Clinical Issues: Emergency Preparedness: How Proactive are Persons with Mobility Impairments?
Eva Miller
Natural disasters have been relatively common across America since its inception, yet after the terrorist attacks on the World Trade Center and the Pentagon on September 11, 2001, and in 2005, Hurricane Katrina, Americans have begun to realize that none of us are exempt from the possibility of having to face catastrophic disasters. Persons with disabilities may be faced with particularly extreme circumstances during such disasters; however, according to the National Organization on Disability [NOD] (2005), only 47% of people with disabilities report having household evacuation plans pertaining to emergency disasters and only 57% report having emergency evacuation plans in the workplace. During times of disaster, individuals with mobility impairments such as spinal cord injuries (SCIs) present with even greater challenges than do persons with less severe types of disabilities. These include the profound complications of evacuation from buildings with more than one story and, in escaping calamity, having to leave behind medical supplies and adaptive equipment such as wheelchairs and accessible vehicles. In addition, persons with SCI and other mobility impairments may rely on personal care attendants who are often unavailable at the time of the life-threatening disaster, and they may well not be available for assistance in the critical period following the incident as well.
While Title III of the Americans with Disabilities Act (ADA, 1990) is the most applicable law to identifying egress for persons with disabilities, there is no requirement for formal emergency plans under the purview of the ADA. That is, while public facilities are required to provide unobstructed routes of exit from any area of a building to a public access (Adcock & Hough, 2004), evacuation plans often overlook the need to prioritize the escape of people who use mobility devices or ignore the need to reunite users with their devices shortly after the evacuation (Rooney & White, 2007). In addition, local emergency preparedness efforts rarely include input from persons with mobility impairments and other types of disabilities, thus, many of the special needs of these individuals are often overlooked or misguided.
The following excerpt illustrates a tragedy experienced by two survivors of Hurricane Katrina (Dobbs, 2005):
Jason is a 30-year old male who was shot 11 years ago and sustained a C5-6 SCI. He and his mother, Willmarine, age 55, survived Hurricane Katrina and have been willing to share the harrowing details of their ordeal.
Jason and his mother were planning to “ride out the storm” until Willmarine had a nightmare that convinced her that she and Jason needed to evacuate their home immediately. Willmarine and an uncle drove with Jason to Dallas, a trip that took 17 hours instead of the normal seven. Jason was forced to leave behind his electric wheelchair, taking his manual chair instead, and quickly ran out of medical supplies. He was also forced to leave behind his dog, Candy, as the family speculated they would be returning to their home a few days later.
When Jason and his mother arrived at the Red Cross in Dallas, Jason was provided with a cot which he could not get onto because of his large size. He developed pressure sores shortly thereafter and left the shelter. They then went to the Salvation Army but were dissatisfied by the lack of support they received so they pushed on. Jason and Willmarine again contacted the Red Cross, only to find out that unless they stayed in the convention center, they would not be given the medications and supplies Jason badly needed. Thus, Jason and his mother were forced to return to the convention center three times a day for meals and were essentially offered nothing else. It was at that time that Willmarine found access to a computer and sent a personal e-mail asking for financial assistance. As the message spread though the Internet, Jason and his mother began to receive offers of clothing, a loaner power chair, and a sparsely furnished apartment which was not wheelchair accessible.
On October 5, 2005, Jason and Willmarine received notice that they could return to their home in New Orleans. Jason’s skin had still not healed and he had dysreflexia from an unknown cause. Willmarine borrowed an accessible van and the two of them returned to their dilapidated home, donning masks before entering due to the overpowering stench. Because they were both unemployed, they wondered how they would ever rebuild the house.
At this time, Jason is in the hospital. Willmarine is described as sitting alone in an apartment in Dallas, cleaning photos for a restoration shop at a nearby strip mall. Candy was never found. Jason and Willmarine are uncertain as to whether they will ever be able to rebuild their house; they are uncertain about what tomorrow will bring.
