S1E30 - Parks on Disaster Relief
Margaret talks to Parks from Appalachian Medical Solidarity about providing medical interventions after a disaster.
Margaret talks to Parks from Appalachian Medical Solidarity about disaster relief, what kinds of medical interventions are often needed after a disaster, and how to both respond to and prepare for them.
Guest info and links
SPEAKERS Margaret, Parks
Margaret Hello, and welcome to Live Like the World is Dying, your podcast for what feels like the End Times. I'm your host, Margaret Killjoy. I use she or they pronouns. This week I'm talking to Parks, who is a medical professional who works with Appalachian Medical Solidarity. And when I say this week I mean I recorded this interview at the very beginning of starting this podcast, which was just before the pandemic. I started this podcast in early 2020 when I had no real reason to think that COVID was going to become COVID in the way that it did. So this episode about, you know, medical things and disaster situations didn't really seem like it made a lot of sense. It's not what a lot of people were thinking about when it came to disaster and medical issues throughout all of 2020. But I actually, I still think this information is really important. And there are so many other crises that are happening now and will continue to happen. And so we talk a lot about, well, just what it means to be a responder to disaster, especially from a medical point of view, and I hope you get a lot out of it. I know I did. This podcast is a proud member of the Channel Zero Network of Anarchist Podcasts and here's a jingle from another show on the network.
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Margaret So, welcome to the podcast.
Parks Thank you.
Margaret Do you want to introduce yourself with whatever name, pronoun, and affiliations that you would like to be known for for this podcast?
Parks Sure. So my name is Parks, I use he/him pronouns, and I'm affiliated with Appalachian Medical Solidarity.
Margaret Could you maybe start by talking about what Appalachian Medical Solidarity is, like what you all do?
Parks Sure. Appalachian Medical Solidarity is a group that is centered in Asheville and the southern Appalachian area. And we provide disaster medical interventions, particularly after hurricanes and things of that nature. And we're working on other projects around the area, we do a lot of education in the area. For example, we taught a CPR certification class this weekend, and a Naloxone class.
Margaret So one of the reasons I wanted to talk to you is that you told me once—you went through the list of how people design die and natural disasters and how it's not what people think it is. And clearly preparing or understanding how natural disasters work is, like, comparable to understanding how larger disasters work and things like that. So I was wondering if you wanted to talk a little bit about disaster and what the actual, like, kind of threat models are?
Parks Sure. So there are several kinds of disasters and natural disasters, as you and your audience are likely aware. One that my group deals with specifically based on our geographic location is hurricanes. In developed countries, or countries with well-built infrastructure such as buildings and roads, deaths from hurricanes tend to come after the event itself. So the hurricane may kill less than 10 people—I'm not, I'm making up numbers there—but a small number of people will be killed by things like wind and falling trees and powerlines coming down and, you know, maybe a tree falling through their house and hitting them, that type of thing. More people die in flooding during the event than anything else. So most people don't die from being hit by a tree or blown away. They die from drowning and flooding, particularly when trapped in houses or when trapped in their cars, situations like that. So in places like the United States, those fatalities tend to be low. More people die in the few days after the hurricane. So as the power is out and infrastructure is down and people start to do things to cope with the infrastructure being down, part of the issue in developed countries is people are not accustomed to the infrastructure being down, so they're not necessarily aware of safety precautions to use when using things like grills or propane heaters or other non-conventional items, or in non-conventional areas. So people tend to die of carbon monoxide poisoning when they're using devices that need to be used in a ventilated area indoors, such as propane heaters, gas grills, things of that nature. They also tend to die after those events from chainsaw injuries, that's pretty common one, or from improper use of chainsaw, so trying to cut down trees and people being untrained to do so and having the tree fall on them. In that scenario, that type of thing. That's a much more common way to die in developed or over developed countries after disasters. People also die from food poisoning after disasters as they eat things out of their refrigerators and freezers that are going down. That's not as common, but it does happen. Sometimes people have issues with the spread of contagious illnesses inside of shelters. But here again, that's not usually causing a lot of people to die, it's causing a lot of people to have colds.
Margaret So would you say that one of the better ways to prepare is more about, like, knowing how to use your emergency equipment—like knowing, like, chainsaws and propane and all that or?
