Louisiana Public Health Emergency Preparedness

Louisiana Earns Perfect Score in Public Health Emergency Preparedness

State is tops in readiness for health emergencies

Tuesday, September 20, 2011  | 

Contact: Bureau of Media & Communications (225) 342-7913

 

BATON ROUGE, La.—For the second consecutive year, Louisiana scored a perfect 100 on the Centers for Disease Control and Prevention's (CDC) evaluation of the state's public health emergency preparedness and response capabilities. Louisiana and seven other states scored 100 two years in a row. Louisiana's public health laboratories also received exemplary marks. The CDC's "Public Health Preparedness: 2011 State-by-State Update on Laboratory Capabilities and Response Readiness Planning" report released today evaluates the state over a three-year period, from 2007-2010.

Louisiana Department of Health and Hospitals (DHH) Secretary Bruce D. Greenstein says the report reaffirms what he saw in action during the recent Pearl River fish kill, New Orleans marsh fires and Tropical Storm Lee. "Governor Jindal has challenged every state agency to execute our disaster preparedness and response functions flawlessly. I am so proud of our team at DHH, our sister agencies and all of our partners who have together proved that Louisiana is tremendously well prepared to respond to a health crisis. Whether it's been in the face of a hurricane, an oil spill or a pandemic flu, they have proven that fact time and again," Greenstein said.

DHH's Center for Community Preparedness Director Doris G. Brown, RN, MEd, MS, CNS, said the perfect score is a direct reflection of the hard work of the state and its partners through the Public Health Emergency Preparedness Cooperative Agreement between the Office of Public Health, the federal Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services' Hospital Preparedness Program. "We plan and train with our partners so that when we are faced with a man-made or natural disaster we are ready," Brown said.

In the report, all 50 states and 4 localities directly funded by the Public Health Emergency Preparedness Cooperative Agreement were graded on their ability to effectively receive and distribute the CDC's Strategic National Stockpile (SNS), a cache of drugs and medical supplies to protect the American public if there is a public health emergency severe enough to cause local supplies to run out. The CDC and state public health departments conduct annual technical assistance reviews (TAR) to assess emergency preparedness plans for receiving, staging, storing, distributing and dispensing the SNS to ensure continued readiness for all disasters. The state must attain a score of 79 or higher in order to continue to receive preparedness funding from the federal government.

The report also evaluated states' public health laboratories. The DHH labs received high marks for their ability to test for and detect chemical and biological agents and their ability to assist DHH epidemiologists in carrying out epidemiological surveillance for early detection of potential threats. The DHH labs test daily for bacteria in foods and human samples to ensure rapid response to public health emergencies. The labs also help the state's public drinking water systems maintain federal Safe Drinking Water Act standards by testing for contamination. The state has four public health labs.

The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens.

To learn more about DHH, visit http://www.dhh.louisiana.gov/.

For up-to-date health information, news and emergency updates, follow DHH's blog, Twitter account and Facebook.

Trauma: Grant Funding. Crisis Counseling Assistance

https://www.rkb.us/contentdetail.cfm?content_id=56827

Crisis Counseling Assistance and Training Program  

Department of Homeland Security

Source: Department of Homeland Security (DHS)/ Federal Emergency Management Agency (FEMA)

 

Summary:

 

The Crisis Counseling Assistance and Training Program (CCP) provides supplemental funding to States, U.S. Territories and Federally recognized tribes for technical assistance and training as well as short-term crisis counseling services to individuals impacted by a Presidentially-declared major disaster that includes Individual Assistance.

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Objectives

 

To provide immediate crisis counseling services, when required, to victims of a major Federally-declared disaster for the purpose of addressing mental health problems caused or aggravated by a major disaster or its aftermath. Assistance is short-term in nature and provided at no cost to the disaster victims.

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Deadlines

 

The CCP consists of two grant programs, the Immediate Service Prorgram (ISP) and the RSP (Regular Service Program). The ISP provides funding for up to 60 days after the date of Presidential disaster declaration; while the RSP provides funding for up to 9 months from the date the RSP is awarded.  The CCP may be a year or longer in duration if it includes an RSP in addition to an ISP.  Many other disaster relief resources may have terminated services before the CCP. This is another aspect of the program that sets it apart from other approaches to disaster work. The ISP application is due 14 days after the date of the Presidential disaster declaration. The RSP application and ISP extension request are due 60 days after the declaration date and are followed by a Federal grant application review period, during which the ISP can be extended until a decision is made on approval of the RSP application.

Applying for the CCP

A completed and signed application and Federal forms are required to apply for the ISP or RSP. To apply visit www.mentalhealth.samhsa.gov/cmhs/emergencyservices/progguide.asp and follow the instructions to download the application materials. These application materials also can be found on the CMHS Web site at www.mentalhealth.samhsa.gov/ by searching for “CCP guidance.”

Applying for Both the ISP and the RSP

After a Presidential disaster declaration, States, U.S. Territories, and federally recognized Tribes may apply for the ISP. If a continuing need for services is demonstrated, an RSP application can then be submitted. However, States, U.S.Territories, and federally recognized Tribes may elect to apply for only the ISP. Before applying for either program, a qualified entity must determine the need for crisis counseling services by compiling disaster data and conducting a needs assessment, one of the most critical components of the CCP application.

Program Duration

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Description

 

For more than 30 years, Federal, State, U.S. Territory, and federally recognized Tribal governments have worked together with local providers to help disaster survivors recover from the effects of a disaster.  The CCP is a Federal, FEMA-funded program that provides supplemental funding to states, U.S. Territories, and federally recognized Tribes after a Presidential disaster declaration.  Through an interagency agreement, the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) Emergency Mental Health and Traumatic Stress Services Branch provides grant administration and program oversight, as well as training and technical assistance for state and local mental health personnel.

