Review of a disaster preparedness training for tribal leaders

Disaster Preparedness Training for Tribal Leaders http://www.occup-med.com/content/pdf/1745-6673-3-2.pdf (pdf file format)

Describes a disaster preparedness training program for tribal leaders conducted in Arizona. Discusses the role of cultural competency, respect for tribal sovereignty, solicitation of historical examples of indigenous preparedness, and incorporation of tribal community networks in the success of the program.

Date: 2008
Journal: Journal of Occupational Medicine and Toxicology Volume: 3 Issue: 2

from The Rural Assistance Center– a collaborative effort of the University of North Dakota Center for Rural Health, and the Rural Policy Research Institute (RUPRI) funded by a grant through HRSA’s Office of Rural Health Policy. All listings contained in this e-mail can also be accessed from the Rural Assistance Center Web site, Go to http://www.raconline.org/listserv/health/011708.html

• http://www.raconline.org

The Challenges section is very important– pointing out the disadvantages of the “usual approach” to working with tribes (and why grassroots science or community-based programs would be better)

Challenges
There were several challenges to implementing the trainings in the field. These were mostly created by the very short timeline for the project due to funding restrictions. This meant there was little time to visit in the field with key stakeholders and to further encourage participation. As a result, the identification of the training participants was left almost entirely to the BT Coordinator for each tribe. Given the newness of many of these individuals to a newly created role, not all of these coordinators were well integrated into their local public health system. Some were not based within their health programs, but rather operated out of their emergency management departments. As a result several trainings had limited public health personnel participation.

Additionally the scope of the project was very broad as it encompassed all five regions within the state, and required cooperation between tribal, county and federal agency counterparts. Fragmentation within each local public health system resulted in some communication breakdowns and last minute requests.

Other challenges to participation in the training included limited resources available to the tribes. In some cases there were no travel funds for relevant personnel to attend the training session. In other instances, public health emergency preparedness and issues of bioterrorism were not considered priorities particularly compared other competing needs facing under-funded tribal health programs. Subsequently, there were several of the tribes whose BT coordinators and public health personnel were not represented at the training.

In regards to the curriculum, a “one-size fits all” approach created some challenges to meeting the needs of the audience. Due to the diverse backgrounds, roles and skills sets of the participants it was difficult to find the right pitch for all. For some it was too basic and for others too advanced. The content areas required for each module were very broad and it was difficult to present all the content comfortably in three half-day sessions.

Related content (off-site)–
Cooperative Extension Work in Indian Country
Public involvement how-to readings
Developing Minority Community Capacity in Environmental Health & Hazardous Substances
Biocultural Dimensions of Environment and Health

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More emergency and disaster preparedness (special populations)

Special Populations: Emergency and Disaster Preparedness

from the great Bringing Health Information to Communities (see sidebar, BHIC)

A new Web page that addresses emergency and disaster preparedness and special populations has been added to the National Library of Medicine (NLM) Enviro-Health Links to selected Web sites featuring emergency preparedness for special populations. This includes people with disabilities, people with visual or hearing impairments, senior citizens, children, and women. Links to information in languages other than English are also provided.

• Special Populations: Emergency and Disaster Preparedness
  http://sis.nlm.nih.gov/outreach/specialpopulationsanddisasters.html

* Disabled
* Seniors
* Hearing Impaired
* Visually Impaired
* Women and Gender
* Pregnancy
* Children
* Diabetes
* Native Americans
* Foreign Language Materials
* Información en Español
* Guidance for Organizations and Governments
* Guidance for Employers
* Law and Policy
* Lessons Learned from Prior Disasters
* Searches from the National Library of Medicine

See related resources
Top 50 reading list for emergency managementFederal toolkit to promote local pandemic preparedness

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Baby care handwashing

Lynne asks how old a baby can be before a caregiver (or stranger) cuts back on frequency of handwashing before touching the child.

I haven’t kept up with the latest pediatric advice. I would check with a doctor first or the university extension program, especially about a specific baby. Surprisingly, this is another topic difficult to locate specifics for implementation. I suspect the information needed (with supporting documentation) is there, just locked behind subscriptions and as an unfunded person I can’t get to it.

Lynne’s question is really about assessing risk. Here are general guidelines.

• Age-related development terms are: Newborns or neonates are under 1 month old; Infants or babies are usually 3 months to 18 months; toddlers 12-2 years
• Situation posed by Lynne is likely–
  “Normal” or routine baby maintenance
  involving some strangers and family
  with or without other babies around
  We aren’t talking about neonates (newborn) nor day care and play groups nor nurseries. We aren’t speaking of health care providers (who are exposed to many ill people).