Parks I would—yeah, absolutely, absolutely. Knowing how to use equipment without, you know—knowing how to properly use a chainsaw, knowing when and where to properly use a propane heater. The other thing I would suggest is simply not using those items if you're not trained or unsure. You know, after a hurricane event, if you're a little cold, you know, put on extra layers if that's an option. If you can eat crackers and peanut butter instead of trying to, you know, make some kind of makeshift stove inside your house, then do that. You know, wait till it stops raining and you can move your grill outside. So use a little bit of common sense and forego small what are, you know, small luxuries essentially like cooking your food indoors or heat if you can, if you can live without it.
Margaret I want to ask you about Appalachian Medical Solidarity and your experiences with it and like what you've seen, or what people who are part of AMS have seen or like, I know, for example, when we had the conversation before we did this interview that you talked about while you're a medical professional, and you're often not using your, you know, surgery skills or something like that on the ground.
Parks That's true. You know, with Appalachian Medical Solidarity, I am a medical clinician and I don't end up using my medical skills very often after disasters. We occasionally will see things like people having to use insulins—types of insulin they're not accustomed to and they don't know how to do the calculation to identify the proper dose. So sometimes people need help with things like that. And upper respiratory issues. They're not usually—what we're seeing at as a volunteer community group are not the kind of issues that people are going to the hospital for. The hospitals tend to still be in place, people go to the hospital. So the things we're seeing are relatively minor as it comes to medical issues. What we're seeing more is people needing help mucking out their houses, needing help cutting out drywall, needing help getting trees out of the road or off their houses. So mostly what we're seeing is a great need for cleanup and also a need for supplies to get into certain areas. So it can be difficult with trees down and powerlines down and flooding and roads washed out to get things like clean water to certain areas or food that people can eat. So a lot of transporting supplies and the, you know, one to three days after a disaster before FEMA is able to come in ends up being something that we see a lot.
Margaret That's one of the kind of advantages that I found that—or at least people talk about, like autonomous and anarchist disaster relief and mutual aid—how this is about like the ability to mobilize quickly and maybe, like, without some of the inefficiencies of large organized structures. And I'm wondering if you want to talk about how you all organize, to get supplies and aid to crisis areas?
Parks That's a great question and it's one that we've been working on. I think we can improve our dispatching capabilities and how we identify different areas and need. At least in our recent experience, one of the things we've run into is a need to pre stage before disasters when we know a disaster is coming. So that's not always possible. But with hurricanes, we tend to have a sense that that's maybe going to hit, so getting closer to the area—or as close as you can to the disaster zone and stay safe so that you're not just adding to the, you know, people that need to have supplies brought to them. So staying in an area that's near the disaster area where you're still safe. And so you're able to quickly mobilize supplies and able to mobilize personnel into areas that are hardest hit is an important thing. We mostly do it through cell phones and, at times, driving around randomly, honestly, and looking for people. We've also watched flood maps online to see where flooding is the worst and where places might be isolated. News media pretty quickly starts to cover and tell people where isolated pockets might be, like this town is cut off, or that town is cut off, or, you know, these highways are washed out. So you can use that information to try to dispatch your personnel to those areas and to dispatch supplies to those areas. But I think that could be improved upon. So pre planning is certainly a helpful thing, you know, trying to come up with who is going to be a dispatcher, who's going to watch the news, who's going to watch the flood map, who's going to be pre staging, all of those things are important. And one of the points I think, also is that specialized personnel aren't necessarily needed in these cases, you know? Just having people who can drive, having people who have vehicles that, you know, like trucks or trailers that can move a large quantity of water. And just having people that can drive back and forth supplying water and food to certain areas is invaluable. You know, it's nice to have a nurse, it's nice to have someone who can use a chainsaw. But it's, that's not the majority of people that are really needed.
Margaret How do you get into isolated areas?
Parks That's a great question. There was one hurricane in which we teamed up with some private pilots to be airlifted into those areas. I'm not sure if airlifted is the right word, we weren't jumping out of the planes, but small planes that could land and fields or could land in small airports and rural areas would take two or three personnel and a quantity of supplies, and they were able to fly back and forth and bring supplies into places where roads didn't have access for several days. And that was invaluable. So that's one of the more fancy ways that we've been able to access folks who are cut off. Other ways are, you know, tall four wheel drive vehicles. So just having the kind of equipment or having the kind of vehicles that can withstand those kind of conditions and get into places. You know, if you have a small two wheel drive hatchback car, it's not going to make it. So having somebody available, who has the type of vehicle that might be able to get into more challenging environments.