The CCP consists of services focused on preventing or mitigating adverse repercussions of a disaster.  This goal is achieved through the use of a prevention and public health approach.  Beginning with the most severely affected group and moving outward, the program seeks to serve a large portion of the population affected by the disaster.  Program services are community based and often are performed in survivor’s homes, shelters, temporary living sites, and churches.  CCP services include supportive crisis counseling, education, development of coping skills, and linkage to appropriate resources, while assessing and referring those members of the community who are in need of more intensive mental health and substance abuse treatment to appropriate community resources.  The CCP engages community gatekeepers and organizations through direct contact with stakeholder groups, such as unmet-needs committees, and participation in community events in order to facilitate response activities and services to survivors.  The CCP is designed to assist with community recovery and collaboration in order to transition from CCP services to existing community resources upon the phasedown of the program.

Account Identification: 70-0702-0-1-453.

INFORMATION CONTACTS:
Regional or Local Office: See Appendix IV of the Catalog for a listing of addresses for FEMA's Regional Offices.

Headquarters Office
Department of Homeland Security
245 Murray Drive, S.W.
Washington, D.C. 20528
Tel. (202) 282-8000.
Web Site Address: http://www.fema.gov/

Note: Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) Project Officers are available to provide technical assistance and consultation on the Crisis Counseling Assistance and Training Program (CCP).  If you would like to speak with a CMHS Project Officer, please contact the SAMHSA Disaster Technical Assistance Center (DTAC) at 1-800-308-3515 (Monday–Friday 9 a.m.–5 p.m. ET), and a staff member will forward your request to the appropriate Project Officer. CCP applications, supplemental instructions, and guidance documents are available on the Web at: www.mentalhealth.samhsa.gov/cmhs/emergencyservices/progguide.asp.

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Type of Assistance: Grant

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Eligibility
Applicant Eligibility: States are eligible for grants.  If the Governor determines, during an assessment of the need for crisis counseling services, that because of unusual circumstances or serious conditions within the state or local mental health network, the state cannot carry out the crisis counseling program, he/she may identify a public or private mental health agency or organization to carry out the program or request the Department of Homeland Security's Federal Emergency Management Agency (FEMA) Regional Director to identify, with assistance of the Secretary of the Department of Health and Human Services (DHHS), such an agency or organization.

Beneficiary Eligibility: In order to be eligible for services under this program, an individual must be a resident of the designated disaster area or must have been in the designated area at the time the disaster occurred.

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Grant Information Source:
Department of Homeland Security (DHS)
245 Murray Ln - Bldg 410
Washington Dc 20528
Phone: 202-282-8000
Email: askcsid@dhs.gov
Website: https://www.rkb.us/leaving_site.cfm?location=http%3A%2F%2Fwww%2Edhs%2Egov

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Additional Information

• Crisis Counseling Assistance and Training Program Guidance

Trauma: Healing from Trauma.

 http://www.samhsa.gov/nctic/healing.asp#atrium

Healing from Trauma

Trauma-Specific Interventions

Following are some well-known trauma-specific interventions based upon psychosocial educational empowerment principles that have been used extensively in public system settings. Please note that these interventions are listed for informational and educational purposes only. NCTIC does not endorse any specific intervention.

Addiction and Trauma Recovery Integration Model (ATRIUM)
Essence of Being Real
Risking Connection
Sanctuary Model
Seeking Sanctuary
Trauma, Addiction, Mental Health, and Recovery
Trauma Affect Regulation: Guide for Education and Therapy (TARGET)
Trauma Recovery and Empowerment Model (TREM and M-TREM)

 

Addiction and Trauma Recovery Integration Model (ATRIUM)

ATRIUM is a 12-session recovery model designed for groups as well as for individuals and their therapists and counselors. The acronym, ATRIUM, is meant to suggest that the recovery groups are a starting point for healing and recovery. This model has been used in local prisons, jail diversion projects, AIDS programs, and drop-in centers for survivors. ATRIUM is a model intended to bring together peer support, psycho-education, interpersonal skills training, meditation, creative expression, spirituality, and community action to support survivors in addressing and healing form trauma.

Dusty Miller, author and creator of ATRIUM, is available for training, consultation, workshops, and keynote presentations. She works with groups that address issues of self-sabotage, traumatic stress, trauma re-enactment, substance abuse, self-injury, eating disorders, anxiety, body-based distress, relational challenges, and spiritual struggles.

For more information, visit www.dustymiller.org or contact:
Dusty Miller, Ed.D.

dustymi@aol.com

 

Essence of Being Real

The Essence of Being Real model is a peer-to-peer structure intended to address the effects of trauma. The developer feels that this model is particularly helpful for survivor groups (including abuse, disaster, crime, shelter populations, and others), first responders, and frontline service providers and agency staff.
The developer feels that this model is appropriate for all populations and that it is geared to promoting relationships rather than focusing on the “bad stuff that happened.”

The Sidran Institute provides educational materials, training, and implementation support.

For more information, visit www.sidran.org or contact:
Elaine Witman
P: 410-825-8888 x211
elaine.witman@sidran.org

 

Risking Connection®

Risking Connection is intended to be a trauma-informed model aimed at mental health, public health, and substance abuse staff at various levels of education and training. There are several audience-specific adaptations of the model, including clergy, domestic violence advocates, and agencies serving children.
Risking Connection emphasizes concepts of empowerment, connection, and collaboration. The model addresses issues like understanding how trauma hurts, using the relationship and connection as a treatment tool, keeping a trauma framework when responding to crises such as self-injury and suicidal depression, working with dissociation and self-awareness, and transforming vicarious traumatization.

The Sidran Institute provides educational materials, training, and implementation support.

