Capstone Project Proposal Emergency Preparedness For Individuals With Special Needs, Disabilities, And The Elderly

Running head: CAPSTONE PROJECT PROPOSAL 1

Capstone Project Proposal: Emergency Preparedness for Individuals with Special Needs,

Disabilities, and the Elderly

Name

Institution

CAPSTONE PROJECT PROPOSAL 2

Abstract

People living with disabilities and the elderly have been on the sidelines in emergency

preparedness. Their relegation has led to even more disproportionate suffering whenever an

emergency occurs. The project aims to study the effect of the sidelining of people from all

walks of life by studying relevant literature. The findings indicate that while some things

have improved, the overall tone of the procedures show that there is a gap between the

overarching policy envisioned and how it is executed on the ground. The project recommends

communication, inclusivity, and listening to their opinions.

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Capstone Project Proposal: Emergency Preparedness for Individuals with Special Needs,

Disabilities, and the Elderly

Introduction

Disasters – whether they are an act of nature or man – have a profound and lasting

effect on people from all walks of life. Governments around the world have spent vast

amounts of time, money, and manpower to defend against such disasters or to mitigate their

risks. However, in every society, there are those that are more affected by disasters than

others. One such group comprises of people with special needs, disabilities, and the elderly.

One reason for this is that responses to disasters often involve extremely demanding physical

and psychological effort. In the case of the groups mentioned, their conditions preclude such

actions. As such, they must be given additional support if their chances of survival are to

remain high. There are numerous challenges that face people with disabilities when

emergencies occur. However, as Fernandez et al. (2002) argue, the cost of dealing with

people with special needs during and after a disastrous events are significantly higher than

those that would be incurred to inform and prepare the community to respond to this category

of people. Emergency preparedness should be a high priority for any emergency response

organization. The goal of this project is to examine various sources of literature on people

with disabilities and emergency preparedness for them and to the extent to which sufficient

resources are deployed to help them in their unique situation. While emergency preparedness

is a goal for many governments, the disabled and the elderly have significantly been

disadvantaged by these plans as evident from the hurricane in Texas and Florida in 2017

where many elderly people were affected.

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Background Information

The United States has had its fair share of disasters – both natural and manmade.

From the actions of first responders in the aftermath of disasters, key lessons seem to have

been learnt. However, from the performance of FEMA and other agencies in the wake of the

2017 hurricane season, it is evident that there is still a lot more that can be done. The

literature pertaining to emergency preparedness for people living with disabilities exists.

However, the field has not been examined quite as robustly as others. From the available

research, the existing literature can be divided into four broad categories.

The Extent to Which Emergency Management Services Acknowledge People with

Disabilities

The Americans with Disabilities Act of 1990 emphasized the rights of such

individuals to access all government services. While the spirit of the law and the government

is clear on paper, whether it translates into positive action on the ground is questionable. A

study carried out by Gooden, Jones, Boyd, and Martin, (2009) found that in many cases,

research on emergency preparedness mentioning people living with disabilities only referred

to those who are institutionalized and the action plans revolved around them. While this is a

step in the right direction, a glaring gap is evident. In recent years and with advancements in

the medical and psychological fields, more people with disabilities are living independently

than ever before. The population of these individuals is quite widespread. However, the

literature on how to respond to them in case of a disaster is scant. Therefore, more research in

the field is needed.

In another 2007 study, Fox et al. discovered that while some counties and states

recognized the need for additional disaster management planning in the case of people with

disabilities, there were various constraints that impeded progress. One was the limited time

they had for training and awareness creation. The second factor was that funding was too

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little to make any meaningful impact. Even some of the researchers are not taking all factors

into account when studying this phenomenon. One example can be found in a paper by Jones

and Andrey (2007) where they looked at how to formulate vulnerability and recovery indices.

