Disaster Management and Vulnerable Population: A Case Study of Hurricane Katrina and the Haiti Earthquake. Lessons Learned and Recommendations.

                                  

Abstract

Disasters are a complex phenomenon that cannot be boxed in a specific category because they keep evolving. They come in many forms and intensity, from natural catastrophes to political, man-made maneuvering, technological, biological and meteorological events.  While some disasters are quite predictable, others come by surprise, bringing with them unthinkable damages. Responding to a disaster is a daunting task even for the most developed and sophisticated societies. Trapped in the middle of all the chaos is the group of vulnerable population who due to circumstantial reasons are more impacted by disasters than others.  This paper identifies some of the vulnerable population and how their socio-economic, political and/or even structural conditions make them more susceptible to harm than other groups. It takes a succinct look the impacts of Hurricane Katrina and the January 2010 earthquake event in Haiti on the vulnerable population. Without being prescriptive, the paper goes further to suggest some best practices for emergency planners and responders as well as for the communities and vulnerable population  themselves; based on the lessons learned in both events.

Key: disaster, earthquake, Haiti, Katrina, vulnerability, impacts, best practices.

  

                              Introduction

Disasters come in different forms and at different times in the lifetime of a community. Some may announce their arrival while others take the community by surprise. Whatever the case may be, disasters will always occur as long as there is an interface or relationship between the human community, their activities and the environment. A succinct analysis of a community’s hazards and vulnerability can determine its risk level in the face of a disaster. A hazard in emergency management terminology is “a potential harm which threatens our social, economic, and natural capital on a community, region, or country scale” (Pine, 2009, p.3). From this definition, a hazard can be anything capable of causing harm to a human being, his/her property and environment. Vulnerability relates to the susceptibility and resilience of a person or community. There are specific groups that are more susceptible to hazards than others and therefore are more at risk. Risk in this context is a statistical possibility or probability for the occurrence of a disaster. This paper takes a succinct look at the impacts of Hurricane Katrina and the January 2010 earthquake event in Haiti on the vulnerable population. It   identifies some of the socio-economic, political and even structural hurdles that the vulnerable population in New Orleans and Haiti faced before, during and after the disasters. The ultimate goal of this paper is to contextually assess the different social realities of vulnerable population in these two distinct regions; and how it informed their actions or inaction during the disasters. It also analyzes the emergency management and response outcomes from the victims’ pedestal; and proposes some best practices/ recommendations based on the lessons learned.

Conceptual Framework/Definition of Terms:

Vulnerability and Vulnerable Population

The concept of vulnerability is replete with a myriad of definitions by different agencies. Vulnerable population is also called “at-risk” or “special needs” population in other contexts. A careful condensation of the different definitions shows that the term vulnerability means proneness to harm. For the sake of this paper, we shall concentrate on social vulnerability. Vulnerability is “the susceptibility or potential for harm to social, infrastructural, economic, and ecological systems” (Pine, 2009, p.136). Nearly everyone is susceptible at one point or the other to a situation of harm regardless of their social status or position within the social strata. But there exist a segment of population in almost every society; often called “at-risk” or “vulnerable group” that have higher susceptibility to harm due to their specific conditions. A vulnerable population has been broadly defined by the Iowa Public Health Preparedness Program (IDPH) as “any individual, group, or community whose circumstances create barriers to obtaining or understanding information, or ability to react as the general population” (as cited in Nick et al., 2008, p.338).  As cited by the North Carolina Preparedness and Emergency Response Research Center (NCPERRC), the Center for Disease Control and Prevention (CDC) frames vulnerable or at-risk population as people “whose needs are not fully addressed by traditional service providers or who feel they cannot comfortably or safely access and use the standard resources offered in disaster preparedness, relief, and recovery” (NCPERRC survey, 2012). Vulnerability according to the International Federation of Red Cross and Red Crescent Societies (IFRC) is  the “…diminished capacity of an individual or group to anticipate, cope with, resist and recover from the impact of a natural or man-made hazard” (2012). This implies that vulnerable groups are limited in their potential or ability to anticipate, cope or recover from disasters in the same capacity as everybody.

Responding to a slow or sudden emergency is always a huge challenge to every community, regardless of its level of preparedness. It may anticipate a disaster but never the extent of the damage. In an emergency, the stress level and challenge is more heightened for the vulnerable groups in the community. The vulnerable population is comprised of the elderly or frail, persons with disability (physical, mental, emotional), the uneducated, children, recent immigrants and tourists, low income persons, racial minority, medically or chemically dependent, pregnant women, religious fanatics, prisoners and the homeless.

Emergency versus Disaster

The terms emergency and disaster are often used interchangeably by most policy –makers, first responders and even the academia. However the similarities, conceptualizing the terms in their right context may portray some slight differences.

In the public health framework, an emergency occurs “when its health consequences have the potential to overwhelm routine community capabilities to address them”. In other words, it is a situation “whose scale, timing, or unpredictability threatens to overwhelm routine capabilities.” (Nelson et al., 2007). Thus, emergencies are somewhat related to surges created by disasters. In an emergency, a community, locality, or state’s system is overwhelmed by an incident to the point where its resources cannot match the surge capacity. Disasters are usually associated with emergencies. Both are interconnected but they are two distinct elements.