For more information, visit www.riskingconnection.org or contact:
Barbara Levin
P: 410-825-8888 x206
training@sidran.org

 

Sanctuary Model®

The goal of the Sanctuary Model is to help children who have experienced the damaging effects of interpersonal violence, abuse, and trauma. The model is intended for use by residential treatment settings for children, public schools, domestic violence shelters, homeless shelters, group homes, outpatient and community-based settings, juvenile justice programs, substance abuse programs, parenting support programs, acute care settings, and other programs aimed at assisting children.

The developer indicates that the Sanctuary Model’s approach helps organizations to create a truly collaborative and healing environment that improves efficacy in the treatment of traumatized individuals, reduces restraints and other coercive practices, builds cross-functional teams, and improves staff morale and retention.

The Sanctuary Leadership Development Institute provides on-site assessment, training, and implementation support.

For more information, visit www.sanctuaryweb.com or contact:
Sarah Yanosy, LCSW
P: 914-965-3700 x1117
syanosy@jdam.org

 

Seeking Safety

Seeking Safety is designed to be a therapy for trauma, post-traumatic stress disorder (PTSD), and substance abuse. The developer feels that this model works for individuals or with groups, with men, women or with mixed-gender groups, and can be used in a variety of settings (e.g. outpatient, inpatient, residential).

The developer indicates that the key principles of Seeking Safety are safety as the overarching goal, integrated treatment, a focus on ideals to counteract the loss of ideals in both PTSD and substance abuse, knowledge of four content areas (cognitive, behavioral, interpersonal, and case management), and attention to clinician processes.

Seeking Safety provides on-site training sessions and telephone consultation.

For more information, visit www.seekingsafety.org or contact:
Lisa Najavits
P: 617-731-1501
info@seekingsafety.org
Back to the top

 

Trauma, Addiction, Mental Health, and Recovery

Developed as part of the first phase of the SAMHSA Women, Co-Occurring Disorders and Violence Study, TAMAR Trauma Treatment Group Model is a structured, manualized 15-week intervention combining psycho-educational approaches with expressive therapies. It is designed for women and men with histories of trauma in correctional systems. Groups are run inside detention centers, in state psychiatric hospitals, and in the community.


The Trauma Addictions Mental Health and Recovery Treatment Manual provides basic education on trauma, its developmental effects on symptoms and current functioning, symptom appraisal and management, the impact of early chaotic relationships on healthcare needs, the development of coping skills, preventive education concerning pregnancy and sexually transmitted diseases, sexuality, and help in dealing with role loss and parenting issues.

For more information contact:    Marian Bland, LCSW-C
Maryland Mental Hygiene Administration
p: 410-724-3242
blandm@dhmh.state.md.us

 

Trauma Affect Regulation: Guide for Education and Therapy (TARGET)

TARGET is a model designed for use by organizations and professionals with a broad range of experience with and understanding of trauma. The developer feels that TARGET works with all disciplines and can be used in all levels of care for adults and children.

The developer indicates that TARGET is an educational and therapeutic approach for the prevention and treatment of complex Post Traumatic Stress Disorder (PTSD). The developer feels that this model provides practical skills that can be used by trauma survivors and family members to de-escalate and regulate extreme emotions, manage intrusive trauma memories experienced in daily life, and restore the capacity for information processing and memory.

The University of Connecticut’s Research and Development Corporation is creating a behavioral health service company to provide training and consultation in the TARGET model which will include training, long-term small group consultation, quality assurance, and program evaluation.

For more information, visit www.ptsdfreedom.org or contact:
Julian Ford, Ph.D. or Judith Ford, M.A.
P: 860-679-8778 or 860-679-2360
ford@psychiatry.uchc.edu or fordj@psychiatry.uchc.edu

 

Trauma Recovery and Empowerment Model (TREM and M-TREM)

The Trauma Recovery and Empowerment Model is intended for trauma survivors, particularly those with exposure to physical or sexual violence. This model is gender-specific: TREM for women and M-TREM for men. This model has been implemented in mental health, substance abuse, co-occurring disorders, and criminal justice settings. The developer feels this model is appropriate for a full range of disciplines.

Community Connections provides manuals, training, and ongoing consultation in TREM and M-TREM.

For more information, visit www.ccdc1.org or contact:
Rebecca Wolfson Berley, MSW
P: 202-608-4735
rwolfson@ccdc1.org

Snow removel and exercise. Community Participation. Whole Community Approach

SNOW EMERGENCIES.   “ONE BLOCK AT A TIME.”

Many individuals treat snow emergencies as just an inconvenience or interruption to normal individual and community routines.  But, snow emergencies have physical & mental health, financial and economic impacts on a community.   

Treating snow emergencies with the same planning requirements, and preparedness as earthquakes, tornadoes, flooding, and man-made disasters will contribute to decreasing health effects, and the financial and economic impacts.   

Communities can plan block traffic parking patterns, and block snow removal plans that can greatly increase the movement of neighbors and emergency personnel.  Planning with public safety and transportation departments on snow removal plans have to be considered long before these events occur.   

A weekend snow emergency exercise with neighbors can provide assurance that each neighbor knows what will be the procedures for parking, snow shoveling, and assistance to those that are unable to remove even small amounts of snow due to physical limitation.   

Contact your local public safety, transportation, or other authority for snow removel on public roads and residential areas.  Communities with home owner or other residential associations have snow removal plans.  Contact them for snow removal patterns in your area.

Recovery from Disasters. Secondary Effects. Sanitation.

http://new.paho.org/disasters/index.php?option=com_content&task=view&id=543&Itemid=904

Cholera in Disaster Situations

Cholera is an intestinal infection caused by toxigenic Vibrio cholerae, group O-1 or O-139. Natural and man-made disasters which produce overcrowding, a scarcity of safe drinking water, improper elimination of human waste, and the contamination of food during or after its preparation are risk factors for the spread of the disease.

Description

In areas where cholera has not been confirmed, a suspected case is defined as severe dehydration or death from acute watery diarrhea in a patient over 5 years of age.

