2021 World Water Day Q&A with IDM’s Michelle Ritchie

World Water Day is about celebrating water and the many roles it plays in our households, cultures, health, environment and more. Yet, despite how crucial water is to our daily lives, changes in climate are posing threats to access around the world. Michelle Ritchie, a PhD candidate in geography and climate science and an assistant professor here at IDM, elaborates on some of these concerns:

How have changes in climate already begun to impact water insecurity?

Water security varies across the world and is considered largely dependent on access to fresh water, such as lakes, springs, and aquifers.  To be considered ‘water secure’, an area needs physical and economic access to fresh water.  So, a water secure area has a reliable source of fresh water and the capital and infrastructure to access this water.  For example, the ‘global North’ faces much more physical water scarcity than it does economic water scarcity (figure 1). Conversely, much of the ‘global South’ faces economic water scarcity rather than physical water scarcity.  Despite physical distance and differing water scarcities, this phenomenon highlights our complex global entanglements with water, and therefore with each other.  For example, we—you and me—need to acknowledge and explore how our water use is entangled not only in what comes out of our hoses and faucets, but also in what we buy and use.  Apparent or not, water is embedded in the production of all of our ‘things’, including the built environment.  For example, it takes many hundreds of gallons of water to make a single cotton t-shirt.  In this complex equation, climate change serves to highlight existing inequalities in the global supply and demand of fresh water.  Disproportionate impacts across space and place requires us to work toward solution-building as a global community in support of a sustainable relationship with the global hydrologic system.  Today, I challenge us to consider how we impact people in places that are physically distant from us through our relationship with water.   

Figure 1
Source: United Nations

Your course “How to Survive the Apocalypse” addresses ways in which these issues can be mitigated and/or adapted to. What are our most pressing concerns regarding water, and the best ways to address them?

Less than 3% of the water on Earth is fresh water, of which less than 1% is available to us in the form of surface or groundwater (figure 3)!  Most of our global groundwater sources are already being depleted past sustainable use.  That is, how quickly and effectively the groundwater is replenished is superseded by how quickly the groundwater is removed. Concurrently, the global hydrological cycle is speeding up under the influence of climate change, which means surface water is being evaporated more readily and water is cycling through the system at a faster rate (figure 2), potentially impacting the amount and quality of water that is available for replenishment of local fresh water sources.  As a global society and as individuals we need to be responsible caretakers of Earth’s freshwater systems, particularly as they will continue to face increasing stressors from climate change amid increasing global demand.  

In “How to Survive the Apocalypse”, we explore these and other confronting and seemingly insurmountable topics.  I want students to understand how issues like water insecurity are reproduced globally and experienced locally, particularly in the context of climate change. I also want students to engage with complex problems using perspectives that are solution-facing.  For example, existing literature on the Ogalala Aquifer—the United States’ largest groundwater system—is ripe with evidence of overuse and the negative ramifications of this impact on people and ecosystems.  Concerns regarding water are seemingly endless—and it can be hard to see a viable path forward when we are overwhelmed by the negative picture—but for every complex problem there are many solutions that draw from a wide, creative mix of strategies and entry points.

Figure 2
Source: NASA
Figure 3 Source: U.S. Geological Survey


What are some resources we can all use to track our own ecological footprint?

I encourage everyone to use the templates and tools that are available to calculate their footprints!  Ecological footprints translate consumption habits into the amount of land and water required to support demand, carbon footprints translate consumption habits into a total amount of greenhouse gasses required to support demand, and so on. Your results will vary for each calculator, so be sure to put in as much detail as you can.  Your results may surprise you!  How many Earths would we need if everyone had your ecological footprint? 

I also encourage everyone to use these calculators as a starting point, not an end point.  Now that you have measured your footprint, what about the results would you like to change?  Pick one key area and make a specific and measurable goal, then monitor your use in this key area to serve as a baseline.  Work toward your goal one step at a time, then check back in with yourself by calculating your footprint again.  How will it change over time?  You get to decide!  Pose a little friendly competition by asking others to calculate their footprints, too!  How do you compare to your friends and family?

