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					     Preparedness for Persons
     with Mobility Impairments
By Catherine Rooney, Michael H. Fox,
Glen W. White, and Jennifer Rowland

           Considerations in Emergency
  Preparedness: A Two Track Conference
         Mailman School of Public Health
                    Columbia University
                       Washington, D.C.
                      December 13-15, 2005
Intro: “I have Juvenile Rheumatoid
Arthritis and use a wheelchair. We
had a bomb threat at work…
Everyone evacuated, but I was still
left on the 3rd floor by the
stairwell for the firefighters to
come get me. But no one came.
Finally, I just struggled and I used
pure fear to get myself down the
stairs…” (From: Nobody Left Behind
On-line Consumer Survey, 2004).
             Nobody Left Behind Findings   2
Disaster Preparedness for Persons
    with Mobility Impairments
  October, 2002 - September 2005
CDC grant awarded to KU, RTC/IL, TS#
08040, Principle Investigators: Dr. Glen
White and Dr. Michael Fox.
Objectives: To determine if emergency
preparedness and response systems
 Meet the needs of persons with
  mobility impairments;
 Use surveillance systems to identify
  persons with mobility impairments;
 Have elements of emerging best
             Nobody Left Behind Findings   4
         Federal Emergency
 Identify
 Management Agency (FEMA)
 declared disasters between 1998 –
       a random sample of 30
 Select
 counties or equivalent units
 (boroughs, parishes, cities) across
 each of the 10 federal regions.
         the county emergency
 Interview
              Nobody Left Behind Findings   5
Methods (Cont.)
         disaster plans and any
 Evaluate
 programs for persons with mobility
 Identify   possible best practices.
 Administer    on-line consumer survey.
       with project advisors to
 Consult
 recommend changes.

                Nobody Left Behind Findings   6
   Nature of the Problem

Lack of empirical data on
the safe, efficient
evacuation of people with
disabilities, including
mobility impairments.

         Nobody Left Behind Findings   7
Research on Disasters and
Persons with Mobility
 Few empirical research studies were
 Two studies identified correlation
  between disabilities and risk of death
  from earthquakes (Chou, Y., Huang, N.,
 & Lee, C., 2004; Osaki, Y. & Minowa, M.,

New Findings from Katrina
Survey of evacuees in Houston
shelters found:
 61% did not evacuate before the
 38% were either physically unable
  to leave or caring for someone
  who was physically unable to
  leave (Kaiser, Harvard, Washington Post).
    Nature of the Problem

Current evacuation systems
are designed for non-
disabled persons where
walking or running is
required (survival of the
fittest mindset).

          Nobody Left Behind Findings   10
    Nature of the Problem

Restoration of accessible and
other post-disaster living
situations for persons with
mobility impairments are often
not addressed.

           Nobody Left Behind Findings   11
 Focus Areas of the Research

 Emergency Managers Training
 Surveillance Systems
 Local Emergency Management Plan
 Inclusion of Persons with Mobility
  Impairments Nobody Left Behind Findings   12
     Findings on Emergency
     Managers Training
63% of the emergency
managers had not taken the
FEMA, G197, or similar course
on “special needs

         Nobody Left Behind Findings   13
Elements of Best Practices in
Emergency Managers‟ Training
   Local emergency management
    plan specifies that training and
    exercises involve persons with
   Drills include evacuating
    persons with mobility
    impairments from different
             Nobody Left Behind Findings   14
    Findings on Surveillance

Among the emergency
managers, 57% do not know
how many people with mobility
impairments live within their

         Nobody Left Behind Findings   15
Surveillance Findings (Cont.)
Among those who had
numbers on persons with
mobility impairments:
17% use database
17% use an estimate.
10% use census data.

          Nobody Left Behind Findings   16
Elements of Best Practices
with Surveillance
   Planning for Special „Medical‟
    Needs Shelter (shelter for medical
    and electricity/equipment needs)
   Plan covers identifying
    persons/needs, creating database,
    shelter design and location,
    consumer education. (Lamar
    University, Department of Nursing, Pam
    Moss, RN., Beaumont Emergency
    Management, Sgt. Robert Smith).
                Nobody Left Behind Findings   17
Response to Katrina
“Taking a lesson from New
 Orleans, Kansas Gov. Sebelius
 ordered state emergency
 planners to identify residents
 of Kansas‟ major cities who
 would be unable to evacuate …
 whether due to a physical
 disability or lack of
 transportation.” (From: Lawernce
 Journal-World, 9-8-05)

Consumer Survey
 Collected on-line personal disaster
experiences from persons with mobility
 From participants‟ recommendations two
disaster preparedness posters were created. click on “Findings”

     Findings on Emergency
     Management Guidelines

Only 20% of the emergency
managers reported having
specific guidelines to assist
persons with mobility
impairments during disasters.

          Nobody Left Behind Findings   20
Elements of Best Practices on
Plan Guidelines
 Created Annex/Appendix on
  Persons with Disabilities.
 Made specific reference to
  the needs of persons with
  disabilities in the various
  sections of the local
  emergency plan.
           Nobody Left Behind Findings   21
     Findings on Inclusion
     of Persons with Mobility
Little to no representation of
persons with mobility impairments
in planning or revision stages.

No Best Practices Found

          Nobody Left Behind Findings   22
Findings on Resources Needed
To develop guidelines for persons with
mobility impairments, emergency
managers need:
  67% Financial resources.
  33% Knowledgeable and trained
  25% A FEMA, State, or County
  17% Greater public education
            Nobody Left Behind Findings   23
   Consumer Feedback
 No evacuation plans in
 multi-story buildings,
 leaving people who are
 unable to walk abandoned at
 stairwells or at inoperable
 elevators without

         Nobody Left Behind Findings   24
      Consumer Feedback
   The Americans with Disabilities
    Act (ADA) has been in existence
    for more than 15 years, yet
    disaster-related or local services
    still can be found to be
    inaccessible and disaster-
    related personnel uninformed of
    the needs and how to assist
    people with disabilities.

              Nobody Left Behind Findings   25
    Consumer Feedback
 Other frightening and
 sometimes life-threatening
 situations occur when
 infrastructures fail, including
 electrical power outages and
 non-accessible transportation.

          Nobody Left Behind Findings   26
 Questions After Katrina
 Are there differences in
  disaster preparedness
  for persons who are
  disabled, seniors, or
  the seriously ill, and
  within classes, races
  and among states?
 4 years after 9/11, when
  will local emergency
  infrastructures be

 The Next Disaster: Avian &
    Pandemic Influenza

Are You Prepared? Have You
 Prepared Your community,
   including Persons with
    For more Information:

         Nobody Left Behind Findings   29

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