In areas where an epidemic is under way, a suspected case of cholera is defined as acute watery diarrhea, with or without vomiting, in a patient over 5 years of age.

A confirmed case of cholera is defined as the laboratory-confirmed presence of V. cholerae 01 in any patient with diarrhea. Once the presence of the disease has been confirmed, it is unnecessary to examine specimens from all cases or contacts. Monitoring should include ongoing laboratory confirmation of a small proportion of cases.

It is important to adopt this definition. However, for clinical management of cases of acute watery diarrhea in an area in which an epidemic is under way, cholera should be suspected in all cases in patients aged 2 or older. It should be noted that in Central America, cholera primarily strikes adults, with 80% of the recorded cases representing individuals 5 years of age or older, while 80% of diarrheal diseases from other causes occur in children under 5.

There are more than 60 serogroups of Vibrio cholerae, but only the O1 serogroup causes cholera. V. cholerae occurs as two biotypes: classical and El Tor. Each biotype has two serotypes: Ogawa and Inaba. The El Tor biotype (first isolated in Egypt in 1905) is responsible for almost all the recent outbreaks of the disease, producing a greater proportion of asymptomatic infections than the classical biotype and surviving longer in the environment. This biotype can live in association with certain aquatic plants and animals, which makes water an important reservoir of the infection.

History of Cholera in the Region

The second cholera pandemic spanned the period 1826 to 1837. This was the first pandemic that ravaged England and Western Europe, causing thousands of deaths in early 1830. The epidemic spread to Canada, the United States, and Mexico in continental North America, to Guyana in South America, and to Cuba.

In January 1991 Vibrio cholerae 01 reached a town on the coast of Peru, trumpeting the arrival of the seventh cholera pandemic in Latin America. By the year 2000 the epidemic had spread to 21 of the 35 countries of the Region of the Americas, with Canada, Uruguay, and the Caribbean remaining free of the disease.

Moreover, in 1999 Argentina, Bolivia, Chile, Costa Rica, French Guiana, Guyana, Paraguay, Panama, and Suriname did not report cases of the disease.

In the 19th and early 20th century cholera was a predominantly urban phenomenon with high case-fatality rates (30-50%). In contrast, the Latin American epidemic of the 1990s was rural, with lower case-fatality rates (around 2%). The disease is also becoming endemic, and an incipient seasonal epidemiological model can be observed.

Risks for the Traveler

People who follow the usual tourist itineraries and observe food safety recommendations face practically no risk when visiting countries that have reported cases of cholera.

The 10 Most Frequently Asked Questions

Q. When we speak of cholera we often refer to it as a pandemic. What is a "pandemic"?
A pandemic is a disease that strikes the majority of the population in a large region, emerges simultaneously in different parts of the world, and is a long-term phenomenon.

Q. Is cholera as widespread and serious now as it used to be?
No. In the 19th century cholera was found in major cities, causing high case-fatality rates (30%-50%), while today the infection is often mild, self-limiting, or subclinical and is found in rural areas, with relatively low case-fatality rates (2%).

Q. What led to the changes in the model of the disease?
The following factors can be mentioned: (a) El Tor, a biotype of V. cholerae in circulation, which produces a greater proportion of asymptomatic cases than the classical biotype; (b) greater access to safe drinking water; (c) better excreta disposal systems; (d) health education, and (e) primary health care.

Q. Is it possible to contract V. cholerae through person-to-person contact?
It is possible, but this type of transmission is very rare.

Q. What are the main steps in managing a suspected case of cholera?
The main steps are: assess for dehydration, rehydrate with a solution of oral rehydration salts, observe the patient, replace missing fluids, administer oral antibiotics only to patients with serious dehydration, and feed the patient.

Q. Do we need a health system with a high level of complexity to treat cholera?
Fluids and simple electrolyte replacement therapy produce excellent results in the majority of cases. Serious cases may require antibiotics (doxycycline or tetracycline for adults; trimethoprim sulfamethoxazole for children). These interventions can be carried out at the primary level.

Q. Are travel and trade restrictions recommended in outbreaks of cholera?
No. Travel and trade restrictions between countries or between different areas of a country do not prevent the spread of cholera. Not only are they ineffective, they lead to the suppression of information on outbreaks of the disease. WHO modified its International Health Regulations in 1973 so that travelers would no longer be required to show a certificate of vaccination against cholera.

Q. Are vaccinations recommended for cholera control?
No. The traditional vaccine against cholera (based on whole, killed cells) is characterized by low levels of efficacy and high reactogenicity. Therefore, it is not recommended for the control of epidemics. The new vaccines might be considered, but with these, there is a rapid loss of protection, giving people a false sense of security. Resources should be channeled to the most useful control methods.

Q. How do we protect young children against cholera?
In infants under 6 months, breast-feeding protects against the disease. Careful preparation of formula and food with safe drinking water should protect infants who are not breast-fed.

Q. Is it mandatory to report cholera outbreaks?
Yes. The diseases listed as reportable by the International Health Regulations are cholera, yellow fever, and the plague. WHO publishes the data on cholera outbreaks in the Weekly Epidemiological Record; the CDC publishes its semiweekly "Health Information for International Travel" to inform the public about where cholera and yellow fever have been reported.

What to Do at the Institutional and Community Level

• Adopt long-term policies to ensure that all populations have access to adequate systems for excreta disposal and the provision of safe drinking water;

• Offer basic health services through primary health care systems. The majority of cholera cases respond well to simple therapies; Prescribe antibiotics only for cholera cases showing signs of severe dehydration;
• Monitor the susceptibility of V. cholerae to antibiotics; 
• Maintain specificity in reports, employing the case definitions developed by PAHO/WHO; 
• Update the epidemiological profile of areas with cholera or considered at risk for the disease; 
• Offer periodic training to physicians and paramedical personnel for the clinical management of patients with acute diarrhea; 
• Maintain a stock of essential emergency supplies, especially oral rehydration salts (ORS) and solution and appropriate antibiotics. 
• Maintain a buffer stock of drugs at appropriate points in the drug administration system; 
• Emphasize safe disposal of human excreta through health education; 
• Construct sanitary systems for human waste disposal, suited to the local conditions. 
• Promote community production of chlorine so that it can supply itself.
  