Disasters on the other hand are products of nature, human action, the environment or all three combined. According to the United Nations Office for Disaster Risk Reduction (UNISDR), a disaster is a “…serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources (UNISDR, 2007). This definition is similar to that of the International Federation of the Red Cross and Red Crescent Societies (IFRC, 2013) which considers disasters as a “sudden calamitous event that seriously disrupts the functioning of a community or society…”. There exist a perfect correlation between hazard, vulnerability and risk if one looks at these concepts through the prism of social class composition and/or distribution in a community. If hazard is a harmful event (natural or man-made) and vulnerability is the predisposition or susceptibility of being affected by that identified harmful event as a result of one’s social location, status or class; then the probability of being affected (risk) can be estimated in real time. 

Background to the Disasters

Hurricane Katrina

Brief Overview of the Event

New Orleans is the largest city in Louisiana State. It is situated between the Mississippi River and Lake Pontchartrain.  The city is one of the lowest points in the US, located between .3 and 3 m below sea level and it is protected by a range of levees (Mazora et al., 2006, p. 301). The city’s location, the lost of wetlands over the years due to human activities and the rising sea level  have all contributed in transforming New Orleans into  a very susceptible environment for floods and other natural catastrophes. Hurricane Katrina started from small tropical waves around northern Puerto Rico on August 19; where it developed into a tropical depression on August 23 some miles away from Nassau in the Bahamas. As it progressed westward towards south Florida, it was named “Tropical Storm Katrina”.  It evolved into a Category 1 hurricane just two hours before it hit US soil on the eve of August 25 and on August 26, it grew into a Category 2 Hurricane as it moved southwestward.

     

Katrina was downgraded to a tropical storm as its strength dropped by August 29. Despite its weakness, Katrina still caused some reasonable damages with 62 tornadoes from Florida to Pennsylvania as it moved (NOAA, 2005, pp5-7). According to the British Broadcasting Corporation (BBC), Katrina left 100,000 homes without power as it crossed the south of Florida. From a tropical storm level, Katrina intensified as it moved towards Louisiana and made massive landfalls at Grand Isle some 90 km south of New Orleans on August 29. The waves destroyed houses and buildings in Mississippi and Alabama (BBC, 2013). The storm surges in Mississippi and Alabama were not as serious as in New Orleans. The storm surges caused massive floods when the levee broke. Flood waters from the Industrial Canal breach covered much of the city, particularly in St. Bernard Parish where many where trapped in rooftops.  Canal Street and several other levees in New Orleans over-topped and caused a catastrophic flooding dilemma which left about 80% of the city under water (NOAA, 2005, pp.7-8). The damages of Hurricane Katrina are untold. An estimated 1,353 people died and 275,000 homes were destroyed. The American Insurance Service Group estimated the insurance loss at $40.6 billion; meanwhile the National Hurricane Center estimated the damages to be at $81.2 billion (NOAA, 2005, p.1). No matter the final estimate, it is clear that Katrina was one of the costliest disasters in US history.

               

Haiti Earthquake

Background to the Disasters : Brief Overview of the Event

Haiti is one of the poorest countries located in the Western Hemisphere and is ranked number 145th out of 169 countries in the United Nations Human Development Index (HDI) . It is located between 71°20' and 74°30' West longitude and 18°0' and 20°6' North latitude and covers a surface area of 27,750 km2. Situated 77 km southeast of Cuba, Haiti shares boundaries with the Dominican Republic and engulfs other Island such as La Navase, L’Ile-a-Vache La Tortue and La Gonave. It is a mountainous and rocky country and it is the second largest country in the Caribbean Island. The Capital of Haiti is Port-au-Prince and the official languages are French and Creole. Haiti is the most densely populated country in the Western Hemisphere due to its ever growing population but the economic situation has been stagnant. According to the 2005 World Bank estimate, Haiti’s population was 8.5 million and it is estimated that it would grow to 10,804,812 million by 2015. Haiti has three main religions which are Protestantism, Voodoo and Catholicism. The poverty ratio in Haiti is very high and according to the World Bank indicator in 2005, Haiti’s GDP growth was 1.8 %, with a GDP per capita growth standing at only 2.0 % (Embassy of Haiti in Washington DC).

Vulnerability and the Challenges of Survival during Katrina and Haiti

Disasters impact people in different ways. Some people are more impacted as a result of their condition and location. The ability or capability to respond to , cope or respond to a disaster more or less depends one’s socio-economic and geographical condition and factors. 

