An Initiative of Leadership Required

Hospitals must take a lead in emergency preparedness as population shifts to areas prone to natural hazards

By Michael Barrick

This week, the United States Census Bureau reported that 47 of the 50 fastest-growing areas in the United States were in the South and West. This is significant news for hospitals serving those growing populations, for these are the same areas that are among the most likely to experience natural hazards.

What this means is that hospital administrators and emergency managers must exercise an initiative of leadership in planning for the increased mortality, morbidity and financial costs sure to arise from these dangerously merging trends.

This year, the Joint Commission – the independent organization that accredits and certifies hospitals and other health care organizations – has dramatically increased its scrutiny of hospital emergency management plans. And, for 2009, it will likely focus even greater attention on those plans, as it is proposing to take emergency management out of the Environment of Care Chapter and make Emergency Management its own chapter, meaning a hospital’s plans for emergency plans and operations will be on par with the other seven chapters that cover major aspects of hospital clinical and support activities.

These increasingly stringent standards are overdue and should be welcomed. Yet, it may still not be enough if hospitals do not assert leadership roles for disaster planning within these rapidly growing regions. According to the Census Bureau report, communities in Florida, North Carolina, Georgia, Texas, Arizona, California, Louisiana and Nevada were among the nation’s ten fastest growing locations.

So, regions that are prone to natural hazards such as hurricanes, earthquakes, tornadoes, wildfires, and droughts are seeing the greatest population growth. As natural hazards impact these areas, hospitals will be overrun with victims from mass casualty incidents; and, financial losses (property damage, health care delivery costs, and the cost of response and recovery) will increase.

These are hazards that hospitals cannot afford to ignore. Recent disasters caused by naturally-occurring events have proven that “all roads lead to the hospital.” In other words, disaster victims often bypass first responders and transport themselves to the hospital. Yet, for even those that are transported by ambulance, how they get there is ultimately irrelevant – they will get there. So, while other community responders and agencies may be entering the recovery (or final) phase of a disaster, the hospital will find itself in the middle of the response phase – and may for an extended period of time.

It is true that laws in many states mandate that counties or municipalities serve as the primary entity responsible for disaster planning and response. These statutory requirements, however, cannot be used by hospitals as an excuse for not taking an aggressive, leading role in collaborative community planning for natural hazards. Hospitals must be active partners in developing community all-hazards plans that account for population growth – which includes not only more people, but more structures that pose risks in severe weather. They must also take into consideration historical climate data, the identification of available resources, and plans for finding funding streams to meet the shortfalls in needed resources for the inevitable risks caused by these migration patterns.

Obstacles to effective disaster planning, preparedness and response must also be identified, acknowledged and overcome. Much of government funding – especially since the terrorist attacks of September 11, 2001 – has been directed to response agencies. There remains a reluctance among responders and receivers to establish, cultivate and maintain the necessary relationships to understand and work together to complement each others’ roles. Also, the hospital industry is growing increasingly competitive. So, a culture of mistrust between hospitals filters into areas where it should not, such as emergency preparedness. These political, cultural and economic factors must not be allowed to stand in the way of hospitals fulfilling their ethical responsibilities.

Too often, they do. Yet, this is not because of a lack of regulation. In addition to the Joint Commission, the Federal Emergency Management Agency (FEMA) now requires that hospitals demonstrate that they are preparing for and managing disasters utilizing a proven and standardized command structure and system – the Hospital Incident Command System (HICS).

So, while systems are in place that should foster interoperability and standardized approaches for emergency planning and response, their success is dependent upon the people responsible for implementing them. Consequently, those running hospitals must exert an initiative of leadership to account for increasing populations in areas prone to natural hazards. Anything less is a recipe for disaster.

© The Barrick Report, 2008. Michael Barrick works in a hospital in the field of emergency preparedness.

Responding to Needs with an ‘Army of Compassion’

Convoy of Hope equipping believers, reaching the needy

Note: This is the main article in a three-part series on Convoy of Hope. Convoy of Hope mobilizes, resources, and trains churches and other groups to conduct community outreaches, respond to disasters, and direct other compassion initiatives in the United States and around the world. To read the other two articles, visit the ‘Ministry & Missions’ category of The Barrick Report.

By Michael Barrick 

There is only one thing about Convoy of Hope that could be clearer than its simply stated Mission and Vision statements – its success in meeting those ideals. Its mission is simply stated – “Convoy of Hope is a Christian compassion organization that meets physical and spiritual needs.” Of course, that’s not a unique objective – many Christian ministries exist for the same reasons. What makes Convoy of Hope stand above most other ministries, however, is how it accomplishes its objectives – its highly effective and efficient use of gifts-in-kind and its successful determination to bring entire communities together in accomplishing its mission, as expressed in its Vision Statement – a determination to empower and equip the Church, combined with collaboration with multiple agencies, organizations and corporations (see sidebar). It is based in Springfield, Mo.

Convoy of Hope, founded in 1994, works through three service divisions. It coordinates community outreach efforts in the United States designed to help communities meet the needs of the poor, it responds to disasters in the United States with truckloads of donated goods and supplies utilizing local volunteers, and offers community assistance and disaster response in foreign nations. It is also in the process of developing an initiative as part of its disaster response, HOPE (Helping Others Prepare for Emergencies), designed to help community churches, agencies and businesses prepare for and respond to disasters. 

Each of these efforts can only be accomplished through what Founder, CEO and President Hal Donaldson calls “an army of compassion.” The use of the phrase does indeed seem apt, as it has a huge central location – a 300,000 square foot distribution center; it establishes staging areas when threats – such as impending hurricanes – are identified; it operates as a first responder to the victims of disaster; it works with hundreds of thousands of volunteers; and has mobilized more than 15,000 churches and other organizations. 

