Vulnerable Populations and Disaster Preparedness:

Developing Culturally Competent Preparation for Vulnerable Populations in Response to

Disaster Threats©

Dr. Amy Lippmann

March 2009

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Sentinelese inhabitant, Tsunami 2005

“ Our ancestors taught us that when the earth shakes we go up the mountain into the caves.”

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Abstract

This dissertation examines the need for developing culturally competent protocols for vulnerable populations in response to disaster threats.

The study examines 2 cultural minorities in the State of Maine, the Passamaquoddy tribe on Pleasant Point Reservation and the Somali refugee community in Lewiston, Maine.

This exploratory research questions preparedness in cultural minority communities. Despite efforts by public administration disaster management systems to improve organizational infrastructure addressing disasters, minority communities remain an ‘Achilles heel” in the overall preparation program.

A lack of understanding of the needs of these vulnerable minority populations puts them at greater risk than ‘mainstream’ communities. This study examines parameters in which the basic differences between communities have a direct effect on their ability to prepare for disaster threats.

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Statement

Identifying and addressing the cultural needs of vulnerable minority populations, will improve disaster (preparedness) management in these communities.

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Purpose of Study

Identify cultural parameters that affect preparedness

Prepare vulnerable populations for emergencies by eliminating disparities

Build on social dynamics in place to help save lives and minimize damage

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Disaster Management

Control, Predict, Change

Evidence Based Knowledge

Shared Experience

Organizing to Survive

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Steps in Disaster Management

Preparedness

Mitigation

Response

Recovery

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Risk Assessment

Experts Risk Assessment ≠ Victims Risk Perception

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Background

Imbalance in preparedness exists and the concept of disaster as a social construct based on past experience and community life may be interpreted differently in different cultures.

Preparedness is defined as concrete behaviors evolving from perceptions that individuals and groups develop in the face of disaster ( Norris ).

Minority populations in a mainstream society are vulnerable to this imbalance due to lack of understanding on the part of the public disaster management organizations.

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Hypothesis

There is an association between culture and preparedness.

There are cultural differences between minority communities and mainstream communities that effect the level of preparedness to disaster threats and therefore need to be addressed

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Hypothesis (continued)

Differences in:

Cultural beliefs and traditions

Risk perception

Social organization

Access of information

Past experiences

Gatekeeper effect

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Outcome planning

Based on analysis of both the ethnographic and field survey data, it was possible to pinpoint specific areas where intervention and training can be implemented to increase community preparedness levels.

A benchmark database will be established for further longitudinal follow up studies.

Based on data collected and continuing coordination among the communities, culturally specific protocols can be developed.

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Dependent variable

Emergency preparedness

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Independent variable14

Culture

Voices from the community

We maintain our culture and are not interested in acculturating, the border between Canada and the US does not exist for us as it separates our families.

Humans are G-d’s joke, any animal can survive in nature on it’s own except man, animals have to help man.

We do not fear natural disasters, we live in harmony with nature. When there is a power failure, we go to the elders to avoid government intervention.

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Voices from the community

The clan elder mothers make all the important community decisions. Chief as the tribal leader is a fabrication in American twist-ery.

We will never evacuate our homes, last time we did they left us to die of TB.

We won’t accept government help, remember the blankets with the small pox? That was the

help they gave .

Passamaquoddy community members

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Voices from the community

“Share a shelter with the men ,are you kidding, don’t you remember what happened to us in the refugee camps?”

“Domestic violence is common especially during disasters we need to protect our daughters .”

“ Allah decides, we have no control over what overcomes us”

Female Somali community member.

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Voices from the community

“I am responsible for this part of the neighborhood, if a hurricane hits ,I know that inside one multifamily unit is an old woman in a wheel chair, who is going to need help to leave. I have 11 single mothers on the second and third floors with children under two who will need help evacuating and special needs in the shelters. I have two pregnant women who will need special attention.”

Cuban Women’s Federation member, Havana.

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Voices from the community

In our shelter we collected the laundry from the other shelters, the next shelter prepared the food, the last shelter brought supplies when needed. We did well without intervention from the government or the military.