Low Income, Minority and Education

Certain conditions existed prior to Hurricane Katrina and the Haiti Earthquake of 2010 that altered the response calculus of the vulnerable population. One of them is the poverty and income level. Economically disadvantageous population face the double weakness of being susceptible and geographically exposed to hazards as well as being unable to easily recover from disasters long after they occur due to their limited resources to afford the cost of repairs, reconstruction or relocation. This population is one of the most affected during disasters. Disasters eat deep into the fabrics of low income folks and also increase their level of poverty in the aftermath. Poverty spreads across a wide spectrum and impacts different categories of people in the society such as women, children (dependent), documented and undocumented, students the elderly and persons with disability/special needs.  Due to the lack of access to certain resources, poor or low income individuals may not have the capability to respond to a disaster with the same swiftness and flexibility as those who are better-off. They may be impeded in their actions by conditions such as the lack of transportation facility, the inability to recover through insurance coverage because the majority live in rented houses and the lack of financial means to relocate to temporary dwellings upon receipt of disaster alerts. Minorities and migrants are most often victims of society’s impartial distribution of opportunities; leaving them to fend for themselves with less than a dollar a day. Poverty decreases their access to educational opportunities and increases their inability to properly decipher and process alert messages coming from various sources. Misinterpreting the seriousness of alert messages and/or misjudgments may cause serious response blunders as was the case during Katrina.   In addition,  poverty leads to class distinction and discrimination and affects a person’s knowledge, ability to obtain a job with good remuneration, housing location and structure, access to healthcare and education. Research has shown that the poor residential areas are mostly noticeable by the high level of noise, pollution, crime, victimization, insanity and vagabond behaviors (Mecanic & Tanner, 2007, pp.1223-1224). Due to poverty, some individuals such as those with acute and repeated medical conditions/disorders, persons with disability and those incarcerated find themselves stigmatized, discriminated against and excluded from the society.

Katrina

In 2005, U.S. Census Bureau revealed that 37 million people lived in poverty (12.6 percent of the population). While the level of poverty of non-Hispanic whites was 8.3 percent, it was three times higher among blacks -24.9 percent- and Hispanics - 21.8 percent- (Center for Public Health Network, 2007, P.15). Prior to Katrina, a majority of the African American population in New Orleans lived in high level of poverty and low-waged jobs compared to their white counterparts. In 2005 an estimated 21, 787 African Americans households did not have a car which could facilitate evacuation. That explains why about 20,000 to 30,000 New Orleans residents remained stuck in the Superdome when the floods took over the city (Masozera, Bailey & Kerchner, 2006, p.303). Also, between 100,000 to 120,000 could not evacuate before Katrina because of the lack of transportation according to estimates from the US Census Bureau (Barnshaw& Trainor, 2007). Moreover, due to low educational level among the African American and other minority groups, many had problems deciphering the alert communication prior to the flood.  It was hard following and analyzing the different messages and because of that, some did not give the alerts the seriousness they deserved.  That contributed to the elevated number of entrapments and death. As pointed by Hoffman (2009, pp.1505-1507), African Americans refugees who attempted to enter Gretna, a neighboring city were stopped by armed police because Gretna city residents did not want to help them. Minorities accounted for 72% of the population of New Orleans, with a median household income of $31,369 and per capita income of $19,711 which was below the national median household income average of $44, 684 and per capita income of $24, 020 respectively. To make matters worse, many African-Americans and minority groups lived in mobile homes and single-unit housing structures which turned out to be a safety hazard during Katrina than a safe abode as statistics later showed (Masozera, Bailey & Kerchner, 2006, p.302).

Haiti

As one of the poorest countries in the Western Hemisphere, the majority of Haitians (about 80 %) survived on less than two dollars a day meanwhile approximately 60% are on less than a dollar per day. This level of poverty was exacerbated by the elevated level of unemployment.  Approximately 70% of the population depends on agriculture and other menial jobs for subsistence. About 5% of the population own 75% of the land meanwhile 1% controls more than 40% of the wealth in Haiti. This imbalance has led to a huge gap between the rich and the poor. Many Haitians live in shanty dwellings where the lack of electricity, clean water, sanitation and transportation means has become an accepted norm (P81 Haiti relief, 2013).

In 2005, Haiti’s GDP per capita (PPP) was $1,200 and the unemployment rate was 40.6% according to Poverty Resolution (2013). The composition of the labor force is very complex with 38% in agriculture, 12% in industry, and 50% providing services. In Haiti, the median age is 21 meanwhile life expectancy for men is 61 years and 64 years for women. With an adult literacy rate of 53%, response to emergencies and prior alerts became very complex (Poverty Resolutions, 2013). In addition, because of the high poverty rate, it became difficult for most Haitians, particularly in Port-au-Prince where the earthquake hit most, to evacuate or even recover or relocate to the rural areas where the impact was less felt.  This also explains why approximately 220,000 Haitians were killed and close to 25% displaced.  According to UN reports, almost 370, 000 remained in displacement camps because they could not afford temporary housing elsewhere (Torgan, 2012).

The Elderly

In the World Health Organization’s (2013) context, an elderly person is one who is 65 years and above. The United Nations does not have a specific age for elderly persons but it does mentions 60+ years as the threshold.  People between the ages of 60 to 65 and above are a very vulnerable and frail because they are more likely to suffer from chronic diseases and conditions such as arthritis, hypertension, heart disease and diabetes. In addition, the elderly have difficult economic, physical (mobility) as well as cognitive and sensory limitations. These constraints or conditions reduce their emotional and mental capacity to interpret and/or process alert messages. Those who succeed to process the messages are often impaired in their response efforts by their pre-existing physical and health limitations (Hoffman, p.1501).

