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October 19
Providing care and restoring health services in Puerto Rico

October 20 marks thirty days since Hurricane Maria barreled through Puerto Rico, stripping the lush forests of their leaves, limbs, and even bark and toppling utility poles like fallen dominoes in a line. Pictures can’t do justice to the damage. The devastation looked much like a war zone. Federal, territory and private sector partners steadily are making progress in restoring healthcare services to the island after the destruction wrought by the storm.

Initially, 100 percent of the island was without electrical power. Today, roughly 17 percent of the island has power and major roads are open, although back roads are still being cleared. I had the opportunity to witness this firsthand, and I was overwhelmed by the resilience of the people of Puerto Rico. They survived the storm and are moving forward steadily to rebuild their communities.

Dr. Kadlec receiving briefing from NDMS DMAT 

Most people think of the federal government as swooping in to save the day. In reality, all disaster responses are led by the local, state and territorial officials. When the needs go beyond their resources, they request federal assistance. As the lead agency for the federal government’s public health and medical response, we have three priorities in Puerto Rico: save lives, stabilize the health care infrastructure, and restore health care services.

To save lives, we have coordinated with the Puerto Rico Department of Health (PRDOH) and local hospitals to overcome unprecedented challenges and make progress. We dispatched medical equipment, supplies and personnel from our National Disaster Medical System and U.S. Public Health Service to areas where they were needed the most – where hospitals were struggling to provide care after the storm. Initially half to a third of local medical professionals were unable to report to work. That’s changing as roads clear.

NDMS DMAT deploying to remote town in Puerto Rico 

As I toured our sites throughout Puerto Rico, I saw HHS teams performing in the most austere conditions. They set up tents near emergency departments at hospitals with no power, no air conditioning, and some with significant structural damage. They worked together with local doctors and nurses to provide the care residents needed after one of the worst disasters in Puerto Rico’s history.

View from inside a medical tent 

At one point after the storm, our teams were working at a hospital that completely lost power while they had more than 50 patients. Our team began to manually ventilate several ventilator-dependent patients to keep them alive. Four other patients at the hospital were in an operating room when the power went down, and they, along with more than two dozen others with critical needs at the facility had to be transported by helicopter to USNS Comfort, a Navy hospital ship with excellent trauma care for patients. Patients are transported to Comfort or a medical facility in Puerto Rico when they need a level of care beyond what is available at their local hospital or clinic.

USNS Comfort Navy Hospital Ship 

Our teams went into communities to find people who needed medical care but didn’t know that temporary medical facilities had been set up to care for residents. Smaller health and medical task forces walked through communities and knocked on doors to let people know care was available. In the first 30 days, HHS, along with the Departments of Defense (DoD) and Veterans Affairs (VA) collectively cared for over 8,700 patients in Puerto Rico.

NDMS DMAT personnel caring for a patient 

Now, in some locations, we are working alongside medical professionals from New York hospitals – volunteers who were coordinated by the Greater New York Hospital Association and deployed under an emergency medical assistance compact, an agreement between Departments of Health in New York and Puerto Rico.

To help in the emergency situation, VA clinics even opened to civilians as well as veterans and their families.

Some patients need care after they’re discharged from a hospital and with their homes destroyed have no safe place to go. Working with our partners at the Centers for Disease Control and Prevention and VA, we have set up Federal Medical Stations in key locations to care for patients like these until they can return home or reunite with family elsewhere. These sites are being staffed by our outstanding U.S. Public Health Service Commissioned Corps officers, medical professionals from the VA, and Puerto Rico Medical Reserve Corps volunteers.

Panoramic photo of inside a temporary medical station 

One of the common reasons people visit hospitals or our temporary medical facilities after disasters is lost or damaged medication for chronic health conditions. To help, we activated the Emergency Prescription Assistance Program, which pays for prescription medications for people without health insurance who are affected by disasters. In Puerto Rico, 750 pharmacies are participating and more than 900 prescriptions have been filled so far.

To stabilize the local health care infrastructure, we are working with PRDOH to help restore public health and health care services so they become self-sustaining.

We worked with federal partners so that medical supplies and fuel delivery to hospitals and dialysis centers received priority. This includes fuel for hospital suppliers as well as hospitals.

About 60 percent of hospitals are on grid-power today; almost all others are on generator power and a few are still closed due to structural damage. Rebuilding the island’s electrical grid will take months. To help hospitals remain continually open, we are working with the state and with federal partners to provide generators designed for long-term use as back up to the short-term generators the facilities have.

