Developments in Disaster Planning for Older People in Canada

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Developments in Disaster Planning for Older
People in Canada

• Gloria M.Gutman, PhD
• Simon Fraser University, Vancouver Canada
• Immediate Past-president International Assn of
  Gerontology and Geriatrics (IAGG)
• Presentation at IAGG 19th World Congress of
  Gerontology, Paris, France July 5-9, 2009

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Milestones

• Madrid Plan of Action (2002)
• Hyogo Framework for Action (2005)
• International Association of Gerontology and
  Geriatrics World Congress (June 2005)
• White House Conference on Aging (December 2005)
• Toronto Knowledge Exchange(February 2006)
• Winnipeg Workshop (February 2007)
• Halifax Workshop (March, 2008)

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MIPAA Recommendations re older persons and
emergencies

• In emergency situations, such as natural
  disasters and other humanitarian emergencies,
  older persons are especially vulnerable and
  should be identified as such because they may be
  isolated from family and friends and less able to
  find food and shelter. They may also be called on
  to assume primary care-giving roles.
• Governments and humanitarian relief agencies
  should recognize that older persons can make a
  positive contribution in coping with emergencies
  in promoting rehabilitation and reconstruction.
• Objective 1 Equal access by older persons to
  food, shelter and medical care and other services
  during and after natural disasters and other
  humanitarian emergencies.
• Objective 2 Enhanced contributions of older
  persons to the reestablishment and reconstruction
  of communities and the rebuilding of the social
  fabric following emergencies.

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Hyogo Framework for Action (2005)

• Framework for disaster reduction adopted by 168
  governments
• Growing consensus on vulnerability reduction by
  building disaster-resilience and adaptive
  capacity
• Consensus on pro-active approach to manage and
  reduce risks

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18th International Association of Gerontology and
Geriatrics World Congress (June,2005)

• Presidential Symposium convened in response to
  2004 Tsunami, 9/11 and other disasters to raise
  awareness
• that older persons are often given low priority
  when it comes to relief distribution, and that
  few international agencies have programs tailored
  to their needs.
• Post-emergency recovery programs tend to focus
  on the young, even though older persons also face
  rehabilitation issues.

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Hurricane Katrina Stats, Dec.2005
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Race Sex of 853 Katrina decedents(Source
Family Assistance Center, April 2006)
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Age of 853 deceased Katrina Victims (Source
Family Assistance Center, April, 2006)
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White House Conference on Aging (December, 2005)

• Gathered international experts to explore the
  issues raised at the IAGG Congress.
• Resulted in a commitment to collaborate to
  determine/evaluate common principles regarding
  emergency planning for older persons.

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The Toronto Knowledge Exchange (February, 2006)

• Goal was facilitate exchange of knowledge on
  older persons and emergencies among governments,
  civil society and older persons.
• Identified need for an international workshop as
  a platform to increase international awareness
  and action.
• Identified a need for more collaboration between
  Gerontological and Emergency Management
  communities

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Public Health Agency of Canada

• Since 2005, the Public Health Agency of Canada,
  has been working with partners within Canada and
  across the world on the issue of older persons
  and emergency preparedness.
• Key Principles of Canadas strategy
• Older persons as full participants
• Recognize older persons needs and their
  contributions
• Collaboration and strategic planning
• Build resiliency by promoting healthy aging
• We consider that a comprehensive approach to
  emergency management which reflects healthy,
  active aging across the lifespan is key to
  reducing older persons vulnerability and
  fostering resiliency. If older persons and their
  communities are healthier to begin with, they are
  more resilient in the face of an emergency.

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• Two International Conferencesconvened

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Winnipeg International Workshop on Seniors and
Emergency Preparedness (Feb. 2007)

• Brought together older persons, planners and
  emergency responders
• Goals were to
• Mobilize networks to influence changes to
  emergency preparedness policy and practice, in
  order to better integrate older persons
  contributions and needs.
• Achieve a common understanding of current
  evidence and status of older persons and
  emergency planning activities in Canada, and
  internationally.
• Identify opportunities for further collaborative
  action within jurisdictions and at an
  international level and prioritize next steps
  from both perspectives.
• Identify key policy options to address gaps and
  encourage use of better practices.
• Public Health Agency of Canada agreed to act as
  Secretariat for ongoing work, including the
  establishment of 2 steering committees one
  Canadian and one international, each of which
  subsequently established working groups.