Israeli woman from Kiryat Shimona during

the war with Hezbollah in 2006.

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Literature Review

The chances of surviving a disaster has a lot to do with how well an individual ,family or community is prepared.The frequency, intensity, and form of social interaction among members of ethnic groups have been one of the prime suspects in how disaster information is passed along, made acceptable, and integrated into appropriate disaster preparedness behaviors ( Kirschenbaum, 2002 ).

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Literature Review

Being prepared ,as an integral part of the survival process would mean different things to different peoples in different cultures.( DeVries , 1995 )

Concern for family has long been recognized in disaster research as a core social unit involved in such decision making decisions affecting evacuation.( Drabeck , 1986)

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Literature Review

Israeli Jews make more of an effort to be better prepared than Israeli Arabs and the more the doubt that the military can neutralize an attack; the more individuals have invested in means of protection( Kirschenbaum and IDF Home Front Command ).

Cuba shows us a rare example of successfully building Community Based Disaster Management into a national risk reduction program (Oxfam)

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Literature Review

In emergencies, legal limitations fall by the wayside and officials act, leaving legal consequences to deal with later.( Posner )

Disasters provide ample opportunity for persons with limited power to organize against government organizations responsible for recovery, there by asserting their own power into new turmoil caused by disaster.( Stallings )

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Literature Review

Building a culture of prevention is not easy. While the costs of prevention have to be

paid in the present, its benefits lie in a distant future. Moreover, the benefits are not

tangible; they are the disasters that did NOT

happen. ( Kofi Annan 1999 ).

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Literature Review

Experience shows that without the deliberate involvement of women in planning and implementation of preparedness, response and recovery programs overall national performance will suffer. International frameworks for disaster response would be strengthened by greater focus on the potential role of women and by including women in the decision making for disaster preparedness and response work (Kate Wood).

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Research Methods

Cross- sectional, exploratory research design

No formal sample size calculation was performed

Data collection based on questionnaires, field studies, interviews

Use of pre-collected data

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Statistical methods

Comparisons were performed between each cultural group and the mainstream.

Categorical variables were tested using χ2 test followed by Fisher exact test.

Continuous variables were tested using ANOVA followed by Dunett post hoc tests.

Significance level was defined as a=0.05.

No adjustment for multiplicity was performed.

Statistical analysis was carried out using SPSS Inc. 15.02 software

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Research process-Sampling method

Sample Population Sampling Rate

Passamaquoddy 63 2,005 3.142%

Somali 59 3,750 1.573%

Mainstream 35 1,200,000 0.003%

Non probability convenience sample with high representation rate for the minorities

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Findings29

Demographic characteristics

Gender

59.7

83.9

60.6

40.3

16.1

39.4

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Passamaquoddy Somali Mainstream

Male

Female

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Preparedness

Feel safe

ObjectiveSubjective

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Objective Measurements 32

English Proficiency

English Level

0

20

40

60

80

100

Passamaquoddy Somali Mainstream

%

English Speaking

Understands English

Reads English

Reads Newspaper

**

**

*p<0.001, Fisher exact test

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Cultural Background

Cultural background

0%

20%

40%

60%

80%

100%

Passamaquoddy Somali Mainstream

%

Keep all rituals

Keep religious objects

Consults spiritual leader

**

*

**

*p<0.001, Fisher exact test

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Past experiences with disaster

Have you ever been involved in a crisis?

0

10

20

30

40

50

60

70

80

90

100

Passamaquoddy Somali Mainstream

%

Car accident

Hurricane

Flood

War

Terrorist attack

Earthquake

** *

*

* *

*p<0.001, Fisher exact test

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Access to Information

Where would you go to get information in case of crisis?

0

10

20

30

40

50

60

70

80

90

100

Passamaquoddy Somali Mainstream

%

Internet

TV (Media)

Family

Friends

Police/Army

Neighbor

*

**

*p<0.005, Fisher exact test

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Definition of Objective Preparedness

Composite endpoint includes at least 3 of the following:

English Proficiency

Access to information

Received information from the government

Trust in police, government or politicians

Family Emergency Behavior

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Subjective Measurements38

Risk perception

Do you think you are at risk of the following?