Margaret One of the things that I'm interested in is sort of the cultural bridging that happens during disaster and crisis. And I've heard stories that there was kind of an interesting cultural difference between the types of folks who own small airplanes and the types of folks who organize anarchistically bring supplies places, is that something you feel like you can talk about it?
Parks Sure, that's absolutely the case. And I think that's a major issue in people signing up to be personnel after disasters, you know? I think people who initially are going into these areas in the first two or three days need to be people who can interface with all kinds of people, who can withstand being insulted, who can withstand, you know, different things like that, like it's not a—it's not as safe and supportive working environment in any way. You know, socially, the people who were operating the private airplanes, for example, tended to be wealthy individuals, often were white males who were wealthy, a lot of them—or possibly all of them—were Republican, these kind of things. So folks who feel uncomfortable interfacing with those folks, or feel uncomfortable building bridges with those folks, you know, there's a need to be polite, there's a need to reach out, there's a need to work together, there's a need to problem solve with people who are very different from yourself, who, whose ideas of, you know, even who should deserve help are very different than yours. So, being someone who's very diplomatic is very valuable in those scenarios. And folks who aren't as diplomatic or who don't want to interface with people, you know, that are very different than them, are possibly better suited to roles like doing dispatch, or gathering supplies, or, you know, there are plenty of roles to do. But it's important to consider that folks are going to have to interface with a lot of different people who are not necessarily being their best selves, and who are very different than them and have a different idea of reasonable politeness than they do.
Margaret Yeah. I mean, that's kind of one of the things that sort of interesting about disaster scenarios and apocalypse and all that kind of crap is that you get into this idea of a lot of different types of communities having to pull together in order to survive. And one of the things that I'm kind of trying to explore with this podcast is the sort of idea of the opposite of—instead of like a nationalist approach to disaster, where you like bunker up with your friends and you have yours, fuck you—like this, like, internationalist approach of, like, working together with diverse communities and things like that. And so it's just fascinating because usually when I think about, like, working with diverse communities, I don't think of, like, right wing libertarian types, you know? And yet, I mean, there's a certain amount of, like—and maybe I'm being overly generous—but like, okay, yeah, they may be a rich Republican, but they're willing to fly into storms and small planes in order to give people things for free. So that's kind of what we want from people. You know?
Parks I absolutely agree. You know, there's something called the disaster bug, which is where people go into disaster zones, and they, they get really fixated on it, or they really enjoy it, and they seek out that scenario again. And part of the reason for getting that disaster bug in my opinion is, you know, people are at their worst at times, but really overall people are at their best. You know, people are ready to collaborate, people are willing to do things they wouldn't normally do, like, help people, they wouldn't normally help, things like that. So watching communities draw together, watching people, you know, go to their neighbor's houses and see if they need anything, is beautiful and a wonderful thing. And, you know, you get to meet all kinds of people that you wouldn't normally get to meet—or I get to meet all kinds of people that I wouldn't normally meet. And I really value that and my experience. You know, I think it's interesting to meet the rich Republican dude that wants to fly people into a difficult flight situation and deliver food to people they might not normally think about. I think that's great. You know, it expands their horizons potentially, it expands our horizons, and, you know, ultimately it helps people and that's really the purpose. But I personally think that's great. But I also recognize that that can be a challenge for some folks.
Margaret Yeah, that makes sense. I want to talk about how have you—and if you don't we can cut this part out—have you had to do sort of disaster triage or like—like, in what way has like your—as a medical provider or whatever, how do you plan for medical care, specifically in disaster situations, or especially if you're preparing for a situation in which hospitals weren't available, but even in preparing for situations in which hospitals are harder to get to and things like that?
Parks Sure, that's a reasonable question. And I don't have a great answer to it, actually. You know, hospitals and paramedic teams and those kind of groups already have triage processes in place. So there are, for example, toe tags or tags that medical personnel will put on individuals indicating the severity of their illness. And then they will decide based on the number of casualties and the number of people needing medical care what order to treat people in when they can't treat everyone at once. So those kinds of organizations already have a system for that. I can't say that my group has had a need to triage people in that way because we simply haven't seen large numbers of injuries at once, which is fortunate.