In general, my guess would be 18 months is an age when others can resume everyday handwashing, certainly no sooner than 12 months or whenever infants can get around on their own (crawling or scooting). Their immune system should be in good shape then. If I remember my development biology correctly, babies get some immunity protection from their mothers for the first few months, while they switch over to their own developing system. However, getting born is a shock. Babies even experience a growth suppression then growth spurt. A lot is going on with them, so hand hygiene by others is important.

I would think there are three four main considerations–
* everyone should practice good hygiene (not excessive germ phobia) because as people we share our environment This includes keeping the living areas clean and dry.
* babies usually have pretty intimate contact with others (diapers, kissing, sharing food, sharing toys, mouthing everything) so others need to be aware of how they transmit germs to babies (don’t share chewed food or teething toys, for example)
* babies are developing their own immune systems. They need exposure to the normal environment, but intense exposure or exposure to contaminated environments can overwhelm.
* if you live in a community with an ongoing outbreak of salmonella, listeria, RSV, pneumonia, TB, norovirus, etc. and / or difficult access to clean water, then be extra vigilant with hand hygiene. see related, Give germs the boot, not our babies: unwashed hands make everyone sick

As babies get older, regular hand hygiene *by everyone* should be sufficient (by everyone is the key) for simple contact with the baby. That is, wash hands after bathroom use, after food preparation, after returning home from work, after contact sports, after petting the cow, etc.

I’m not real happy with this answer because I think it is too general. However, I’ll keep looking. I don’t really trust a lot of those new baby books either, but I don’t have access to their science to evaluate them. If anyone runs across a better suggestion, please let us know.

Protecting Against Flu - Infant Care
http://www.cdc.gov/flu/protect/pdf/infantcare.pdf

for hcw (health care workers) http://www.cec.health.nsw.gov.au/campaigns/cleanhandssavelives/documents/FAQ020207.pdf

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New scientific summary of flu transmission and protection

Influenza and Personal Protective Respiratory Equipment

The Council of Canadian Academies was asked by the Government of Canada to undertake an assessment on the modes of transmission of influenza and the contribution of respirators or surgical masks towards inhibiting the spread of the virus.

Question: How and where is influenza (both seasonal and pandemic) transmitted? Based on the conclusions of this review, what is the contribution that N95 respirators or surgical masks will make in the prevention of transmission of influenza?

in pdf file format
The Complete Report (0.98 mb)
Report in Focus (235 kb)
News Release (102 kb)

• http://scienceadvice.ca/influenza.html

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Castor oil soap and Dettol Lysol

My apologies for not returning sooner to Mr. M. Manogaran’s interesting query left as a comment at
http://ykalaska.wordpress.com/2006/05/03/disinfectants-for-camp-field-and-household/ (Scrounging for funds interferes with interesting work.)

Kindly write to the %age proportion of Castor Oil Soap-35% being used to formulate Antiseptic Liquid Like Dettol.

I think the interest is in
* why is there soap in a disinfectant and
* why is the soap made from castor oil?

If I have failed to ask and/or answer your questions correctly please let me know. If anyone can provide additional references or a better discussion, please note in the comments.

Unfortunately, I am not an organic chemist so I can’t give great detail. But here is what I think is the short answer. The soap is used to keep the germicide (cresol or phenol) in solution until it is mixed with water for actual use (the cloudy mixed result indicates the phenol compound becoming suspended rather than dissolved). Soap is made from a fat or oil and an alkali. Castor oil has particular physical properties which make it a good molecule for making the soap to interact with the cresol/phenol molecule.

The liquid concentrate of Dettol ® and brown-bottle Lysol ® are composed of a phenol or cresol compound, alcohols, pine oil (Dettol®) and “other ingredients” which are soap, water, and caramel for coloring. When first introduced to Britain, the formula for Lysol was 50% cresol and the rest liquid soap. Lysol was so important that its commercial formula was legally established in the British Pharmacopoeia and in 1934 court standards “held that Lysol must contain 47 to 53 per cent. of cresols”. ["To use this [fake] article as a disinfectant might be worse than using none at all; its use would give a false feeling of security.”
http://www.rsc.org/delivery/_ArticleLinking/DisplayArticleForFree.cfm?doi=AN9345900691 (pdf file)]

I have added below some references for further examination but in particular the chemical references or databases used for the lay term lysol, Lysol ® and Dettol ®. I have tried at the end to give the identification numbers for the compounds under discussion. These ID numbers, for example the CAS number, are unique to a chemical compound. The use is similar to the binomial scientific name used to specify which of the very many different plants in different cultures that have the same common name.