Though the community outreaches are essential to the success of its vision, the most visible aspect of Convoy of Hope is the well- planned and organized response efforts, driven home by its name – its convoys of trucks and volunteers responding to disasters with the aim of delivering physical and spiritual hope in the name of Jesus. 

Mr. Donaldson acknowledges that the highly visible fleet of semi-trucks rushing to the scene of a disaster, as well as the scores of trained volunteers distributing the food, medicine and supplies at disaster scenes is what defines Convoy of Hope. He notes, however, “Our fleet of trucks serves all three divisions. The procurement department (those charged with securing gifts-in-kind from corporations) serves all three as well.” 

Convoy of Hope responded to more than 70 communities impacted by hurricanes during the past several years, deploying millions of dollars of food, water, medical supplies and other essentials, all while employing a volunteer force of roughly 200,000 people and 15,000 organizations. It partners with local churches, the Federal Emergency Management Agency (FEMA), congregational response teams, the Salvation Army, the Southern Baptist’s North American Mission Board, and local organizations. 

It held Outreach efforts in more than 50 U.S. cities (see sidebar) designed to bring churches, community agencies and businesses together to help the poor. 

Through its international efforts, it holds similar but scaled-down events and also responds to disasters with food and supplies, just as it does in the United States. 

All serve to meet the ministry’s mission, explained Mr. Donaldson. “Our motivation is to mobilize the churches and let them see what they can do locally. Internationally, it’s the same thing with missionaries and pastors. Though the ministry operated in more than 40 nations last year, totaling 100 during the life of the ministry, it is feeding as many as 12,000 people a day in El Salvador, Haiti and Kenya, combined. Mr. Donaldson noted that a primary focus in foreign nations is feeding children. “It’s usually done through a school initiative. When kids come to school, we can make sure that they get at least one meal a day.” Food, water and vitamins are distributed, often in partnership with USAID, which provides some funds through grants. 

Still, the ministry’s disaster response remains its most visible aspect, largely because of changing conditions in the last few years. Mr. Donaldson noted, “Disaster response has really changed in recent years. When we started there wasn’t a lot of cooperation and collaboration.” Now, though, agencies such as FEMA “…have done a really good job of bringing a group like ours into the mix.” He continued, “As a result, we’ve become a lot more sophisticated. We’re part of a well-coordinated response.” 

The ministry’s outlook is essential also, said Mr. Donaldson. “When we go in as partners, we ask, ‘How can we help you.’” As a result, in response to Hurricane Katrina, the ministry was able to mobilize 10,000 volunteers to repair about 3,000 homes. He revealed that the ministry initially distributed $35 million worth of wholesale goods with 700 truckloads. He added, “To date, we’ve distributed over $100 million worth of goods from corporate America and helped over 20 million people.” 

He continued, “We did it across denominational lines. Within the church, there are tremendous resources. Within weeks of Katrina, we had mobilized tens of thousands of people. Convoy of Hope was near the top in terms of mobilizing people.” Indeed, the overwhelming needs of Hurricane Katrina led the ministry to develop the H.O.P.E. Begins Here campaign (Helping Other Prepare for Emergencies), which will be launched this spring. Mr. Donaldson explained, “When we went to the Gulf, we spent a great deal of time developing relationships We asked what they needed rather than saying, ‘This is what we’re going to do.’ We asked how we could help in the long-term.” The need for disaster preparedness topped the list, so modeling this new program after their Community Outreach programs, the ministry is working with churches, civic groups, agencies, and corporations to prepare communities for the next disaster. 

Meanwhile, in war-torn Kenya, the ministry has partnered with a husband and wife team that began a school and is helping to clothe and feed 400 to 500 children a day. “It’s just devastated,” said Mr. Donaldson. “There is no sewer system, no water. I’ve been in 60 countries. It’s just one of the poorest places I’ve been. It’s on par with Calcutta.” 

All of these experiences provide learning opportunities, acknowledged Mr. Donaldson. “You learn something every time you do it. We’ve just taken the adage you don’t stop learning.” He pointed to crowd control as one experience from Katrina and the value of combining education and feeding programs as a lesson learned from ministering in other nations “Those are things you learn quickly. We’re learners. We haven’t arrived.” 

While managing volunteers has always proven to be a challenge in ministry, it’s a core mission of Convoy of Hope. He noted that the Community Outreaches provide opportunities for providing training, but acknowledged also that on-the-job training is also necessary, especially in disaster response. He offered, “The results far outweigh the challenges. Anyone can pass out ice or water or a bag of groceries. Just come, we’ll find a way to use you.” 

Mr. Donaldson, who himself was a beneficiary of the generosity of others after his father was killed by a drunk driver in 1969, said that even after so many years of helping people, he still remains motivated, largely from an encounter he had with Mother Teresa in Calcutta. “She challenged me to do something.” In response, he decided to walk streets in eight of the largest cities in the United States. He recalled, “What I saw was incredible need. I saw that the church can play a part in meeting the needs of the cities, but can also partner with others. We can bring hope, we can bring peace to our cities that need fixing. The government should not fear the church and the church should not fear the government. We need to work together to make America a better place.” 

He concluded, “When I met Mother Teresa, I said she was a special woman. She said, ‘No, there are many who do what I do.’ We’ve been privileged to meet them. It has been part of my own personal transformation.” 

© The Barrick Report, 2008. To learn more, email mbarrick@charter.net