What Does Intentional, Human Centered Disaster Response Look Like?

In my last post, I wrote about how prior trauma can affect first responders and the way they respond to disasters. Over on Medium, where I reposted the piece, I was asked:

"[G]iven that large scale systemic responses will likely always have a degree of impersonal logistics, how can we intentionally design ‘pockets’ of compassion and human centered care directly into our official disaster preparedness protocols?"

As I responded, that's very difficult to answer, and I'm not sure I'm truly qualified to do so. What I wrote was:

The 'pockets' of compassion and human centered care have to come from willing humans themselves, not from being planned for them. That can become complicated when, say, something happens no one anticipated. Even if it's been planned for, it might happen in an unexpected way that throws the whole response out of balance.

At that point, arguably, community members need to be prepared to care for themselves, but how 'care' is defined is the question. One thing the documentary raised was how people stuck at the Superdome and Convention Center turned to what those in power called 'looting,' even though the people who needed help were at risk of dehydration and starvation. Of course, the story of their desperation turned into rumors about criminal activity and danger, which led to more 'official' responders becoming unwilling to help.

Ultimately, 'care' has to be reframed to account for how people give and receive assistance in times of disaster. And that, I'm not sure people in power are willing to do so easily.

Humans need to be present to deliver human centered care

There are two levels of "being present." The first is, of course, literal. Following a major disaster, portions of volunteer response may be impeded owing to volunteer evacuations, flooding or fire or road washouts, and other logistical challenges that can impair community-based response.

Again, the people in a community who are trained to render aid might be affected themselves. So even if they haven't evacuated the area prior to a hurricane or wildfire, even if they're as caught by surprise as anyone by a tornado or earthquake, they may be unavailable.

Even when they're present, of course, chaos makes it difficult to communicate. Not just in terms of actual radio, news, or phone communication, but also the words people choose and the way they convey them.

The larger the catastrophe, the harder it can be for your brain to catch up to and comprehend what it's seeing. There's something unreal about an event that's so far out of your normal, it may as well be on TV. The less training and experience you have, the worse the effect can be.

You might be so focused on the injured people that you miss critical details, like the fluid leaking from a tank or the high-pitched hissing that could indicate an imminent explosion. Or, you might not be focused at all. Your efforts to help might be scattered and ineffective; you might even find yourself in responders' way, or worse, in danger.

The pressure amps up when you're the only one available to direct the response effort. It can be difficult to communicate what's needed in the moment, much less explain in a way that helps people to understand. People have different learning styles, diagnosed or undiagnosed learning disabilities, and of course, egos.

In my experience, communication challenges can be triggering. In leadership roles, I've worded things poorly, expecting people to be able to follow my intent, and been met with aggression that made me feel worse than uncomfortable.

The second level of "being present," then, is more metaphorical. "Being present" is a core tenet of mindfulness and meditation, remaining grounded in the here and now rather than getting stuck in the past or worrying about the future.

Being present is messier. It's vulnerable. Both past and future feel more certain to us, either because we've already experienced it or because we envision a self that executes on something without making the mistakes we know we're capable of.

These, of course, are but illusions. We don't remember things precisely the way we experienced them. We can't just say what happened; we also have to attach meaning to it. It happened because. We tell these stories without possibly being able to have enough information to tell them accurately.

The same is true, of course, for the future. It hasn't been written yet, and we're trying to write it based on the past we only believe we've experienced.

So, a crisis happens – major or minor – and you try to communicate about it, but you mess it up. You trigger the person you're trying to tell. Their reaction triggers you right back.

On the one hand, you can't worry about how people feel. But on the other, nothing much gets done unless and until people feel safe, seen and heard before they can act effectively.

Best case, you recognize the triggering for what it is as it's happening, and you make the effort to change it. Worst case, you keep on looping until communication completely breaks down.

Emergency response demands healing, healed responders

We're experiencing a broader cultural moment around, for example, role expectations. The toxic forms of both masculinity and femininity can involve active and passive forms of aggression, paternalism versus protectiveness, smothering (or neglect) versus nurturing.

In my experiences, I felt as if overly aggressive men expected me to back down and submit after I miscommunicated. It is entirely possible that I was correct; that my nervous system recognized a familiar and dangerous territory.

At that point, human-centered care and compassion starts with ourselves. We might recognize there are personalities we simply can't work with to effectively get the job done. That even if we're wrong, in this present moment, we need to watch out for ourselves first.

Of course, during a disaster, things need to get done. To that end, we might be tempted to put ourselves aside to accomplish our mission. Suck it up and deal. Put on our big kid pants.

If I'd followed this line of thinking, I might have made things worse. As it was, I found it too busy and high-pressure – and the event itself too short-lived – to correct the miscommunication on the spot. Too much of a risk that I might bend and crack altogether, if met with further aggression.

Later on, though, I had the chance to understand how planning can help mitigate the effects of trauma and other communication issues.

A few days later there was a smaller, quieter event. Then, I had the chance to notice how a new lead in training, a woman, took the opportunity to move people around different positions so they could focus on learning each position's requirements.

There was no pressure to get the job done, so people had the chance to ask and answer questions and form "muscle memory" at each turn. They were able to learn the easier tasks so that later on, more attention can go towards problem solving when the inevitable crops up.

Perhaps more importantly, people had the chance to form trust bonds, or at least the foundation for what to expect from one another in the future.

I'd forgotten about the importance of forming this kind of foundation, or maybe more accurately, felt limited by my own introversion and healing process.

In a perfect world, I'd pay attention to the personalities I'm working with and what they need to feel successful, without projecting too many of my own needs onto them. I'd learn to slow down and think through what I need to communicate and what words to choose.

My imperfect world, though, includes still working on protecting myself, holding myself and my own needs equal to others', not bending over too far backwards to accommodate others.

So it's not just healing we need for effective emergency response. It's also community members who are ready, not just with food and water and shelter and transport, but also with social skills and a good sense of where and how to shore up response where others fall short.