What to Do at the Personal Level

• Drink only safe water (tap water, boiled for a minute or more, or water that has been disinfected with chlorine or iodine tablets);
• Avoid raw food (except fruits or vegetables that can be peeled); 
• Cook food until hot both inside and out and eat while still hot; 
• Carefully wash and dry kitchen or serving utensils; 
• Wash hands carefully with soap after using the toilet and before preparing or eating food or feeding children; 
• In emergencies, while a better latrine is being constructed, a simple pit (0.3m x 0.3 m x 0.5 m) can be dug at least 30 meters from the well or other source of drinking water. Latrines should be located below the level of the water source. Avoid swampy ground.

What Not to Do

• Do not eat mollusks, shellfish, or other fish or seafood from polluted waters, unless they are cooked thoroughly;
• Do not eat raw vegetables; 
• Do not wash kitchen utensils or eat with water known to be contaminated; 
• Do not bathe in water known to be contaminated; 
• Do not mix raw food with cooked food; 
• Do not drink milk that has not been pasteurized, unless it has been boiled adequately; 
• Do not eat ice cream or use ice, unless it is from a safe source; 
• Do not take antibiotics, unless prescribed by a health worker; 
• Do not issue a quarantine in an effort to control the spread of cholera.
  

Suggested Readings

• "WHO Guidelines for cholera control", Revised 1992 WHO/CDD/SER.80.4 REV 4 (1992) Orig. English. Spanish version: "Lineamientos para el control del cólera".
• WHO "Guidance on formulation of national policy on the control of cholera" WHO/CDD/SER/92.16 REV.1 Original Spanish-English version: "Lineamientos de la OPS para formular una política nacional de control del cólera".
• WHO "Diarrhea management training course: guidelines for conducting clinical training courses at health centers and small hospitals" Geneva, WHO, 1990 WHO/CDD/SER/90.2 (English only)
• WHO "Guide to simple sanitary measures for the control of enteric diseases". Geneva, WHO, 1974 (English only)
• Manual for laboratory investigations of acute enteric infections. WHO/CDD/83.3 Geneva, WHO, 1987
• The treatment and prevention of acute diarrhea: practical guidelines. 2 ed. WHO, 1989 (Available in English, French, Portuguese, and Spanish)
• Manejo de los pacientes con cólera. WHO/CDD/SER/91.15 Rev. 1 (1992) Geneva, WHO, 1992
• CDC -Centers for Disease Control and Prevention "Health Information for International Travel" 1999-2000 DHHS, Atlanta, GA. On-line version.
• "Textbook of International Health" by Paul F. Basch (Chapter 1 - Historical Background) Department of Health Research and Policy, Stanford University School of Medicine. Oxford University Press (1990)
• La Investigación de las Dolencias Infecciosas en la Historia (Las seis primeras pandemias - pp 274-284) Arturo Romero B, MD Academia Colombiana de Ciencias Exactas, Físicas y Naturales. Colección Enrique Pérez Arbeláez, No. 12 Santafé de Bogotá, DC Colombia, 1997
  

Contact

Dr. Marlo Libel
Phone: (202) 974-3129
Email: libelmar@paho.org

REENTRY PROGRAM for Ex-Offenders & Disasters. ‘Whole Community Approach’

REENTRY PROGRAM for Ex-Offenders & Disasters.   ‘Whole Community Approach’

“Thinking outside the box.”

·        Can ex-offenders be utilized in all phases of the emergency management process for communities in recovering from disasters (natural, and man-made)?

·        Could the FEMI EMI community based online courses be used in the release\parole process, then be supplemented by direct Community Emergency Response Team (CERT) training upon release so that these individuals are a vital resource welcomed back into the community?

·        Is this an under utilized resource for community recovery?

In developing your community programs utilize all available resources for planning and long-term recovery.  The whole community approach encompasses using all members of your community for recovery, and providing assistance.  Senior citizens, the disabled, individuals, families, and businesses in your area must be included in your efforts.

For grant and funding opportunities take into consideration long-term part-time positions using these individuals.

Comments?

Disasters and Domestic Violence

http://www.ptsd.va.gov/professional/pages/disasters-domestic-violence.asp

Disasters and Domestic Violence 

Fran H. Norris, PhD

Prevalence and impact of domestic violence in the wake of disasters

Two questions require attention when considering the implications of domestic violence for postdisaster recovery.

The first question is whether domestic violence increases in prevalence after disasters. There are only minimal data that are relevant to this question. Mechanic et al. (1) undertook the most comprehensive examination of intimate violence in the aftermath of a disaster after the 1993 Mid-western flood. A representative sample of 205 women who were either married or cohabitating with men and who were highly exposed to this disaster acknowledged considerable levels of domestic violence and abuse. Over the 9-month period after flood onset, 14% reported at least one act of physical aggression from their partners, 26% reported emotional abuse, 70% verbal abuse, and 86% partner anger. Whether these rates of physical aggression are greater than normal is not known because studies of domestic violence from previous years and under normal conditions have showed the existence of rates of violence as low as 1% and as high as 12%.

A few studies have produced evidence that supports the above. Police reports of domestic violence increased by 46% following the eruption of the Mt. St. Helens volcano (2). One year after Hurricane Hugo, marital stress was more prevalent among individuals who had been severely exposed to the hurricane (e.g., life threat, injury) than among individuals who had been less severely exposed or not exposed at all (3).

