CBRN Gear for Humanitarian Aid: Engaging in Safe Disaster Relief
While rendering humanitarian aid is a noble cause, one has to make sure that they are also taking steps to protect themselves while they are doing so. This aid is sent in the first place because a dangerous situation or environment has manifested, and people there are in need.
But as history has shown us, when people do not take the necessary steps to protect themselves as they render humanitarian aid, they can quickly become casualties. A wise person once said that one of the best ways to ensure you can take care of others is to ensure you are also taking care of yourself.
So how can we do this? What steps can one take to protect themselves when dealing with a humanitarian emergency? And what does history show us here? Let's take a look.
Table of Contents
History Dictates Humanitarian Aid PPE
What Can You Do to Stay Safe?
Kill Fear. Keep Helping.
Frequently Asked Questions
History Dictates Humanitarian Aid PPE
Americans are the most generous people in the world. Anytime there is a national disaster within our borders, the American people willfully give their own time, money, and abilities to bring necessary equipment and workforce to the scene via several charitable organizations.
We want to keep our hearts attached to our brains, though, and part of this is making sure that we are doing things that keep people safe. This is where effective PPE comes into play. How? Well, let's look at what history has to say.
The Experience of Hurricanes
Hurricanes are one of the most common natural disasters that America experiences, and when they hit, the loss of life and the damage can be catastrophic. There are still aspects of life in New Orleans that have not recovered from Hurricane Katrina. When a single storm is capable of causing billions of dollars worth of damage, this shouldn't come as any surprise.
The issue with hurricanes is the flood waters that they bring. While there likely won't be dust plumes floating in the air after a hurricane (unless demolition teams are trying to clean out still-standing, damaged buildings), there will be a lot of molds, and there will also be dust generated anytime somebody attempts to clear out debris.
One of the interesting things about Hurricane Harvey was that researchers found visible evidence of mold regularly as they examined the potential health impact of the storm. These researchers also noted that floodwaters were contaminated with sewage, toxins, and other potential health threats.
Removing ruined drywall and insulation in an attempt to stave off mold and rot after Hurricane Harvey. (Image courtesy of Jill Carlson from Wikimedia Commons.)
Hurricane Katrina resulted in a similar impact. Researchers found that 46% of homes in the impacted region had mold and that 59.3% of children examined in this study reported to the E.R. with new health problems. Hurricane Sandy resulted in more of the same. Asthma-related ER visits and hospitalizations spiked after the storm, with many of these people being those with pre-existing conditions. Approximately 34% of those already on the WTC Health Registry in New Jersey saw an increase in respiratory problems during this time.
With this information, we can draw a parallel between being a soldier and getting involved in humanitarian aid.
A soldier who joins the Army utterly unaware that other people shoot at you when you're in the infantry will be shocked when he discovers the reality of his situation. He's doing a good thing serving his country, but he needs to understand the risks if he is to soldier as effectively as possible. Similarly, if you are involved in flood cleanup, this is a reasonable and necessary task, but you must understand the potential risks.
Don't let yourself be blindsided.
(Image courtesy of The US Navy surveys some of the aftermath of Hurricane Katrina in Mississippi.)
The World Trade Center
Everybody remembers where they were on September 11. We were ready for war. Many flocked to the scenes of Ground Zero to do what they could to save those trapped underneath the rubble.
While 2753 men, women, and children were murdered that day, these figures don't take in the full scope of all those whose health was directly affected by what had happened. It wasn't until years later that "World Trade Center cough" would enter America's lexicon.
(Image courtesy of Dust covered survivors of the WTC murders.)
The World Trade Centers were filled with 40 floors of fireproofing spray, asbestos, and several other dangerous chemicals and compounds spread throughout New York City in the form of a massive dust cloud as the buildings collapsed. Everything within a 1.5-mile radius was layered under the plume, with an estimated 400,000 – 500,000 people being within range of breathing it in. While it took 100 days for firefighters to finally extinguish the blazes at Ground Zero, it took even longer for the dust plume to finally settle.
(Image courtesy of The dust cloud as the WTC collapses. )
This meant plenty of time for many people to breathe in that dust. In the immediate aftermath of the attack, New York hospitals saw a massive spike in respiratory, cardiac, and stroke cases compared to what they usually saw. These conditions could, at least in part, be explained by extensive periods of breathing in noxious chemicals.
A NOTE OF INTEREST
Some have postulated that the alkalinity of the WTC’s dust may have also contributed to the rise in respiratory symptoms post-September 11.
Within six years after September 11, the number of new asthma cases in the city jumped 8%, a precursor of the future. It would later be found that the plume resulted in fast-growing prostate cancer. Those exposed to the dust would later be classified as having World Trade Center cough, with 29% of those diagnosed with the condition being firefighters.
