritual comfort it provides, cannot be overestimated, particularly when it includes the cultural menu of local cuisine and ingredients.
Chef Andres also opened feeding kitchens during the disastrous government shutdown for furloughed public workers. Hundreds stood in line in the winter cold for a hot meal.
While thousands came to Texas and the Gulf Coast to assist, there were also numerous entrepreneurs, scam artists, and predators mobilizing to take advantage of the extremely traumatized and vulnerable. Public safety must insure that while residents are evacuating, looters and other criminals are not infiltrating damaged neighborhoods and taking advantage of strained or absent police and fire resources. There are those that see great opportunity in disaster, and use it as an opportunity to personally enrich themselves through the suffering of others. There is little comfort in realizing that you not only survived a disaster but were also victimized.
Unfortunately, not everybody who responds to a disaster is there to help the victims and survivors. Just because one is in a shelter doesn’t mean one is safe. Sometimes a disaster is used as a major distraction to take advantage of those already enduring immense suffering. Domestic abusers, substance abusers, and sexual abusers all find temporary homes in shelters. Predators and entrepreneurs find much vulnerability in the postdisaster environment. Unscrupulous contractors or funeral operators take advantage of the postdisaster trauma for their own economic benefit. There are always stories about roofers who prey upon the elderly and take a huge deposit to replace a leaky roof and then disappear. Helping provide comfort can mean helping people pay attention so that they don’t become a victim of a crime of opportunity.
For those who do not evacuate, there are also major public health concerns, such as when sewers back up and pollutants mix with floodwaters. Mega shelters must also ensure sanitary conditions and not become a warehouse of communicable diseases. Preexisting conditions, such as diabetes and addiction, also tax public health resources, again adding to the complexity and intensity of needs. Imagine how quickly an infectious disease can go through a mega shelter like the old Astrodome? The Red Cross worked with a team from the Harvard School of Public Health, during Katrina and Houston, to ensure food safety and infection control. It was very successful.
In my experience, those who have been trained in hospice work have a natural connection with disaster work. Hospice workers must have tremendous patience to work with those who face “slow” death or declining health over a period of weeks or even months. Waiting for wildfires to burn out, flood waters to subside, or watching for that monster hurricane to pass over the southern Atlantic, all have time in common. They are slowly unfolding disasters and not overnight “stun and done” events. In contrast, human-caused disasters generally happen quickly—mass shootings, dirty bombs, chemical explosions, plane crashes are all examples of faster death.
I deployed two chaplains with hospice experience to Iowa after a tornado hit a Boy Scout camp. The scouts had just finished eating spaghetti and had very little warning when the tornado struck. They were in a stone-walled building and the winds were clocked at 165 mph. One survivor was aware he was being sucked up a fireplace that was collapsing at the same time. This was a killer tornado that hit in the early evening and killed 4 young scouts and injured 48.
Any disaster where lives are lost creates lifelong issues for the survivors, their families, and loved ones. Survivor’s guilt is primary but also a lifelong wondering about the meaning of the event, because even years later, it may feel overwhelming, and nearly impossible to stave off depression. For those Scouts who died instantly at the hand of weather, their day had been filled with service projects and leadership training. These were good kids and even with accurate weather forecasts, one did not feel in danger. Having access to a secure building does not make one immune to walls collapsing or trees exploding.
When a natural disaster kills, it generally is quick: drowning in a flood, being killed in a building collapse during a tornado or hurricane, being caught in one’s vehicle while trying to escape a wildfire. A tsunami or volcanic eruption may give some indication of occurrence before it hits, but earthquakes give precious little warning. Some fatalities may linger in collapsed buildings, unable to be found in time. In Haiti, family members dug with their own hands through debris and concrete and rebar. Rescue and recovery are not mutually exclusive. While trying to save the trapped, one may encounter fatalities. That is never easy, not even for the seasoned responder.
After Hurricane Katrina, coroners spent seven months identifying bodies. When a positive identification was made, a chaplain would be made available to offer comfort to waiting family members. But the chaplains also supported the mortuary workers. Sometimes, they wanted to talk about their job; more often, they wanted to discuss sports or movies, anything to feel a sense of normalcy in the horrific conditions of the Louisiana heat and humidity in a morgue.
Natural disasters may also be criminal events. Many of the western wildfires with fatalities were set purposely. Criminal charges are normally filed once the perpetrators are identified, which may come weeks and months later, as forensics teams work to find the origin and cause of the fire.