Here are a few calculator tools to get you started: / /

Dr. Curt Harris on Operation Wesley

Conducted November 4 – 8, 2019, Operation Wesley was the largest mock Ebola patient transportation exercise to date. Dr. Curt Harris, IDM director and principal investigator for the project, gives more insight into the experience:

What led to the development of this exercise? How long was the process – from the original idea to the final execution?

Harris: This exercise is the culmination of years of planning and actual response to the 2014 West African Ebola Virus Disease (EVD) outbreak. EVD had never been a major concern in the U.S. as the disease was not endemic geographically. That all changed in December of 2014 when the CDC confirmed the first travel-associated case of EVD in the US. The initial diagnosis was almost immediately followed by positive tests for two healthcare workers that had cared for the index case. This event, along with others who were transferred to U.S. healthcare facilities following exposure to EVD while working in West Africa, identified an immediate need for training and education on emerging serious communicable diseases.

The U.S. was fortunate in the outbreak of 2014 that it never became unmanageable in terms of patient volume for our healthcare facilities to be able to handle. The idea of this exercise is, “What if that happened?” What if the outbreak was so out of hand that all of the treatment and assessment beds were filled with EVD patients? Can we handle that scenario? So, the goal is to test the collective response capabilities of our pre-hospital and healthcare providers in Health and Human Services Region IV. The planning for this exercise began in August of 2018 and will conclude in January of 2020.

What kind of insights can an exercise like this provide? Can it contribute to preparedness for other types of public health emergencies other than infectious disease?

Harris: Exercises are invaluable resources that allow organizations and individuals the opportunity to practice their plans, policies and procedures in a no-fault environment. This exercise is essential for many of our participants in the pre-hospital and healthcare arenas due to fact that very few of them have had an actual patient. As operational gaps from the exercise are identified, participants will update and strengthen their plans, policies and procedures; have a better understanding of community partnerships; and more fully understand the entirety of the process and players involved.

This exercise will definitely contribute to preparedness for other types of public health emergencies. The Georgia Department of Public Health is to be commended for utilizing the preparedness dollars they received for Ebola over the last five years and building an Infectious Disease Network for the state. There are a set of skills that have been developed by pre-hospital and healthcare providers in Georgia that are ubiquitous for other infectious diseases. The personal protective equipment, signs and symptoms, and precautions may differ; but the foundational understanding of protection of self and equipment, prevention of the spread of disease and notification procedures remain the same.   

With the current Ebola outbreak being in the Democratic Republic of the Congo, how substantial is the threat of an Ebola outbreak in the U.S.? Are there other infectious diseases to be concerned about?

Harris: The DRC is currently dealing with the world’s second largest EVD epidemic on record. However, this outbreak is unique because there are significant access and security concerns in the area that has stagnated a full humanitarian response. Fortunately, for the rest of the world, this epidemic has been mostly contained in the DRC with only one case moving into Uganda that was quickly identified at a border screening and no contact was made with any Ugandan citizens. While the U.S. should remain vigilant to the current epidemic, the current threat to the U.S. remains low to receive a traveler and/or patient with EVD.

There are certainly other diseases U.S. citizens should be currently concerned about. These include, but are not limited to:  measles, various strains of influenza, various strains of hepatitis, legionellosis, mumps, pertussis, HIV, meningitis, tuberculosis, acute flaccid myelitis, and others.

How was the scenario/setting devised? What kind of trends was it based on?

Harris: The scenario was devised based on the current outbreak in the DRC. The caveat was the need to simulate the epidemic spreading into Nigeria and Nigeria being unable to contain the disease within its borders. We required a sufficient outbreak that it would test the full capacity of the infrastructure of HHS Region IV, and the current DRC outbreak certainly fits that mold.

What have been the biggest challenges in the process of preparing for and executing this exercise? What has been most rewarding?

