(Photo by: Sandy Millar)

During Hurricane Florence, Joseph “Chip” Hughes, Jr., MPH, was with his family in Chapel Hill, North Carolina, 120 miles from the coast. But his university town, one that usually avoids hurricane damage due to its inland location, was met with a torrential downpour. He watched the waters rise, flooding his neighbors’ homes, his street, the local shopping center. Hurricane Florence had flooded out dozens of communities along its path, many of which were agricultural and were unprepared for the deluge, but the most vulnerable communities -- those without resources to prepare or rebuild -- are suffering the most. Among the wreckage, numerous disaster preparedness experts are preparing to begin clean-up efforts. Hughes is the Program Director of the Worker Training Program with the National Institute of Environmental Health Sciences, which has deployed training teams to North Carolina’s hardest-hit areas, to begin training disaster recovery workers and others who will have to determine how to clean up after the waters recede.

“Hurricane Floyd in 1999 was the largest environmental catastrophe [that we’ve seen]. This one hit the same location,” Hughes noted. The agricultural lands of North Carolina, the second largest hog producer after Iowa, is dotted with hog lagoons -- large pits filled with hog fecal matter. Many of those lagoons breached across the region, spilling raw fecal matter into the floodwaters spreading across the countryside. “We’re very concerned about what the clean-up process may be and the amount of exposure to clean-up workers,” he admitted. “Nobody has ever done a large-scale hog waste decontamination and clean-up process.” Hughes also expressed concern over the clean-up of confined animal feeding operations (CAFOs), thousands of animals kept in a confined space. The carcasses of hogs, chickens, and other farm animals caught in the floodwaters will require another serious and logistically straining environmental response, including the possibility of aerial removal, he said.

Hughes notes that the Worker Training Program is at the very early stages of response, but the group has already briefed the North Carolina health department with numerous materials integral to their training program. The training program centers on three primary concerns: flood and hurricane response; mold clean-up and debris management; and responder resilience and mental health issues. (See below for Hughes’ recommended resources from NIEHS.)

(Photo by: NOAA)

As climate change progresses, extreme weather events will continue to become more severe and more frequent, and Florence’s extensive flooding, both at the coast and inland, may be yet another sign that such incidents aren’t a concern of the future. While Hughes’ work centers on preparing disaster responders like emergency response technicians, he admits that clinicians are playing larger and more critical roles as disasters begin to occur with greater frequency and in new locations. He says that, since 9/11, his work has been to help our society “develop a culture of preparedness.” With advancing climate change, the culture of preparedness extends across the country.

“Almost anybody can be put in the position of being impacted by a climate disaster,” Hughes noted. “Where we’re evolving to as a society is that almost everybody needs to have a level of preparedness, knowledge, skills, and abilities. Before, we might have only put it in the hands of the police, fire departments, and EMTs -- now, that’s been a big change, but we have a long way to go.”

Clinicians, he says, can and should become a critical focalpoint of community response and resilience. “When a disaster happens, people are going to look to you to have the knowledge to know how to evacuate, protect their health from whatever they’re experiencing,” Hughes noted. “Health care facilities [like clinics] are usually such a core part of the community that you really want them to make sure they can function during the disaster and afterward,” he added.  (Such leadership efforts by community health centers was exhibited in the aftermath of Hurricane Maria in Puerto Rico; MCN’s newest project utilizes a community mobilization framework to emergency preparedness to reinforce, replicate, and institutionalize the leadership efforts that Puerto Rican community health centers showed after the disaster. Read more about it here.

“How you’re able to quickly respond to a situation is really important for clinics and hospitals,” Hughes said. “That’s an important part of resilience for individuals and communities.”