The geographical scope of the paper was limited to the city of Vancouver. The academic

scope was narrowed to mobility and communication for people with disabilities. The authors

managed to formulate somewhat meaningful indices. However, they did not include in their

results a way to factor in statistics on disability into their indices, meaning that for the most

part, they were running on simulated or outdated data. The more time passes, the less the

results of the indices mean.

From another perspective, other researchers are slowly investigating some of the ways

in which disaster management could incorporate people with disabilities, and progress has

been made. For example, the premise of one paper was that if EMS was to have a chance at

formulating a coherent response strategy, they first would have to have an idea of how many

people in a certain community lived with disabilities. In this paper, a cross-referencing

system was set up, looking up data on the CDCs Behavioral Risk Factor Surveillance System

and correlating it with census information. Even though the correlation would not be perfect

(mainly due to differences in definitions) the results of the check would provide all covered

regions with approximations on how many people living independently but with disabilities

were in their community. It is evident that there is too little focus on the role of people with

disabilities in the context of disaster management and emergency preparedness. Many studies

point to this omission. For instance, Renne, Sanchez, and Litman (2011) found that people

with special needs were often relegated to the sidelines when it comes to emergency planning

and preparedness. Therefore, it is evident that these groups have been neglected in many

ways.

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The findings in this paper were similar to those in Fox et al. (2007). The lack of

resources was a major factor identified by Renne, Sanchez, and Litman (2011), as well as

Bryan and Kirkpartrick (2007). According to the latter, the evacuation of people requiring

medical supervision is often unsuccessful since healthcare staff depends critically on the

assistance of emergency response personnel and law enforcement officers. Such an

expectation is often unmet since they are too busy performing evacuations elsewhere. The

two cases are a representation of Clarke’s (1999) assertion that planning will only take a

community so far. No emergency will ever occur exactly according to the plan. Therefore,

while advances are being made in generating more responsive procedures, the planners must

allow for a high degree of flexibility within the overall emergency response framework.

Personal Preparedness

In spite of the fact that numerous agencies coordinate emergency response, the

likelihood of a successful strategy is significantly increased by heightening personal

preparedness. The latter refers to the level to which an individual has collected the required

knowledge, skills, and tools to survive a disaster. In addition to this, the level of preparedness

of individuals should be factored into the overall disaster response framework as it will help

to allocate resources where they are actually needed instead of using them to help those who

have gathered the capacity to help themselves. Marshall et al. (2007) found that a DHS and

FEMA effort to educate residents on Rhode Island led to a 10 % increase in personal

preparedness. Education and awareness creation is a very crucial aspect as evidenced by

Marshall et al. (2007). One of the factors that make individual preparedness more effective is

a personal experience. A study by Mishra and Sual (2007) conducted in India discovered that

personal experience combined with public education campaigns raised preparedness levels in

people. Unfortunately, however, they did not develop a way to measure the increase.

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Therefore, different stakeholders should devise ways of informing people about disaster

preparedness.

Another factor discovered in literature is social capital. One trend that emerged from a

study done by Hausman, Hanlon, and Seals (2007) was that people with higher social capital

had, in general, a greater understanding of the extent and consequences of disasters. The

study focused on terrorism – a man-made disaster. The researchers found that as a result of

the higher level of appreciation for emergencies, those with higher levels of social capital

tended to be more aware of individual response measures and were more prepared than their

counterparts. The three factors mentioned above help to increase individual preparedness

(personal experience, social capital, and awareness campaigns) are largely a responsibility of

the person. However, other challenges that impede individual preparedness are out of a

person’s control. For instance, dissemination of information tends not to reach every

individual living in a community. An example of this is in situations where people are

informed of hurricane warnings through mass media and over online platforms. If someone

does not have access to these, then it is likely that such information will not get to them.

When disabilities, age and special needs are factored in, the challenges facing people with

special needs are compounded. Such is the conclusion reached by Fernandez et al. (2002).

The focus of their study is on the population of the elderly and how well prepared they are.