Harris: I would say the biggest challenge has been the logistics of coordinating all the players from the various states and federal government into one, week-long period of exercising. I do not believe the general public, and many of the exercise participants, fully understand the volume of coordination required to receive, transport, and treat a single EVD patient. When you multiply that by a factor of 10 or more, the difficulty is exponentially increased.

The biggest challenge has also been the most rewarding portion. To see all the players come together for a common goal of protecting U.S. citizens and advancing the science of how we treat global diseases has been amazing to watch. The effort put forth by our team at UGA, the Georgia Department of Public Health, Health and Human Services Assistant Secretary for Preparedness and Response, pre-hospital and healthcare partners, and other states in HHS Region IV has been nothing short of amazing. I am very proud that UGA IDM had the opportunity to lead this initiative.

UGA’s Institute for Disaster Management facilitates largest Ebola patient full-scale exercise to date

ATHENS, Ga – On the morning of November 4, 2019, Anna Chocallo arrived at a local healthcare facility. She had a fever, and her stomach pain and nausea were getting much worse. When her care provider asked about Chocallo’s recent travel and learned about her trip to Uganda, a plan was set into motion.

Chocallo would be transported to a designated treatment facility for patients with suspected Ebola.

Fortunately, Anna Chocallo does not actually have Ebola. She was one of many actors participating in the largest Ebola exercise to date. The facility she visited was, in fact, the University of Georgia’s Institute for Disaster Management (IDM), which organized the week-long event.

The exercise, dubbed Operation Wesley, took place from November 4 to November 8 and involved frontline, assessment and treatment healthcare facilities and emergency medical services (EMS), state departments of public health and many others across seven states in the Southeast.

These groups had discussed their local and regional plans for identifying, isolating and transporting an Ebola patient during a tabletop exercise in June. Now, they had the chance to put their plans into action in this second full-scale exercise.

Operation Wesley tested the notification processes, coordination decisions and resources needed to move patients with suspected or confirmed Ebola using both air (simulated) and ground transportation resources.

“This exercise is essential for many of our participants in the pre-hospital and healthcare arenas due to fact that very few of them have had an actual patient,” said Curtis Harris, director of IDM.

“As operational gaps from the exercise are identified, participants will update and strengthen their plans, policies and procedures, have a better understanding of community partnerships, and more fully understand the entirety of the process and players involved.”

Though the exercise was focused on the transportation and containment of patients with Ebola, the methods practiced can be applied to other cases of infectious disease outbreak.

Recently, the Georgia Department of Public Health confirmed a case of measles in Cobb county, urging health care providers in the area to stay watchful for new cases of the disease. Harris says infectious diseases like this are as concerning as Ebola.

To add a greater sense of realism, a hypothetical national Ebola scenario was created and updates on the crisis were provided to the participating facilities in the days leading up to the week-long exercise.

Chocallo and her fellow actors’ simulated symptoms provide an opportunity for healthcare personnel to experience the realism of responding to a live patient.

“Live actors greatly enhance the realism of the exercise,” said Kelli McCarthy, IDM program coordinator and Operation Wesley lead. “By having to diagnose and treat a live person, healthcare facilities and EMS agencies are able to identify any gaps in plans and resources. The reaction to a piece of paper just doesn’t have the same effect.”

Chocallo says she enjoyed the novelty of the experience: “It’s not every day that you can come to work, contract Ebola, take an ambulance to the hospital, interact with paramedics donned in personal protective equipment and leave from work all in the same day.”

“If I were a real-world Ebola patient, the confidence of the paramedics involved in infectious disease transport provided a sense of security amidst the hectic nature of the exercise,” she added.

Though media coverage of the Ebola crisis has dwindled since September 2014, when the first confirmed case of travel-associated Ebola arrived in the U.S., it remains an ongoing crisis in places like the Democratic Republic of Congo.