Parks It would be good for us to prepare for that perhaps I haven't really taken it into consideration. But, you know, a lot of what we're seeing is needing to assist people using their own medications. So needing to help people find their inhaler in their ruined house, or find a neighbor who uses an inhaler that they can borrow, or calculate a new dose of insulin based on what insulin might be available to them. So getting people supplies, getting people on medications that they already take, you know, having people—helping people to find the medical equipment that they already have that they need, those things are helpful. And prior—you know, certainly prioritize people with medical needs in terms of transporting them to shelters or transporting them to hospitals, things of that nature. But we have not been responding in the—well, I should say, I have not been responding in the minutes and hours, you know, few hours right after a disaster during which time people may need things like swift water rescue, or may need things like airlifting out situations, where there may be people who are injured enough that they require getting to a hospital within a few minutes or within an hour. Those would be done by—those kind of rescue things will be done by specialized teams and we're certainly not trained to do those.
Margaret Okay, and maybe also the people who are more immediately already on the ground?
Parks Correct. So not only people with specialized training, but people who are already on the ground, you know. I would certainly advise any group to be well aware of what I would call scope of practice. So be well aware of what you can safely offer and what you cannot safely offer. And don't go outside of that. Don't try to offer something that you aren't trained to do, don't try to offer something that you're not prepared to follow up with, that you're not able to do all the way through. You know, don't offer someone transport to the hospital if you're not sure you can get them there, or if you're not reasonably sure you can get them there. You know, because you're delaying their getting into an ambulance, you're delaying their getting into a medical fight helicopter if you're offering something you can't follow through with, if that makes sense.
Margaret Yeah, that's actually a really interesting concept. And, like, could apply to a lot of situations, but even gets back to the, like, the chainsaw use for example of, like, you know—I've only recently started actually training with a chainsaw and I always thought it was just a matter of, like, making sure you're not in the way of the blade. And like making sure that, you know, if it bucks back, the blade won't hit you. And that's, like, that's a big part of it. But then I'm like learning that there's, like, a lot of stuff about the way trees hold tension and that apparently what kills a lot of chainsaw operators is just, like, releasing the tension on a tree and having everything go crazy. And so the scope of practice, that's a useful phrase I hadn't heard before.
Parks Absolutely. And I would say, you know, do what you can. A lot of people don't do what they can, you know? Step up, do what you can, decide you're going to help. That's the first thing. You know, assess the situation, decide you're going to help, and then help in a way that you're able to. And of course if you set up in a truck, you don't know if you're going to come up to a washed out road. And if you do, that's okay, you know, turn back, don't try to cross, you know, a flooded area you can't cross or anything like that. Don't try to offer medical care to someone who's more hurt than you can really help them with or—or do what you can, you know? If what you can do is hold their head still while the EMS gets there, great, do that. You know, do it, you can. Absolutely step up and do what you can. But don't try to do things that are outside of your abilities. And don't take risks. In a scenario where it's difficult to get people in and out of a situation, if you are a relatively healthy person who's going in to help and you get hurt, you are delaying care for people who are already hurt, you know, you're clogging up the system. And, you know, you're also getting hurt, which is a problem. But not only that, but you know, you're clogging up the system, you're making one more casualty for medical personnel to deal with, you're making it worse. You know, one of the first rules in medical care is do no harm, right, don't make it worse. And it's really easy to make it worse. It's a lot easier than you think to make it worse. You know, don't go in and say you're going to sterilize water and you don't know how and you poison someone. You know, don't go in and think you're just going to figure out a chainsaw and get hit by a tree. You know, there's lots of things that might be trickier than you think.
Parks So go and help but sit and think a while before you take on a project that you might be unprepared for and might be dangerous.
Margaret What are some—if people are interested in doing either disaster response or preparedness within their own communities for potential disaster, what are some of the skills—especially like first aid or medical type skills—that you think people can and should develop? Like in a more generalized sense, like what should people be learning and focusing on?