The government concluded that this was an undeniable problem, creating the World Trade Center Health Program as a result. This program monitored the health outcomes of all those involved in the WTC attack, later showing that at least 60 different types of cancer were all associated with exposure to the WTC dust. At least 4627 of those exposed to that dust have died.
(Image courtesy of BaseOn at Wikimedia Commons.)
The research on earthquakes shows over and over again the importance of proper respiratory protection when you're dealing with the aftermath of such an event. Japan, in particular, has done a fabulous job of cataloging the outcomes of those exposed to collapsed buildings.
Like with the World Trade Center, anytime you have widespread building collapse, you end up with toxic material plumed out into the atmosphere. Anybody that is near ground zero is going to end up breathing in some of that dust.
The Hanshin-Awaji Earthquake. (Image courtesy of Masahiko OHKUBO at Wikimedia Commons.)
From the research that this author is familiar with, it does seem that the majority of the threat here from a city-wide dust plume tends to disappear within seven days.
For example, after the Tottori-Ken Seibu earthquake in Japan, it was found that 82% of the asthma attacks reported (by those studied) happened within one week of the earthquake. Admittedly, increased stress and a lack of medication could have played a part in these attacks, but there's no denying that so could breathing dust.
(Image courtesy of The aftermath of an earthquake-caused tsunami in Japan, 2000.)
The 1995 Hanshin-Awaji Earthquake gave more definitive answers here, however.
One emergency room in the area of Hyogo Prefecture, Japan, found a drastic increase in the number of pneumonia cases within the first month after the event, a 4.5-fold increase in the usual number of patients with respiratory diseases (half of which were from infectious agents), and a significant increase in asthma attacks as well.
There's no denying that breathing in large amounts of dust can set the stage for a respiratory infection. Was it dust from these quakes that directly led to these infections? This author believes this is the only conclusion we can come to here.
A NOTE OF INTEREST
In the interest of fairness, researchers studying the 2004 Chuetsu Earthquake – once more in Japan – did not find any increase in asthma attacks post-quake. Was Japan better-prepared healthcare-wise for this quake? Was a quicker response initiated? Could there be other variables here?
The best thing you can do for somebody living amid a forest fire is assist with evacuations. Get everybody out, provide them shelter, food, and medical care, and then let them return when the fire is out.
What we find over and over again in the research is that the more smoke you breathe in, the higher your chances of needing medical treatment. When Albury, Australia, had a 38-day smoke event, 70% of those in the impacted area noted experiencing respiratory symptoms.
North Carolina Pains Bay Fire. (Image courtesy of U.S. Fish and Wildlife Service Southeast Region at Wikimedia Commons.)
After North Carolina experienced an 18-county-wide peat fire, there was a 65-70% increase in the cumulative relative risk of hospitalizations for COPD, asthma, bronchitis, pneumonia, and upper respiratory infections.
Even after the fire is well-burned out, you still need to ensure that you stay safe when involved in the debris removal process. Ash is very dusty, and if you are involved in the cleanup of burnt-out homes, you will be exposed to a great deal of this aerosolized dust. You need to ensure that you wear proper respiratory protection when working in these environments.
A NOTE OF INTEREST
Keep in mind that earthquakes cause fires as well. The 1997 Kobe, Japan Earthquake resulted in the outbreak of 300 seperate fires.
(Image courtesy of The 2020 Mullen Fire, Wyoming.)
If there is a dangerous chemical spill in a region, humanitarian aid workers aren't going to be the ones who are involved in the cleanup. That job will be retained for specialists. Disaster relief workers will be involved in the influx of food, water, medications, and other necessary goods to the disaster zone.
However, the problem arises when we treat a chemical spill like any other disaster. These types of disasters are entirely different and must be treated respectfully.
A case in point here would be the recent Ohio train crash.
Then the CDC later admitted that seven members became sick while in the area. The first thought you may have is that these people were directly involved in collecting samples from the site or something of the like. But in reality, they were conducting door-to-door interviews.
Creek cleanup in East Palestine, Ohio (Image courtesy of thunderlips36 at Wikimedia Commons.)
This means these seven people grew ill simply by being exposed to the air in the region.
The fact of the matter is that a large swath of American soil has been poisoned, and considering that dioxin – a primary cancer-causing chemical – is one of the chief toxins that has spread throughout the area, we're not anywhere near seeing even the beginning of the health outcomes of the train crash here, unfortunately.
If you're rendering aid in an area where people are coughing up blood simply by breathing in the air around them, would it be wise to wear some means of respiratory protection while you do so?
Creek cleanup in East Palestine, Ohio. (Image courtesy of thunderlips36 at Wikimedia Commons. )
What Can You Do to Stay Safe as a Humanitarian Aid Worker?
While there are some inherent risks to being involved in humanitarian aid, there are several things that one can take to mitigate them. Here are a few concepts you will want to keep in mind.