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Overarching themes from Winnipeg

• Develop a culture of emergency preparedness,
  from the international to the local level, within
  governments, NGOs, and the private sector.
• Build community networks and resiliency.
• Instil a sense of responsibility for personal
  disaster planning.
• Educate and train emergency managers to recognize
  and include seniors as a resource in the planning
  process.
• Include seniors in the creation of training
  programs, and train them as volunteer responders
• Seniors mental health issues are vital to
  recognize in all phases of emergency management.
• Recognize frail seniors as a vulnerable group and
  identify where they are located
• Develop partnerships with the media to support
  the effort to enhance political will at all
  levels and to create education programs.
• Advocate to ensure continuation of this process.

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Guidelines Resources

• In order to fill some of the knowledge gaps, PHAC
  commissioned 15 case studies for presentation at
  the Winnipeg Workshop through a project with the
  World Health Organization.
• Four concerned Canadian natural disasters
• 1996 Saguenay Quebec Flood
• 1997 Manitoba Flood
• 1998 Quebec Ice Storm
• 2003 BC Fire Storm
• Synthesis Report of the 4 Canadian disasters
  (Gutman, 2007)
• WHO report with specific recommendations compiled
  from these case studies.

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Halifax International Workshop on Seniors and
Emergency Preparedness (March, 2008)

• Assembled 130 international and Canadian experts
  in emergency preparedness and seniors issues
  including older persons as experts!
• The goals of this Workshop were to facilitate
  action on the priorities identified in Winnipeg
  and to set in motion specific activities for
  ongoing collaborative work

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Goals for Halifax

• I- Development of a Tool kit Assemble and
  identify practical tools and resources
• II- Development of Key messages
• III Strengthening Networks/partnerships to
  reach a broad range of stakeholders involved in
  emergency management.
• IV - International Policy Determine best ways to
  influence international policy to integrate
  seniors and their needs into emergency planning
  and response.

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Other Canadian Activities

• In 2007, Canada provided 150,000 in funding to
  the WHO for a project entitled Seniors in
  Emergencies Engaging in Humanitarian Action. 
  The funding supported international efforts to
  champion the cause of older people whose specific
  needs and potential contributions are neglected
  during emergencies.

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UN

• Outcomes of Winnipeg conference, reported in
  Building a Global Framework to Address the Needs
  and Contributions of Older People in Emergencies
  presented to the UN Commission on Social
  Development, New York, February 2008.

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Conference Presentations

• Barratt, J. Presentation at joint meeting of
  National Council on Aging / American Society on
  Aging , March, 2007.
• Roush, R. Gutman, G. Geriatric emergency
  preparedness and response disaster mental health
  issues for caregivers of older people. Poster ,
  19th World Conference International Union of
  Health Promotion and Health Education, Vancouver,
  June , 2007.
• Gutman, G. Engaging the gerontological community
  in emergency preparedness. Paper presented in the
  symposium Seniors and Emergency Preparedness,
  VI European Congress of International Association
  of Gerontology and Geriatrics, St Petersburg,
  Russia, July 2007.
• Gutman, G. Seniors and disasters Canadas
  response. Paper presented in a symposium on
  seniors and disasters, 8th Asia/Oceania Regional
  Congress of Gerontology and Geriatrics, Beijing,
  China, Oct. 2007.
• Gutman, G., Gordon,M., Gibson,M., Hirst, S.
  Meier, H. Addressing Vulnerabilities and
  Fostering Resilience Symposium at 36th Annual
  Scientific and Educational Meeting Canadian
  Association on Gerontology, Calgary, AB, Nov.
  2007
• Toews, V. Presentation by the Manitoba Seniors
  and Healthy Aging Secretariat and Manitoba
  Office of Disaster Management, at Manitoba
  Disaster Management Conference , Winnipeg ,
  February 2008.
• Cox, R. Gutman, G. Emergency Planning for
  Seniors, symposium at 21st Emergency
  Preparedness Annual Conference sponsored by
  Canadian Red Cross, City of Vancouver, Insurance
  Bureau of Canada, Justice Institute of BC, BC
  Ministry of Health and Provincial Emergency
  program, Vancouver, Nov. 2008.
• Gutman, G. Developments in emergency planning and
  older people in Canada. Paper presented in
  Presidential symposium on Emergency Preparedness
  and Older People , Annual Meeting Gerontological
  Society of America, Baltimore, MD, November,
  2008.
• Gutman, G., Gibson, M., Hirst, S., Fisher, R.,
  Roush, R. Physical health and psychosocial issues
  for older persons in disasters and emergencies.
  Presented at the 16th World Congress on Disaster
  and Emergency Medicine, Victoria, B.C. May, 2009.