Parks Basic medical care at home is a good thing to focus on. So the number one thing that I see people not doing enough of is washing their hands and washing their hands properly. That sounds really basic, but people really don't do it enough. So learning how to wash your hands, washing your hands for an adequate amount of time with clean water, with soap, and doing it consistently when you need to. You know, if you're touching a person and you go touch another person and you haven't washed your hands, you're spreading, you know, potentially you're spreading all kinds of pathogens from one person to another and to yourself. So learning how to wear gloves, when to wear gloves, how to take them off without contaminating yourself, you know, how to wash your hands in a way that's effective. I would start there. I think those things are really important. Recognizing an infection is a helpful thing. You know, being able to look at a wound and say, within reason, if it's obviously infected or not. I mean, that's—that can be a specialized skill, but there are some things that, you know, a regular person might be able to learn in advance that may be helpful. So those things are important. I would say also water is a big thing after any kind of disaster that's gonna affect infrastructure. So focus on getting enough water, storing enough water, knowing how to sterilize water, knowing water from—knowing what source to get your water from, you know, you don't want to use flood water, for example, that's very difficult to impossible to sterilize in a way that's going to be accessible after a disaster. You know, there might be people out there with specialized skills who know how to do that, but most people are not, you know, that's not a good idea. You know, finding a stream is going to be better, collecting rainwater is going to be better. There's lots of different, you know, water sources that you can identify that might be better choices for you. So if you want to get fancy or do a little more, you might identify water sources near your home, for example, you might find out where your nearest stream is. If you're, you know, if you're living in a place that might have the kind of disasters where your water infrastructure might go down, and that's more likely in some places than others. But first and foremost, I would say water.
Margaret What, um, can you talk more specifics about, like, for example, what kinds of places the water infrastructure is more vulnerable and also, like, how people might, yeah, get water, filter water, sterilize water, whatever they need.
Parks The CDC has some good guidelines on that. As does as FEMA actually, so FEMA's website has good instructions on what kind of sources to look for after a disaster. Firstly, knowing about storing of water is helpful. It's not great to store water in your empty, you know, gallon water jug that you got from the, you know, from the store, unless you're able to sterilize it. And you can sterilize it by using a mix of bleach water, I don't remember the ratio, but shake that around in your container, empty it out, rinse your container, and store water. So prior to events know how to store water if you're going to use your own containers and know how to store it properly. And, you know, be wary of glass containers because they can break. And if your water supplies on glass containers and it breaks, you know, you're out of luck. So first of all know how to store water beforehand. And if you're able to do that, you can avoid having to find sources of water afterwards, which is ideal. You know, sterilizing your tap water is something that may be accessible to you if the tap water is not contaminated. The other thing to do is to know how to turn off the main—the water mains to your house. So if there's an announcement that the water is contaminated, you would turn off the water main to your house, empty the faucets, and you can typically still use the water that's in your hot water heater if you have one. So—and a lot of this is geared toward people who live indoors, obviously. So if you don't live indoors that's going to be a different scenario. But if you do live indoors, using the water and your hot water heater can work. And there's a, usually there's a way to empty it. There's like a faucet at the bottom of the hot water heater or something like that. You can use the water in there. You'd probably want to add bleach to it. But look up the proper ratios of bleach to water and, you know, have some bleach in your house that's fresh. Bleach goes bad after about maybe six months or a year. So make sure you have something that's unopened and not flavored or scented or—I guess not flavored, but whatever. Not scented and without like additional cleaning agents. You don't want to use, like, a tile cleaner with bleach. You need to use, you know, the regular bleach in a bottle that that's all that's in there.
Margaret What about like the kind of water purification tablets and things like that?
Parks Iodine water purification is not generally recommended. Generally bleach is recommended because it kills more of the pathogens that you're going to be encountering after that kind of disaster. You know, if that's all you have, then that's all you have. But in terms of pre planning and what to get, I would recommend bleach.
Margaret Are you talking about, like, maybe you'll get Giardia or like maybe you'll, like, die immediately? Or like what's the—what's the threat model from contaminated water like floodwater or whatever.