The team at IDM, in collaboration with regional and state emergency response organizations, has been monitoring the current outbreak and used it as the basis for the fictitious scenario in Operation Wesley.

“To see all the players come together for a common goal of protecting U.S citizens and advancing the science of how we treat global diseases has been amazing to watch,” said Harris.

Operation Wesley was conducted in collaboration with the Georgia Department of Public Health, and the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR).

IDM training course prepares nursing homes for natural disasters

The Institute for Disaster Management at the University of Georgia College of Public Health has received $1.6 million in civil money penalty funds from the Centers for Medicare and Medicaid Services to better prepare certified long-term care facilities’ staff to respond to natural disasters and other emergencies.

In the past two years, Georgia has been hit with an unprecedented number of disasters. This represents a significant risk for the growing number of older adults moving into Georgia, said Curt Harris, associate director of the Institute for Disaster Management (IDM) and lead investigator on the project.

“Georgia’s 65 and older population is expected to increase by 143 percent by the year 2030,” said Harris. “Older adults, especially those who live in long-term care facilities, are historically vulnerable to disasters. If residents require specialized medical care, caregivers need to have a plan in place to keep residents safe and healthy.”

Harris and his team are working with Georgia caregivers and administrators in long-term care facilities, like nursing homes, to equip them with the critical skills they need to develop emergency preparedness plans to protect their residents and staff in the event of more natural disasters such as Hurricane Irma and Hurricane Michael.

New federal regulations went into effect in November 2017 requiring long-term care facilities to develop plans showing how they will keep residents safe during a natural disaster and how their efforts will plug into community-level emergency response plans.

“We’re going from a hospital-only approach to the idea that we are, in fact, health care communities and coalitions, and we all need to be prepared in order to handle a disaster,” said Tawny Waltz, a research scientist with IDM and part of the training team.

Specifically, facilities need to develop an all-hazards plan, which is a new concept to most organizations, said Waltz.

“People used to write plans based on individual disasters, so they would have a fire plan, a tornado plan, a hurricane plan, and whenever they encountered something new, they might write a plan,” she said. “Well, that’s a lot of plans, and it’s not feasible to keep those up to date.”

In contrast, an all-hazards plan identifies what an organization would need to respond to any type of natural disaster, such as access to utilities, communications, food, and medical supplies, despite the type of event taking place.

Through a two-part training course, the team is guiding facilities through the development of their all-hazards plan, but the first step will be to review the basics of hazards response, what Harris describes as “emergency preparedness 101.”

The project also provides opportunities for trainees to attend professional conferences to build a network of support in the emergency response community. Harris emphasizes that collaboration is the key to keeping people safe.

The UGA team is using curriculum developed in partnership with the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Georgia Department of Public Health, the Georgia Department of Community Health, the Georgia Health Care Association, the Office of the Assistant Secretary for Preparedness and Response, the Nursing Home Council Coordinators, and local emergency managers.

Evacuating with pets during a disaster is complicated, UGA research finds

Imagine there is a powerful storm bearing down on your town. Officials are calling for everyone to evacuate. Where would you go – and if you couldn’t bring your pet, would you go anyway?

These are the questions researchers with the Institute for Disaster Management at the University of Georgia and Illinois State University are working to understand.

Sarah E. DeYoung, an assistant professor of health policy and management at UGA, and Ashley Farmer, an assistant professor in criminal justice studies from Illinois State, are leading the project to study how pet ownership impacts the decisions we make in the face of an emergency.

“From a public health perspective, the focus of disaster research is safety and preventing loss of life,” she said. “We look at what facilitates and at what hinders evacuation decision-making.”

DeYoung first recognized the need to focus on companion animals when she was gathering survey responses and anecdotes from Carolina coastal residents who chose not to evacuate ahead of Hurricane Matthew in 2016. Repeatedly, respondents expressed that they didn’t want to leave their pets behind.

In the wake of Hurricanes Harvey and Irma, DeYoung won a National Science Foundation RAPID grant to dig deeper into issues related to pets and evacuation decision making during a range of natural disasters.

