Roundtable on Emergency Management and Resiliency Building, Centre for Emergency Preparedness and Response, Public Health Agency of Canada
Stepping into the Known and Unknown & Building Community Resilience
Our communities – complex, multi-cultural, and ever-changing – are intricately intertwined by family relationships, community networks, opportunities for livelihood, and a deep-seated need for a safe environment that fosters growth and well-being. Over recent years, the move throughout the United States and globally has been for public health to join emergency management and other key stakeholders, including the private sector, community and faith-based organizations, and key community members, to build disaster-resilient communities. Events such as SARS, the Avian Flu, and tragic human-caused terrorism attacks such as 9-11 confirm that holistic, multi-stakeholder planning across the disciplines is the framework necessary in our search for resiliency to possibly achieve what author and journalist, Malcolm Gladwell, refers to as the tipping point, that moment in time when ideas suddenly flame, “tip” and social behavior spreads. Yet how do we get there?
While it is easy to agree on the need to work together, actually moving from theory into action remains challenging. Multi-disciplinary, integrated approaches require moving out of the safe zone of our own disciplines, taking on new risks and new partners, and using unfamiliar resources. Moving to action also necessitates taking valuable time to examine how we can apply lessons learned from others’ experiences to make our own work more effective. And while difficult, it may be our only solution to weathering the unexpected disaster health crisis, the never-ending politics and inevitable budget cuts, and being prepared for the constant shifts in our community’s social landscape.
Over the last couple of years, an intensive effort in the San Francisco Bay Area of California has been underway trying to figure out what regional resiliency just might look like and to start the process of putting such an integrated system into place through cross-jurisdictional stakeholder planning. Funded through federal dollars, the Super Urban Area Security Initiative (SUASI) supports the development of a ten-county regional planning effort to prepare and respond to disaster events. Community program leaders, researchers, and others involved have focused on identifying, examining, and applying the best practices of programs throughout the country and internationally for their application to building the Bay Area resiliency effort. Questions are being asked, regional plans are being developed, as well as new programs, informational toolkits, virtual public information networks, exercises, and interdisciplinary planning workgroups.
While immeasurable lessons have been and continue to be learned by the hundreds of individuals involved, I offer five lessons from my own experience with this initiative that were either verified or learned for the first time. I offer these points as ideas or perhaps simply as discussion starting points to my Canadian colleagues who are well underway addressing similar challenges in their search to build disaster-resistant communities throughout Canada.
Who is Socially Vulnerable?
A special focus in the San Francisco Bay Area planning efforts has been addressing how to reach the populations in our communities that are considered high-risk, vulnerable, or marginalized.
Everyone whole heartily agrees that we must better meet the needs of those most impacted by disaster, those who often fall beneath the many safety nets in life by not being able to adequately prepare for or respond to a disaster, or those who take much longer to recover. Yet the stakeholders in the Bay Area continue to be challenged to being able to agree on who should be considered socially vulnerable in action planning efforts.
While legislative efforts outline requirements, each community or each program representative provides unique viewpoints and attributes for vulnerability, whether addressing general issues of disabilities, laying out response protocols, or crafting plans for sheltering. This search for a shared definition continues to stimulate robust discussion in the Bay area experience! The thoughts I offer in this paper build off of this healthy struggle.
Building a Framework for Success
Lesson One: Integrate
My research activities and facilitation of discussion forums and focus groups confirmed that a multi-pronged planning strategy allowed more individuals and organizations to become and stay involved in a strategic effort. As is well known, working apart from others’ planning and implementation efforts often leaves out the rich resources available. Going it alone often allows the program effort to die when funding, political support, and staffing dry up and other issues of equal or greater “importance” take precedence. A move towards a systems approach brings the efforts of everyone involved into an integrated planning process.
Integration of communications outreach campaign approaches penetrates the target populations more inclusively and more effectively. For example, in studying the approaches of citizen preparedness programs, my colleague and I discovered that most of the successful, resilient programs approached their mission by combining the efforts targeting schools, community groups, and the media, all in the same program structure. Efforts that only used one approach, targeting one population group, often initially provided good results, but they limited the number of people engaged. Most importantly, a single focused program didn’t provide for the ripple effects of information that comes with hitting the community from different angles and therefore being shared with a multiplicity of key individuals and information carriers who could influence and encourage widespread action.