Hurricane Katrina

In 2004, more than 20% of people 65 and above lived in abject poverty in New Orleans. Many of them were dependent and living in nursing homes (Masozera, Bailey & Kerchner, p.302). According to the US Census Bureau, 12 % of the population of New Orleans was made of people aged 65 and above (Barnshaw & Trainor, p.99). The majority of them low income and impoverished had medical conditions of different types. Many elderly succumbed to the flood due to their economic condition and inability to evacuate with the swiftness of youthfulness.  An estimated 9,000 residents sought a last resort move by taking refuge in the Superdome and the American Red Cross sheltered some 3,000 people in 45 shelters (Barnshaw, p.99). Many senior citizens died in the flood, helpless and lonely. A total of 178 elderly people from the ages of 75 and above perished in their homes amongst which, 115 of them died by drowning (Brunkard et al., 2008, p.5). 

Haiti

The elderly in Haiti are affectionately and respectfully called "gran moun”. The elderly population of 65 and above makes up 3.4% of the Haitian population.  But during and after the brutal earthquake of January 10, 2010, the elderly were left to their own fate. The general desperation for those who resided in Port-au-Prince after the earthquake was directly followed by the complete abandonment of the elderly. According to a private census, 84,000 out of 1.2 million Haitians who were displaced by the earthquake was made of people aged 60 years and above (Urbina, 2010). Some had lost their children in the earthquake and loneliness became their sole companion. This accounts for the elevated death of elderly persons who became single-headed household occupants and died without help in the after-math of the earthquake. The few who were in nursing homes such as the Municipal nursing home were submerged by the hot temperature.  Others were in dire need of diapers, water, food and other basic necessities.  Before the earthquake, most elderly lived with some family whether direct or extended from whom they received care and support. Very few were in retirement homes like in America because of the strong sense and the largeness of family units in Haiti. Those without family were catered for by churches and some by the government. During and after the disaster, the elderly who survived were abandoned to themselves. Many had to cope with whatever help they could receive from humanitarian organizations and some well-wishers. They took showers outside in open air, and used bed sheets as cloths. They suffered from the extreme heat, hunger and thirst. Some with prior medical conditions had no access to their medication and hence, died prematurely. According to the Haitian government, the disaster killed approximately 220,000 elderly individuals (Booth, 2010). 

Women and Girls

Women have a particular vulnerability to disasters. This stems from various angles. They are more likely to be stricken by poverty at a greater rate than men and face the challenge of evacuation due to a lack or limitation of resources. Also, pregnant women and lactating mothers have special needs which may impede their quick response during a disaster and impair their fast recovery. Generally, some women with pregnancies have had birth complications of all sorts in the aftermath of disasters such as premature deliveries, delivering abnormal or overweight babies or miscarriages. In addition, women in general and pregnant women in particular may be forced to evacuate without their medication, hence, complicating their health and the health of their unborn children (Hoffman, p, 1501). That goes without saying that women are twice likely to be victims of gender-based violence in the midst of a disaster.

Katrina

During Hurricane Katrina, the percentage of women in New Orleans living below the poverty line was 25.9 and that of men was only 20 %. Most women in New Orleans at the time of the disaster lived in public houses and did not have cars for transportation since they depended on relatives, friends or on public buses. That explains why some women were stranded in the city when the flood started. Moreover, women made up a great percentage of the elderly group and because of their physical and health frailness, they faced evacuation challenges and many drowned in the flood either in their homes, on the streets or in nursing homes. Women were victim of gender-based violence during and after the Hurricane and suffered from different types of trauma. According to the Institute for Women’s Policy Research (2010, p.1), the rate of gender-based violence both domestic and sexual assault rose from 4.6 per 100,000 per day during the disaster to 16.3 per 100,000 per day a year later. This level of gender-based insecurity did nothing but complicate women’s recovery from Hurricane Katrina.

Haiti

The condition of women in Haiti prior to the earthquake was marked by low income, high level of poverty and dependency on family networks for survival. It was very difficult both for single-headed households and their dependencies to survive. The earthquake made things even worse for women in Haiti.  A great proportion of women died after the quake and survivors whose homes were destroyed and shattered were forced to take refuge in shelters and tents. The temporary shelters set up by international non-profit organizations were no safe haven for women. The blackout that engulfed almost the entire capital Port-au-prince, gave room for indiscriminate acts of rape and sexual exploitation against women in their tents and shelters. The most horrendous of the acts were committed by some of the over 7,000 run-way prisoners and criminals who broke loose and flooded the streets and camps when the jail walls collapsed (New York Post, 2010). In addition to gender-based violence suffered by women and girls in Haiti post earthquake, they also face challenges of accessing reproductive, post-rape and other healthcare services that are crucial in preventing or controlling maternal and infant infections and/or mortality. Thanks to the advocacy work of some humanitarian organization, the Haitian government instituted free healthcare for all but accessing the services was and still is a huge hurdle for female victims in Haiti. Approximately 60 % of hospitals in Haiti were destroyed after the earthquake, making access even more tedious with many women scrambling for the existing few.  With more than 300,000 women and girls in displacement camps, the exacerbation of poverty after the earthquake has forced some women and girls to trade sex for food and other basic needs. Some women and girls still give birth in horrible sanitary conditions more than a year later (Human Rights Watch, 2011). According to KOFAVIV, known by its English name as  the Commission of Women Victims for Victims; a nonprofit organization that fights sexual abuse in Haiti, approximately 640 sexual violence cases were reported in 2011 (The Huffington Post, 2012). With the plethora of socio-economic difficulties, recovering from the disaster has been a great challenge for women and girls in Haiti.