In September, the researchers deployed to cities in Texas and Florida that had been heavily impacted by the storms. At each location, they conducted interviews with pets-focused personnel, such as shelter coordinators, animal non-profits and veterinarians, and pet-owning evacuees.

“Our research is asking, among those who have the ability and resources to evacuate, are pet owners more likely to leave sooner than non-pet owners because pet owner is responsible for life of animal?” said DeYoung.

The resources available to us — money, transportation, family living nearby — play a key role in how we make decisions, says DeYoung. When people have limited access to resources, they become more vulnerable to the type of drastic change a natural disaster presents.

“Where you’re situated in a social system can make you more or less likely to have access to certain resources,” said DeYoung. “Having a pet can make you very resilient in some ways but may hinder your evacuation in others.”

People who don’t have a car, for example, may not be able to take their animals on a city bus.  Evacuees are also often unsure if pets will be accommodated in the hotels or shelters taking them in evacuees.

Much of the decision to evacuate with or without an animal depends on how the animal is viewed, says DeYoung. If a pet is like a member of the family, people are more likely to evacuate with that pet.

Yet, once owners choose to evacuate with a pet, the question of its care becomes more complicated. Often, shelters are not prepared to care for animals, even if they accept them, and having enough supplies on hand is a common issue.

“Shelters in Texas had too much dog food after the storm,” said DeYoung,” but not enough pee pads, leashes and kennels.”

Emergency planning for natural disasters is left up to individual counties, and DeYoung hopes her research will highlight the need to account for pet evacuations in their emergency plans.

“One of our first priorities is identifying small, low cost things that would make evacuating with pets easier,” she said.

They are looking to the policies that worked and examples of when policies failed to identify best practices for future emergency plans. The findings may also offer lessons for pet owners and for groups working with the people and their pets.

For example, cats are not as independent as most people think. “Their owners assume that they could manage on their own for a few days. In fact, cats are just as vulnerable as other pets to natural disasters,” said DeYoung.

There are numerous complicated factors that play into a creating a successful emergency evacuation plan both at the community level and for individual families, but one thing is clear to DeYoung — people really care about their pets and accommodating animals should be a priority.

“Some people said, I don’t care that I lost my house,” she said. “I just want my dog or my cat back.”

You can follow DeYoung’s Pets & Evacuation Research project on Facebook.

Groups providing prenatal, postpartum care for refugee women need more support, UGA study finds

As the refugee crisis continues to grow in Europe, Bangladesh and now in Central and South America, a growing number of non-profit organizations are working to provide a range of humanitarian services to refugees in camps and after resettlement.

But not enough attention is given to the special needs of pregnant and postpartum refugee women, according to new research from the University of Georgia.

Among the 21 million registered refugees, half are women and girls. Yet comprehensive women’s health services are often lacking, and pregnant women are particularly vulnerable to lapses in necessary care.

Prenatal and postnatal care should be prioritized for all pregnant women, but especially for refugee women. They are not only managing a pregnancy and preparing to care for a newborn infant, but also learning to navigate a new healthcare system and cultural norms, says Aishah Khan, who led the study as a graduate student at UGA’s College of Public Health.

Khan and collaborator Sarah DeYoung, an assistant professor of health policy at the college, interviewed five U.S.-based nonprofit organizations that deliver maternal care services to refugee women from more than 25 countries in camps and after resettlement in the United States and identified key organizational successes and challenges.

They found that success stemmed from organizations’ ability to provide individualized support to clients and connect them to the health services they need, while taking into account their cultural and linguistic needs.

“One of the most interesting concepts we saw was organizations employing people who had used the services before,” said Khan. “That really helped to build community and build trust with the organization, and helped the women not feel so isolated.”

The main organizational challenge for these organizations is funding. Khan believes this is related to pervasive misperceptions and unease about refugee settlement.