Large Mobile Generator 

We continue to work with private sector to get fuel and supplies to dialysis centers and clinics. Today, almost all dialysis centers report that they are fully operational (although on generator power) and they have returned to providing full treatment sessions for dialysis patients.

We’ve done much more behind the scenes for pharmaceutical manufacturers and health care facilities so they in turn can help the people of Puerto Rico. We have been working closely with manufacturers of critical medical products to identify potential disruptions and to support their efforts to maintain the availability of critical healthcare products upon which residents of Puerto Rico and the continental United States rely. HHS’s Food and Drug Administration also worked with private sector partners to cut through red tape to allow pharmaceutical manufacturing to be shifted from impacted facilities to facilities outside the areas hit by the storms.

We are committed to continuing to work with the governor, mayors, the Puerto Rico Department of Health, local health care providers, and the private sector to help communities in Puerto Rico recover.

HHS NDMS Medical Tents 

October 19
Scripts, Surge and Success: How One NDMS Pharmacist Helped Puerto Rican Pharmacists Provide Emergency Prescription Assistance

When a Disaster Medical Assistance Team from South Carolina began seeing patients in Fajardo, Puerto Rico, it didn’t take long for the team members to realize that patients weren’t getting the lifesaving prescriptions they rely on to stay healthy every day or to fight infections in the wake of Hurricane Maria.

DMAT personnel going over supplies 

Pharmacist Russell Huiet saw a way to help those patients by reaching out to local pharmacies. He helped pharmacists better understand how a key federal assistance program works, where to find other open pharmacies, how to handle the surge of patients who need help, and how to work with suppliers to restore critical services.


Open for Business?

In many cases, people just didn’t know where to go to get their prescriptions. Their local pharmacy might be closed and many roads are still closed. Just finding an open pharmacy that had common prescriptions in stock remains a real challenge.

Huiet worked with his team to go out into the community and learn the basics. He went to different pharmacies in the area to see who was open, how long they thought they could stay open, what medications they had in stock, how they were getting resupplied, and how they were communicating their needs to corporate offices and suppliers.

Huiet also worked with local pharmacists to help them understand the scale of the surge in patients that they were about to see. Before the storm, a pharmacy might process 300 prescriptions a day. Now, those pharmacies might need to start processing as many as 2,000 daily prescriptions.

Huiet showing staff medicine locations 

Emergency Prescription Assistance

Nearly half of the patients they were seeing didn’t have health insurance, but many of those patients were eligible to receive help under the Emergency Prescription Assistance Program (EPAP). EPAP was created to help people after a disaster who don’t have health insurance get the prescription medications, medical equipment, medical supplies and vaccinations they need.

Under EPAP, patients could register to receive a 30-day supply of their medications at no cost to them. People just had to register and then go to one of the over 750 participating pharmacies in Puerto Rico to get their medication or supplies. The patients were given a “cheat sheet” to help them navigate the registration process.

After patients applied, pharmacists could start filling prescriptions for life-saving medications, critical medical equipment and more – but the pharmacists weren’t familiar with the process. This is the first time that EPAP has been activated in Puerto Rico, and many pharmacists didn’t know how the program works.

Huiet created a “cheat sheet” for the pharmacists that explained the technical ins and outs of the system, helping pharmacists process requests more quickly and keep up with demand for medication.


Lights, Power and Refrigeration

As a pharmacist in South Carolina, Huiet knew exactly how pharmacies do business and he was able to provide pharmacies with information about disaster response they might not have.

He helped retail pharmacies work with suppliers to make sure they had power, refrigeration, communications, and enough life-saving medications the residents of Fajardo so desperately needed.


Helping Patients in the Days Ahead

Huiet and his team are working day and night in sweltering hot temperatures to help people in Puerto Rico get the care that they need. Huiet is hesitant to be too far from the action and he even found an innovative way to get a little sleep when he wasn’t on duty, setting up a makeshift cot just inches away from the pharmacy.

Pharmacist Huiet catching a nap when possible 

This is just one of many stories of responders from the National Disaster Medical System (NDMS) helping patients get the care that they need and supporting the health care system as it recovers from Hurricane Maria. NDMS responders are intermittent federal employees. In their everyday lives, they are the doctors, nurses, EMTs and other medical professionals and para-professionals that we rely on for routine care. But when disaster strikes, they may be called on to deliver the best of care in the worst of times.

