Transcript of Get Ready Report Podcast, episode 34

This is the American Public Health Association’s Get Ready Report, coming to you from Washington D.C. Today’s episode, “Family Communication During an Emergency,” interviews Dr. Jeffrey T. Mitchell, clinical professor of emergency health services at the University of Maryland-Baltimore County, and co-founder of the International Critical Incident Stress Foundation. He is interviewed by Get Ready team member Lavanya Gupta.

Thank you, Dr. Mitchell for joining us for this interview. My first question: Social media and the Internet play a big role in communication today. Can you give an example of how they’ve successfully been used to communicate between family and community members during an emergency?

Yes, actually from a personal experience, my niece was in New Orleans. And when they had Hurricane Katrina come through there, one of the most effective means for my niece to keep in contact was the family system — was to go to a place where they had active Internet, and she was able to put out on Facebook items that said, you know, “We’re safe. We’re okay. Our home was destroyed, but we’re safe and we’re living in a shelter right now.” So that kept the other family members very well involved. There were several family members who did not have an account on Facebook, so those of us who did picked up the messages and forwarded them on to family members who did not have Facebook. So I think that’s one aspect where you might see utilization of social media between family members during a crisis.

That’s great. What about text messaging in an emergency situation?

I think as the technology evolves and it continues to evolve, we need to take into consideration all the various means of communicating, whether it be by text, by phone, or whether it be by email, or by Facebook. I think we should incorporate all of those potentials into our system and not forget some of the “reliables,” such as the home phone and those sorts of items. But occasionally, one aspect fails, so what’s really important is to have multiple approaches so that if something isn’t working, maybe we can move on to the next technology and try that. If that’s not working, then move to the next one down the line. So, I think families need to keep in mind that you ought to have backup plans for backup plans during disasters because occasionally things all go in the wrong direction, and communication becomes extremely difficult.

Sure, thank you. My next question: It is important to develop a communication plan with your family in advance. What are your suggestions for a reliable plan?
I think a reliable plan should be to make sure that everyone is “on plan.” That’s one of the most important things that the family list should be available to all the participants. You want to make sure that you have what is the high priority: Will it be by text, will it be by internet, will it be, you know, something that’s related to a phone system? And list those things; it should be very clearly stated, “If this should fail, try the next thing. If that should fail, try the next thing down.” And one of the things that’s very important for planning for families in disaster situations is to make sure that you don’t make the plan so complex that people are not able to follow it. It needs to be simple; it needs to be done with some degree of speed, and it has to be very effective so that you make a plan that is going to work for the family system. If you have elderly people in the family who are not on the Internet, and they rely heavily on phone communication, then that needs to be build into the process as well.

Sure, that’s a great response. I think that sometimes, if there is an emergency that is local to a certain town or community, it might be constructive sometime to have a contact maybe out of that area. Is that something that you would suggest — having a friend or family member that is somewhat removed from that area point of central contact?

Yeah, if you do not establish and maintain direct communications with family members, but there is a possibility of going in an indirect route — that is, communicating to a friend or a business associate at some distance from the affected area — if the communications can be established with them and then they can be established as the acceptable route for the family, then that is one way to deal with this. Make sure they are built into the plan so if I cannot reach my family directly, or they cannot reach me, but there is access for both of us to the third party, then we need to have that established, okay? When New York was attacked on Sept. 11, 2001, my nephew was a firefighter there. And, you know, our whole family was concerned for his safety. There was no direct communication with him whatsoever, and eventually, he did get to a place where he had a signal that he could send out a telephone message to another family member who lived almost across the country. And that family member was relaying information back to people on the East Coast from the West Coast. So having those backups and backup plans where you have someone else as a third party can be extremely helpful in a family emergency.

And on the same vein, would you suggest in certain circumstances to also in your family plan establish an out-of-town meeting location? I guess that would apply more to adults than children, but is that something that would be a possibility?

Yeah, if you’re talking about a major disaster in which evacuation is the requirement, having an established locality or location in a particular place or in a particular town where the family members can gather, that can be very helpful. So it should be an easily accessible and easy-to-find location, and it needs to be someplace where people would have either written instructions in advance that they keep in an emergency kit that they take with them if they’re evacuating, or they need to have some means of communicating that. It’s easiest to have it done in advance, so you can take it out of the house when you’re leaving your home as a result of an evacuation order.

 Do you recommend any resources that families can readily refer to they’re trying to construct their communication plan?