Crime scenes need to be secure environments. Until deaths are investigated and evidence collected, the designated area must be kept away from the general public and press so as not to corrupt the site or the evidence. Most natural disasters are not deemed criminal acts unless you extrapolate human-caused climate change. Because of the magnitude and complexity of disasters, there may not be a “smoking gun” to assign human blame or neglect. With more people moving to southern coastal states and the growing intensity of hurricanes and tornadoes, one can speculate that more people are moving into harm’s way.
There are those who “collect” disasters and demand access merely because of who they are. Some may show off their hats and badges and pins from all the disasters they participated in. This isn’t helpful; it seems more self-serving. Oftentimes, self-deployed chaplains overwhelm a service delivery site because they feel they have a right to be there, even though their presence is not helpful. But no one has a right to access the victims or survivors of a natural or human-caused disaster except first responders and medical personnel, and, oftentimes, a chaplain who has been sent there from a legitimate local rescue service.
So, how do you comfort the survivors of natural disasters? The basics still apply—give them hope with a safe place to stay and food to eat. Give them trusted counselors and, for persons of faith, chaplains that are familiar with the language of hope and the future. Comfort can be offered with the knowledge that there will be a safe place to stay and reliable assessments of needs. Comfort will be offered by giving facts, from which neighborhood is flooding to an explanation of what help is being offered.
Parents and children also need to know that schools will reopen as schools when the need to use them as a shelter ends. It is important to get back to the new normal. Children are very resilient and can adapt to new classrooms, but they also, along with their parents, need to process the emotional and spiritual damage done in a safe place. This may be a shelter or school classroom or place of worship.
Comfort may be as simple as hugging the family dog, who is also welcome in the rescue boat. The images of rooftop rescues during Hurricane Katrina can trigger sentiments buried for years. Survivors will always remember their hurricane, their fire, their flood. A hurricane is not something that one must “get over.” A hurricane, for those directly impacted, will always be there. Comfort is knowing there are so many good people united in one effort. Comfort also can be the reassurance that this disaster will end, the rain will cease, and the sun will come out again.
In the first responder community, there are many traditions. Many unspoken and unadvertised but profoundly important nonetheless. Many spouses may give a bracelet or a necklace that is always worn and not only when responding to a disaster. It is a constant reminder of another’s love and prayers for protection and extremely comforting. These are totems and are symbols of a first responder tribe and are taken extremely seriously.
It’s a comfort to always know where the exits are and tell others.
It’s a comfort to always include pets in a family sheltering plan.
Volunteer in a shelter or emergency response operation.
Shut up and let the silences speak.
Set up a meditation room in a shelter or family assistance center.
Always ask the choir to sing. Be present and engaged. Use what you have.
Start a conversation with a policeman or fireman and tell them how much you appreciate what they do. You might start with a general comment about the local sports team.
Help an elderly relative sort through bids for house repairs.
Don’t misuse your power to comfort.
Comfort may not be a big gesture but a small action.
Water: one gallon of water per person per day for at least three days, for drinking and sanitation
Food: at least a three-day supply of nonperishable food
Battery-powered or hand-crank radio and a NOAA weather radio with tone alert
Flashlight
First-aid kit
Extra batteries
Whistle to signal for help
Dust mask to help filter contaminated air and plastic sheeting and duct tape to shelter in place
Moist towelettes, garbage bags, and plastic ties for personal sanitation
Wrench or pliers to turn off utilities
Manual can opener for food
Local maps
Cellphone with chargers and a backup battery
Consider adding the following items to your emergency supply kit based on your individual needs:
Prescription medications
Nonprescription medications such as pain relievers, antidiarrhea medication, antacids, or laxatives
Glasses and contact lens solution
Infant formula, bottles, diapers, wipes, diaper rash cream
Pet food and extra water for your pet
Cash or traveler’s checks
Important family documents such as copies of insurance policies, identification, and bank account records saved electronically or in a waterproof, portable container
Sleeping bag or warm blanket for each person
Complete change of clothing appropriate for your climate and sturdy shoes
Household chlorine bleach and medicine dropper to disinfect water
Fire extinguisher
Matches in a waterproof container
Feminine supplies and personal hygiene items
Mess kits, paper cups, plates, paper towels and plastic utensils
Paper and pencil
Books, games, puzzles or other activities for children[1]
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