NDMS can be called into action at the request of state, local, tribal or territorial authorities or by other federal departments. The Puerto Rican government called on them to support the response to Hurricanes Maria and Irma to support hospitals, provide patient care in communities, work with pharmacies, and much more.

Temporary Medical Facility tent 

There are many great ways for both medical and non-medical professionals to help communities in the wake of a disaster, but the best time to choose to serve is before a disaster strikes. Are you up for the challenge? Take a few minutes to learn how you can help the next time disaster strikes. To learn more, visit www.PHE.gov/Serve.

October 18
Open and Operational: NDMS Sets-up Temporary Hospital to Provide Patient Care in Aguadillo, Puerto Rico

The halls of Hospital Buen Samaritano Calle Jose de Diego Aguadillo in Puerto Rico are quiet. The hospital was severely damaged during Hurricane Maria and only a few patients remain in the facility. However, there are still people in Aguadillo who need to be treated for everything from chronic conditions to the infections and injuries that are common in the wake of disasters.
Buen Samaritano Calle Jose de Diego Aguadillo Hospital

To ensure that the health care needs of the residents in the Aguadillo community are met, HHS has set up a temporary medical facility that is open and operational. This facility is staffed with medical professionals from the National Disaster Medical System (NDMS) and other federal partners who are ready to help.

Temporary Medical Facilities

The temporary facility is located close to the Hospital Buen Samaritano Calle Jose de Diego Aguadillo and word has gotten out to the community. Patients start arriving as early as 6:30 AM and a steady stream of patients comes to the hospital from the time that it opens at 8 AM to the time that it closes at 8 PM.

Aguadillo residents waiting for care

Although the main hospital was damaged, responders are still able to use the buildings around the hospital to admit patients. Members of the DOD Area Support Medical Company collect information from patients so that they can be seen by medical responders from NDMS Disaster Medical Assistance Teams.

DOD staff collecting patient information

Patients then are brought to the triage area of the hospital where medical professionals evaluate them and address their medical needs. The medical professionals have specialized training in disaster medicine and are familiar with the challenges of providing care in austere environments. When these NDMS medical professionals deployed, they brought caches of medical supplies, medical tents and other equipment that they would need to care for patients in the wake of the storm. These responders are working around the clock to care for patients while the health care system in Puerto Rico recovers.

Patient in wheelchair entering medical tent

Since the response began, NDMS medical professionals have helped treat people of all ages across Puerto Rico, including this little boy below who is recovering from a dog bite. Even before Hurricane Maria struck Puerto Rico, federal response personnel from the U.S. Departments of Health and Human Services (HHS), Defense (DoD), and Veterans Affairs (VA) and the Federal Emergency Management Agency (FEMA) have been coordinating efforts with local emergency response officials to ensure that medical care is available for Puerto Rico residents after the storm, and to re-establish the island’s healthcare infrastructure. Together, they have helped over 8,000 people get the care they need in the wake of the storm.

NDMS staff member holding young boy
October 07
From Cut-Off to Connected: HHS and the U.S. Army Work together to protect health in Utuado, Puerto Rico following a landslide

A small community near the town of Utuado, Puerto Rico has been hit by back-to-back disasters. First came Hurricane Irma, then Hurricane Maria, and then came the landslides that cut the community off from the rest of Puerto Rico. The 39 families who live there had no way to reach the outside. They were left without power or access to medical care.

Puerto Rican medical providers were worried. Nobody had heard from these people and there wasn’t a good way to reach them. The Puerto Rican medical providers, who were already working with partners from HHS and the U.S. Army, shared their concerns.

Responder and Helicopter in Utuado 

Understanding that the community needed help quickly, Disaster Medical Assistance Teams (DMATs) from HHS and U.S. Army Urban Search and Rescue (USAR) Teams worked together to organize a combined mission to reach the 148 residents of the community. On September 30, the DMAT and USAR teams flew into the community and launched an agile response.

DMATs and USAR prep for mission to Utuado 

Once on the ground, the teams worked together to assess the health and well-being of the people; provide food, water and medications; and offered to evacuate people as needed. The teams worked with people in the community to create a patient list. DMAT personnel provided medical care to patients and people with chronic conditions. They also provided medication to the people with chronic conditions so that they could stay healthy after the responders left the community.

In the end, none of the community members wanted or needed to be evacuated. But the community was relieved to get the medical care it needed and the kids really loved checking out the helicopter.