“There isn’t a lot of political support for settling refugees in the U.S.,” she said. “That influences the funding [organizations] receive from the federal government and also individual donors.”

Khan says these findings can offer a framework of best practices for organizations working with refugees or other marginalized groups, but she also hopes that highlighting the work these organizations do will help make people more aware of the need to support health services for refugees.

The study, “Maternal Health Services for Refugee Populations: Exploration of Best Practice,” published September 6th in Global Public Health. It is available online here.

[Featured Photo: USAID partners including UN Children’s Fund and the UN World Food Program screen and treat children for malnutrition and provide additional food to women and children in the Kutupalong refugee camp in Cox’s Bazar, Bangladesh. Maggie Moore, USAID. (CC BY-NC 2.0)]

Why don’t people evacuate during a hurricane?

As the east coast prepared for Hurricane Florence, Dr. Sarah DeYoung, an assistant professor at the Institute for Disaster Management, spoke with UGA weather expert Dr. Marshall Shepherd on why some individuals faced with dangerous weather events don’t leave. The interview was published in Forbes.  Dr. DeYoung also offered insights and advice on how to convince family to evacuate during a hurricane to the Huffington Post.  This article featuring Dr. DeYoung was also referenced in a piece by Inquisitr.

In the wake of Florence, How Stuff Works interviewed Dr. DeYoung to learn more about logistics of evacuating the entire U.S. coastline during Hurricane Florence. She was also interviewed by Jim Galloway at the AJC’s Politically Georgia blog about some of the challenges faced by emergency management services in NC, SC and VA.

FEMA updates US nuclear disaster plans

Dr. Cham Dallas, director of the Institute for Disaster Management, presented at a two-day National Academies of Sciences workshop for public health and emergency response officials. Dallas shared “speculative” analyses of nuclear detonations modeled for several cities, and discussed what makes medical planning for a large nuclear detonation more difficult.

Dr. Dallas’ presentation was featured in coverage from BuzzFeed, with follow up at NewsMaxSputnik NewsThe HillMotherboard. Additional coverage in Nature and Scientific American references a 2017 study by Dr. Dallas.

Even higher income nations struggle with safe infant feeding during a disaster, UGA study finds

A recent World Health Organization resolution sought to encourage breastfeeding as the healthy and safe choice for infants around the world but especially in poorer, developing countries where clean water and food security may be a concern.

However, new research from the University of Georgia says that despite a country’s wealth, they may struggle to implement safe infant feeding in disasters.

“First responders and shelter personnel need to think of infant feeding as a food security issue,” said Sarah DeYoung, an assistant professor of health policy and management in UGA’s College of Public Health and lead investigator. But at the moment, she says, “infant feeding is an afterthought in disaster sheltering and evacuation.”

In the first study to measure the impact of a large-scale wildfire evacuation on infant feeding, DeYoung and her team surveyed the experiences of mothers and caregivers who fled the wildfires that swept through Fort McMurray in Alberta, Canada, in 2016.

Over 88,000 people were forced to leave the remote town and shelter in cities hours away, and most Fort McMurray residents didn’t return home for almost six weeks. The strain of the evacuation was amplified for mothers and caregivers.

Many of those surveyed said they experienced stress related to infant feeding and food security. Some respondents indicated that they had concerns about breastfeeding or difficulty finding space to clean bottles and feeding supplies.

It’s crucial to incorporate safe infant feeding protocols in emergency response plans, said DeYoung especially for babies who are younger than six months old.

“That’s a critical time frame,” she said. “Babies should be breastfed until they are at least six months old, so if there is a four or five-month-old in an evacuation, early weaning can still have health implications.”

Yet, the number of women exclusively breastfeeding dropped from 64 percent before the fires to 36 percent. Some mothers said they struggled to breastfeed or pump milk, believing that their milk supply diminished due to the stress of the evacuation.

Many of the caregivers also shared that because of the evacuation, being physically far away from their healthcare or lactation specialists made it difficult to access support regarding feeding concerns.

