Disaster Response and Covid-19

How many times have you listened the news recently and thought, “Surely, we have never, ever, had to face anything like this before?”  And we haven’t.  Each disaster is unique.  They impact different people in different ways, in different places and for different reasons.  It could be for reasons of fire, or flood, or hurricane, or earthquake, or tsunami, or violence… or epidemic. 

The Cluster System

But around the world, whenever there is a major disaster, a well-oiled machine of equipped and experienced people and processes moves rapidly into action.  It is far from an exact science, but amidst the utter chaos and despair, certain principles and practices come into play which do, eventually, help the impacted community see the wood from the trees.  Coordinated by a UN ‘cluster system’, governments, agencies and civil society prioritise and work through the chaos, from disaster onset through to a reconstruction or development phase, saving lives, restoring equilibrium, and creating a platform for a new post-disaster norm.
​
Response, Recovery, Reconstruction.  These are the fundamental stages that follow major disasters.  We could also discuss a Pre-Disaster Stage, but we’ll leave that for another day. 

The Response Stage 
The Response Stage can be thought of in terms of initial search and rescue, and by other emergency responses needed to ensure survival, such as triage and medical response, food security, WASH (water, sanitation and hygiene), security and protection, shelter, logistics and distribution, telecommunications, camp coordination and education.
 
This is all well and good, but surely it is only really relevant to tsunamis, hurricanes and earthquakes in far-away lands – the ‘over there’ stuff that pains us for twenty minutes or so when we see it on the news?  We may have a massive Covid-19 crisis on our hands, but this is different.  We’re the UK. 
Well, no.  Let’s take another look at that list of clusters, and this time add some brackets:

• Triage and medical response (NHS)
• Food security (flour and toilet rolls)
• WASH (hand washing)
• Protection (social distancing)
• Shelter (care homes)
• Logistics and distribution (key workers, drivers, shop workers)
• Telecommunications (WhatsApp and Zoom)
• Camp coordination (Nightingale Hospital)
• Education (daily briefings, combatting false information and fake news)        

With any shadow of doubt, the principles are the same, and the lessons and priorities being learned by disaster response practitioners are highly relevant to our present situation.

The Recovery Stage
Depending on the nature of the disaster, after maybe 3-8 weeks the Response Stage makes way, gradually, messily, to a Recovery Stage.  This will last a lot longer, maybe 18 months to 2 years.  Early recovery is a time when temporary accommodation is built, when children return to makeshift schools, when wells are cleaned, and when access to markets is re-established.  Medium to long term recovery does similar things, but when more robust winter-proof shelters, permanent schools and polyclinics are rebuilt, and the beginnings of normality gradually returns.  The priorities and the strategies are different.  The urgent makes way for the important. 

The Reconstruction Stage
The third phase is often called the Reconstruction Stage.  It is a time for aid to give way to development, and for local people to be empowered and properly established on their own two feet.  Aid gives things away, but holds onto the power, or control.  In the Reconstruction Stage, the opposite applies.  Things are no longer given away, but the power is.  Activists become facilitators; doers become enablers.  This is about ensuring that the impacted community owns and becomes responsible for its own destiny.

Trauma Recovery

This is all well and good in a practical sense, but what about the emotional state of those caught up in disasters?  In UN’s rather technical and clunky terminology, they like to talk about this (cross-cutting sub-sector) as “Mental Health and Psycho-Social Support”, or MHPSS.  Let’s look at this under the same framework of Response, Recovery and Reconstruction.

The Response, or ‘Safety and Stabilisation’ Stage
In the emergency Response Stage, many people (but not all) are exhibiting a very wide range of intense emotional reactions.  Fight, flight or freeze.  While some remain in denial, and others have fled, we also find in the first few days - maybe weeks - after the event, some heroes emerge.  These are people fuelled by altruism - and often by adrenaline.  They are high on activity (although often low on productivity).  They are wonderful temporary role models, but their judgements are often impaired.  So look after them when they crash, as some of them will.  There is also a honeymoon period that quickly follows – another emotional high when one might least expect it.  With great optimism we declare, “We can do this!”  All our previous squabbles are forgotten, and our community is bound courageously by an urgent and common purpose.  In trauma terms, I would call this the Safety and Stabilisation Stage, and as for appropriate responses, I would regard the key words to be listening and accepting.  It is not a time for giving advice.  Listening is a gift, and it takes energy.    
   
The Recovery, or ‘Remembrance and Mourning’ Stage
Then comes the Recovery Stage.  Motivation plummets as the cameras leave, our limits are realised, exhaustion sets in, conflicts re-emerge, and a noticeable gap starts to grow between those impacted and those who were not.  A sense of abandonment sets in.  Re-traumatisation can happen when new events trigger off memories of the disaster.  This is often called the disillusionment stage.  But here is the good news.  It might be tough, and it might feel like it’s lasting for ever, but this is reality and, gradually, and not without a few setbacks, another phase is on its way.  In trauma terms, I regard this as the Remembrance and Mourning Stage.  It is a time to grieve, to give honour, a time of ceremony and memorial.  To summarise the key words of appropriate response, I would say ‘ask questions, and keep your eyes open’.  Look out for signs of resentment, blame, self-blame, guilt, regret, irritability, unpreparedness to trust or to commit.  These are inevitable and natural, but should not become the bedrock of a person’s worldview.  The questions you ask will help the traumatised person to articulate and work through their thoughts.  Celebrate small successes and milestones, be prepared for setbacks, and introduce some light and sensitive humour.  Diary key dates and anniversaries, as a reminder to yourself to contact grieving people accordingly. 

The Reconstruction, or ‘Re-connection and Integration’ Stage
In the Reconstruction Stage, green shoots are reappearing.  We feel some sense of achievement.  We have survived, even though there were many times when we didn’t think we would.  Motivation starts to return, we gain new skills, establish new support networks, and roots begin to go down again.  It will never be the same, but we are coming to terms with post-disaster life and, in some ways, we are changed for the better.  We appreciate the little things more, we value relationships, we adjust our priorities, we built new trust.  I call this (in trauma terms) the Re-connection and Integration Stage, when the traumatised are ready to look upward, outward and onward once more.    Our key responses to traumatised people at this stage should be encouragement and empowerment.  Encourage some shape, framework; and plan some simple new initiatives.  Seek to build locally owned social structures and communities.  Ensure nothing you do or say builds dependency, and seek to re-build a strong work ethic.

Finally 

It’s messy.  We don’t move seamlessly from one stage to another.  Steady state is a goal, a phase and a process.  You will need a lot of patience, forbearance, and mercy.  But let’s be honest; when it comes to the milk of human kindness, we could all do with an extra pint.       
​