Within 6 months after Hurricane Andrew, 22% of adult residents of the stricken area acknowledged having a new conflict with someone in their household (4). In a study of people directly exposed to the bombing of the Murrah Federal Building in Oklahoma City, 17% of noninjured persons and 42% of persons whose injuries required hospitalization reported troubled interpersonal relationships (5).

The second question is whether domestic violence, regardless of the reasons how or why it occurs, influences women's postdisaster recovery. An important finding from Mechanic et al.'s (2001) study was that the presence of domestic violence strongly influenced women's postdisaster mental health. Thirty-nine percent of women who experienced postflood partner abuse developed postflood PTSD compared to 17% of women who did not experience postflood abuse. Fifty-seven percent of women who experienced postflood partner abuse developed postflood major depression compared to 28% of nonabused women. Similarly, Norris and Uhl (3) found that as marital stress increased, so too did psychological symptoms such as depression and anxiety. Likewise, Norris et al. (4) found that 6 and 30 months after Hurricane Andrew, new conflicts and other socially disruptive events were among the strongest predictors of psychological symptoms.

These findings take on additional significance when it is remembered that not only are women generally at greater risk than men for developing postdisaster psychological problems, but women who are married or cohabitating with men may be at even greater risk than single women (6,7). In contrast, married status is often a protective factor for men (8,9). It also has been found that the severity of married women's symptoms increases with the severity of their husbands' distress, even after similarities in their exposure have been taken into account (7).

In summary, although the research regarding the interplay of disaster and domestic violence is not extensive and little of it has been derived from studies of incidents of mass violence, the available evidence does suggest that services related to domestic violence should be integrated into other mental-health services for disaster-stricken families.

Screening for women's safety may be especially important. Helping men find appropriate ways to manage/direct their anger will benefit them and their wives. It will also help their children, as children are highly sensitive to postdisaster conflict and irritability in the family (7,10).

Summary of empirical findings

• Although there is little conclusive evidence that domestic violence increases after major disasters, research suggests that its postdisaster prevalence may be substantial.
• In the most relevant study, 14% of women experienced at least one act of postflood physical aggression and 26% reported postflood emotional abuse over a 9-month period.
• One study reported a 46% increase in police reports of domestic violence after a disaster.
• Other studies show that substantial percentages of disaster victims experience marital stress, new conflicts, and troubled interpersonal relationships.
• There is more-conclusive evidence that domestic violence harms women's abilities to recover from disasters.
• In the most relevant study, 39% of abused women developed postdisaster PTSD compared to 17% of other women, and 57% of abused women developed postdisaster depression, compared to 28% of other women.
• Marital stress and conflicts are highly predictive of postdisaster symptoms.
• In light of the fact that, in general, married women are a high-risk group for developing postdisaster psychological problems, it seems advisable to integrate violence-related screenings and services into programs for women, men, and families.

References

1. Mechanic, M., Griffin, M., & Resick, P. (2001). The effects of intimate partner abuse on women's psychological adjustment to a major disaster. Manuscript submitted for publication.
2. Adams, P. R., & Adams, G. R. (1984). Mount Saint Helen's ashfall . American Psychologist, 39, 252-260.
3. Norris, F. H., & Uhl, G. A. (1993). Chronic stress as a mediator of acute stress: The case of Hurricane Hugo. Journal of Applied Social Psychology, 23, 1263-1284.
4. Norris, F. H., Perilla, J. L., Riad, J. K., Kaniasty, K., & Lavizzo, E. A. (1999). Stability and change in stress, resources, and psychological distress following natural disaster: Findings from Hurricane Andrew. Anxiety, Stress, and Coping, 12, 363-396.
5. Shariat, S., Mallonee, S., Kruger, E., Farmer, K., & North, C. (1999). A prospective study of long-term health outcomes among Oklahoma City bombing survivors. Journal of the Oklahoma State Medical Association, 92, 178-186.
6. Brooks, N., & McKinlay, W. (1992). Mental health consequences of the Lockerbie disaster. Journal of Traumatic Stress, 5, 527-543.
7. Gleser, G. C., Green, B. L., & Winget, C. N. (1981). Prolonged psychological effects of disaster: A study of Buffalo Creek. New York: Academic Press.
8. Fullerton, C.S., Ursano, R.J., Tzu-Cheg, K., & Bharitya, V. R. (1999). Disaster-related bereavement: Acute symptoms and subsequent depression. Aviation, Space, and Environmental Medicine, 70, 902-909.
9. Ursano, R. J., Fullerton, C. S., Kao, T. C., & Bhartiya, V. R. (1995). Longitudinal assessment of posttraumatic stress disorder and depression after exposure to traumatic death. Journal of Nervous and Mental Disease, 183, 36-42.
10. Wasserstein, S. B., & LaGreca, A. (1998). Hurricane Andrew: Parent conflict as a moderator of children's adjustment. Hispanic Journal of Behavioral Science, 20, 212-224.

Date Created: 01/01/2007 See last Reviewed/Updated Date below.

Scholarship Opportunity. Entering College for the First Time.

http://www.gmsp.org/publicweb/AboutUs.aspx

The Gates Millennium ScholarS Program

For students entering college for the first time in the fall 2012, the GMS 2012 Scholarship Application online process is now open. The deadline for all submissions is Wednesday, January 11, 2012 at 11:59 p.m. EST.
GMS will select 1,000 talented students each year to receive a good-through-graduation scholarship to use at any college or university of their choice. We provide Gates Millennium Scholars with personal and professional development through our leadership programs along with academic support throughout their college career.

Our program is more than a scholarship—it’s an opportunity to change your life! Just ask Deonte Bridges how much the GMS scholarship means to him.

If you are willing to serve as a nominator or recommender for deserving students, you can make a difference in their lives. 