Children

The International Conventions on Child Labor and the United Nations classify a child as anyone under the age of 18 years (United Nations, 2013). Children are another set of vulnerable population before and most especially during disasters. Children are frail, dependent and sometimes may not have the maturity to make the right decisions during times of emergencies. They most often depend on their parents and closed ones for survival and livelihood. Children are at greater risk of separation from their parents or care givers during disasters and suffer periods of trauma long after the disaster is over. Physiologically and anatomically, children are different from adults and are more likely to be less resistant to certain diseases and trauma that comes with disasters. One of the greatest challenges for neonates, infants and young children in disasters is getting the appropriate medical- mental attention.  Most first responders lack the requisite training to deal with children and other pediatrics, reasons why  their  needs are often overlooked during  disaster response (Hoffman, p. 1504).

Katrina

Children made up more than 25% (73.3million) of the US population in 2004 and about 20.1 million of that estimate was under the age of 5. During Katrina, there was the insufficiency of pediatric-specific medical resources and the surge capacity was very elevated. Many children died in the flood because their anatomy could not withstand long hours under such horrible conditions.  About 300,000 school-aged children were reportedly displaced, losing their homes, pets, school mates and separated from their families in the chaos. Most of the children who survived the flood were left in conditions of shock and multiple cases of Post-Traumatic Stress Diseases (PTSD). There was a great need for children supplies such as baby food, diapers, cloths and water after the disaster. Poverty also increased among the children population. Those who were displaced to nearby counties had problems integrating their new environments and adjusting academically. The stress and behavioral issues that manifested contributed in lowering their academic performances and many dropped out of school. An estimated 121 babies were evacuated from New Orleans to Baton Rouge, Dallas and other locations. Child exploitation and abuse was also a big trend after the disaster amidst the general chaos (Centers for Public Health Preparedness, p. 25). 

Haiti

In Haiti, over 40% of the population is made up of children from 18 years and below. Surviving in Haiti before the disaster in Haiti was an uphill task for children. Many lived in extreme poverty and some were pushed to engage in criminal activities to survive. Approximately 18% of children in Haiti were underweight due to malnutrition and inadequate medical attention. These preconditions resulted in the high infant and child mortality rate in Haiti. UNICEF and CIA fact books estimated that 1 in 6 children in Haiti will not live to see their fifth birthday. About 50 % of Haitians in 2010 were illiterate as a result of high cost of education in Haiti and only 1 out of 5 children in Haiti makes it to secondary school (Poverty Resolutions, 2013).

Persons with Disability

According to the Americans with Disability (ADA) Act of 1990, a person with a “disability” is one who “Has a physical or mental impairment that substantially limits a major life activity, has a record of such an impairment, is regarded as having such an impairment” (as cited in Phillips, Thomas, Fothergill & Blinn-Pike, 2010, p.190). Statistically, the US Census of 2006 places the number of persons with a disability over the age of five at approximately 15.2 %, that is 14 million (Phillips et al., 2010, pp.188-189). Persons with disability are of special interest because they have often always been neglected, ignored or overlooked in most emergency preparedness and response activities.  This is a general truism in most countries in the world. In the United States, despite the legal provisions that protect the rights of persons with disabilities, their needs have not yet been fully embraced, understood  or integrated by some responders (at individual level) or agencies. Although Section 504 of the Rehabilitation Act of 1973 legally protects the civil rights of Americans with Disability and ensures their access to Federal programs and assistances without discrimination; many persons with disability are still feeling victimized in public service distribution on particular and in emergency response in general.  This is due to the fact that many people still look at disability through the prism of impairment instead of civil right (Fleischer & Zames, 2005).

Besides their situation of impairment, persons with disability are highly susceptible to harm as a result of a set of structural, policy, environmental and social factors or disadvantages which are not commonly faced by the rest of the community. For example, structurally, some buildings and apartments and houses are not disability-friendly; thereby making it twice difficult to quickly act in a sudden emergency. Policy wise, some organizations or agencies still fail to incorporate persons with disability in most emergency response and/or preparation activities.

