[Editor’s Note: June 1st marks the beginning of hurricane season. In Puerto Rico, Migrant Clinicians Network engages numerous community partners and industries to build hyper-local emergency preparedness that engages the entire community and ensures that the most marginalized in a community are not left out. This month, we highlight some of the incredible work that MCN’s Puerto Rico team has accomplished during the pandemic, and how their work builds preparedness and resilience, for the next crisis.]

In August 2020, only five months after the first COVID-19 case was confirmed in Puerto Rico, the first pandemic school-year calendar was published. It left out one of the most important items all students, parents, and school personnel expected to see: the modality of learning. “The plan we designed is a flexible one of constant evolution supported by scientific data and expert recommendations. We will start classes remotely and we will make the determinations along the way,” explained Eligio Hernández, former Secretary of Education, at the time. The uncertainty around this new reality transcended and expanded across all levels of the educational hierarchy. However, the worry was particularly amplified among students, their parents, and teachers, as their mere presence in the classroom was now a potential risk to their own health and safety, instead of a learning effort. The conversation about a safe in-person learning experience was only beginning. It was hindered by speculation, conspiracy theories, and misinformation that saturated media channels and drowned evidence-based strategies, resources, and information that could be helpful to teachers and school personnel to keep them and others safe at school.

Safety in schools amid the COVID-19 pandemic remains one of the most repeated topics of public discussion in Puerto Rico and around the world – and a key aspect of that conversation is around implementation of protocols that aim to protect the health and safety of students and school personnel. An integral part of an efficient and sustainable health and safety protocol is training the personnel, from teachers and administrators to custodians and cafeteria workers and all who bear responsibility at the school, who will implement and ensure compliance. Trainings for key members of the school sector foster a safe work environment. It helps administrators identify limitations and provide solutions while empowering personnel to manage and reduce the risk of contagion in individual activities. School personnel is an essential group of workers who need tools to work safely. Advanced training allows schools to address concerns in such a way that lessens work stress brought on by a lack of knowledge of practical and adequate mechanisms to protect individuals. Within the public discussion, some of the questions or concerns expressed by teachers or other participants in the educational system included risk analysis strategies, knowledge of indicators to determine the safety of in-person activities, and alternatives to avoid infection in the workplace.
 

In Puerto Rico, Migrant Clinicians Network (MCN) launched a series of capacity-building interventions to address the uncertainty among school personnel during the pandemic and help schools design evidence-based responses to COVID to make in-school learning safer. Using a comprehensive model, we provided training to Health Department school monitors, teachers, school staff members, and school health authorities to promote the coordination, technical assistance, and support network that would enable a sustainable emergency response. This program also encouraged participants to share the information with the broader school community, including parents, students, and other community members.

Our training program took place during September 2020, the first semester of the school year, as the Department of Education of Puerto Rico planned to re-open schools across the island. Concerned teachers, administrators, other school personnel, and school community outreach staff enrolled to address their training needs and knowledge gaps in occupational health and safety and best practices for infection control and risk assessment. Through MCN's partnership with the Rutgers University Atlantic Center for Occupational Health and Safety Training, supported by the National Institute of Environmental Health Sciences (NIEHS), we carried out two virtual series of four workshops each, specifically for school personnel in Puerto Rico, reaching a total of 284 participants. The first series targeted the public educational system, with representation from throughout Puerto Rico. The second series focused on the private sector serving students with functional diversity. In this case, participants included professionals providing speech and occupational therapy, along with teachers and administrative staff. For four consecutive weeks, the participants attended workshops that introduced clinical and epidemiological aspects of COVID-19, the regulatory framework related to occupational exposure, risk assessment and controls to mitigate risk, and best practices in school settings. These interventions gave participants a clear overview of what to expect in decision-making at governmental, administrative, and community levels, including individual strategies for different educational activities. Part of the training included brainstorming adaptations to  the academic curriculum in light of the current public health emergency. Participants acknowledged they acquired skills to use at work and felt motivated to make their work environment a safer one. They also indicated that what they had learned made them feel like they wanted to work more safely. More than 95% said the training prepared them to identify COVID-19 hazards at work and increased their knowledge on how to respond in a safe way to COVID-19 risks. As we continued ongoing technical assistance, we became aware that our training provided the tools to promote the incorporation of non-managerial staff into the development and implementation of school health and safety protocols. It also empowered workers to advocate for better protection and guidance in their work. MCN continued to provide technical assistance to public and private schools to conduct safe re-opening and operation. As a result, our organization supported the development of the state guidance and protocol to implement in public schools.
 

The exchange of information and the open discussions in these educational activities promoted the identification of new opportunities for growth and training in the school settings to promote safe and healthy work environments. We believe this model could increase the capacity to respond to and manage similar emergent public health issues in educational and other organizational settings. We have continued to implement similar training models in our worker health and safety program during public health emergencies, serving other labor sectors and collaborating with Hospital General Castañer in Lares, Puerto Rico. We also continued our collaboration with the essential educational sector in other areas such as safe water management and natural disasters as part of the Environmental Protection Agency grant. The need for worker training is substantial, it carries a ripple effect impact on involved communities, and it is essential to cope with and overcome the emergencies confronting not just Puerto Rico but communities across the planet.

When asked about the most important things they learned in training, one participant said, “I was able to review the vaccination requirements in the school environment and identify possible risks in the school environment. I learned about the different prevention, mitigation and protection strategies to manage infectious diseases.” Another said, “thank you for the seminar… I feel like a safer person.”

Other participants indicated they now knew proper mask usage and care, protocol implementation practices and adherence, proper cleaning and disinfection, and the importance of physical distancing practices. They also mentioned learning the following concepts: administrative controls, time of contact, risk assessment, the difference between cleaning and disinfecting, personal protective equipment, and their rights as employees related to the pandemic and their health.

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