The goal of GMS is to promote academic excellence and to provide an opportunity for outstanding minority students with significant financial need to reach their highest potential by:

• Reducing financial barriers for African American, American Indian/Alaska Native, Asian Pacific Islander American and Hispanic American students with high academic and leadership promise who have significant financial need;
• Increasing the representation of these target groups in the disciplines of computer science, education, engineering, library science, mathematics, public health and the sciences, where these groups are severely underrepresented;
• Developing a diversified cadre of future leaders for America by facilitating successful completion of bachelor's, master's and doctoral degrees; and
• Providing seamless support from undergraduate through doctoral programs, for students selected as Gates Millennium Scholars entering target disciplines.

The Gates Millennium Scholars (GMS) Program, established in 1999, was initially funded by a $1 billion grant from the Bill & Melinda Gates Foundation.
The GMS Scholarship Award Provides:

• Support for the cost of education by covering unmet need and self-help aid;

• Renewable awards for Gates Millennium Scholars maintaining satisfactory academic progress;

• Graduate school funding for continuing Gates Millennium Scholars in the areas of computer science, education, engineering, library science, mathematics, public health or science;

• Leadership development programs with distinctive personal, academic and professional growth opportunities.

Program Accomplishment:

• Funding more than 15,000 Gates Millennium Scholars since the inception of the program

• Obtained a 79.9% graduation rate in five years*

• Supported Gates Millennium Scholars enrolled in more than 1,500 colleges and universities

• Supported Gates Millennium Scholars representing 50 states and five outlying areas

• Graduated over 7,000 Gates Millennium Scholars since the program's inception

• Five year retention rate of 87.7%*

*Reflects cohorts 1 through 4

Administration:

UNCF—the United Negro College Fund—administers the Gates Millennium Scholars Program (GMS). To reach, coordinate and support the constituent groups, UNCF has partnered with the American Indian Graduate Center Scholars, the Hispanic Scholarship Fund, and the Asian & Pacific Islander American Scholarship Fund to assist in implementing the program.

The GMS Advisory Council has seven members: six members from higher education and one member representing the Bill & Melinda Gates Foundation. Advisory Council members include:

• Youlonda Copeland-Morgan, Associate Vice President for Enrollment Management, Financial Aid Service, Syracuse University
• Carmen D. Lopez, Executive Director, College Horizons Inc.
• Dr. Raymund Paredes, Commissioner of Higher Education, Texas Higher Education Coordinating Board
• Margaret Daniels Tyler, Senior Program Officer, Education, Bill & Melinda Gates Foundation

The GMS program is more than just a scholarship. The GMS program offers Gates Millennium Scholars with ACademic Empowerment (ACE) services to encourage academic excellence; mentoring services for academic and personal development; and an online resource center that provides internship, fellowship and scholarship information.

Disaster Assistance. Water damage to furnaces from flooding.

http://www.fema.gov/news/newsrelease.fema?id=58935

Disaster assistance may help prepare flood-damaged furnaces for winter 

Release Date: October 22, 2011
Release Number: 4021-060

» More Information on New Jersey Hurricane Irene


NEPTUNE, N.J. — With this week’s seasonal winds and rain and the impending arrival of winter, New Jersey homeowners should ensure that their home-heating systems are in good working order. 

This is especially true of systems that may have been damaged by Hurricane Irene and the resulting floods.
Federal disaster assistance may cover furnace repairs that are related to severe storms and flooding that happened from Aug. 27 through Sep. 5, according to disaster officials with the Federal Emergency Management Agency (FEMA).

Federal help may be available for cleaning and testing a flood-damaged furnace for repairs, or for replacement if the furnace is destroyed.  New Jersey residents who had flood damage to their furnaces should register for assistance from FEMA by the Nov. 30 deadline.

If the need for repair or replacement is discovered after a homeowner receives federal aid to cover cleaning and testing expenses, the resident has the option of filing an appeal for additional disaster funds. 

The appeal must be made within 60 days of the date of the award or determination letter.

Registering with FEMA is the first step.  There are three ways to register for assistance – go to www.disasterassistance.gov, to m.fema.gov or call FEMA toll-free, 800-621-3362 (FEMA). 

Those with access or functional needs and who use a TTY may call 800-462-7585 or use 711 or Video Relay Service to call 800-621-3362. Telephone lines are open from 7 a.m. to 10 p.m. ET; multilingual operators are available.

Trauma: Stress. Disaster Recovery

http://www.fema.gov/news/newsrelease.fema?id=58932

Disasters Touch Everyone - Look Out for Signs of Stress 

Release Date: October 21, 2011
Release Number: 4025-077

» More Information on Pennsylvania Tropical Storm Lee
» More Information on Pennsylvania Hurricane Irene


HARRISBURG, Pa. -- The initial trauma from Pennsylvania's two late-summer disasters - Hurricane Irene and Tropical Storm Lee - has passed, but the psychological effects can linger.

Stress caused by loss or a traumatic experience can sneak up on people and influence behavior and emotions. The elderly and children are particularly vulnerable to stress after a disaster and may require special considerations.

The Commonwealth of Pennsylvania and the Federal Emergency Management Agency have developed a list of things to look for and tips for helping yourself and others get through this difficult time. Some common signs of stress are:

• Trouble concentrating or remembering things.
• Difficulty making decisions.
• Replaying the events and circumstances of the disaster over and over in your mind.
• Anxiety or fear, especially when things remind you of the traumatic experience.
• Feeling depressed, sad or down much of the time.
• Trouble sleeping.
• Nightmares.
• Increased use of alcohol, tobacco or illegal drugs.
• Feeling overwhelmed.

Stress isn't just emotional. It can manifest in physical sensations like fatigue, stomachaches or diarrhea, headaches, sweating or chills, chest pain, or a rapid heartbeat. Changes in behavior also can signal that you are under stress. Do you withdraw or isolate yourself, even from family and friends? Are you restless or prone to emotional outbursts? Do you startle easily?