Responders with Utuado community members 

September 19
Rapid Assessment Tools for Responders to Address Needs of Individuals Experiencing Homelessness during Disasters

Natural disasters and emergencies – such as hurricanes, flooding and other extreme weather conditions – create challenges and significantly impact communities. The recent destruction and devastation caused by this year’s hurricanes highlight concerns for the addressing the disaster needs of impacted populations.

Of special concern during these events are at-risk individuals – these include people with access and functional needs that may interfere with their ability to access or receive medical care before, during, or after a disaster or emergency. Under federal civil rights laws, many at-risk populations are protected from discrimination in emergency situations to ensure equal access to certain health and human services. Integration of at-risk populations into emergency planning is critical to ensure the safety and well-being of the whole community and compliance with civil rights laws.

Whole community planning for response and recovery activities must include the effective integration of at-risk populations, such people experiencing homelessness. Individuals and families experiencing homelessness face unique obstacles during disasters. Those experiencing homelessness are especially vulnerable due to limited resources and fewer connections to their communities. Healthcare providers offering aid to people experiencing homelessness must recognize the increased prevalence of medical and psychiatric conditions. Additionally, the increased demand on the healthcare systems during disasters can stretch the capacity of providers to address immediate needs. These compounding factors can become barriers to accessing or receiving medical care during or following disasters such as the 2017 hurricanes.

In order to be prepared to respond to and support the long-term recovery needs of individuals and families experiencing homelessness, there are tools and resources that homeless-serving providers and disaster professional can use to ensure access to healthcare and behavioral health needs. To assist communities in planning for such disaster, HHS joined the Department of Veterans Affairs and Department of Housing and Urban Developing in creating a toolkit called Disaster Preparedness to Promote Community Resilience Information and Tools for Homeless Service Providers and Disaster.

This toolkit provides a practical overview of challenges that may occur during disaster-caused disruptions and the impact of these challenges for people who experience homelessness. The toolkit also provides guidance for identifying and collaborating with partners to address disaster response and recovery needs of homeless community members and outlines strategies to engage in preparedness and minimize service disruption from a disaster.

Furthermore, the toolkit specifies how to enhance the capacity of healthcare settings with providers experienced in serving people who are homeless, and provide expanded care following a disaster or public health emergency. The toolkit is a significant new resource to enhance communities’ preparedness in the face of natural disasters and public health emergencies.

When disasters strike, the vulnerabilities of all at-risk populations become exacerbated. Ensuring individuals experiencing homelessness and other at-risk individuals can access needed services is pivotal in withstanding and recovering from adversity.​

August 30
BARDA adds new antibiotic to treat drug-resistant bacterial infections in order to protect the American public

Antibiotics underpin nearly every facet of modern medicine. You can’t have a hip replacement or a caesarean section without effective antibiotics to prevent or treat bacterial infections. The same holds true in a mass public health emergency involving a chemical, biological, radiological or nuclear (CBRN) threat. During a biodefense emergency, people may be hospitalized for prolonged periods, potentially exposing them to secondary infections including drug-resistant infections that are occurring at an alarming rate.

That’s why BARDA is focused on development and approval of new antibiotics. Over the last 10 years, 32 BARDA-supported medical countermeasures have achieved licensure or approval from the U.S. Food and Drug Administration. Now, FDA has approved VABOMEREExit Icon, the first antibiotic drug in BARDA’s antimicrobial portfolio.

FDA approved VABOMERE to treat complicated urinary tract infections and a kidney infection called pyelonephritis in adults. VABOMERE also addresses gram-negative bacteria that produce certain enzymes, called beta-lactamase enzymes, which have spread in the United States and Europe, particularly the Klebsiella pneumoniae carbapenemase (KPC) enzyme. KPC-producing bacteria are responsible for a large majority of all carbapenem-resistant Enterobacteriaceae (CRE) in the United States and are classified by the U.S. Centers for Disease Control (CDC) as an urgent public health threat.


National Security and Public Health Implications of Fighting Antibiotic Resistance

Because drug-resistant infections complicate the medical response in any public health emergency, BARDA sponsors development of new antibacterial products that can be used in an emergency to protect health, save lives, and enhance national security.

Many patients who are treated for diseases, injuries or illnesses resulting from chemical, biological, radiological or nuclear emergencies will need to be put on supportive devices, such as ventilators, urinary catheters, or intravenous catheters. Patients whose care requires these sorts of devices and patients who must take antibiotics for weeks or months are most at risk for hospital-acquired infections such as bacterial pneumonia or infections due to CRE. These infections – particularly those due to CRE – also may be resistant to many different types of antibiotics and are notoriously hard to treat.