DeYoung says it’s important to communicate with mothers and caregivers that breastfeeding is still possible during emergencies as it remains the safest form of infant feeding post-disaster.

The WHO cautions against mass formula distribution in emergencies and instead recommends a targeted approach. But the research team gathered data which suggests that shelter personnel handed out formula to without assessment or support.

Almost one third of caregivers reported receiving formula without any preparation or storage instruction, which can lead to gastrointestinal distress and dehydration if the formula is improperly mixed. In fact, one of the largest shelters for Fort McMurray evacuees did experience an outbreak of diarrhea, prompting the sheltering staff to bring in infant feeding specialists.

DeYoung says these findings offer some immediate takeaways for emergency planners. Above all, lactation and infant feeding resources need to be on hand to provide support for families with infants, and breastfeeding caregivers should have space in sheltering facilities for infant feeding.

“Mothers and caregivers are experts in what their children need,” said DeYoung. “It should not be viewed as a luxury to make sure the infant has food security during and after the disaster”.

The study, “The Effect of Mass Evacuation on Infant Feeding: The Case of the 2016 Fort McMurray Wildfire” was published in Maternal and Child Health Journal. It is available here.

Co-authors include Jodine Chase with Royal Roads University and SafelyFed Canada, Michelle Pensa Branco with the University of Waterloo and SafelyFed Canada, and Benjamin Park formerly with the University of Georgia, now a medical student at Vanderbilt University School of Medicine.

[Photo Credit: Image of Fort McMurray wildfires courtesy of DarrenRD at WikiCommons.]

High school training could save lives in the event of a disaster, IDM expert says

2017 was a record breaking year for disasters. The U.S. experienced three major hurricanes, out of control wildfires, flooding, mudslides, and two of the deadliest mass shootings to date. All told, these events caused billions of dollars in damage and cost many lives.

In the face of more frequent and deadly events, University of Georgia disaster management expert Curt Harris argues that more regular citizens need to be prepared to help others in the event of a disaster.

That means training people who are not traditional “first responders” to help injured people get to a safer place or perform life-saving interventions, said Harris, who is the associate director of UGA’s Institute for Disaster Management in the College of Public Health.

Sometimes, friends and neighbors are in a better position to react to an event than firefighters or emergency medical personnel, said Harris, who published his case for more civilian training in International Journal of Environmental Research and Public Health. For example, bystanders who pitched in to help stop bleeds and evacuate victims from the scene before responders could arrive saved lives in the wake of the Boston marathon bombing.

“It’s about empowering knowledge,” he said.

Harris and his co-authors propose adding a universal disaster response training and education curriculum to existing first aid curriculum in high schools. Currently, 32 states require that high school students complete CPR training before they graduate.

“We’re not looking to reinvent the wheel, but for someone to understand how to open up an airway, how to stop a bleed, these are things that we know to be lifesaving,” he said. “Whether it’s a tornado, a shooter, or a bombing event is irrelevant. These are the interventions that save people’s lives.”

Harris feels confident this type of training would stick with high schoolers into early adulthood because of how common disaster events have become.

“I think disasters have become so ubiquitous in our culture that it’s necessary to learn these skills at an early age so they can be put into practice when the time comes,” he said.

This “new” disaster training is not meant to stand alone. The goal is to broaden the emergency response workforce, and anyone trying to implement this curriculum should partner with existing emergency management community/organizations.

“It takes a village. There is no one discipline, no one set group of people who manage an event,” said Harris. “This has the opportunity to be a force multiplier for our health care and emergency management community, and I think that’s one of the major advantages.”

The paper, “Expanding Understanding of Response Roles: An Examination of Immediate and First Responders in the United States,” was published 16 March 2018. It is available online at

Co-authors include Kelli McCarthy, Parker Prins, and Tawny Waltz with UGA’s Institute for Disaster Management; and E. Liang Liu, Kelly Klein, and Raymond Swienton with the University of Texas Southwestern Medical Center.