October is National Disability Employment Awareness Month, and is specifically dedicated to implementing the mandate spelled out in the 2010 presidential Executive Order 13548: “Increasing Federal Employment of Individuals With Disabilities.” That awareness also serves as a reminder that the nation’s emergency responders and receivers must be prepared to handle people suffering from a broad range of physical and psychological disabilities. According to the U.S. Department of Health and Human Services’ Office on Disability website, an estimated “one in every five people” has some type of disability. Moreover, as time passes, “the likelihood of having a disability of some kind increases.”
Of course, those suffering from various disabilities must constantly overcome and adapt to physical and psychological barriers to preserve their livelihoods on a daily basis. However, in times of emergencies, natural disasters, and other incidents that disrupt daily routines, the community of people with disabilities tends to expand to encompass many additional persons with “functional needs.”
Educating Those With Existing Functional Needs
According to the Federal Emergency Management Agency (FEMA) website, Functional Needs Support Services (FNSS) are defined as “services that enable individuals to maintain their independence in a general population shelter.” In addition, according to the November 2010 Guidance on Planning for Integration of Functional Needs Support Services in General Population Shelters, “Children and adults requiring FNSS may have physical, sensory, mental health, and cognitive and/or intellectual disabilities affecting their ability to function independently without assistance.”
Unfortunately, even though there is usually some level of planning already in place to assist disability communities before various disasters/emergency incidents actually occur, a broad range of actions addressing issues that might easily occur during and after such incidents have not yet been fully examined. Evacuations, for example, and either sheltering either in place or in a previously designated shelter, require additional planning for those with functional needs. After a disaster strikes, moreover, another type of functional-needs group emerges – those with “newly acquired” disabilities.
People with existing disabilities have had time, in many cases, to develop at least some level of independence and already know how to address their personal needs and how to follow specific regimens for being resilient before, during, and after various types of disasters and/or other emergencies. However, even this prepared community usually needs more information about the “real” expectations they might reasonably have about first responders. If members of this community understand that, sometimes, their best course of action is simply to get out of harm’s way, proper planning by those in the functional needs community can actually help first responders better allocate their limited time and available material resources.
With an acceptable support system in place, those with disabilities can personally help to ensure that a plan is in place: (a) for someone to help them evacuate; (b) to shelter in place or somewhere other than where they live; (c) to have transportation available when needed; and, perhaps most important of all, (d) to manage their own immediate medical needs. Plans for providing additional medications and such other medical needs as oxygen tanks, surgical dressings, and wheelchairs would help avoid dependency on first responders to provide these resources, which are already in high demand during emergencies when responder agencies are most likely to be overwhelmed. In addition, better planning by persons with existing disabilities would allow more time for responders to attend to higher priority situations.
Educating Receivers As Well As Responders
From the responder as well as receiver perspectives, managing those persons with functional needs in the wake of a disaster is obviously to be expected, but there is much more to consider than the more visible injuries or disabilities. Lives are sometimes lost during a particularly traumatic situation – a spinal cord injury, the amputation of a leg or an arm, a traumatic brain injury, and sudden blindness and/or deafness – for which no amount of training could fully prepare even the most conscientious responder.
Moreover, these particularly unfortunate people often do not yet grasp the reality of their own injuries and cannot yet imagine their future lives as persons with such disabilities. Today, the Boston Marathon images of responders and nearby citizens carrying and otherwise transporting victims with lost legs or arms from the incident scene still evoke strong mixed emotions. In addition, the after-action investigations and reports have developed and publicized a number of important “what if” questions, including the following:
- What happens in such situations if there are no medical facilities and ambulances nearby?
- What else would have happened if there had been even worse traffic congestion stalling the transportation of survivors to the medical facilities?
- What if the victims included persons with preexisting physical disabilities who were unable to use normal transportation?
- What if there had been no taxicabs and buses, fitted with the lift equipment needed?
- What if there had been no way to quickly move some of the victims away from what might have been other potential bombs?
The lessons learned from the Boston bombings boil done to the fact that any combination of people with existing disabilities and others with newly acquired disabilities generates added concern about the lack of supplies, equipment, and other resources for the functional needs community. To lessen such stress, there are many planning considerations that planners must address, the most important of which are: (a) the number of people who require care; and (b) the services and equipment most likely to be immediately available to cope with unexpected incidents.
First responders often prepare to help with persons with newly acquired disabilities, but it is a reality that they may never be fully ready to face. Planning for mass casualties and preparing for shelters is just a small step forward in this dilemma. Face-to-face planning encounters also make a huge difference. Knowing how to address the disability community’s needs is another step forward, but the human and humane factors involved are just as important. Among the non-room capabilities needed are the following:
- Communicating with deaf persons, even if only to help navigate them out of the way during an emergency;
- Providing safety for blind persons, while also preserving their dignity;
- Ensuring that people with physical disabilities are not left in uncomfortable places or in positions that would require further medical attention at a later time – with no, broken, or battery-less equipment, for example; and
- Helping to prevent persons suffering from mental/emotional disabilities from feeling anxious, afraid, and deprived of a safe space.
Above all, it is particularly important for communities as well as individual responders to remember, not just in October, to reinvest in disability awareness by including additional and upgraded training for all responders. By training police officers, firefighters, paramedics, and other first responders on the “etiquette” as well as respect that those with disabilities deserve and should receive, responder/receiver agencies also can help build a more resilient functional-needs community at the same time. This will continue to be true, regardless of the type, nature, and size of the disaster or incident. Taking the time to address all functional needs in a positive and caring way will help members of the functional needs community feel much more independent, even when faced with a major disaster or other emergency situation.