Otani (2010) confirms that the challenges facing the elderly are functional as there are likely

to be health and other issues compounding the challenge presented by their age. One example

of this is transport and mobility. The National Institute on Aging (2018) shows that there are

numerous challenges the elderly face that many of them quit driving. Such difficulties include

lower reflexes caused by stiff joints and arthritis, sight and hearing problems, and in some

cases, dementia (National Institute of Aging, 2018). The results arrived at by Otani (2010),

Fernandez et al. (2002), and corroborated by the National Institute of Aging (2018) can be

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reasonably extrapolated to cover people living with all kinds of disabilities. Thus, the lack of

preparedness is due to the lack of awareness among the aforementioned groups.

The impact of experience on personal preparedness cannot be overstated. A 2007

study focused on the experiences of people with disabilities who survived Hurricane Katrina

(Spence, Lachlan, Burke & Seeger, 2007). The researchers discovered that the survivors

tended to be better prepared with more supplies in the event of another storm. However, their

transportation plans were not developed to the same level. Interestingly, another study found

that people with special needs and disabilities, including the elderly, had a greater awareness

of the vitality of individual preparedness and how it would fit into the overall disaster

response framework (Rooney & White, 2007). When survivors of disasters who lived with

disabilities were asked their opinion, communication, cooperation with response agencies,

and preparedness were the top responses (Rooney & White, 2007). Thus, while people with

special needs recognize the need for inclusion into the national disaster management

framework, their concerns are not being heard.

The Role of the Community in Formulating Plans

Involving the community in the planning stage seems to be an obvious action. After

all, no one person or entity can comprehensively plan for a disaster alone (Faffer, 2007).

However, research has shown that in many cases, the community is often not brought on

board. Disaster management is, at its core, a management exercise, thus shares some core

tenets and theories with other branches of the discipline. One such theory is the adaptive

management philosophy. According to Reddick (2008), the theory postulates that in business,

management effectiveness is increased whenever customers are included in the strategic

planning process. In reality, however, Reddick (2008) found that less than 60 % of managers

included customer input in their strategic plans, and the figure does not include the

percentage of planners who have looked into the unique needs of various groups. The theory

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can be transferred over to disaster preparedness and management. However, there is no study

that has looked at the proportion of emergency planning managers who have actively

engaged with the community. Therefore, a shortage of exert opinion and research works may

be a reason for poor disaster preparedness.

There are various ways in which the community can meaningfully engage with the

planners in such a situation. The planning theories, as categorized by Hudson (1979), include

rational, advocacy, radical, incremental, and transactive approaches. Rational approaches are

the most common in the nation’s various bureaucracies. The linear fashion in which

procedure is arranged suits the current government accountability machinery. However, for

those who are served by these agencies, such an approach seems to be too rigid. In fact, the

other methodologies of planning are a direct result of this inflexibility. For instance, the

incremental models attempt to bring in some flexibility through compromise. The problem, as

Hardina (2003) notes, is that political, economic, or other forces tend to skew consensus

away from the best plan for the people to be served. Advocacy planning takes a balanced

approach by championing the concerns of the various groups of people with disabilities. The

approach uses the common challenges to bring the various groups together and still delves

deeper to cater to the challenges specific to each group. Transactive planning is similar to

advocacy as it seeks to develop an inclusive and comprehensive approach. However, it builds

consensus through relationships where each side gets to understand the difficulties faced by

the other and the opportunities that they can leverage. Radical approaches to planning are rare

and focus on the power structure in the current system. For example, in the disaster

management framework, the perspective of a radical planner would be that the planners have

power over those living with disabilities. Due to this power imbalance, the ‘oppressors’ are

not incentivised to incorporate the concerns of the oppressed and they end up taking other

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matters into consideration before the wellbeing of the population they are supposed to be

serving.