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Networking

• A National and International Steering Committees
  and several Working Groups were established
  following Winnipeg Conference. This presentation
  highlights the activities of the Health
  Professionals Working Group (Co-chairs R.
  Fisher, M. Gibson R. Roush)
• R. Fisher, co-chair Health Professionals
  Working Group (HPWG)- established working
  relationship with American Geriatrics Society -
  Special Interest Group on Seniors and Emergency
  Preparedness.
• - linked HPWG with the Interprofessional
  Disaster Emergency Action Studies (IDEAS) network
  to plan a seniors component to a pandemic
  tabletop exercise, including development of a
  volunteers training manual.
• - together with D. Ryan worked with The
  Regional Geriatric Program in Toronto
• - to add links on their website about emergency
  preparedness for seniors
• - hold teaching rounds on aging and emergency
  preparedness and fire evacuation
• - focus 2007 Annual General Meeting on EP and
  Seniors
• HPWG Co-chair M. Gibson and G. Gutman linked HPWG
  with CHNET-Works! a network of networks linking
  community health professionals and
  decision-makers and in May, 2008 together with
  S. Hirst presented Fireside chats on Mental
  health issues for older adults in emergencies and
  disasters addressing vulnerabilities and
  fostering resilience.

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Meetings Workshops

• Two half day workshops were presented by M.
  Gibson, co-chair HPWG and S. Powell Public
  Health Agency of Canada, during Canadian
  Coalition for Seniors Mental Health conference
  (September 2007) to identify
• - what seniors need to know about
  psychosocial issues and emergencies - what
  emergency managers need to know about seniors
  psychosocial issues in emergencies.
• Canada's Association for the Fifty-Plus (CARP)
  hosted a National Roundtable on Seniors as
  Partners in Environmental Emergencies (June
  2007) to develop recommendations to guide actions
  before, during and after environmental
  emergencies, with specific reference to
  identifying and responding to the needs of
  vulnerable seniors as well as creating effective
  partnerships with seniors as volunteers.
• A Forum on Emergency Preparedness and Seniors was
  held in Winnipeg (January 2008). Co-hosted by
  the Seniors and Healthy Aging Secretariat and the
  Office of Disaster Management, this Forum was
  designed to mobilize seniors networks in
  Manitoba and educate on the topic of emergency
  management.

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Publications

• R. Roush and PHAC staff jointly developed
  section on Frail Elders for CDC - ASPH
  Resource Document for Public Health Practitioners
  as their contribution to the Vulnerable
  Populations Collaborative group.
• Article on seniors and emergencies by M. Gibson
  published in the spring 2007 edition of
  Psynopsis, the Canadian Psychological Association
  newsletter.
• Report on Psychosocial Issues Pertaining to
  Seniors in Emergencies (M. Gibson, 2007)
  published by Centre for Emergency Preparedness
  and Response, Public Health Agency of Canada.
• Article on continuing work of the Emergency
  Planning and Seniors Committees contributed by
  PHAC to International Federation on Aging journal
  Global Ageing.
• D. Maltais , author of reports of 1996 Quebec
  Flood and 1998 Ice storm, coordinated special
  issue on senior and emergency preparedness of
  Vie et vieillissement ( Journal of the Quebec
  Association on Gerontology).
• Older persons in emergencies Considerations
  for action and policy development (D. Hutton,
  2008) published by World Health Organization.
• Older persons in emergencies An active ageing
  perspective (L. Plouffe Coordinator) published
  by World Health Organization in 2008.
• NEW Literature review The Roles and
  Responsibilities of Health Practitioners of Older
  Adults in Emergency Management (Fitzgerald
  Maxell, 2009).