CAS REGISTRY and CAS Registry Numbers. The CAS REGISTRY is the largest and most current database of chemical substances [...] http://www.cas.org/expertise/cascontent/registry/regsys.html

These databases can also be searched for the chemical or toxic properties of other chemicals. The Chemical Abstract Service (CAS) the 100-year old database of the American Chemical Society, is an excellent resource but only available for a fee. There is a comparable US Pharmacopoeia (USP) and a British Pharmacopoeia (BP) but perhaps someone else can locate the Internet links to these databases.

Skip to
• General Notes
• Lysol / Dettol
• Castor oil soap
• Resources (** are especially good to start with)
• Castor oil
• Soap
• Historical
• Lysol Dettol chemistry

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Federal toolkit to promote local pandemic preparedness

CIDRAP which has been recommended before points to a new effort of the US government to get local governments busy participating in community preparedness.

HHS offers tools to promote local pandemic preparedness, http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/dec0407toolkit2.html

He said the gap between what public health experts know and what the public knows about pandemic planning is still very large, and more work is needed, particularly on community mitigation efforts that may be needed in a severe pandemic, such as school closures and student dismissals.

One component that seems to be missing from the HHS toolkit is a plan for distributing it to community leaders who are well positioned to use the materials, Dworkin said. “As of right now, they are available online, but who knows about them? How will community leaders, school boards, and others learn about their existence?” he asked.

Answer: readers please talk this up among your tribal councils and churches. Maybe eventually the school districts and regional hubs (such as Bethel) will get busy.

HHS pandemic planning toolkit for community leaders
http://www.pandemicflu.gov/takethelead/index.html

“Tools
Talking Points Fact Sheets
Pandemic Flu Preparedness (PDF - 53.05 KB) Pandemic Flu Basics (PDF - 59.75 KB)
How to Get Your Peers Involved (PDF - 58.56 KB) Community-Based Interventions (PDF - 51.42 KB)

Checklists Sample Newsletter Articles
Pandemic Flu Preparedness (PDF - 64.29 KB) Pandemic Flu Preparedness (PDF - 44.54 KB)
Stocking Food and Supplies (PDF - 65.27 KB) Stocking Food and Supplies (PDF - 67.04 KB)
Food and Supplies Drive (PDF - 66.72 KB) Good Health Habits (PDF - 55.05 KB)
How to Get Involved (PDF - 45.5 KB)
Sample E-mails
Pandemic Flu Preparedness (PDF - 46.71 KB) Posters
Stocking Food and Supplies (PDF - 65.27 KB) Cover Your Cough (PDF - 90.72 KB)
Good Health Habits (PDF - 46.96 KB) Food Drive Template (PDF - 51.8 KB)
How to Get Involved (PDF - 45.15 KB)
‘Chain’ E-mail (PDF - 50.39 KB)

Resources
Incentive Ideas (PDF - 49.2 KB)
Links to Internet Resources (PDF - 47.93 KB)

Complete ‘Take the Lead’ Toolkit (PDF - 377.34 KB)”
http://www.pandemicflu.gov/takethelead/index.html

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Mass disease pass, 2007

One of the Tundra Teachers ** I read was able to take advantage of the flu shot clinic this weekend. Actually, it was the mass dispensing exercise to demonstrate disaster preparation in the region, held for the second year.

• Does mass dispensing exercise prove disaster readiness
• Illustrations of public involvement (risk communication) related to H5N1 avian flu or pandemic preparedness

Unbelievably, the 2nd prize again this year is a pass to the “emergency shelter” which still doesn’t exist. First prize is the free shot, which this year should be an effective shot (last year it wasn’t sure the vaccines had been kept at the proper temperature so, letters were issued to come in again later. The elders who go to the senior center will get their flu shots next week, just before Thanksgiving. Elders don’t get flu shots earlier in the season, depending on how much vaccine the state sends out to us.)

I can see how someone last year must have thought it was “more authentic” to issue a pretend pass to a non-existent shelter; unacceptable but plausible. But, again? Who has the authority to declare an Infectious Disease Outbreak? Why is there a non-existent shelter for disease outbreaks and not for flooding, electrical explosion, chemical fire? What happens if a member of your family or a neighbor didn’t get a flu shot at the mass dispensing– Will they be denied access to the non-existent shelter? What if I lend my card to an elder? Can I bring my active TB?

How effective are official false hope and rumors in risk communication, preparedness, and disaster mitigation? What will you E-mail the Governor?

“Sunday, November 4, 2007
Get a Flu Shot

They were giving out free flu shots at the National Guard Armory yesterday, so Avery and I went and got one. The interesting thing about this is that once we got done with our flu shots, we received an interesting card. It’s a business card from the State of Alaska and the YKHC (Yukon Kuskokwim Health Corporation) and this is what it says….”

http://alishaadventures.blogspot.com/2007/11/get-flu-shot.html

see previous

• More questions to ask: church responsibilities in case of pandemics
• Bird Flu: Communicating the Risk, Sandman & Lanard
• Getting Results from Your Experts
• Resources to Understand Epidemiology & Disease Ecology
• British teachers use Suffolk H5N1 outbreak
• Top 50 reading list for emergency management

[Tundra Teachers** are a mix RSS feed in the sidebar here and individually at the Edublogs site So many teachers qualify this year (blogs from teachers in the Arctic and sub-Arctic) that I am behind in posting links.]