The radical theory can be viewed as an extension of the incremental theory or, more

accurately, the course of events in the case where the incremental approach does not yield

results. One of the events that led to the increased pressure of community inclusivity is

Katrina. A review published by Allen and Nelson (2009) found that during disasters, the

elderly with disabilities who were institutionalized received disproportionately less help once

responders became overwhelmed. Included in their study was information from Katrina.

Another source that focused on the treatment of the elderly and people with disabilities

during and after Katrina is Kailes (2006). According to her research, almost half of the people

who refused to be evacuated were either people with special needs or they were caring for

such individuals. The researcher provided additional information in reports that some people

with disabilities were rejected from the numerous informal settlements and evacuation

centres that had been set up. Apart from the fact that such actions are illegal under the

Americans with Disabilities Act, the fact that the entire emergency response system was

turning away people based on their disabilities coupled with the vast number of people who

wanted to evacuate but could not, shows a glaring gap in the national Disaster Response

System. Other papers have as well shown this misstep on the part of the planners (McClain,

Hamilton, Clothier, and McGaugh, 2007). The common conclusion in all these cases is that

the performance of the response personnel would have been better, and perhaps more lives

would have been saved, had those who made the plans included the views of the people with

special needs.

Issues in Emergency Preparedness that are Unique to People with Disabilities

Issues that disproportionately affect people with disabilities during emergencies can

be classified into three groups namely transport, the response of the healthcare system, and

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registries. As noted by Renne, Sanchez, and Litman (2011) and the National Institute on

Aging, people without cars are the ones who often suffer more in times of evacuation. A lot

of people with disabilities and the elderly do not drive themselves. Rather, they depend on

public transportation or other specialized means where it is available in normal times. Many

of them as well depend on their family, friends or caregivers (Fox et al. 2007). Transportation

not only encompasses the evacuation of people but the movement of supplies and personnel

to those who have been affected. The lack of preparation for Katrina has led to a wealth of

research on the various issues that went wrong.

For instance, one paper found four major flaws that made the response to Katrina a

second disaster. Firstly, the evacuation efforts started too late when many areas were already

enveloped by the storm. Secondly, evacuation centres had not been properly designated or

fitted out with supplies and personnel (Smith, Peoples & Council, 2005). Third, the

responders did not make use of all the technology available to them, specifically GIS

systems. As such, many people had to travel far longer than they should have due to hazards

on the roads. Lastly, the plan assumed that human behaviour would not change in a disaster

and thus, had no plans in place for it (Smith, Peoples & Council, 2005). Another government

report stated that where the transportation of people with disabilities was conducted, little to

no consideration was given to their families, service animals, caregivers, or vital equipment

(Government Accountability Office, 2006). The evacuation efforts of Katrina were as well

disorganized on a much larger scale according to Kendra, Rozdilisky, and McEntire (2008).

Therefore, public transport and economic status of people with disability play an important

role in their emergency preparedness as well as evacuation plans.

Regarding the level of preparedness of health centres, Katrina found them woefully

inadequate. The level of preparedness of health care centres is more concerning to people

with disabilities than to others who may only need the services in case they have been

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injured. Some people who have health conditions require special needs shelters that are

equipped to provide them with the medical support they require. In 2006, a study by Deal et

al. found that a majority of the nurses in special needs shelters thought that the access that

people had to medical equipment is vital to their continued survival. As well, they felt that the

volunteers were not well versed in providing services to these people. Another study found

that hospitals and other health centres were the central places in which people with

disabilities were taken during an evacuation. The researchers concluded that the vast majority

of the healthcare institutions were not equipped to handle the sudden influx of people

requiring constant medical supervision as would happen in the case of a disaster (Keim &

Rhyne, 2001). Therefore, proper strategic initiatives and plans are essential in providing

solutions to the problems faced by these groups.