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Projects

• Office of Climate Change, Health Canada -
  examined risk perceptions and adaptations to
  extreme cold and heat waves
• G. Hinton (St John Ambulance), Order of Malta and
  Johanniter Order are collaborating on a
  Emergency Preparedness project for Canada's aging
  population.
• Health Canadas Vulnerable Populations Office
  held a workshop in February 2008 on seniors and
  environmental health
• PHAC CEPR hosted a roundtable on resiliency as
  it relates to emergency management and at-risk
  populations.
• The ManitobaGuardian Program, an innovative
  emergency preparedness program has been
  implemented in the Village of St. Pierre Jolys,
  Manitoba.
• Disaster/Emergency Preparedness "For Seniors, by
  Seniors" A partnership between Good Neighbours
  Seniors Centre and the City of Winnipeg has been
  established to target residents in the
  Elmwood/Kildonan area.
• Public Safety Canada funded a research project to
  map the activity of high risk populations in
  Canada, with respect to emergency planning and
  preparedness. This research was undertaken by the
  Canadian Red Cross with support from Brandon
  University and PHAC. (Don Shropshire).

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To sum up

• Our aim is
• to build consensus and capacity, and to promote
  networking and alliances.
• to share, listen, learn, prepare for action.
• promote healthy ageing and to save lives.

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Because disasters will continue to happen

• Types of Disasters
• Floods 28
• Health 12
• Earthquake 11
• Storms, heavy rains, tidal waves 11
• Explosion 5
• Food security 5
• Refugees 4
• Snow/Cold 4
• Technical accident 4
• Fire 3
• Unrest 3
• Volcano 3
• Drought 2
• Landslide 2
• Total 100

• Location of Disasters
• No
• America 12 32
• Europe 12 32
• MENA 17 17
• Africa 77 30
• Asia/Pacific 39 99
• Total 100 257
• Average annual deaths and directly affected 1994
  2003
• Deaths 75,000 to 59,000 per year
• Affected 213 million to 303 million per year
• 2002 India drought affected 300 million
• 2003 China floods affected 150 million

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International Classification of Natural and
Technological Disasters

• Natural

• Technological

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(No Transcript)
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Canadian Disaster Timeline
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(No Transcript)
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Pictures courtesy of
The Seniors to Go!
32
Peterborough, ON Flood, 2004
Manitoba Flood, 1997
Pictures courtesy of
The Seniors to Go!
33
Okanagan, BC Forest Fire, 2003
Pine Lake, AB Tornado 2000
Pictures courtesy of
The Seniors to Go!
34
Hurricane Juan, NS 2003
Pictures courtesy of
The Seniors to Go!
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Public Health Impacts of Disasters

• Mortality
• Material Losses
• Morbidity
• Social Disruption
• In the last ten years
• An estimated 600,000 people around the world have
  been killed by natural disasters (half of these
  in 2004 and 2005 alone)
• The reported economic cost of natural disasters
  around the world was well over 600 billion. Some
  estimates for post-Katrina reconstruction are
  over 200 billion

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Mortality, Number Affected and Damages, Natural
Disasters, Canada, 1900-2002
37
WHO Model of Health Impacts of Climate Change
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Challenges and opportunities

• Challenges facing the older population
• Physical Limitations
• Cognitive Limitations
• Chronic Illness
• Dependency
• Opportunities offered by the older population
• Life experience
• Resiliency
• Availability
• Community involvement

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UN Secretary Generals Statement

• We have a moral, social and economic obligation
  to act now in building resilient communities and
  nations Disaster reduction is everybodys
  business. All of us can do our part to raise
  awareness and reduce our vulnerability to future
  hazards. I urge all concerned -- Governments,
  civil society and the private sector,
  international financial institutions and other
  international organizations -- to invest in
  disaster reduction and to step up implementation
  of the Hyogo Framework, with concrete measures to
  reduce vulnerability.