Drugs like VABOMERE that address drug-resistant, Gram-negative bacteria, including CRE, can reduce the risks posed by secondary infections that can occur in the wake of a CBRN attack due to the patient’s compromised immune system.


Improving Patient Health through Partnerships

Whenever practical, BARDA and its partners in the Public Health Emergency Medical Countermeasures Enterprise pursue medical products that address multiple high-priority threats and could become commercially available.

Since 2010, BARDA’s Antimicrobial Program has been forming public-private partnerships with industry to develop new antibacterial drugs and diagnostics to combat antibiotic resistant bacteria, including those that could be used in an intentional attack. The program has brought several antibiotic candidates into late stage Phase III clinical development.

In addition to approval of VABOMERE, BARDA has been working with industry partners to achieve FDA approval of more antibiotic candidates in the next one to three years. Last year, BARDA also established CARB-XExit Icon, a novel, global public-private partnership aimed at promoting innovation in antibacterial product development. CARB-X will ensure a robust and diverse clinical stage pipeline of new antibacterial candidates that will have the potential to obtain support from BARDA or other stakeholders. Collectively, both BARDA’s clinical stage antibiotic program and CARB-X aim to reduce the barrier of entry to any company willing to innovate in this space.


Combating an evolving threat

Drugs that treat antimicrobial infections are important tools in enhancing our national security; drugs that are approved and readily available on the commercial market enable us to respond better to a CBRN attack. However, antimicrobial resistance is a perpetual and ever-evolving threat. Bacteria will always evolve mechanisms to circumvent new antibacterial therapies. We need continued investment in this space in order to maintain a fresh armamentarium of novel antibacterial drugs to treat these infections.

The antibiotic development pipeline does not contain a sufficient number of drugs to keep up with the rapid rise of antibiotic resistance. The private sector’s declining interest in developing novel antimicrobial drugs is attributed to the low return on investment and uncertainty in the marketplace uptake at the product launch. Research associated with identifying and developing new drugs is risky and uncertain.

BARDA’s antimicrobials program, in collaboration with other public and private partners, helps shift the return-on-investment equation which encourages corporate participation. While BARDA support is helpful, robust innovation likely will not return to antibacterial drug development without a known and definitive return on investment for bringing one of these products to market.

We are excited about the FDA approval of the first BARDA-supported antibiotic. We also know that much work still needs to be done to combat the drug-resistant bacteria that place our nation at risk. BARDA continues to seek proposals for the advanced development of novel antimicrobials to treat illness caused by biological threat agents and address the growing threat of antimicrobial resistance.

August 23
Recovering from the Fourth Worst Disaster in U.S. History: Implications for Children’s Health in Recovery

Last year’s flooding in Louisiana ranked as the fourth worst disaster in U.S. history. Fifty-six of Louisiana’s 64 parishes were affected by major floods in 2016, and communities are still recovering with the help of an interagency federal response.

Child care centers and schools closed. The statistics related to children were staggering.

Recovering Continues a Year after the 2016 Louisiana Flood. 20,000 children adversely affected. 660 child care slots remain unavailable (as of June 2017). 20 schools closed. 300 buses were totaled. 10,639 children became homeless as of June 2017 (increasing State total to 28,672) 

Abrupt closings of child care centers or changes to child care relationships can have negative consequences for children, parents or other caregivers, and providers. The child’s developmental and emotional supports are interrupted. Parents no longer have the sense of security that a routine child care center provides. Parent or caregiver hours of work may be disrupted or discontinued, causing financial hardships and possibly relocation.

The federal government acted by using an existing coordinating structure: Recovery Support Functions (RSFs). The RSFs describe six key functional areas of assistance in the National Disaster Recovery Framework (NDRF). In the wake of both disasters, all six Recovery Support Functions (RSFs) were activated, including the Health and Social Services RSF. Substantial data were gathered, analyzed, and evaluated, applying recovery core capability-specific expertise to identify recovery needs and issues as well as recovery-related effects that may exceed state and local capacity.

Just as the assessment and determination was being completed for the March floods, the August disaster struck, prompting the team to reassess its approach to recovery coordination. Early indications were that the issues of concern in the northern parishes were very similar to those in the more heavily damaged southern parishes multiplied by greater numbers of residents.