Most importantly, hospitals and homes for the elderly are not self-sufficient enough

not only to provide services to the patients and residents but also to handle more people

brought in. A registry, in this case, means a compiled list of people living with disabilities in

a certain region. On the face of it, the logic behind a registry is sound. If emergency

responders knew how many people required special attention in times of a disaster, resources

could be allocated precisely. In addition to this, in the event of an evacuation, it would be

much easier for responders to evacuate these individuals in a manner that caters to their

disability. However, once one wades deeper into the issue, it is clear that there are other more

complex factors at work. Two primary challenges face the creation of the county, state, and

national registries. The first, as identified by Kailes (2006) and Roth (2005), is what the term

‘special needs’ encompasses. The term has a broad range and includes people with long-term

physical and mental conditions such as diabetics, the mentally handicapped, and those with

physical injuries that severely restrict their mobility. In addition to this, people with language

barriers such as non-English speakers (immigrants and tourists) are considered persons with

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special needs as well. Although they may not need additional material support, finding

directions to shelters and gathering information on the changing nature of the threat may be

difficult for them. Individuals with temporary injuries (broken bones, comas, and others) fall

into the category of special needs as well. Unsupervised children and pregnant women fall

under the umbrella term. With so many different groups of people being eligible for the

registry, and with their status changing so frequently (people healing and others getting

disabling injuries), maintaining a registry is an almost impossible task, even with the full

cooperation of the people. The lack of cooperation, however, is unfortunately common. There

are various reasons why people may not want to have their names and addresses appear on a

registry. The individuals may be philosophically opposed to it, perhaps their political

ideology informing them that such a registry is a form of government overreach. Others may

want to avoid the chance of discrimination, while some may want to protect their privacy.

Research Method Used

The project being undertaken will be a desk study, analyzing information from

various sources to determine the nature of emergency preparedness levels for people with

special needs, disabilities, and the elderly. From the literature review conducted above, four

issues have emerged that negatively impact special needs people in times of disasters and

emergencies. The factors are acknowledgement and fair treatment of people with disabilities,

personal preparedness, community engagement, and emergency preparedness unique to

people with special needs. The project will seek to unearth information on the deficits in the

current practice of emergency preparedness and what is being done about it. All four issues

will be addressed separately. Finally, a conclusion will bring together the information and

determine whether the efforts so far put forward are enough. The concluding parts will make

recommendations for both government agencies and non-governmental institutions on what

can be improved to ensure that people with disabilities are adequately catered to.

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Research Findings

From the research questions identified in the introduction in conjunction with the

extensive literature review offered, it is evident that there is indeed a lot of room for

improvement when it comes to disaster preparedness for people living with disabilities.

Previous research papers have identified numerous ways in which the emergency

preparedness for this group of disadvantaged people can be better prepared for future

disasters. The revelations unearthed will be grouped and presented within the framework of

the four categories outlined in the literature review above. The rationale for this choice of

presentation is that the project can achieve a systematic and comprehensive coverage of the

issues affecting people with special needs and the elderly regarding disaster preparedness.

While many studies, articles, and papers point to the existence of a shortfall, a number of

them provide solutions for the specific issue that they discuss. It is these issues, along with

external evidence of their application (at least in the cases where it exists), that have been

analyzed and categorized.

Acknowledgement of People Living With Disabilities in the Emergency Preparedness

Framework

Only by acknowledging people with disabilities that such groups can receive

sufficient resources to ensure that in the event of a disaster, they will be adequately handled.

In the last decade or so, the acknowledgement of the disproportionate suffering of people

with special needs and the elderly has been given increasing focus. On the policy and

advocacy levels, there have been numerous calls from various agencies – both governmental

and non-governmental – to increase the awareness of people with disabilities during

emergencies. In this regard, the National Council on Disability (NCD) has been instrumental.