Katrina

During and after Katrina, the National Council on Disability (NCD, 2006) drafted a report on how the disaster was managed vis-à-vis persons with disability. The Council revealed that mentally ill victims were discriminated against during evacuation, rescue and relief. Mentally sick victims were highly maltreated, institutionalized, and incarcerated.  Many died due to such poor and inhumane treatments from the responders. The needs of persons with disability were not included during the disaster planning. Persons with psychiatric disabilities were banished from shelters while others were either sent to some far away nursing homes, psychiatric centers or simply sent into the cold streets. It was reported that FEMA refused trailers to mentally ill persons because some were unable to follow instructions or fill out an application. Contra Times reported in 2006 that the elderly and persons with disability/special needs were among the highest victims (70%) of Hurricane Katrina in New Orleans. Twenty percent of the bodies found in private homes or nursing homes were found on wheelchairs ( Reynolds, January, 2006) Centers that were later on opened for special needs persons only catered for the needs of persons with physical disabilities and excluded those with mental concerns (Reynolds, June, 2006). According to the NCD’s estimates, when the Katrina waves went down, a total of 155,000 (25%) persons with disability from ages 5 and above were wondering in the counties such as Biloxi, Mississippi, Mobile, Alabama and New Orleans.

Haiti

In Haiti, anyone with a disability is called “Cocobai” or “kokobi”, a Creole slang which means “worthless” or “good for nothing”. From this premise, it becomes very easy to visualize the social annihilation that persons with disability suffered in a country which dangles between political instability and economic recovery. According to Handicap International, non-governmental organization (NGO) working in Haiti, there were approximately 800,000 persons with disability in Haiti before the earthquake (Phillips, 2011 p.ii). Also, an estimated 7 to 10 percent of Haitians lived with some form of disability according to World Health Organization (Eitel, 2010. para.2). Persons with disabilities in general and those with mobility impairment in particular have been relegated to the ranks of social misfits in the Haitian society. Disability is more or less regarded as a curse and parents of children born with or who acquired a disability either abandoned them or treated them with less affection. Disability was often seen or regarded as something mysterious, either a curse from an enemy or a punishment from the gods which they called Iwa (Jabobson, 2003. para. 43). With such a huge negative stereotype, it comes as no surprise that persons with disabilities were and are still less represented in areas such as the employment market, are inadequately integrated into the school systems with limited brails in Creole for the blind; and encounter mobility constraints due to unpaved streets, the absence of ramps in most of the city’s infrastructures as well as the steep rocky mountainous roads in the rural areas.

Moreover, before the earthquake, there existed very few rehabilitation professionals and services to handle prostheses and wheelchair needs. From investigated statistics in 2001, only about three stores offered prostheses services in the entire country (Lezonni & Ronan, 2010. p.813).  As was the case with people with disabilities in New Orleans, Haitians with disability had the worse poverty level due to limited access to employment opportunities.

Lessons Learned and Recommendations

The above empirical data on the different impacts the disasters had on vulnerable population both in New Orleans and Port-au-Prince shows how much planning needs to be done to mitigate, prepare, prevent, and properly manage future disasters. Learning from the mistakes and shortcomings in the way disasters were managed both from an individual (vulnerable population) level and from an administrative (political) level would better inform our future judgments and decision. This section combines lessons learned from the impacts and provides some recommended actions for individuals and emergency managers. The political and economic capacities of both countries may differ but the realities of the needs of vulnerable population both in New Orleans and Haiti are somewhat identical. Without being prescriptive, the following segment suggests factors and things to consider or put in place for improvement. The objective of these recommendations are simply to guide and provide policy options that can enable decision-makers, emergency managers, first responders , vulnerable population and the community make informed decision.

Minorities, Low income and Migrants

• The lack of transportation facilities greatly impeded evacuation in both disasters. Prior to Hurricane Katrina, there were only 464 buses and these could only evacuate 10% of people without cars. The situation was even worse in Haiti where transportation terns to be a luxury rather than a necessity. In this regard, Governments need to set up free transportation systems (during emergencies) or improve the accessibility of existing public transportation systems in remote/ rural areas to enable easy mobility or evacuation for low-income families who don’t have private cars. Moreover, free or accessible means of transportation will enable victims of gender-based violence in Haiti have access to hospitals and health centers. Many women who are victims of rape are unable to access treatments because of the lack of resource to get to the hospital.
• Many residents in low-income communities lacked the financial power to survive during and post Katrina. Approximately 70% of the people who took refuge in the Houston Astrodome did not have credit cards and 2/3 of them did not have a bank account whether savings or checking (Enarson, 2013, p. 265). Learning from the challenges faced by low income individuals and families, it is important to improve the income distribution in communities occupied by a large number of minority groups.  Government needs to set platforms that open up more public and private job opportunities. Wealth determines the kind of housing or geographical location an individual or family will live in; the kind of transportation system they will use or the kind of health and education they will have. In this light, it is imperative that people in New Orleans and Haiti have access to jobs that pay well, enough to have a decent lifestyle and access to decent facilities and opportunities.  Governments and local authorities need to tackle the issue and raise the minimum wage level a little bit higher.
• Many low-income families lacked the financial resources to cover for repair and reconstruction costs unlike the wealthy that had insurance coverage and tax rebates for disaster mitigation activities.  Governments and local authorities need to facilitate access to grants and loans as well as eliminating the bureaucracy associated with the processing. This will help the poor to easily rebuild and recover from disasters.