Jason and Willmairne’s story is just one of many that describes the aftermath of a catastrophic disaster. Many people with SCI and other mobility impairments who survived Katrina remain in nursing homes across the country today, lying in beds without access to any equipment, including their wheelchairs. Although some have been fortunate enough to receive help from independent living centers and national organizations such as the Red Cross, the Salvation Army, and the Federal Emergency Management Agency (FEMA), we have clearly seen just how ill-equipped Americans are when it comes to emergency preparedness for persons with disabilities.
Rowland, White, Fox, and Rooney (2007) conducted a study to assess emergency response training practices for persons with disabilities. The authors surveyed 12 participants consisting of one emergency services administrator and one first responder (i.e., firefighter) from each of three urban and three rural locations in Northeast Kansas. Some of the questions asked included how these individuals assist persons with disabilities during emergencies, how they determined where persons with mobility impairments lived, and potential barriers to developing emergency procedures for persons with mobility impairments. The results of the study revealed that agencies did not have emergency preparedness policies and guidelines specifically designed to assist persons with mobility impairments, many relied on personal contacts such as longtime neighbors to assist people with mobility impairments, and others indicated that they used whatever means necessary to assist all people, including those with mobility impairments. The primary barriers to developing policies and procedures to effectively assist people with mobility impairments during emergencies were a lack of financial resources, a lack of training on how to assist people with mobility impairments, and a lack of knowledge about the number of persons with mobility impairments living in their respective communities.
Although there are few published articles on emergency preparedness for persons with disabilities, there are some general guidelines provided specifically for persons with disabilities. The American Red Cross (2007) suggests the following:
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1. Design a personal disaster plan, keeping copies of the plan in readily accessible places such as in one’s wallet, vehicle, or wheelchair pack.
2. Share emergency plans with one’s network.
3. Make an emergency information list designed to inform others of what they need to know and whom they will need to contact if they find you unconscious or unable to speak.
4. Ask a relative or friend who lives at least 100 miles away from your home to be your “contact” person.
5. Compile a medical information list that includes a list of medications, medical card numbers, and medical health care providers.
6. Have at least a seven-day supply of medications and medical equipment.
7. Keep service animals in a safe place with you during emergencies.
8. Identify as many exits as possible from buildings you are in;
9. Be prepared to ask for necessary accommodations;
10. Become familiar with emergency or disaster evacuation plans for your office, school, or any location where you spend a considerable amount of time; and
11. Develop an emergency preparedness checklist that includes the above information.
Others, such as Adcock and Hough (2004), have suggested that persons with disabilities become familiar with resources relating to emergency preparedness, including FEMA, the American Red Cross, and local civil defense headquarters. In any event, people with SCI and other mobility impairments need to closely examine the actions they are prepared to take prior to, during, and following both natural and man-made disasters in order to afford themselves the best possible chances for survival and safety in a challenging world that is in constant flux.
References
Adcock, R.J., & Hough, S. (2004). Accessibility for safe evacuation following a spinal cord injury during an emergency: Safety for whom? SCI Psychosocial Process, 17(3), 158-162
American Red Cross (2007). Disaster preparedness for people with disabilities. [Electronic version]. Retrieved May 19, 2007 from http://www.redcross.org/services/disaster/beprepared/prep.html
National Organization on Disability (NOD). (2005). Harris Interactive Inc: Emergency preparedness topline results. [Electronic version]. Study No. 26441. Retrieved May 21, 2007 from http://www.nod.org/Resources/PDFs/episurvey05.pdf
Dobbs, J. (2005). When home is not home. New Mobility: Life on Wheels, December 2005.
Rooney, C., & White, G. W. (2007). Narrative analysis of a disaster preparedness and emergency response survey from persons with mobility impairments. Journal of Disability Policy Studies, 17(4), 206-215.
Rowland, L. K., & White, G. W., Fox, M. H., & Rooney, C. (2007). Emergency response training practices for people with disabilities: Analysis of some current practices and recommendations for future training programs. Journal of Disability Policy Studies, 17(4), 216-222.