Formed in 1978, the NCD has always championed for the rights and equal representation of

the disabled and those with special needs. However, the organization’s interest in emergency

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preparedness was explicitly stated in 2003 and was followed with the publication of Saving

Lives: Including People with Disabilities in Emergency Planning (National Council on

Disability, 2005). The report was instrumental in ensuring that after Katrina, the PKERMA

(Post-Katrina Emergency Management Reform Act) adequately provided for people with

disabilities in the areas of “emergency preparedness, disaster relief, and Homeland Security

programs, including the incorporation of access to technology, physical plants, programs,

communications,... procurement, and emergency programs and services” (National Council

on Disability, 2005). The formation of such groups and organizations is the reason why

emergency preparedness for the people with disabilities has significantly improved.

Other organizations have as well recognized that people with disabilities may tend to

suffer disproportionately during times of crisis. For instance, the American Red Cross,

Homeland Security, and FEMA maintain a site dedicated to people with disabilities and their

disaster preparedness. The website has numerous links to additional information on the three

steps of disaster preparedness; “get a kit, make a plan, be informed” (American Red Cross,

Department of Homeland Security & FEMA, n.d). In addition to this, there is a link to

download a mobile emergency app created by the three institutions. The CDC has a section

on its website dedicated to emergency preparedness for people living with disabilities. The

website provides a wealth of information including data sets, registries and tools that are used

to provide comprehensive assessments of data shelters to ensure the ease of access for people

with special needs. The site has a section where all stakeholders in disaster management can

find resources on taking care of people with special needs during such crises (CDC, 2017) as

well. The primary drawback for these organizations is that the resources offered do not cover

the entirety of the country. The assessment tools are state-specific. On the one hand, having

state-specific shelter assessment tools provides a more tailor-made approach. During

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nationwide or multi-state disasters such as hurricanes (which often impact more than one

state at a time), an integrated cohesive approach is difficult and resource-intensive.

From the literature, it is evident that at the policy level, the special treatment of people

living with disabilities is acknowledged and encouraged. The question is whether such is the

case in practice. The 2017 hurricane period was one of the worst in the history of the United

States, costing hundreds of lives (especially in Puerto Rico) and billions of dollars in

damages. Papers detailing the evacuation of those living with disabilities and the elderly are

yet to be published. However, separate accounts show a trend where the policies

acknowledged above are yet to be implemented. As Stein (2017) reported, many elderly

people and those with disabilities were not adequately catered to. O’Brien (2017) concurs,

noting that one family with a sick matriarch could not access emergency oxygen tanks from

her home care company as they did not have enough. Yet another report by Reisner, Fink,

and Yee (2017) reported that eight people in a nursing home just down the street from a

hospital died from the direct effects of the Hurricane Irma. While government reports are yet

to indicate the status of individuals with disabilities, it is evident from the report that little

was done in accordance with the policies that the federal government, through DHS and

FEMA, had put in place.

Personal Preparedness

Regarding personal preparedness, the literature has shown that experience with past

disaster events, communications, and cooperation with responding agencies were all factors

that had an impact on personal preparedness. In the report by the National Council on

Disability (2005) and a later one by the same organization (National Council on Disability,

2009), personal preparedness was a key point of focus. However, as the latter report notes,

for people living with disabilities, preparation is not easy without outside help. As Hausman

et al. (2007) notes, people with disabilities are among those with the lowest social capital. As

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such, they are more likely to be overlooked in planning public projects. The increased need

for outside help and the marginalization, when put together, lead to a situation where this

group of people is pushed even more towards the sidelines. Therefore, looking at the policy

level on personal preparedness, it is evident that various government and non-governmental

organizations are offering information on how one can prepare for such eventualities.