Parks That depends. I don't have a great answer for that. You know, in eastern North Carolina, in floodwater, there are millions of dead animals floating, you know, stuff from septic systems can be in there. So any kind of fecal oral type pathogen could be in there and, you know, think of water with, you know, human waste in it as well as rotting pigs. You know, sometimes the wastewater pits overflow, like from coal fired power plants have wastewater pits, and those can get into the groundwater or into the floodwater. So there's not just bacteria in floodwater. There's also toxic chemicals that can't be filtered out, that can't be removed with bleach, for example. So that's one of the reasons why flood water is not going to be a good option. If you can find a stream that's not contaminated heavily, you know, that's not a strange color, that's not covered with floodwater, that may be an option. Collecting rainwater is an option. You can remove salt from salt water by like taking a large pot with a—that has a lid with a handle, turn— flipping the lid over so the handle is facing inside the pot, suspend a mug or a cup from the handle inside the pot on a string. Put saltwater in the bottom of the pot, boil that for 20 minutes or so. The condensation will collect on that upside down lid, drip down the handle, and drip into your mug. You can probably find diagrams of that and your listeners might already know how to do this kind of thing.
Margaret Home distillation.
Parks Right. But some some knowledge of home distillation might be helpful. You know, I've never been in a situation where that was helpful, but I'm sure people have been.
Margaret Yeah. You mentioned how some—a lot of the advice that goes around is more helpful for people who live indoors. Do you want to talk about—do you have any information about either how to help people who are, or people who are themselves not living inside in disaster situations?
Parks If you know does that stress coming, it's good to let people know who might not already know. So some folks who live outdoors are certainly going to be in the know about, you know, things that are happening in their community. But it can be helpful to spread that information. So let people know that there's a hurricane coming, let people know that flood—flooding is going to be happening so that people can, if they have encampments, they can move them uphill, you know. I live in a mountainous area so, you know, in this area moving uphill as an option. That's not necessarily going to be an option in a lot of places. But seeking shelter, securing whatever, you know, materials that you have for housing or trying to keep dry, all of those things are going to be important. Letting people know where security—or where like emergency shelters are in case they want to go to emergency shelters can be beneficial. Just making sure people are aware in advance. You know, somebody who—I live inside, so somebody who lives outside might be able to—might be better able to provide information on preparedness and that scenario.
Margaret Off the top of your head—or, what are some of the common myths about disaster survival that that irritate you?
Parks I don't think this is a myth. But I think people are both underprepared and over prepared. Okay. Sometimes people prepare for like situations that sound more interesting, rather than situations that are more likely. For example, people might have wilderness survival skills that involve starting a fire with sticks or, you know, distilling water in strange situations or, I don't know. And while those things might come in handy at some point, things like washing your hands and knowing how to store your water reasonably safely, you know, knowing that expiration dates of foods or how to tell if your meat is spoiled or not, you know, those like less romantic, I guess, skills are actually going to be far more important and far more useful and far more likely to be utilized. So I think it's easy to prepare for, like, what are we going to do if civilization collapses? And while living in the woods, like we need all these skills on like, you know, do you—like, do you really—like in what situation are you going to, like, need to go and kill a deer because you really can't get literally anything from the grocery store?
Parks You know, that might, I don't know, maybe that happens. But you know, in the United States that's really unlikely to be—depending on where you live. You know, maybe if you live rurally and you already depend on killing deer or killing animals for your food then, of course, you know, you're going to continue to rely on that food source. But for people that don't already rely on that food source, you know, developing those more specialized skills is interesting and cool, but don't neglect the less interesting skills and preparations. Like it's good to have a radio that runs on batteries. It's good to have extra batteries. Do you need 100 guns? Probably not. You know, guns are really overrated. I think after disasters, you know, most people are very kind to each other after disasters. You know, if people are looting, it's generally because they need the stuff. And if you're the kind of person that wants to shoot people because they're stealing items from a store, I don't know what to tell you other than, you know, you might reevaluate your life. But, you know, I don't know how useful it's going to be unless you're planning on hunting because that's something you already rely on. You know, for a lot of folks like myself who don't rely on hunting, live indoors, you know, a gun is not actually going to be helpful. I don't think, you know, having social skills, having the ability to talk to people that aren't like you, you know, knowing how to wash your hands, I really can't say it enough.
Margaret That's gonna be the title of this episode: Wash Your Fucking Hands.
Parks Wash your hands and do it right. You know, using hand sanitizer—this is an important one—using hand sanitizer after you go to the bathroom is not effective. You need soap and water.
Parks The kind of pathogens that are spread from the oral fecal route, so to speak, are not cleaned off your hands by hand sanitizer.
Margaret What is hand sanitizer good for?
Parks Hand sanitizer is good for anything that gives you a stuffy nose. Anything that gives you diarrhea, you need soap and water.