0

20

40

60

80

100

Passamaquoddy Somali Mainstream

%

Ice storm

Fire

Hurricane

Terrorist attack

War

Pandemic Flu

**

* *

*p<0.05, Fisher exact test

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Risk perception

Risk Perception

0.0

0.2

0.4

0.6

0.8

1.0

Passamaquoddy Somali Mainstream

%

4-6 Risks

1-3 Risks

No Risk

*

*p<0.001, Fisher exact test

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Preparedness-Summary

Do you feel safe or prepared?

0

20

40

60

80

100

Passamaquoddy Somali Mainstream

%

Feel safe?

Feel prepared to dealwith threats?

Objectively Prepared

**

*

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Preparedness

Sig. Odds Ratio

95% C.I. for OR

Lower Upper

Culture 0.005

Passamaquoddy 0.157 2.2 0.7 6.9

Somali 0.001 10.3 2.5 42.4

Risk perception 0.033

Low Risk 0.030 5.0 1.2 21.7

High Risk 0.009 8.0 1.7 37.8

Age 0.122 1.0 0.9 1.0

Female vs. Male 0.014 2.9 1.2 6.9

Constant 0.038 0.1

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Strengths

The study contributes data to a virtually untouched area. This analysis allows “the voice of the people” to be

heard. The study has strengthened relationships and

cooperation between the communities. It has introduced mainstream communities and public

disaster organizations to the unique social infrastructure of these collectivist cultures.

It will help build culturally competent disaster management plans that will save lives and minimize damage should a disaster occur.

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Limitations

Difficulty in communicating with the Somali population (Lack of English Proficiency)

Lack of male representation in the surveys of Somali population.

Distrust of surveys amongst the Passamaquoddy.

Use of cultural brokers/translators allows self interpretation of answers to survey questions.

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Limitations

Due to the fact this was a convenience sample it may not be representative of the community which complicates the ability to generalize the results.

Difficulty in immersing one’s self into the communities researched

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Discussion

The data raises many questions and further

investigation is needed.

To maximize the networking abilities of the female members of the community, to minimize domestic violence ,to maximize the “mother hen effect” it can beneficial to empower these women to manage the communication networks in their community in preparation for emergency.

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Conclusions

Based on the analysis of the data, it is possible to pinpoint specific areas where intervention and training can be implemented to increase community preparedness levels i.e. access to information through community based communication networks, use of gatekeepers

A benchmark database has been established for further studies

Baseline data identifies emergent issues

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Conclusions

There are differences between cultural minorities and mainstream in the level of preparedness

By understanding the concept of preparedness and its link to culture, disaster managers will be able to reduce risks and save lives.

The data will be utilized by the Office of Minority Health and MEMA to develop protocols for these populations

The data supports the hypothesis.

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References

De Vries, Marten W. 1995. Culture, community and catastrophe: Issues in understanding communities under difficult conditions. Extreme Stress and Communities: Impact and Intervention. NATO ASI series. Norwell, MA, Kluwer Academic Publishers(pp.375-393)

Drabek , T.E. 1986 Human responses to disaster: an inventory of social findings. NY: Springer-Verlag.

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References

Levit , N. & Verchick, R.(2006) The Feminist Legal Theory.

OXFAM Report Weathering the Storm: Lessons in Risk Reduction from Cuba.(2004) http://www.oxfamamerica.org/newsandpublications/publications/research_reports/art7111.html

Posner, R. (2006) Not a Suicide Pact: The Constitution in a Time of National Emergency.

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Ancient Chinese Fable

A monkey and a fish were caught in a terrible flood and were being swept downstream amidst torrents of water and debris.

The monkey spied a branch from an overhanging tree and pulled himself to safety from the swirling water.

Then, wanting to help his friend the fish, he reached into the

water and pulled the fish from the water onto branch.

The moral of the story is clear: Good intentions are not enough.

If you wish to help the fish, you must understand its nature.

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Thank You For more information :

lippmannamy@gmail.com

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