The aforementioned agencies play a critical role in emergency preparedness. The

CDC (2017), American Red Cross, DHS, and FEMA (n.d) all have pertinent and up to date

information on how people can better prepare themselves. Further, the institutions offer a

comprehensive plan wherein personal preparedness complements the efforts of the

responding agencies. The American Red Cross motto reads, “get a kit, make a plan, be

informed (American Red Cross, Department of Homeland Security & FEMA, n.d). It offers a

guide for people to best prepare individually. Again, at the policy level, there is a clear move

towards catering to the needs of the elderly and people with disabilities. On the ground,

however, the situation is significantly different. Looking at the role that communication plays

(‘be informed’) it is clear that in the case of Hurricanes Irma and Harvey, it was not properly,

or even sufficiently followed. As Stein (2017) notes, Miami-Dade County had severe

problems with their communications. The announcement of shelter locations came less than

48 hours before Irma made landfall. Additionally, many of the shelters were not yet ready,

meaning that a lot of people had to wait outside for the volunteers to arrive. Additionally,

Stein (2017) makes a note of one county resident who had no information on where the buses

would pick her and her son. Only after innumerable calls was she given the location – over

three miles from her apartment – and had to walk there. While statistical data on the

communications operations during Irma and Harvey is scant, the reports do not present an

encouraging picture of the response groups.

Community Involvement

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Community involvement is part and parcel of an effective response to a disaster. As

seen in the literature review, there are cases where the community has not been involved and

the plans have not been successful. Looking at the response of various federal agencies in the

wake of Irma, Harvey, and Maria, it becomes evident that there was community participation

in formulating the plans, but it was not enough. For instance, as Stein (2017) notes, many

shelters did not have the necessary resources to cater for people with disabilities. The case

that the author quotes is one among many. The seventy-six-year-old woman with cerebral

palsy with two children – one using a walker (38 years old) and the other in a wheelchair (32

years old) – found themselves in a shelter that had no medical facilities to cater for their

needs. In fact, the shelter did not even have cots on which they could sleep. In addition to

this, the family of three had travelled to five other shelters where they were turned away due

to a lack of space (Stein, 2017). Looking at the disorganization reported in the media, it is

evident that the community of people with disabilities was not thoroughly consulted on

actions to take once disaster struck. The lack of community involvement often leads to

disorganization since people are doing what they think is best when in reality, they are not.

Therefore, communities must be involved.

Unique Issues

Transport is one area that does not favour people with disabilities and the elderly in

times of emergencies. Many elderly people do not drive and rely on aides, family, or friends.

For those who live independently, however, transport is a key issue. Looking at the reports on

the response from Hurricane Irma, it is clear that transport was not as smooth as it should

have been. For instance, Stein’s (2017) report of the mother and son three-mile hike to a stop

is especially instructive. On the positive side, the planners realized that they would need to

use public transport to evacuate people. However, on the negative side, the routes for the

buses were reduced, thus limiting the number of individuals they could effectively reach. The

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article implies that normally, the woman’s stop is much closer to her house. The efficiency of

health centres has been found wanting as well. O’Brien (2017) makes note of the family that

was denied emergency oxygen tanks from the care centre that their elderly mother frequents.

Stein (2017) reported on the elderly woman and her two children – all three with disabilities –

who could not find a shelter with a bed, let alone medical equipment. The one area that has

been improved upon is the use of registries to approximate the number of people in an area

who may need extra help. A number of states have such registries, which people can

voluntarily pre-register so that health centres can have adequate space and time to plan.

Limitations of Research

The project has been limited to a desk study due to the unavailability of resources for

a comprehensive field research. One drawback of conducting a desk research is that all the

information being obtained is second-hand. Due to this, there are inherent issues of reliability

and verifiability at work. Furthermore, there is the potential that unreported bias in the

individual papers will lead to a bias in the project. The use of numerous studies and papers

has been made to avert potential biases and all points of view have been considered. Finally,

the execution of a disaster response to the 2017 hurricane season is still being analyzed by

various groups. In this way, there is little scholarly or peer-reviewed information that has

been released apart from government reports. Moreover, many of the reports used to

determine the effectiveness of emergency preparations for people with special needs,

disabilities, and the elderly are from news sources. Hence, there is the danger of a bias which

has been largely side-stepped by examining numerous news sources.