Understand the Threats that You are Dealing With
You must know what you're dealing with to be involved in humanitarian aid. Otherwise, you'll end up becoming a statistic. Why do disaster relief organizations train their workers before they send them out into the field – teaching them about tuberculosis, waterborne diseases, lice, and bloodborne pathogens?
It's because they understand that unless their workers understand these threats, they aren't able to last as a charitable organization for long. This is why it is vital to know as much as possible about the situation you are moving into before you head to the scene. There are things to think about here. What happens to your charitable organization if it's found that many workers end up ill? Does that hurt future donations or mission recruitment? What does that mean legally for your organization if your workers blame you for not making them mindful of the risks? What does it mean if they say that you didn't provide them with the PPE that they needed?
These are things to think about.
(Image courtesy of Jeff Fisher of the Tennessee Titans, wearing gloves and an N95 mask, assists in the flood cleanup at Nashville, 2010.)
A NOTE OF INTEREST
At least as of 2000, if we looked internationally, violence was the number one killer of humanitarian aid workers. Sixty-nine percent of all killed in this line of work were directly attributable to this. Car crashes were the second leading cause of death (17%).
Make Sure You’re Still Sleeping
You have to make sure that you are taking time to sleep still while in these types of efforts. Not only will this better protect your staff's immune health, but it will also help keep them from injuring themselves while on-site or from growing apathetic toward their personal safety.
This was one of the interesting (yet unsurprising) findings from Hurricane Katrina: sleep-deprived first responders were at an increased risk of injuring themselves while on the job.
USAID member sleeping while assisting with 2023 Turkey earthquake relief effort.
Bring Appropriate CBRN Equipment
If you're distributing food in a refugee camp, handing out water bottles, or offering a mobile health clinic, that's one thing. If you're going to be directly involved in disaster cleanup after a flood, earthquake, large fire, or the like, however, you need to ensure that you are protecting the respiratory health of your workers.
For a good reason, we've written extensively about asbestos, fiberglass, and other toxins here at MIRA Safety. These aren't "Chicken Little" threats. These are real threats, and it is not "taking things too far" to protect yourself against them.
(Image courtesy of Flood cleanup in Colorado, 2013. Note the gloves and respiratory protection. )
Asbestos removal should be saved for asbestos removal specialists. You must ask yourself if it is fair to your workers or their families to involve your staff in such a task if asbestos is found on site. If you are still taking care of the disaster victims by giving them shelter, food, water, money, and healthcare, you are still doing something, even if you aren't helping them to remove their contaminated homes.
The TAPR is a half-face respirator that will help protect against respiratory threats without the heat retention of a full-face gas mask, making for more comfortable wear in hot and humid environments. Of course, a respirator must be paired with an effective filter; this is where our ParticleMax P3 Virus Filters come into play. These are excellent filters for the tasks that a humanitarian aid worker is apt to encounter. They filter out 99.9995% of both viral and bio particulates. If they can protect you from the minuscule size of a virus, they can most certainly serve to protect you against the larger particles that comprise aerosolized dust. Their lightweight design means they can also be worn for long periods with minimal neck tiring.
(Image courtesy of The TAPR system)
(Image courtesy of ParticleMax P3 Virus Filter)
An Ounce of Prevention is Worth a Pound of Cure
If you are in an environment where you aren't 100% certain if there are respiratory threats, it's best to remember Benjamin Franklin's advice here. In the emergency room, physicians and nurses always operate as if every patient who comes through those doors has AIDS. Does everybody? Of course not. But by acting in this manner, healthcare staff can ensure they stay as safe as possible. Risk is minimized.
When helping out in a humanitarian aid emergency, it would be wise to do the same in the situations that warrant it. Use discretion to determine what these situations may be.
Protect Your Food and Water
The first task is to ensure your staff has clean water to drink. Waterborne diseases are endemic to disaster regions, and they can be lethal. Within America, we tend not to think about waterborne disease killing people – something we should be thankful for, but we should also take steps to protect ourselves in these environments.
Trucking in water supplies – both for victims and staff – when feasible – is likely one of the safest options here.
Safe food trucked in from the Red Cross.
When it comes to food, you want to ensure that staff has clean food to eat and that they are not exposing it to dangerous dust clouds. Mesothelioma doesn't just impact the lungs; it can also affect the gut. This happens when people eat asbestos-laced food. Anything with asbestos should be reserved for experts, but the point is that you don't know what's floating around in the dust when you are involved in cleanup efforts. So, keep your food covered and away from cleanup sites until it is time to eat.
(Image courtesy of A safe food site in Galveston, Texas, 2009.)
Keep Tabs on Who of Your Staff You’re Sending to Do What Job
Whoever is in charge of the mission needs to understand who they have on their team, their skills, and their medical conditions. Sending somebody with a pre-existing lung condition or compromised immune system into a high-risk environment sets them up for failure.