These findings were the basis for developing a unified Recovery Support Strategy (RSS) encompassing those communities affected by the March and August flooding events and directing the unified work of recovery in Louisiana. The Louisiana Floods RSS documents comprehensive strategies for identified issues and involves extensive coordination among federal, state, local, and community partners. The Health and Social Services section of the RSS identified multiple recovery areas, including the effects to children and families.

During response the Health and Social Services RSF Field Coordinator convened a federal inter-agency school task force to ensure federal agencies were aware of the data affecting children and youth and addressing identified needs accordingly.

The data the Task Force gathered informed the next steps that federal and state partners took, such as:

  • FEMA’s Public Assistance Program prioritized installing temporary school facilities, and repairing and rebuilding existing schools and eligible child care facilities;
  • USDA extended free and reduced lunches to all students in declared parishes;
  • HHS Administration for Children and Families allowed grantees to postpone child care facility immunization requirements and increase the number of children per provider; and
  • The Louisiana Department of Education issued waivers that allowed buses to operate past their 10-year cycle.

Over the next month, the Health and Social Services RSF will work with the Louisiana Department of Children and Family Services and five parishes to support the Children’s Disaster Recovery Task Forces so the needs of children and families are known in response and planned for in recovery.

A disaster may only last for a few days or weeks, but its effects may be felt for many years. With solid planning and good coordination, federal and state partners can work together to help communities recover.

August 22
Discovering a Career in Health

For teachers, volunteers, and leaders looking to engage young people, it can be hard to know where to start or how to get those young people involved. Often the best avenue to engage new audiences is to go directly to them in the places they already spend time. In looking to engage young people, professionals should look to other areas in their community where young people volunteer. In her own words, here is one student’s journey, from local library volunteer to HOSA President, that shows how an initial spark of interest in volunteerism and community involvement can build into the start of a long career in public health.

From the age of 6, I’ve known that I wanted to be a health care professional. As I grew older, I became involved with the community and started volunteering at my public library. It showed me that service to others is an important part of being a leader. As I went into high school, I knew I wanted opportunities where I could serve others in the health field.

When I entered my 9th grade, I kept my eyes open, eagerly looking for the chance to pursue a path in health. On the first day of my Introduction to Healthcare class, I was introduced to HOSA Future Health Professionals, an international student-led health organization. I immediately joined, and ever since, this organization has given me with numerous experiences in volunteering and leadership.

I served as the Secretary and President of my local chapter, President-Elect and President of Georgia HOSA, President-Elect of National HOSA and
Picture of Priya Rathakrishnan
currently serve as the Pesident of HOSA-Fututre Health Professionals, leading over 220,000 members alongside my officer team. Throughout the past 7 years, I have learned about the different fields of health and have been exposed to various health professions and leadership opportunities through class internships as a part of Career and Technical Education, blood drives, and service projects for organizations like the Juvenile Diabetes Research Foundation, Leukemia Lymphoma Society and the National Alliance on Mental Illness.


When I attended my first HOSA conference, I couldn’t believe the energy level and excitement that I felt. Thousands of members from different backgrounds who share the same passion for health, united together in one room, all ready to pursue the journey to becoming future health professionals. It felt surreal to me. Recently, I attended another conference, the HOSA Public Health Leadership Scholars Program in Washington, D.C., where I interacted with distinguished public health leaders and have now come out of this program with information that will craft a better path for me as I approach my future.

If anything at this program, we learned that public health represents a broad umbrella that includes many aspects of health, such as medicine, veterinary medicine, allied health, emergency medical services, public safety, community health, and behavioral health.

While my experiences with HOSA have been filled with an abundance of new information each moment, the entire experience has provided me with a clearer outlook on what my future will hold. Currently a junior majoring in Biology on the pre-health track at Emory University in Atlanta, GA, I feel fully equipped with motivation and insight to make a difference in my own community.

Knowing what the true broad meaning of public health is, I look forward to educating others to make sure that we as a community are paying attention to the needs of our population. I am more aware of emergency management and am now constantly thinking about my own emergency preparedness plan, assessing how it fits with any given situation. And most importantly, I look forward to raising more awareness to mental and behavioral health in my own community because I truly believe that this aspect of public health is a determinant factor in one’s overall wellbeing. I look forward to the years ahead as not just a future health professional but a public health advocate as well.

August 16
Get Social: Using Online Networks to Advance Health Security

You probably know that Americans of all ages use social media, but did you know that social media has emerged as a critical resource for the public in disasters, providing timely situational awareness, preparedness guidance, and emergency assistance?