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Living with climate change: are there limits to adaptation?

Even if readers don’t wish to present a paper at this conference, the question is well worth considering by communities. What are your priorities as family or community?

Living with climate change: are there limits to adaptation?

The Tyndall Centre for Climate Change Research and the University of Oslo, with the support of the Global Environmental Change and Human Security (GECHS) project, announce a two day international conference to be held on 7 and 8 of February 2008 at the Royal Geographical Society in London. The title of the conference is “Living with climate change: are there limits to adaptation?” The overall objective of this conference is to consider strategies for adapting to climate change, in particular to explore the potential barriers to adaptation that may limit the ability of societies to adapt to climate change and to identify opportunities for overcoming these barriers. The conference is aimed at researchers and practitioners with an interest in understanding how societies adapt to climate change.

Keynote speakers include: Garry Peterson, McGill University; Benjamin Orlove, University of California; Susanne Moser, National Center for Atmospheric Research (NCAR) See:
http://www.tyndall.ac.uk/research/programme3/adaptation2008/index.html

see also

Adaptation Planning in Arctic Communities

Less talk, more action on climate change

On-line health environment (biocultural science and adaptation) bibliography

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Bethel area: upcoming prep preparation 2007

• [deadline] Oct 25, 26 2007
• Nov 3 2007

Mass disaster training is scheduled for October 25 and 26, 2007 (Thursday and Friday) at the Cultural Center. I don’t have any notices about it but I did see a flyer at the post office and two months ago there was a brief mention on KYUK radio. The training may be similar to the state training last year, which also included NIMS (National Incident Management System) which is very good training.

I think the training is provided only by the state and not by the hub City of Bethel nor by the tribal governments.

• Kuskokwim “tabletop” exercise

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Another mass vaccination clinic is planned for November 3, 2007. Contact Public Health in Bethel for information. There is plenty of vaccine this year and the shots are available for $25 again this year, unless you go to the mass disaster clinic get one for free.

see previous posts,

• Does mass dispensing exercise prove disaster readiness
• Mass dispensing exercise (free flu shots) Oct. 28
• Flu-Season Wealth of Vaccine

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How even a 4 year old can plan for disasters

So, why can’t your city or tribal government?

Going by the book: 4-year-old calls 911, stays calm after mother falls ill

The day of Tony’s 911 call was like any other day in the Sharpe household, which is located off Badger Road….

While Courtenay lay on the floor in agony and barely conscious, her son called 911, drawing help from the North Star Volunteer Fire Department… “Can you call the ambulance?” he asked the dispatcher. “When Daddy gets here, Daddy will see if there’s something wrong with mommy,” he added.

The 4-year-old described the family’s apartment building as white with a blue roof.

Deidre Savarino was wandering the toy aisle, as grandmothers do, at a St. Louis store when she came across a book with a bright red cover and a telephone dial pad.

“It’s Time to Call 911: What to do in an Emergency” seemed like the perfect read for Savarino’s grandson, Tony, an inquisitive 3-year-old whose mother suffers from asthma. Savarino bought the book and mailed it to her grandson, who is now 4 and lives in North Pole.

Read the story and listen to the 911 call [...]

• http://newsminer.com/2007/04/29/6736

The book is
It’s Time to Call 911: What to Do in an Emergency (It’s Time to) (Board book) by Inc. Penton Overseas (Author)
# Reading level: Baby-Preschool
# Board book: 16 pages
# Publisher: Penton Overseas; Bk&Acces edition (January 3, 2005)
# Language: English
# ISBN-10: 1591252741
# ISBN-13: 978-1591252740
# Product Dimensions: 7.3 x 7 x 0.5 inches

• http://www.amazon.com/Its-Time-Call-911-Emergency/dp/1591252741

If you listen to the 911 call, you will note that the dispatcher asks some yes-no questions that are not very helpful. For example, “Can I speak with your mommy?” “Yes” which is true but mommy couldn’t speak because she was unconscious. On the other hand, there were some very good questions, too, from which a 4-year old could convey information.

From the description of the book, it is built on a number of clear learning principles for young children. Another excellent brief source, with practice ideas and games, for families from,

http://www.familytlc.net
• SAFETY BEGINS AT HOME (pdf file) http://www.everydaytlc.com/sept06ccbnc/SeptemberTLC06/September18_TLC.pdf

Add this to Bookmarks:

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