Cultural Interrelatedness

Texas Health Presbyterian Hospital Denton is a 255-bed hospital featuring more than forty three specialties, the hospital is located adjacent to a major highway which is used to transport hazardous materials, commuters and cargo. Texas Health Presbyterian Denton is a suburb of the Dallas-Fort Worth metroplex, which has an estimated population of seven million residents and covers a geographical area of approximately 9,000 square miles. The Dallas-Fort Worth metroplex is the largest metropolitan area in the South and the fourth largest in the United States. The purpose of this paper will be to evaluate the Texas Health Presbyterian Denton’s Emergency Operation’s Plan to determine if it address a comprehensive response to threats, emergencies and disasters while safeguarding the welfare of its citizens.

Whenever a disaster strikes an unsuspecting community, from natural weather events like hurricanes and tornadoes to the manmade catastrophes caused by contamination, local community health nurses become a lifeline for stricken victims, providing medical care, basic sanitation, and nutritional sustenance. While treating the ailments of the sick and dressing the wounds of the injured are the chief priorities for any nursing professional, community health nurses typically administer care within a close-knit population group, and this familiarity often requires the offering of spiritual support as well. The immediate aftermath of any major disaster, whether natural or manmade, is a chaotic time when panic, fear, and uncertainty can easily run rampant, and community health nurses must prepare themselves to handle the nonmedical aspects of assisting patients through their recovery. Setting aside one's personal views on organized religion or faith, alleviating a patient's outward symptoms can only be effective to a certain point when they are grieving for the sudden loss of a loved one, or contemplating an uncertain future after their property and

Natural disasters may lead to many ethical challenges that are different from normal medical practices. Disasters can vary when comparing to their time, place and extent. Therefore, ethical questions may not always have such simple solutions. Ethical values and principles in every aspect of health-care are very important. Reviewing legal and organizational regulations, developing health-care related guidelines, and disaster recovery plans, establishing on-call committees as well as an adequate in-service training of health-care workers for ethical capability are of the most important of steps. It is only by making efforts before disasters, that ethical challenges can be minimized in disaster responses.

Question One: What populations are vulnerable and what resources are available for vulnerable citizens? The vulnerable populations in Houston are the low income communities (including homeless people), the elderly, people with disabilities, immigrants, and the "linguistically isolated communities…Chinese, Somali, Spanish, and Vietnamese speaking groups" (Nepal, et al, 2009). The St. Luke's Episcopal Health Charities prepared a report on disaster preparedness for the Houston Department of Health and Human Services (Peranteau, et al, 2009). The report explains that vulnerable populations tend to be more impacted by hurricanes and other disasters than the middle class and upper middle class communities in Houston. The report state that "…Failure to address the needs of low income communities and individuals, who are disproportionately affected by natural disasters," hampers the recovery from a hurricane for all communities. "Low income communities" (i.e., vulnerable communities) are "disproportionately affected by natural disasters, and are disadvantaged again when the recovery process does not take their unique needs into account" (Peranteau, p. 3). The point of the research was to determine how best to serve this population during hurricanes and tropical storms, which are very common in Houston.

The people of Texas can be somewhat relieved that the disastrous Hurricane Harvey occurred after September 11, 2001 and after Hurricane Katrina in 2005. “After the terrorists attacks on that day in 2001 numerous plans were put in place to prepare and assist for disasters. The emergency management department in the United States began to develop responses to different disaster scenarios. This department used a multidisciplinary approach to handling disasters” (Community and Public Health Nursing, 2016). After the devastation left by Hurricane Katrina, many new disaster and emergency policies were put in place for man- made disasters, such as hurricanes.

Editor’s Note: This Chapter is the continuation of an adaptation of a state plan for disaster preparation and response. In total, the original chapter comprises Chapters 1, 14, 16-18.

In day to day operations, uncertainties do occur. Henceforth it would be important to have a contingent and well detailed disaster preparedness plan and procedures. Healthcare systems, on a day to day basis, are faced with emergencies in form of disasters. As a result, majority of medical centers have well-structured exit plans in the event of a disaster occurring("Hospital Disaster Preparedness: Your Guide to Getting Started - Emergency Preparedness", 2011). However, this essay will aim at interviewing one of the top disaster preparedness staffat the Houston Methodist Hospital. In the interview, I will seek to identify the top three disasters that the Houston Methodist Hospital is prepared for. Similarly, in the interview, I would seek to identify the top lessons learnt from disaster preparedness at the hospitals.As it concludes it would summarize the findings with regards to the interview stated below. Below is an excerpt from the interview to answer the two aforementioned questions.

