Last week council was trained on our Emergency Management Program, which I found absolutely fascinating. I have a thick binder full of info, but I’ll give you the outline of the different kinds of things that go into Emergency Management; maybe a future post will break down the Emergency Response Plan for Brighton.
The presentation was put on by a representative from Emergency Management Ontario, the provincial agency that helps municipalities comply with the Emergency Management and Civil Protection Act. The Emergency Management Program is oriented around five elements: Prevention, Mitigation, Preparedness, Response, and Recovery.
As we go through these, I’ll give examples from a few key emergencies. In Brighton we’re becoming accustomed to flood emergencies, so that’s an easy example, but these same five elements apply just as well to the opioid crisis. As we go through these five elements, you’ll notice that they overlap or bleed together very easily, and that if there’s a lack in any one category the others will also suffer for it.
Prevention
Prevention is “actions taken to stop an emergency or disaster from occurring.” We would obviously prefer not to have a crisis in the first place!
With regard to flooding, this is why we have Conservation Authorities. CAs were just becoming common in Ontario when Hurricane Hazel hit Toronto in 1954, and floods wiped out a neighbourhood that was built in a flood plain. The preventable deaths and destruction added some political force to the idea that a Conservation Authority could help regulate development so that we don’t build homes in places where floods are likely to happen. Right now, Lower Trent Conservation Authority is working on a project to redraw the flood plain maps for parts of Brighton, a task we should continually be doing as our climate warms and our weather becomes less stable. Some municipalities are buying properties that are prone to flooding, and insurance companies are withdrawing coverage: they won’t support the risk a homeowner may be willing to take by living in a flood plain.
With the opioid crisis, we know that drug addiction is usually a symptom of other problems, things that are often called the “social determinants of health.” People are much more likely to do drugs, and to get addicted to drugs, if they’re already experiencing trauma, poverty, homelessness, and/or abuse. We know that the best way to prevent a drug overdose is to ensure that a person has access to the basic amenities of life: housing, healthy food, and a supportive social network.
Mitigation
Mitigation is “Actions taken to reduce the adverse impacts of an emergency or disaster.” The emergency is happening, how do we reduce its impacts?
With flooding, some mitigation strategies are built into our homes. For example, we know that some building materials repel water more than others, and some designs are more likely to lead to flood damage than others. Homes designed to mitigate flood damage recognize that water in the ground (in some places more than others) is a given, so we may as well design in a way that assumes its presence and works around it. On a larger scale, this has been the approach of the Netherlands: entire sections of the country are below sea level, and they’ve learned that it’s safer and cheaper to make space for the water to flow than it is to always try to keep the water out.
With regard to drug addiction, Mitigation is where Harm Reduction comes in. Harm Reduction is a philosophy as well as a suite of resources. The philosophy acknowledges that drug addiction is a symptom of other problems, that it’s a physical dependency that many people have (and therefore people do drugs not as a choice, but as a requirement), and that any moral compunctions we may have about drug use in general don’t actually save the life of a person who is likely to die from using tainted drugs. The resources and programs that come with this philosophy include an Overdose Prevention Site or Safe Consumption Site, where healthcare professionals or even volunteers stand by to administer life-saving medication like Naloxone to someone who has overdosed; distributing clean needles for intravenous drug users to prevent the spread of HIV, and needle disposal bins to prevent people from stepping on used needles; and in some cases, distributing a “safe supply” of drugs that are not laced with fentanyl or other drugs that so often result in overdoses and intensify addiction. Here’s a great interview with our local Health Unit all about harm reduction.
Preparedness
Preparedness refers to “Actions taken prior to an emergency or disaster to ensure an effective response.” Like when the fire department reminds us to replace the batteries in our smoke detectors on a regular basis, or recommends that we have an emergency kit in our home.
Flood preparedness includes having the tools to divert water (like flood barriers), having a plan for setting up those barriers, and having an escape plan if they fail. It also includes buying insurance.
Preparedness for the opioid crisis includes having capacity in the healthcare system, adequate numbers of adequately trained first responders, or individuals getting their own Naloxone kit and learning how to use them to save a friend’s life.
Response
Response refers to “Actions taken during or after an incident to protect people, property, the environment, the economy and/or services.” Our trainer pointed out that in Ontario, it’s in that order of priority; but that he’d been to some southern states in the US where protecting the economy was explicitly the top priority. I’m very pleased with the priorities we have!
A flood response would include calling out emergency services and volunteers to set up flood barriers, help neighbours evacuate, set up temporary accommodations for evacuees, provide food for them, etc.
A response for opioids would be to use Naloxone, provide healthcare, and on a macro level, build political will and coalitions to provide housing and other preventative and mitigative efforts.
I’ll say here that we almost always think of Response when we think of emergencies…but as central as Response is, the very need for a response is often a sign of the failure to prevent, and the intensity of the response that is needed is often a sign of a failure to properly mitigate. If the response itself is hard to pull off, then we may have failed to properly prepare.
Recovery
“The process of restoring a stricken community to a pre-disaster level of functioning.” This definition has a few things I’d like to challenge:
First, the notion that it’s restoring a community to a pre-disaster level of functioning assumes that the pre-disaster level of functioning is even desirable. As I said just a moment ago, often the severity of an emergency shows us just how poorly we’ve prepared or how badly we’ve failed to prevent or mitigate that emergency. And as I pointed out above, often the key to Prevention and Mitigation is systemic: the kind of infrastructure we build (and where), the kind of attitudes in the community, etc. “Restoring” the very situation that produced a state of emergency is not desirable.
Second, we’re all used to the phrase “build back better” by now: rebuilding is an opportunity to correct the mistakes of the past and prepare for the future. I asked the EMO presenter about this, and he confirmed that where there is funding for restoration, it is specifically aimed at reaching “a pre-disaster level of functioning.” The same is true of insurance payouts. Thankfully, we’re beginning to see signs that this may change, which makes a tremendous amount of sense. It’s incredibly expensive to rebuild a faulty system: it either results in the same disasters all over again, or we spend more rebuilding to previous standards and THEN upgrading to prevent future disasters. It would be better to spend public funds in advance, upgrading systems to prevent disasters, then to reserve them for restoration projects that perpetuate the disaster into the future.
Recovery for a flood emergency refers to insurance payouts and rebuilding efforts. Recovery for an opioid emergency could be restorative healthcare, restorative justice, housing and income supports, and anything else needed to help someone get healthy and stay healthy.
Bottom Line
So that’s the framework: Prevention, Mitigation, Preparedness, Response, and Recovery. With some minor tweaks, you could apply this type of framework to virtually any scenario and you’d come out with solid planning, but there are a few key points to it all:
First, in the same way I hope you can all tell at this point that there are no clear divisions between these five points, I hope it’s also clear that a failure or inadequacy in any one point puts more stress on the others. The lack of affordable housing in our area (which I classified as Prevention of opioid overdoses) leads to a homelessness crisis which has an effect of more opioid use and overdoses – but it also prevents Recovery, because until a person has shelter they can’t effectively deal with the crises that led to drug use in the first place; and the lack of prevention or permanent solutions puts way more pressure on Mitigation measures, such as emergency shelters and harm reduction services, than those services can hope to effectively carry. An inadequate Recovery of a flood emergency, such as a failure to build back better, leaves us just as vulnerable to the next flood emergency.
Second, I hope it’s clear that Prevention of disasters is always best. That sounds like a simple thing we should all agree on, but when it comes to funding and political will it often seems that Prevention isn’t even an option. We spend a fortune every year on disaster response and recovery, and almost nothing on prevention. We need to do better.