Screening who is allowed onto the team in the first place is a part of this, but we also need to remember that people can participate in multiple types of disaster relief jobs. Only some people need to be involved in water cleanup.
Carrying hundreds of packs of water bottles is a task fit for someone without orthopedic issues. Use the same discretion with other forms of disaster assistance.
If you have somebody not in the best of health who wants to assist in your efforts, that's great – just find something for them to do that is well within their capabilities. Some can hand out water, some can provide counseling, and some can be involved in communications. Know your team and abilities and make wise decisions as the team leader.
Ensure All Asthmatics are Regularly Taking Their Medications
This goes hand-in-hand with the initial point. If you have asthmatics on your team, as the team leader, you have to ensure they regularly take their medications. Not taking asthma medication while in a disaster zone has been noted as one of the potential reasons attacks are so common in the aftermath of a disaster.
Also, keep in mind that stress is a potential cause of asthma attacks as well. You have to take care of your team.
A NOTE OF INTEREST
One of the most practical life-saving measures a humanitarian aid organization could take in the aftermath of any disaster is to ship in healthcare personnel with plenty of respiratory treatments.
Kill Fear. Keep Helping.
The goal here is not to paint the picture that to work in humanitarian aid is to sign a death warrant. That is not the case at all. Millions of Americans regularly engage in disaster relief missions yearly, and they are fine. Do not let fear hold you back from doing what is good or what you are called to do.
(Image courtesy of Sandbag cleanup after the 2010 Minnesota flooding. )
The point is to get you to take care of yourself when placing yourself in dangerous situations. Firefighters regularly enter difficult situations filled with poisonous fumes, noxious gasses, and collapsing structures to save lives. What they are doing is a good and necessary thing. But let's remember that firefighters also take steps to protect themselves while doing this. They wear heat-resistant clothing, helmets, and oxygen tanks to continue to help people without jeopardizing their health and indirectly impacting their families.
There's a lot that we can learn here.
If you help in nasty situations, you must ensure you can protect your body against that nastiness. This is where MIRA Safety can help.
What are your thoughts on all this, however? Have you found yourself in any dangerous situations while helping with disaster relief? Are there other threats to disaster cleanup to consider? Let us know what you think in the comment section below.
Frequently Asked Questions
This depends upon the type of emergency that you are dealing with. Considering that many kinds of emergencies result in destroyed buildings, it would be a good idea to make thick work gloves and some means of respiratory protection a part of the PPE you use for these situations.
Humanitarian aid is the act of rendering assistance with manpower, money, food, water, shelter, medical care, or with other essentials to those who have been directly impacted by some form of disaster.
Humanitarian aid workers are exposed to bloodborne pathogens, waterborne diseases, violence, extreme weather, inhalation hazards, sharp objects, unstable surfaces, and more.
Floods can lead to mold and rot within a home. If this damage is not promptly resolved, the house may become a total loss.
Of course, there are a lot of variables that go into answering this question, but we can get something of an estimate here if we look at past hurricanes. On a global scale, natural disasters leave hundreds of thousands without a safe place to live every year. Within America, hurricanes tend to displace in the tens of thousands when they hit.
After Hurricane Michael, Bay County, Florida, alone saw 20,000 people that were rendered homeless after the storm. This points to the importance of disaster relief organizations having plenty of beds available in shelters near a disaster zone.
An internally displaced person is technically different from a refugee. These people are still in their native country but no longer have a home. This can result from war, natural disasters, or chemical accidents. For example, after Hurricane Katrina, there were 1,000,000+ internally displaced people within the United States.
Because of their situation, these people can quickly (and unwittingly) become victims of infectious disease outbreaks. These outbreaks then have the potential to jump into the surrounding community where the IDPs have been stationed. A cause for anger against IDPs? No, but instead, a reason for adequate and effective humanitarian aid. Shelter, restrooms, clean food and water, and medical care not only protect IDPs but also help protect the surrounding community.
A refugee is somebody who has fled a crisis in their home. This term typically refers to people who have fled across international boundaries to escape the crisis but can also refer to internally displaced persons.
There are many things that you're going to need to do to clean up after a natural disaster. First, make sure that you have the appropriate clothing and PPE. You want to protect yourself from injury, inhaling respiratory dangers, and germs (e.g., floodwater cleanup). It's the PPE that MIRA Safety can help you with the most.
Regarding the rest of the cleanup, the CDC has a good list of what to do that can be found here.
Actually, refugee camps generally differ from what anyone would consider clean, and the Superdome experiences after Hurricane Katrina attest to this. However, they do tend to offer provisions and medical services that would be unavailable otherwise.
Earthquakes cause building collapse and can also cause tsunamis, flood damage, and fire damage. When giving humanitarian aid in the aftermath of a quake, you must be prepared for just about anything.