Here are some common-sense measures to help you overcome stress and get you back to yourself again.

• Friends and family are good medicine. Talk with them about your feelings. Sharing common experiences helps you deal with and overcome anxiety and feelings of helplessness.
• Get back into your daily routines as soon as you can.
• Maintain a healthy diet and get plenty of sleep.
• Find ways to relax. Do a fun thing after a difficult or stressful task.
• Get some physical exercise every day. Walking is a great stress reliever and you can do it with a friend or relative.

Know that feeling stressed, depressed, guilty or angry is common after a traumatic event. Watch out for problems that are more than you can handle. If signs of stress are serious or if they persist, you should see a counselor or other mental health professional.

For more information about behavioral health services available in your area, please contact your county crisis hotline or mental health office. If you or someone you know is having thoughts of suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Additional information about this disaster is available at www.fema.gov, and www.readypa.org.
FEMA's mission is to support our citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards.

Snow Emergency Plans: Washington, D.C.

http://ddot.dc.gov/DC/DDOT/On+Your+Street/Traffic+Management/Snow/District+of+Columbia+Winter+Snow+and+Ice+Plan

District of Columbia Winter Snow and Ice Plan 

The District Department of Transportation (DDOT) works closely with the Department of Public Works (DPW) to clear snow and ice from District roadways and bridges. Together, DDOT and DPW clear and make safe approximately 2,295 lane miles, bridges, overpasses and ramps.
DDOT and DPW also work closely with the Mayor and other District agencies when deciding to declare and enforce snow emergencies. If a snow emergency is declared residents must immediately relocate any vehicles parked on snow emergency routes.
The District of Columbia begins planning for winter weather months in advance. Equipment must be serviced, vehicles inspected, personnel trained, supplies ordered and snow removal routes evaluated to ensure readiness for the first flake, or the first icy downpour of freezing rain.
As in other jurisdictions, public safety determines the priority for snow removal in the District. Clearing and salting efforts focus first on major roads, commuter thoroughfares and designated Snow Emergency Routes. Streets that are narrow, steep, or shaded, receive special attention, as do those streets scheduled for next-day trash collection.
The District has 330 pieces of equipment and 750 personnel available for any given storm. This includes additional contract plows, if necessary, for major weather events. In addition, the District Snow Team is now using improved route plans - first implemented in 2008 - which divide the city's neighborhoods into 82 smaller, more manageable routes.
The District's Snow Team is committed to faster completion of plowing and salting along major roads and residential streets, which in turn means more rapid return of normal traffic flow and earlier resumption of trash collection and other city services. Residents are reminded to please be patient and allow sufficient time for snow operations to be implemented. If their streets still have not been treated or plowed in a reasonable amount of time they should call the Mayor's Call Center at 311.
Keep up to date on the latest inclement weather reports and advisories with our Snow Alerts.
DDOT and DPW remind commuters and residents to:

• Not drive distracted.
• Remember that driving on ice is significantly different than driving on snow.
• Use extreme caution and maintain safe speeds and distances from other vehicles.
• Remember even a 4-wheel drive SUV does not perform well in ice and additional safety measures should be followed.
• Be aware of road conditions, particularly black ice which can be deceptive in its appearance giving the driver a false sense of security on the road.
• Watch for slippery bridge decks, even when the rest of the pavement is in good condition. Bridge decks will ice up sooner than the adjacent pavement.
• Remember to keep a safe distance from emergency and snow vehicles and please use caution when attempting to pass a snowplow. Give the drivers plenty of room to safely do their jobs.
• Clear all the snow and ice from your vehicle's windows and lights — even the hood and roof — before driving.
• Help your elderly or disabled neighbors remove snow from steps and sidewalks.
• Clear catch basins and fire hydrants.
• Please do not put snow in the street. Put all cleared snow, from parked cars and sidewalks, in the "tree box," front yard, or between the curb and sidewalk.

For more information on the District of Columbia Snow Removal and Treatment Plan, please select below from the Related Documents links.

 

Goals

To clear snow and ice from District roadways and bridges.

International Sector: Hiati Missions

www.lottcarey.org

Lott Carey Mission Alert - Short-Term Missions Assignments to Haiti

13 October 2011 

Dear Lott Carey Partner:

We continue to work to keep the people of Haiti on the minds of the world and in the hearts of God's people.  One way of doing so is to create opportunities for people who feel called to do so, to participate in short-term missions assignments.  The following opportunities still have opportunities for service, and we as you to share them in your circles of influence.

Men's Only Short-Term Missions Assignment

Missionary men will share in construction projects and a men's conference in partnership with Hosean International a service-based ministry, has been receiving teams and coordinating outreaches in Haiti since 1981.

Dates: December 1 -9, 2011

Medical Service Short-Term Missions Assignment Medical professionals are invited to serve with a Mobile Medical clinic at Siloe. The clinic is in need of medical teams to participate in ‘mobile clinics’ to the villages in the mountain region of Grand Goave. Significant time will be spent seeing patients and addressing both emergency treatment, and providing ongoing care. Medical personnel such as: Doctors, nurses, dentists, technicians, EMTs, and more are needed.

Dates: February 8 - 15, 2012; May 9 - 16, 2012

If you hear God calling you to serve in Haiti to be a blessing, please contact Kathi L. Reid, Program Manager, at kreid@lottcarey.org.

 

Remember our sisters and brothers who continue to struggle, and see other short-term missions assignments on our home page at www.lottcarey.org.

 

On mission,

 

David

____________________________
Rev. David Emmanuel Goatley, Ph.D.
Lott Carey
220 Eye Street, NE, Suite 220
Washington, DC 20002
202.543.3200 (office)
202.276.2920 (cell)
degoatley@aol.com (email)
degoatley (skype)
lottcarey (twitter)
www.lottcarey.org (web)