According to the American Red Cross, one in five people will try an online channel for help if unable to reach EMS in an emergency. Many emergency services, health organizations, and even news and government agencies also depend on social media for vital information in crisis and disaster events.

Whether your agency or organization is already using social media regularly or you are considering starting an account, here are four things you can do to enhance your audience outreach and engagement while advancing national health security.

Luck Favors the Prepared

Make sure that you don’t miss opportunities by having a great plan for your social media accounts. Whether you have an active social media account or are just starting out, take a moment to consider your social media plan and the way that it fits into your overall communications plan. Check out the lessons learned and planning tools that CDC has made available through the Health Communicators Social Media Toolkit.

Be ready to keep the conversation going throughout the year. Check out the National Seasonal Preparedness Messaging Calendar to help you learn about conversations on preparedness that will be going on throughout the year.

Learn your ABCs: Amplify, Borrow, Communicate

You know that disasters happen every day across the country – but did you realize that there are a number of existing toolkits that have been developed by federal agencies to teach people about disaster preparedness and to help them recover?

Use existing resources effectively to help you plan and give you more time to focus on the concerns that relate specifically to your area. CDC, ASPR and SAMHSA teamed up to create a library of Public Service Announcements for Disasters. The library contains seven-second videos on YouTube and Vine, short-form messages that are perfect for tweets and texts, longer-form scripts with key facts and statistics, and much more. The toolkit has pre-scripted messages that can help your followers understand everything from staying safe in the wake of a flood to helping dialysis-dependent individuals prepare for disasters.

In addition, CDC has developed a number of infographics and videos that can easily be incorporated into your social media plan. Check out the great graphics they have already developed on issues like extreme heat, hurricanes, tornadoes, and more. Ready.gov also offers a wide range of social media toolkits, from flood and hurricane safety to preparedness month.

Expand your Network

Think about the people your agency or organization connects with every day – from hospitals and clinics to community leaders and partner organizations. Consider following them to expand your social network. If you have a big event or important announcement, reach out to your partners and ask them to share your posts.

Many neighborhoods and communities have group pages on social media channels where residents have conversations. Join these and look for opportunities to ask for volunteers or exchange advice on fun community health-building activities.

Get Behind the Camera

Videos and photos continue to be critical tools for online engagement. Here are a few ideas to help you get started:

  • Take pictures! Think about the things that make your organization unique. Do you work with volunteers in the field? Support vaccination drives? Conduct preparedness drills? Next time you do, make sure that someone brings a camera. Look for opportunities to capture moments that connect your audience to your mission or key priorities.
  • Record educational videos with experts on specific topics that relate to health security, like building community resilience. Keep your videos short and high energy, and use messages that the general public will understand. Take it up a notch by using online resources that make videos using only moving text and animated graphics.
  • Know of any events in your area that are examples of community health resilience or health security activities in action, such as health fairs, volunteer events, block parties, or other preparedness activities? Attend and take photos or videos of them to show your audience what national health security looks like so they know how they can support it. Be sure to use professional equipment to ensure high-quality images or sound.

Create a Two-Way Connection

With millions of Americans engaging with each other through neighborhood-based platforms, local public agencies and organizations are reaching the people within their community like never before.

Create and staff a dedicated account that allows real-time communication with area residents that is focused on important public health and safety topics. Use this channel to answer questions, solicit feedback, and ask for engagement on community activities.

A social media communication strategy is only one part of a larger communication effort, and should be integrated into your overall communication planning, activities and data collection. Therefore, over-arching communication goals should be considered when developing social media activities.

Integrating social media into disaster health communication campaigns and activities allows health communicators to leverage social dynamics and networks to encourage participation, conversation and community – all of which can help members of your community make better decisions when seconds count.

To learn more about national health security activities, visit www.phe.gov/nhss.

August 16
Whatever it takes: Medical Reserve Corps volunteers leverage eastern tradition to aid behavioral health after disasters

After the terrorist attacks of September 11, 2001, managers at St. Vincent’s Hospital in New York asked the nearby Lincoln Recovery Center to provide respite and ear acupuncture treatment for staff and first responders impacted by the tragedy. Some of those treated reported that after treatment they slept better than they had in days or weeks.

Lincoln Recovery had developed an ear acupuncture treatment called the NADA protocol to assist substance abuse detoxification and recovery support in concert with other behavioral health interventions. The successful use of this technique for behavioral health support in the aftermath of September 11 inspired much of its use since then to ease tension and improve behavioral health after major disasters.