Listos was started in the fall of 2010 with generous support from the Orfalea Foundation and the Aware and Prepare Initiative: A Community Partnership to strengthen Emergency & Disaster Readiness in Santa Barbara, California (Listos, 2014). They aim to eliminate the language barrier that interferes with the relationships between first responders and the Latino community. In addition, the Listos curriculum is low to no cost and provides tips for the participants to use during disaster and throughout their everyday lives. The program is a four week discussion series taken from the Community Emergency Response Team (CERT). The topics covered in these discussions are identifying vulnerabilities, fire extinguisher use, important document backup, disaster supply kits, utility shut off, creating reunification and communication plans, triage, disaster medicine, team organization, and disaster psychology (Listos, 2014). Moreover, the program can be adapted to teach diverse vulnerable populations, such as the elderly, children, differently abled people, etc. Listos has trained over 588 monolingual Spanish speakers in Santa Barbara County (Listos, 2014). In 2014, the Listos Program was led in the Bay Area, Los Angeles, and San

Emergency preparedness starts with addressing a community’s specifics needs and identifying its demographics and characteristics. After enough data has been collected and analyzed, developing partnerships, creating and implementing strategies, and evaluating outcomes comprise the process of the Community Hazard Assessment. The region Paso del Norte is situated in the southwest in North America and includes parts of New Mexico, Texas, and Mexico. There are special considerations that this region entails, such as social, cultural, and economical concerns as well as geographical and topographical elements. Paso del Norte includes the United States – Mexico border, three metropolitan areas: El Paso, Ciudad Juarez, and Las Cruces, as well as large military installations Fort Bliss and White Sands Missile Range that would be required to communicate, cooperate, and collaborate in the event of a major disaster.

The disaster which hit the Maricopa County in the State of Arizona in September 2014 was a major disaster that necessitated the community preparedness for leading successful response and a prompt recovery. Besides emergency managers, many officials and the private are involved in the processes. Some of these stakeholders are public health, public safety, and municipal officials. Collaboration is needed for getting all those involved in the processes to interact accordingly. This paper addresses the major collaboration strengths between emergency responders, public health, public safety, and municipal officials to deliver accurate response and recovery during the event, the main weaknesses of the collaboration among all those that were involved in the efforts, and recommendations for improving the collaboration between the stakeholders.

By understanding the steps to prepare for countering and responding to a terrorist, the well-being of US national security interests can be promoted and the exposure to risk and susceptibility to experiencing harm can be efficiently managed for communities, families and individuals in the event of a terrorist incident. The welfare of US national security, citizens and property can be effectively safeguarded through the understanding of protection strategies administered collectively by local communities, families and individuals. Local emergency operations planning, family disaster planning, as well as self-protection planning each represent important protective measures, which serve to educate the nation and its citizens how to

The project aims to educate the Latino community in Worcester, Massachusetts about emergency and disaster preparedness. In determining this project, we consulted Healthy People 2020 topics, and selected from among the new topics the one which most spoke to our experiences. As is supported by the literature, we recognized the recent difficulties over the last ten years in community preparedness for and response to natural disasters and public emergencies (Pokras, Zambrana, Mora, & Aaby, 2007). While communities across the United States have been tested in terms of their resources and organization in responding to emergencies ranging from hurricanes to terrorist attacks and subsequently put in place improved strategies, there are still populations which remain vulnerable (Pokras et al., 2007, Eisenman, Glik, Maranon, Gonzales & Asch, 2009b). Despite the resources which communities have put in place in order to ensure that citizens are prepared for disasters and emergencies, the ability of these resources to reach immigrant populations which may experience barriers due to language, etc. is uncertain (Pokras et al., 2007, Eisenman, et. al., 2009b). One population which has suffered from this uncertainty is the Latino population

Data obtained by assessing social vulnerability must be implemented within each phase of the emergency management process; mitigation, response, and recovery. First, to effectively respond and recover from incidents emergency management agencies must concentrate on the mitigation phase to prevent incidents from happening in the first place. This is achieved through a thorough hazard/vulnerability analysis (HVA). This type of analysis assesses the risk of physical, economic, and social vulnerability within all communities of a given jurisdiction (Lindell et al., 2006, p. 165). Additionally, the basis of the HVA allows emergency managers to effectively plan for disaster by creating pre-planned responses to disasters (rather than improvised response) and staging resources to locations with the highest probability of risk; ultimately contributing to the mitigation and response phases.

In regards to the differing cultures that were affected by the hurricane, emergency responders need to be made aware of the beliefs of some regarding evacuation. It is possible that poor inner-city residents are often the least likely to follow official evacuation warnings, some because they lack transportation and others because they fail to take such warnings seriously. Religious faith also plays a part in cultural considerations during a crisis. Ones religious affiliation may cause them to place their safety with a higher being and not take the necessary precautions during an emergency. The negative association of early evacuation that accompanies some religious individuals, suggest that, emergency planning initiatives can be improved by assisting local civic and faith-based organizations in developing a coordinated, system of hazards education. (Elliot & Pias 2006).

Much of how an individual turns out to be is not only dependant on the genes in which their parents have passed down to them, but also due to the family structure in which they were raised by.