Creating Space After Environmental Disasters

Quetzabel Benavides, HBHE Student

Steep road and damaged home due to Hurricane MariaSteep road and damaged home due to Hurricane Maria, which took place in 2017.

After a week in St. Croix and St. Thomas, I have realized the impact we as consumers can have on the changing environment and climate. I was initially nervous about my limited expertise in disaster relief and recovery community assessments, but the support provided by the local public health practitioners helped contextualize the full experience. Overall, I learned that our public health techniques are most successful when we collaborate with local community experts and that constant adaptation is necessary for public health practice.

I have often wondered about the “first step” in a community assessment process. I have pursued experiences that teach me about different methods of engagement and processes for social engagement. With CASPER, I finally found a method that could provide me with an initial scan of a community. Sometimes we struggle with finding the best way to get the “first start” and I believe CASPER provides us with a quick epidemiologic technique that can generate information in a clear and methodological manner. What I found most interesting from the CASPER in St. Croix and St. Thomas was the selection process of clusters and participant response tracking. Sometimes programs may feel overwhelmed with confusion about how to best collect information in their community, but CASPER provided clear steps about collecting information in a concise, effective and randomized way.

I also appreciated the ability to track response rates in an area, as this information could help us understand the relationship status between community residents and health institutions. The cluster designations also help ensure that the responses were not concentrated from an area of the island. Furthermore, the second stage sampling also helped ensure that, within a cluster, the responses were from different households. This was particularly important for households that lay on different topography. During our St. Croix cluster, we realized that the survey responses regarding ongoing challenges and concerns varied based on the position of the household. For households that were in lower locations, the impact of flooding and debris felt more immediate or pronounced than for households that were located in higher geographic positions. We may not have been able to capture this dichotomy without the sampling methodology employed with CASPER.

As we moved to St. Thomas, I did notice a brief shift in our interactions with community residents. Culturally, I believe we really had to adapt and validate the negative experiences residents had with previous government agencies. Our team experienced a greater number of refusals and I noticed that many residents in our particular cluster were skeptical of our purpose in facilitating the household surveys. Some non-responses simply stated that they had already exhausted their energy with FEMA and had no desire to share more energy towards another survey that could lead to minimal impact. Though unfortunate, I believe this experience further emphasized the importance of maintaining and foster trusting relationships with community residents. More importantly, the relationships between community residents and other institutions can still impact or influence how community residents view public health institutions.

Despite the brief - sometimes literal - road bumps, I am grateful to have worked alongside all of the incredible public health practitioners at the U.S. V.I. Department of Health. In observing their interactions with community residents, I realized how much more work I still need to do to make public health practice accessible. I sometimes think that as students, researchers and academics we lose a certain sway that can help us connect with communities. Every day I saw great examples of community connection through the approaches employed by our community partners. Whether it was sharing language or expressing genuine empathy, the connections offered by our community partners helped shape the success of our assessment surveys.

This experience has been incredibly instrumental and I look forward to incorporating some of the CASPER techniques in my future work. I believe the CASPER process can provide me with a framework to ensure that my data collection methods do not reproduce concentrated narratives. I think it can also help show me potential blindspots and allow me to consider areas that are usually forgotten. Most importantly, I have realized that creating space for people’s experiences is something we must continue to embed in our public health infrastructure. Only then, will we be able to ensure the inclusion of community narratives


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