The benefits of acupuncture have long been accepted in eastern medicine and continue to be discovered and studied in western medicine. One of the strengths of acupuncture is believed to be the release of endorphins; in addition, the time spent in quiet relaxation during acupuncture can benefit blood pressure and calm the central nervous system’s response to stress, trauma, and pain. Acupuncture resources, knowledge, and expertise are still growing in the disaster response community and within the Medical Reserve Corps (MRC) network of almost 200,000 volunteers.

In 2008, an acupuncturist in Santa Barbara, California, experienced the terror of being trapped in a local wildfire and that traumatic event prompted her to volunteer her skills in her community afterwards with her local Medical Reserve Corps unit.

Not long after, in Oregon, the State Department of Health made efforts to standardize roles for acupuncturists in a disaster and to register acupuncturists in their state Emergency System for Advanced Registration of Volunteer Health Professionals (ESAR-VHP).

Around the same time, an MRC leader and member of the National Disaster Medical System’s New Mexico Disaster Medical Assistance Team began teaching a specific acupuncture protocol to high school students on the Native American Reservation of Jemez Pueblo as part of community resiliency and wellness efforts. Today, efforts are underway to form a statewide Integrative Wellness MRC in New Mexico that not only could provide disaster support but also could provide services to veterans managing PTSD and addiction.

After a catastrophic flood in Boulder County, Colorado, in 2013, a local psychiatric nurse and acupuncturist founded the first MRC unit specializing in acupuncture, the Colorado Acupuncture MRC (CAMRC). Local emergency management officials requested stress relief for the staff at the Emergency Operations Center, and that request grew into a larger mission to help the thousands of local residents and first responders receive acupuncture treatments in the first six weeks after the event. CAMRC continued to offer support with smaller community clinics for two years.

In 2015, CAMRC responded to the recovery efforts after the Colorado Springs shooter incident. These MRC volunteers supported the community and first responders at the Disaster Assistance Center and were requested to return the following week for a private clinic for the first responder community. The goal in providing the acupuncture treatment was to foster and restore the resilience and independence of people affected by the tragic incident so that they could rebuild their lives and communities.

Since then, the CAMRC has responded to multiple fires supporting incident command personnel in staging areas and staff and residents in disaster assistance centers, and the CAMRC continues to provide recovery care in fire houses and community centers in Colorado. The team even supported an acupuncture response team in Orlando, Florida, after the Pulse active shooter incident in 2016.

The CAMRC also has been instrumental in developing an Acupuncture Mission Ready Package (MRP), which describes the mission and capabilities of acupuncture services post-disaster. The MRP can be utilized across the United States and integrates within FEMA’s National Disaster Framework. This package describes the role, training, and supplies needed to provide treatment in a disaster setting and outlines its benefits:

  • Auricular (ear) acupuncture is low cost and does not require participants to speak or share their experiences.
  • The treatment can be given in any setting; supplies are mobile and can be kept on the practitioner.
  • Auricular acupuncture protocols can be used for pain, behavioral health, psycho-social conditions, digestion, sleep, traumatic stress and more.
  • Treatments are geared toward supporting resiliency in communities, aiding emergency responders and community members affected by disasters/critical incidents and traumatic events.

The CAMRC continues to educate emergency planners on the use of acupuncture after a disaster for both responders and survivors. They received an MRC NACCHO Challenge Award to conduct research and collect evidence supporting acupuncture in the MRC network to relieve symptoms of stress due to a life-event or events. CAMRC has partnered with the University of Colorado at Boulder’s Psychology Department Clinical Assessment of Injury, Recovery and Resilience (CAIRR) Neuroscience Lab to evaluate the findings. This data will be released in the fall in an effort to foster the development of additional acupuncture MRC units across the United States.

In other parts of the country, MRC units are incorporating acupuncture into their own response and recovery efforts as well. In Texas, for example, an MRC unit began developing acupuncture capabilities following severe flooding in 2015 and 2016. These efforts led to the development of ear acupressure guidance, inspired by an acupuncturist and MRC in Texas and developed by NADA leadership that can be used in the absence of an acupuncturist or until one can be found. Most recently, the Nassau County MRC in New York began to train members in providing treatment in a disaster setting, inspired after experiencing the effects of Superstorm Sandy in 2012.

To learn more about acupuncture and its uses in the disaster, substance abuse, and behavioral health communities, check out these resources:

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