Another example found was the use of integrated media efforts. By using multi-pronged media approaches to reach members of the population through different methods, a wider array of individuals were accessed. Such media included traditional western resources such as radio, television, and print, combined with other outreach approaches such as street festivals, drama, and art competitions. These approaches have now rapidly expanded as new forms of communication are being widely used. Of Important note is the evolution of social media, such as peer-to-peer media, such as text messaging on cell phones and other personal data devices (e.g., Blackberries).
Lesson Two: Customize
One of the most critical attributes of a sustainable program I have found is one based on having done the necessary homework on the target population/community. Over the years, the consistent mark of success has been the program that reflects a deep understanding of the psychological, social, and cultural attributes of the community members. Some create community profiles asking questions. What actions generate the most productive response over the period of time of the program? Who best understands the hazard? The risk? Who should carry our message? Do we use television, parade banners, podcasts, cell phones, or school nurses to reach out? Conducting this type of psycho-socio examination often takes time and includes actively working with members of the target community. Much need to be understood from the eyes of those we are trying to reach, not from those of us who want to be heard.
Existing frameworks can be extremely useful. The age-old rules of journalism offer us an invaluable matrix from which to work: who, what, when, where, why, and how. This simple framework has been shared with disaster program leaders (and public health professionals) throughout the United States and Asia to great success, and I am consistently amazed at how simple and effective it is in helping frame disaster-related planning efforts. There is another set of criteria that many disaster risk communication specialists have used over the years to assess whether they have penetrated target populations. We are using this same framework in the San Francisco Bay Area effort to assess citizen preparedness programs and frame resiliency messaging and program development:
- Hear: ensure that all members of the target population have access to the information.
- Understand: make sure that information is very understandable, not too technical, not too complicated or confusing.
- Believe: present the information in a way and by a person or organization that is trusted.
- Personalize: ensure that members of the target population don’t see the information as just theoretical but see how it impacts them personally and gets them thinking about what they need to do.
- Act: move the target population to action, not only thinking (biggest challenge!).
- Sustain: keep the target population active and engaged.
Lesson Three: Collaborate
As most of us know, developing innovative and strategic partnerships offers more than financial support. Partnering offers invaluable people resources, distribution channels and new, fresh ideas! Strategic partnerships provide a clearer picture of the at-risk community and its individual members. Information distribution channels are extensively expanded, and importantly, greater resource support becomes available that can further expand budgeting options. By developing critical partnerships, more people are included in the decision-making process. Community champions – those critical individuals who can effectively lead the effort in their own communities – can be more easily identified, engaged, and brought into the work effort. In our Bay Area effort, we reached out to identify, interview and pick the brains of those crucial champions through online surveys, email surveys, discussion forums, focus groups, and in-depth interviews. Their ideas, opinions, and feedback were critical to strategizing for regional resiliency and carrying the message to the communities.
Working with multiple partners, especially across disciplines, usually brings new challenges. Partners often have widely differing critical missions, out-of-sync timelines, budget procedures, mileposts, and ways that they measure success. I have found they may have unusual methods on how to reach a consensus, and perhaps it is better than the one planned. By actively involving other stakeholders, the collaboration ensures a much more inclusive thinking process, greater resource commitment, and more chances for support during setbacks. Most importantly, it encourages placing a great emphasis on successful outcomes and program longevity.
This type of partnership effort has served as the critical backbone of the San Francisco Bay Area effort. Active work groups are made up of stakeholders hailing from the public and private sector, disciplines ranging from public health to animal control to police to community and faith-based organizations, and crosses many political jurisdictions – cities, counties, state and federal regions. The work groups meet monthly to share information and resources and examine the process and progress of related projects. Bonds are formed, ideas challenged, and new ground is being broken.
Having worked on building disaster-resistant community initiatives in many different environments over the years, I offer the following key points as a possible starting platform for developing partnerships:
Ten Keys to Successful Partnerships
- Define the risks for each partner and participant.
- Identify the cultural differences of each partner.
- Match the mission of each partner – make it a win-win relationship.
- Define and address the rewards and recognition preferred of each partner.
- Engage those individuals within each partnering group who can “champion” your
- Define the time-critical mileposts or timelines for each partner.