Parks Not anything in the world but, you know, that's a rough estimate.
Margaret Well, okay, so you talk a bit about risk analysis. I'm really excited about what I think hackers but maybe other people coin threat modeling. And like people talking about, like, you know, okay, your internet security might be really good, but based on the wrong threat model. And, you know, a gun for example is a good tool for certain threat models, like someone specifically trying to kill you.
Margaret But a very bad tool for a lot of other threat models. And so it sounds like kind of what you're talking about is that people have sort of poor threat modeling when they think about preparedness in general.
Parks I think that's a great way to put it, you know, just like if you're writing and knowing who your audience is, you know, know what you're preparing for and be fairly reasonable about that and don't, you know, skip things that you think are obvious or skip things that you think are boring. So, you know, if you're preparing—I don't know, if people prepare for earthquakes, I'm not sure how on earth you would do that. You know, they hit randomly and horrible things happen. But if you're preparing for a hurricane, if you're preparing for flooding, you know, prepare for that in a way that makes sense. And do some research, you know, it doesn't take very long if you have access to the internet or a library to do a little bit of research, and don't discount, you know, government websites. Really, the CDC offers good information and FEMA offers good information on preparedness. You're going to have to tailor that to your own specific needs of course. You know, if you use insulin and needs to be kept in a refrigerator, you need to focus on being able to refrigerate that.
Parks You know, if that's not with a cooler, ice, or whatever, you need to prioritize ice if that's your situation. Other people are not necessarily going to need to prioritize refrigeration after that kind of event, for example. Or, you know, as I was saying, if you're planning to live in the wilderness with no contact with any kind of "civilization", then, like, your skill set certainly needs to be different than if you're trying to survive, you know, an urban setting that suddenly has no infrastructure. You know, one of the main issues—well I don't know about main issues—but one of the issues after Hurricane Sandy in New York City was people in high rises who couldn't flush their toilets and didn't—and lived, you know, on the 10th or 12th floor of a building and were unable to haul water up and down the stairs because of physical issues. And that quickly became a very, very dire problem.
Parks So, you know, and that's a problem that's specific to a certain physical scenario.
Parks So preparing for your physical scenario and preparing for the actual threat and having some sense of, you know, maybe over prepare slightly. But you don't necessarily need, like, a year's worth of food for an event that's probably going to take a week or two to stabilize.
Margaret Right. Well, if you have a year's worth of food than you have, you know, 300 peoples' day's worth of food.
Parks That's true. And there may be, you know, scenarios in which that makes sense. But in that scenario, it's still a week's worth of food, you're taking into consideration the number of people. Yeah. And if you want to be able to feed your whole town, that's awesome. You know, is it necessary? I don't know.
Parks You know,
Margaret You once said something something to me that was one of the best examples of risk analysis that I actually use fairly often—I came to you with a medical concern and I said, am I going to die because of this or that thing? And you said to me, well, I can't tell you that—because you're honest to a fault—you're like, I can't tell you that you won't die because that's completely possible, you could also be eaten by a shark today in Asheville.
Parks Right, I remember that. Yeah, and I think those things are reasonable to keep in mind, you know, you're not likely to be killed by a chainsaw if you're not using one after a disaster, so I don't know.
Margaret So I'm not gonna wear my chops all the time.
Parks Right, so you don't need to wear your chainsaw chaps all the time necessarily, unless you're just like them maybe, look, I don't know. But yeah, you know, think about what's likely and think about what's important. So if something is unlikely to occur but will definitely kill you, if it does you may want to be—have some preparedness for that, within reason.
Parks You know, if something is not likely to happen and not going to be a big deal if it happens, you don't necessarily need to prepare for that. Like, how much do you need to prepare for boredom, you know, maybe a little bit, but that's not super important. You know, it's not that likely that you're going to be stuck in your house more than a week. But if you were and you didn't have water, you could die. Humans can survive a fairly long time without food, but we can't survive more than a few days without water. So, you know, that's why I emphasize that too.
Margaret So eat peanut butter and crackers rather than tainted meat if you're only stuck for a week?
