Triumph Over Tragedy, Second Edition: A Curriculum for Extension Professionals Responding to Disasters and Terrorism

Introduction

Following a natural or human-made disaster, communities experience significant stressors, including economic loss, loss of life, and psychological reactions such as grief, anger, and worry. Extension professionals are in a unique position to help specific community segments (e.g., agriculture, schools) prepare for these reactions following a critical event, as well as support those community segments following a disaster.

Rural communities may be particularly vulnerable due to fewer resources to devote to disasters, especially in the case of disasters requiring specialized equipment and training (e.g., HAZMAT). Issues of entrenched poverty, economies largely dependent on "open-field" operations (e.g., farming, ranching, mining), geographic and social isolation, stigma for help-seeking, cultural folkways, and few qualified mental health providers make community-wide psychological recovery particularly problematic following disasters.

Hurricane Andrew (1992) illustrates the scope of physical and psychological damage disasters can inflict. This powerful storm left in its wake over $25 billion in damages (Federal Emergency Management Agency, 2003), an estimated 180,000 people homeless (Centers for Disease Control and Prevention, 1993), and an estimated 33% of surveyed residents reporting high levels of posttraumatic stress disorder symptoms (Ironson et al., 1997).

Human-inflicted disasters may result in even higher psychological impacts, as evidenced by the Oklahoma City bombing and the September 11, 2001 terrorist attacks. Thus, preparedness for disasters and terrorism must include training in the psychological aspects of these events, especially in rural communities that may lack many of the resources found in urban areas.

Disaster Response at the National Rural Behavioral Health Center

The National Rural Behavioral Health Center (NRBHC) was created at the University of Florida in 2001 in order to promote research, education, and Extension designed to improve the status of behavioral health care to rural Americans. Since the mid-1990's, faculty in the NRBHC have assisted communities responding to the mental health effects of disasters, including Hurricane Andrew, the 1997 Red River floods, drought and wildfires in the southeast and far west, and the 2001 World Trade Center attack.

From this work, Extension specialists in the NRBHC developed the curriculum, Triumph Over Tragedy: A Community Response to Managing Post-Disaster Stress (Evans & Sears, 1999) to assist Extension professionals, healthcare professionals, and other disaster response workers in their efforts to provide supportive education and service to communities affected by disasters. NRBHC faculty members have traveled to various states to train health providers, mental health specialists, EMS personnel, policy makers, and teachers using this curriculum.

Development of an "Off-the-Shelf" Resource Manual for Disasters and Terrorism

In response to the success of this initial curriculum and recognizing the need to further expand Extension resources in disaster recovery, NRBHC staff developed the second edition of the curriculum, Triumph Over Tragedy, Second Edition: A Community Response to Managing Trauma in Times of Disaster and Terrorism. This edition now includes information relevant to human-made disasters.

Learning objectives include:

• Preparing and coordinating community responses,
• Controlling psychological contagion and panic,
• Educating community members about the common signs of post-disaster stress,
• Strategies for supporting community members,
• Issues relevant to long-term recovery,
• Improving information management following a disaster, and
• Responding to psychological reactions after a bioterrorist attack

Extension professionals can utilize these materials to train other professionals, as well as lay volunteers, within their communities. A skills-based video is available in conjunction with the first edition of Triumph Over Tragedy that discusses disaster phases in a community, how to recognize warning signs for post-disaster stress, and strategies for having supportive communications with disaster victims. A Web-based videoconference and training materials are also available.

Triumph Over Tragedy is designed for a wide audience:

• Extension professionals
• Mental health professionals
• EMS, fire, and police
• Primary care health providers
• Human resource professionals
• Teachers
• Public health officials
• Political and community leaders

Getting Involved

There are several key areas where Extension can play a vital role. Prior to an event, Extension agents can participate in local emergency planning councils. Agents may also develop Web-based and written educational materials for community members to help citizens prepare for disaster events.

Immediately after a disaster, the curriculum guides agents on strategies for supporting their constituents and providing referrals for further assistance. These materials were also designed to train volunteers and other response workers about the effects of disasters, warning signs for post-disaster stress, how to provide emotional support to victims, and how to teach stress management strategies. In the long-term, agents can collaborate with their communities to provide long-term recovery services, which may include financial counseling, training for teachers, and school, work, and church-based educational programs.

Further Information

For further information on the Triumph Over Tragedy curriculum, please visit our Web site at http://www.nrbhc.org. Follow the links for "Rural Disaster and Trauma" to download materials, find ordering information, and learn more about our work at the NRBHC.

References

Centers for Disease Control and Prevention. (1993). Comprehensive assessment of health needs two months after Hurricane Andrew: Dade County, Florida, 1992. Morbidity and Mortality Weekly Report, 42, 434-437.

Evans, G., & Sears, S. (1999). Triumph over tragedy: A community response to managing post-disaster stress. University of Florida: IFAS Publications.

Federal Emergency Management Agency. (2003). Disasters and emergencies. (Web site section contains links to various statistics). Available at: http://www.fema.org/library/dizandemer.shtm

Ironson, G., Wynings, C., Schneiderman, N., Baum, A., Rodriguez, M., Greenwood, D., et al. (1997). Posttraumatic stress symptoms, intrusive thoughts, loss, and immune function after Hurricane Andrew. Psychosomatic Medicine, 59, 128-141.