• Government need to work with community leaders to identify and extend public assistances and information to vulnerable population (migrant, documented or undocumented). Federal funding can be provided to community organizations and some churches that work to alleviate poverty within the community.
• Government needs to draft policies that protect employees who miss work because of an evacuation alert whether real or perceived.
• Given that racial and / or social minorities and migrants have limited access to formal education, providing access to formal and informal education facilities would be most helpful in curbing the level of illiteracy among vulnerable groups. This will also limit people’s distrust of government information, reliability on rumors, gossips, friends and family for critical information.

Children

• The level of post traumatic stress disorders is most rampant amongst children and women. It therefore becomes a government priority to ensure the availability of disaster mental health services to help victims to quickly recover from disaster. In addition, providing free social support to assist victims post disaster will also help to speed up the recovery process.
• Communities and local authorities need to invest more on the training of first responders and first aid workers on how to respond and meet the needs of children and infants during emergencies. Such skills should go beyond performing CPR and involve other areas such as the identification of shock, stress and the treatment of trauma in pediatrics.
• Easy identification and reporting mechanisms need to be put in place to address child abuse and exploitation during disasters.

Women and Girls

• The governments and communities need to put in place mechanisms and structures that protect and girls from gender motivated violence and facilitate access to post-rape and other healthcare needs. An anonymous system of reporting should also be established so that rape perpetrators can be apprehended and punished.
• The Haitian government should put aside special funds for the recruitment of more patrol guards/police within the shelters and camps. This will improve the security lapses and reduce the prevalent rape in the shelters and camps. Community based security and monitoring initiatives are also very good systems to get the community involved in women and girl protection.
• Community groups in Haiti need to advocate for greater access to emergency contraception and other post-rape care for girls and women. Moreover, they need to reach out to the victims and tell them the resources available, location and how to access them.

• The Haitian government needs to address the housing problem in Haiti by building stronger and long-term public housings to settle those left homeless by the earthquake and those surviving in makeshift camps.

Elderly

• Decision-makers and Emergency managers need to incorporate the needs of vulnerable population such as the elderly and persons with disability within the overall Emergency Operation Plan. This will certainly speed up the decision making process, reduce the confusion in the response coordination and provide a disaster management roadmap.
• In view of addressing disasters in an all-hazard dimension, policy-makers and emergency managers need to provide free additional mental health training to local case managers, care givers, qualified students, and families catering for the elderly and mentally ill in order to improve preparedness.
• The community should establish a list containing the names of elderly persons, their emergency contacts and general needs. The elderly and immediate dependence or caregivers should be trained on how to prepare an emergency “Go-bag”, prioritizing medication needs and other immediate evacuation necessities.

Persons with Disability/Special Needs

• The complexity of the needs of persons with disability may make it seem impossible to address their needs. However, simple actions can save thousands of lives in disasters. Providing interpreters and writing alerts in brails are some of the things to be considered during disaster risk communication.
• Emergency planners and managers need to know the number of persons with disability within their communities and their needs so as to better address them before a disaster. In case a list is drafted, ensure that the list is updated regularly.
• As Haiti rebuilds its broken structures and puts the pieces of the nation back together; the Haitian government needs to seize this opportunity and develop new policies on zoning and building regulations to meet the needs of persons with disability in general and those with mobility impairment in particular. They also need to frame regulations for private and public buildings to enable accessibility to wheel chairs and make it less tedious for people who use crutches. The planning and policy process should not just be limited to government and international organizations, but should include persons with disability and organizations working for persons with disability for find a collaborative solution to meet the needs of this group.
• In addition, although more shelters are needed to cater for the thousands who were displaced by the earthquake, it would be necessary for response organizations to shift their focus from building temporary shelters to building permanent and accessible housing that will provide a long term solution to the problem of homelessness.
• As far as the health care sector is concerned, there is an ever growing need to provide medical attention to former and especially the newly disabled persons. Those with fresh wounds from amputations and other injuries need the constant attention of specialists to ensure that their conditions don’t get worse and lead to death.  There is also the need of special human resources like physiatrists, surgeons and physical therapists to improve the response and recovery process. This will however not be possible if Haiti relies solely on foreign expatriates. In this regard, more Haitians need to be trained in these specialized fields in order to take over and ensure continuity of medical operations when the country gets back on its rails and/or if another such disaster were to occur. USAID has trained and graduated 15 medical professionals and sent them to the field to work but this number is not enough for a country whose population may reach 10 million people by 2015.
• Given that Haiti has entered the recovery phase of the disaster, meeting the medical needs of Haitians who have been injured by the earthquake should be associated with changing the environmental and social climate to break the cycle of stereotyping and make room for inclusiveness. USAID has been greatly involved in activities that support the needs of persons with disability by developing programs that increase their access to key services and advocating for programs and policies within the Haiti Ministry of Health, Ministry of Social Affairs and other local NGOs to increase their integration. USAID signed a three years agreement with the Organization of American States (OAS) to strengthen legal frameworks in favor of persons living with disability in Haiti.
• One of the greatest innovations to responding to the needs of persons in disability in the future will be the use of mobile phone tracking devices. Technology can provide a great resource in the search and rescue phase of emergency response. During a disaster, the general tendency of those living around the affected area is to flee to safety. In this kind of situation, it becomes a huge challenge for emergency managers and first responders to track and provide relief to those most in need. It has been proven beyond doubt that reliance on eye witness accounts or manual head counts are always full of bias. In the case of persons with disability, it is assumed that due to their low social classification, many were excluded from the count during the emergency. A study carried out by Bengtsson, Lu, Thorson, Garfield and von Schreeb (2011) revealed that Haiti had about 3.5 million cell phone subscribers out of a population of 10 million inhabitants; with  close 2.2 million subscribed to Digicel (the largest GSM company in Haiti) alone. Using active SIM card and calls made days before and after the disaster, the study revealed that population movement as well as disease spread can be accurately tracked down using mobile phone date in areas with high cell phone usage (Bengtson et al., 2011. p.9) like Port-au-Prince. As interesting as the results of this study may be, the benefits of this device may not trickle down to the level of persons with disability who may not have cell phones. Persons with disability in Haiti alongside children, the elderly and women are part of the group of people who do not have the privilege of owning a cell phone due to their poverty level. The free phone services with limited calling credit units as practiced in the United States can be a best practice to solve this problem. Access to cell phones by this group will not only help in tracking their movement and position during an emergency but will also provide a good early warning messaging system for early and quick evacuation, thereby saving many lives.   