Parks Sure, yeah, you know, if you have the ability to cook, you know, if you have a grill, if it's not raining, you know how to use the grill, it's the first day after your freezer has gone down, absolutely cook all your meat, you know, and eat it and share it and all those things, that make sense. But if it's been a week, and your freezer has been off for a week, and you've got meat left, you know, and that's it, don't eat it. If it's been sitting out, you know, unless it's jerky or something like that, you know, you don't want to risk a diarrheal illness or a vomiting illness if you if your water supplies are scarce, particularly.
Margaret Probably final question: So we talked a little bit about the the kinds of people that you'd be working with to go into disaster areas. But in terms of going into communities, often as outsiders, what does that look like in terms of not been more trouble than you're actually worth, in terms of making sure that it's like sort of a consensual relationship with the people? I know, I was talking to someone who's from a Caribbean island and he was talking about how, you know, non official organizations showing up to help are often just in the way and doing all the wrong things. While, of course, also most people I know are also very critical of the official organizations who go into help because then they take resources and centralize them and disempower people and cut people out of agency and things like that.
Parks Yeah, don't go to a disaster area unless you have truly something to offer and you're able to get yourself in, supply for all of your needs the entire time you're there, and get yourself out. If you can't do those things, don't go unless you're already there in your chapter with other people, then respond accordingly. But, you know, if you're not already in a disaster area that hit where you are living, don't go on vacation to see how bad it is, you know, don't drive around in an area to gawk at the damage. There's, that's rude. Don't do that. And it's not helpful. You know, if you have, like, two power bars and one 16 ounce bottle of water, don't go into a disaster area and think you're prepared because you're not. You're going to be a drain on resources. You know, there are going to be a lot of people who already have skills in an area, you know, if an area in the United States is hit by a hurricane or, you know, some kind of disaster, there are already medical personnel there. You know, there are already people there who know how to use chainsaws, there are already people there who knows how to hunt or, you know, various things. So, to some extent, you know, keep your ear to the ground, see what people need. If you can, you know, ferry water to the edge of a disaster area and give it to someone who is already networked to distribute it or something like that, that may be very helpful. And it may be boring to you to drive, you know, 100 gallons of water from, you know, where you live to the edge of a disaster zone and then go home again, you might be tempted to like, dive in and drive around, go be helpful. But you know, driving water to the edge and going home is really helpful in certain scenarios. You know, driving in with a bunch of food that you don't know where you're going to leave it, and you're just driving around trying to give it to people who don't, you know, you don't, I don't know, you don't know where the need is. That's not necessarily as helpful. Yeah, don't become a drain. Don't go and need to be fed or housed or clothed or need water in an area that's already strained. You know, the more people that there are in a strained situation with limited resources, the less those limited resources are able to go around. So be realistic about what you can contribute and be realistic about whether what you can contribute is going to be better than what you know the people—the skills that people already there have, if that makes sense.
Margaret That does. If someone wants to learn more about either Appalachian Medical Solidarity or other mutual aid disaster relief organizations, do you have a place to point them to or anything like that?
Parks I'm not sure. I think AMS has a Facebook page. I don't actually know.
Parks Yeah, I'm not sure. If you're in the Asheville area, you know, we do put out announcements for classes and things that, you could certainly come and talk to us. There is a team with AMS, with Appalachian Medical Solidarity, that does stuff on computers and social media.
Margaret And you're not on that team.
Parks I'm not, and I'm not on that team. And I don't use computers outside of work if I can help it because I don't like them. So I'm sorry, but we could probably find that information and add it.
Margaret I'm going to add it, yeah. I'll do an aside.
Margaret Okay. Well, thank you so much for doing this interview. Is there any—Is there anything I missed, any like final takeaway, besides wash your hands?
Parks Just have water, wash your hands. Those are really important. Decide to help, you know, I think is what I would say, decide to help and realize what helping is and realize what not helping is in any given scenario. You know, don't let your worry about, you know, being a burden or not knowing how to help or not having specialized skills, don't let that stop you from helping. Decide to help, but help within reason. Usually—you know, find out what people need, find out what people don't need, don't guess what people need and just start sending a bunch of crap to an area, it's not helpful. You know, but find out where you can plug in, try to get reliable information on what's needed. And if you have the ability to meet any of those needs, then do it. Absolutely. But don't go outside of your scope of practice, don't go outside of what you are actually able to contribute. Contribute what you can, don't try to contribute what you can't. Okay.
Margaret Okay. Thank you so much.
Parks Yeah, absolutely.
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