Recommendations and Implications for the Government and Non-Government

Institutions

It is evident that there is a schism between policy and action. The people in charge of

both areas are not communicating. On the one hand, the policymakers are cognizant of the

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needs of people with disabilities and the elderly during emergencies and are responding by

enacting regulations. On the other hand, the people on the ground managing the disaster are

not carrying out these policies as they have been envisioned. It is not that those on the front

lines are unfeeling of the plight of people with disabilities. Rather, the lack of resources and

adequate planning does not allow them to cater for all in need. Additionally, it appears that

the response to Harvey, Irma, and Katrina were uncomfortably close to the radical theory

detailed in the literature review. However, the response to Texas and Florida was adequate.

For example, FEMA sent 31,000 responders, 3 million meals, and 3 million litres of fresh

water to Texas (Levenson, 2017). Over 40,000 federal employees responded to Miami with

6.6 million meals and 4.7 million litres of fresh water. In contrast, About 10,000 responded to

Puerto Rico and the U.S. Virgin Islands (Levenson, 2017). While the logistics are different

between Texas and Puerto Rico, it does not escape notice that the response was quite

underwhelming. Presidential attention mattered as well since it influenced the value of

donations. President Trump visited Texas twice and Miami once, but did not go to Puerto

Rico (Levenson, 2017). Following the radical theory, it is evident that Puerto Rico, being an

island territory with little in the way of a relationship to the Mainland (and just coming off a

bankruptcy) has less power over national policy and the federal response. The politics of the

poor response has been debated. Therefore, whatever the reasons, there is still proof of a

disconnect between policy-making and execution of ideas.

The recommendation given here is to overhaul the entire emergency response

infrastructure to reflect three fundamental aspects. The first is inclusivity in planning.

Reaching out to the community in which one intends to work with is often the correct thing to

do. Doing so will include the use of registers compiled through means that reflect the wishes

of the people. According to CDC (2017), there are such registers in place but only in a few

states. For instance, it exists in Miami-Dade. However, its existence was not communicated

CAPSTONE PROJECT PROPOSAL 21

well and many people who could have benefited from it did not. The second point, and

related to the first, is to provide enough resources. Having to turn away people from shelters

due to a lack of space denotes extremely poor planning and resource allocation. Resources, in

this case, include communication and information. Telling people what they need to do and

how to prepare themselves in the event of a disaster is the key to ensuring a robust and

efficient response. Lastly, politics must be delinked from disaster management. Making use

of intervention strategies that place political expediency on a higher platform than saving

lives or ensuring resources are optimally used is unlikely to lead to an improvement in the

conditions of people living with disabilities. With these three recommendations based on the

research carried out above, the elderly and individuals with disabilities can have a chance to

be better-taken care of before, during, and after disasters.

All in all, emergency preparedness is a vital skill to have. One has to know what to do

in case of an emergency so as not to endanger themselves further. People with disabilities

tend to be disproportionately adversely affected by disasters. The project has examined the

scholarly literature on disaster preparedness and how significant factors affect people living

with disabilities. The conclusion reached is that there is a schism between what policy-

makers envision, and what occurs on the ground. While the policy is sound, there is often too

few resources to implement them effectively leading to cases of abandoned people. The

recommendations made are threefold. First is to include people with disabilities and the

elderly substantively into any future disaster management plans. Secondly, planning, resource

allocation, and more importantly, communication, must be allocated sufficient resources to

ensure effectiveness. Lastly, disaster management must be decoupled from politics. With

these recommendations, people with special needs will be more likely to survive disasters.

CAPSTONE PROJECT PROPOSAL 22

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CAPSTONE PROJECT PROPOSAL 23

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CAPSTONE PROJECT PROPOSAL 24

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CAPSTONE PROJECT PROPOSAL 25

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