 I think the Federal Emergency Management Agency, FEMA, has some of the best materials for planning a family response to a disaster. It has lists on their website, so that everything from what to put in an emergency kit, such as flashlights and extra batteries and first-aid equipment, and water and things like that. And it also has information that you can utilize to help with communications during an emergency. There is another way that you can communicate, and that is also sometimes to use communication resources that are working. For instance, if emergency personnel are in the area and have a satellite phone, sometimes an emergency message can be transmitted to assist a family during an emergency. So having all those things set up in advance is important. I think having an emergency kit — one that is easy to find, and can be taken with you when you leave your home when you have to evacuate, or are brought to a place where it is easily accessible within a home — is very, very important. With FEMA, folks have some really good documents that help people plan for an emergency.

That’s great. What challenges should we expect when trying to get in touch with our families during and after a natural disaster or other emergency?

Well, one of the things that people have to be concerned about is that despite how elaborate and how well-built our communications systems are, they are vulnerable. They are vulnerable to the collapse of a tower, which happened during the World Trade Center attack in New York, so that almost all telephone communication ports from certain parts of the city were lost entirely, especially any communications that relied on transmission through a communications tower. You can have landline disruptions in an earthquake. You can have things that force you to move to a place where you don’t have the computer, you don’t have the telephone with you, so you may be forced into a wilderness environment based on how bad the situation is. So wherever you can, have backups. If you have a cellphone that you can take with you at all times, make sure that it’s charged, get extra batteries for it, that can help to give you some communications even if you’re temporarily moved to a more wilderness environment where you don’t have accessibility to other communications. The other thing to remember, a big challenge in communications during an emergency, is that you’re not the only family that wants to communicate with family members. There may be hundreds of thousands of people trying to use the same resources at the exact same time. And as a result, some of these computer systems shut down and are unable to communicate for everybody. So it shuts down the rest of the system to allow emergency priority units to use those communication systems.

Now, is there a difference in how we should address family communication with children, versus when we discuss it with other adults?
When you’re trying to communicate about a problem with children, you need to keep in mind that children do not hear things in the same way as adults do. They misinterpret, they can think that there’s something even worse going on than what there is. So communications with children have to be simple, they have to be something that the child can understand. So it has to be in the language of the child. We should never frighten or terrify children or make things feel like it is hopeless. When you’re working with children, you need to be able to communicate important information to them and gain their cooperation, but not to scare them. To do that you need to have simple terms. It has to be a concise message. They cannot tolerate too much information at any one time, so you have to keep that concise and precise, and you need to make sure that you’re repeating the information, and repeating it as often as they need to hear it. Sometimes, it’s just as simple as, “I told you before that this is what’s going to happen; now that’s happening, so here’s how we’re going to react. Remember how we practiced this before.” So you need to make it simple, you need to make it repetitive, and certainly not scary or overwhelming. You don’t want to have an adult who feels out of control and terrified trying to communicate with a child because that adult is going to pass to the child some of the stress that they’re feeling and the child is going to feel distressed. Children need to know that they’re safe, that they’re not in immediate danger, and the family is taking action to protect everybody in the family.
Another thing that’s really important with children is to limit how much exposure they’re having to the television when there’s a tragedy going on. Children sometimes see the repetitions of an airplane going into a building, as we did on Sept. 11, and when it’s shown again and again and again, children think that there are hundreds of airplanes going into hundreds of buildings because they’re seeing it so many times. So it’s really important to limit how much TV exposure children are getting in the family system in order to not scare them further, more that what they are based on what the adults have told them. But they need to know that they’re safe and that there’s a plan in effect, and the family is doing everything possible to take care of them.

You bring up some great points, Dr. Mitchell. Children definitely may perceive things in a different way, so it’s definitely important to consider taking a different approach when explaining potential situations and also when you are in that emergency situation, so that was great. What should we consider to make a communication plan as accessible to everyone as possible, including family members and loved ones who have a disability?

I think you really have to build into the plan as you’re making the plan, making sure that everybody knows what the problem may be for particular family members so that you have specialized communication devices, and those devices are available to them at home. If they need to be removed from the home (make sure) that they’re some way they can communicate with authorities that they have to have a special device in order to communicate with other family members. It’s important that if we do have to evacuate that we let some family members know where we’re going, and what the destination for the evacuation (is). And make sure that whatever links you have with the handicapped person in the family system, that those links are effective. They should be tested every once in a while. Periodically, call someone or communicate with the normal means (through which) you usually communicate with a handicapped person, and test the system; make sure it’s still working. You know, if lines go down, communications get blocked, there are computer failures, so there’s lots of ways that people can lose communication. As Hurricane Sandy approached New Jersey, I called my sister who lives in New Jersey quite frequently to make sure the lines stayed intact, and as the storm began, I called her and we had a plan to communicate in an emergency, should one develop during the storm.

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Posted: Dec. 16, 2013