Other Emergency Considerations

• The Haitian government needs to expand its development strategy in progress to include an “All-hazards” approach and not just focus on specific disasters that have occurred in recent years. Before the 2010 disaster, the last earthquake in Haiti occurred in 1860 (150 years ago) and Haitians never expected nor prepare for it.
• The community needs to build networks and alliances that that transcends racial, social and economic differences for greater information sharing and assistance. This fosters and strengthens the sense of community and responsibility.
• The community through local unions, organizations, and faith-based groups should organize preparedness trainings for target groups, identify and list resources. This way, community members will obtain basic disaster response skills and be aware of the resources that are available for them.
• Emergency managers and first responders need to consider language barriers for low income, minorities, immigrants/migrants and illiterate/low level of English. Emergency managers and community leaders need to know locate this population, their limitations, needs and ensure that alternative modes of communication. For example, kit may be very difficult for people with limited education to access or even understand messages through the internet because they may not have access to a computer or the requisite computer skills.
• Haiti’s emergency needs are very complex because of the high level of poverty. . Given the discrepancy in wealth between the US and Haiti; community members in Haiti need to ensure that their emergency plan is adapted their socio-economic, financial, demographic and political realities.
• In both disasters, coordination was poor and almost ineffective. FEMA and other emergency organizations (US), the Haitian government and International multi-national/humanitarian organizations need to established standardized and/or joint systems of disaster coordination. There is need for more clarity of roles, command and subordination of roles. The ICS structure should be well defined even in the heart of destructive disasters such as Katrina and the Haiti earthquake.
• Community must ensure, alongside government backing, that most public buildings and accommodations respect the clause of Title III of the ADA, which prohibits discrimination in the provision of goods and services against persons with disability.
• Communities must also ensure the reinforcement of Title VI of the civil Rights Act of 1964 which prohibits discrimination based on a person’s color, race, and national origin.
• Use GIS services to improve the response and other emergency actions.

Conclusion

In a nutshell, this paper explored different parameters and dimensions of social vulnerability in relation Hurricane Katrina and the 2010 earthquake that occurred in Haiti. It took a succinct look at the general conditions of vulnerable population prior to a disaster and how their pre-disaster conditions make them more susceptible to be impacted than the other groups in the community. The paper revealed that low-income individuals and minorities face specific challenges that deviates their calculus with respect to evacuation. They lack of resources like cars to ease transportation or financial power to relocate to safer havens made many victims both in New Orleans and Haiti to submit their lives to fate; which turned out to be very costly and detrimental. The elderly and persons with disability where pinned to their houses and care facilities because of their physical weakness. Children were separated from their families and care-givers and became subjects of exploitation. The lack of proper disaster planning for children and pediatrics became a huge challenge for emergency workers and first responders who lacked the appropriate training to deal with children-specific needs.  Women and girls both in Haiti and New Orleans faced almost similar challenges. Their condition was marked by poverty, limited access to health care needs and gender-based violence. Women and girls need more financial and social empowerment and protection before, during and after a disaster. A condensation of all the challenges of vulnerable population in New Orleans and Haiti, the lessons learned requires changes both at the policy and decision-making level, as well as at the local, community and individual level. The paper provided some recommendations drawn from the lessons learned following these disasters and it is hoped by the author that the concerned authorities will take them into consideration and include some of the ideas in current or future emergency planning. If some or all the recommendations are implemented, the conditions of vulnerable population with regards to disaster prevention, mitigation, response and recovery will be much improved.

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