- Continually educate each partner on the outreach efforts, developments, success, and
- Document the successes, problems, and lessons learned and experienced in the partnership
- Commit partners to spend time together (physically).
- Publicize and celebrate partnership successes.
Lesson Four: Measure
Another challenge that seems to haunt program success is the ability to answer one simple question, the old How ya doin’? Once a program effort is underway, many find it very, very difficult to critically and objectively assess the program’s success and failures. The reasons behind this roadblock reflect not only time restraints but also legal issues and political concerns by program and project managers, as well as funding agencies, and the lack of knowing how to do it. Yet to move forward to ensure success, measurement questions must remain at the forefront of all program efforts at all times. While interviewing national and international program leaders, this point continually resurfaced. Of all of the insights gained over the last year and a half, this challenge is one of the most important issues for building programs for resiliency.
Measurement criteria, along with a vetted, clearly thought-out procedures for taking measurements, must be built into program efforts from the very onset of goal development and carried throughout the lifecycle of the program, short-term initiative, or disaster response activity. Consistently, this performance measurement piece appears missing in local California programs, US national programs, and programs from around the world, be it directed towards community preparedness, an informational/educational campaign, a disaster shelter activity, or a voluntary management program. While a small level of measurement exists in many programs, what seems limited is the depth of the criteria measurement, understanding the ways for reporting out, documenting the review, and then knowing what to do with the information once gathered.
For many volunteer-based programs, there appears to be understandable concern about the possibility of losing the hard-earned, meager resources of what has been put into place. In many instances, managers face legal restrictions for measuring their own programs, often due to agency rules and requirements or federal mandates limiting evaluation activities. This measurement limitation offers an excellent opportunity for a partnership, for example, working with a local university to provide the evaluation process on the agency’s behalf.
In the San Francisco Bay Area projects, a variety of criteria are being used to assist work groups evaluate projects and programs for application to the region. These criteria can perhaps offer insight into the evaluation process already underway for Canadian programs. The following points are offered for consideration:
1. Has Regional Impact
2. Is Cost Efficient
3. Leverages Current/Past Projects
4. Addresses Known Gaps
5. Provides Time to Develop/Implement within Established Timeline
6. Is Sustainable
7. Addresses Broad Range of Community
8. Is Multi-Hazard
10. Engages Target Population
Lesson Five: Sustain
Many resiliency efforts begin and quickly end. To figure out how to create a successful program that retains great people, we need to sustain the effective ones in place, get rid of the bad ones, and craft new ones that will ensure further success. So much easier said than done!
The research on programs from across the U.S. from around the world pointed out that preparedness program efforts need to be consistently active, not start and stop, not shift gears when a program officer changes course, the epidemic ends, the summer comes, or funding falls short, ongoing and consistent.
This is where partners can take up the mantle when we falter. And this leads to one last but key thought based on the lessons learned, by expanding our use of well-placed volunteers, we can overcome our overwhelming “to-do” lists, overcome cultural barriers, and move us closer toward creating that magical tipping point. To do so, we are challenged to learn how to more effectively excite and retain a critical volunteer base through innovative, informed program managers passionate and experienced with disaster and skilled at managing volunteers.
While all of us who answer the call to create disaster resiliency face difficult challenges, we can learn important lessons from our peers throughout the world who face similar uphill battles. Perhaps one of our greatest feats is simply to find precious time to listen, learn and apply these lessons. We can build safer, stronger, and smarter communities.
When we engage a wide variety of stakeholders, we have already taken a first significant step in expanding our capabilities and penetrating our target communities. We breathe life into our work that has a sustainable social and institutional context. We can build a common risk framework that crosses disciplines, taps into deeply held belief structures, and appropriately reflects cultural traditions.
By customizing our efforts through a systems approach and actively involving those who have a stake in the health of their own neighborhoods, community associations, and know and love the children running through our schoolyards, we can foster new ideas and strategic approaches. Our data can become intelligence.
Our directives for a boil water order can make sense to those who barely speak our language or understand how the government system works. In doing so, we may move a bit closer to agreeing on who is our socially vulnerable and, perhaps ultimately, reach a magical tipping point that creates a social movement to safeguard our communities and move them one step closer toward sustainability.