Sumter Regional Hospital, Thompson Medical Library, Georgia

Claudia LeSueur, from the Thompson Medical Library at the Sumter Regional Hospital in Americus, Georgia, talks about a tornado that affected the hospital library in March 2007.

Interview date: July 12th, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

On March 1, 2007 at about 9:25 pm, a devastating tornado hit our community and destroyed our hospital.For photographs of the tornado damage, see: http://sumter.fastcommand.com/photo_album/detailed_image.php?id=243&pic_count=0

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

News about the tornado reached me about 10:30 pm. It took me one hour to drive two miles due to trees having fallen across the roads all around town. Much help was needed at the hospital and people really rallied. However, by the time I got there the patients had been moved to the OR and ER areas. Patients were being transferred to other hospitals and ambulatory patients were waiting in hallways near ER to be transported as well. I briefly visited the library when I arrived and saw a lot of devastation. Books and journals seemed safe (no windows near them) and the water that had fallen from the ceiling had not fallen in this area. About the only thing I could do at that point was help talk to people to relieve some tension. Our staff had done such an excellent job and the activity that seemed chaotic was actually very organized. It was beginning to be so crowded that they really only needed a few people so I left.I felt like just finding a place to stake a claim (geographically speaking) was very important for the library. People tend to think everything is on the internet and they might realize too late that it isn’t. Promoting awareness that you are there and have services that need to continue is a must.

When you are dealing with just plain survival the “extras” can seem small. The first place the hospital went the night of the tornado was to First Baptist Church where first aid was set up. We operated there until we got some tents from FEMA. From the tents we have moved to some FEMA/GEMA modular buildings and are just starting the building of the 70 or minus bed interim hospital. It is an unbelievable story and it goes on day after day after day. There is almost no way to describe it.

(3.) How has the library (or the services provided) changed as a result of these events?

I was able to get in the hospital after about three days to see the library and assess the damage. The text and journal collection looked safe. Water had not fallen in this area. However, my office had two large windows and water was everywhere as well as debris. My cabinets in the library were near the windows and they had a large amount of debris on them. I began looking for a temporary place and started out in a building being used by hospital administration. Then someone helped me find a larger office in a modular building owned by the hospital and across the road from the rear of the hospital. We have a company that is helping with salvage and we have a warehouse where cleaned furniture is being placed. From this warehouse I have removed bookshelves and am using them to house the journals collection.At this point we do not have an open library for people to walk in at any hour. We are members of the Mercer Medical Library (Macon, GA) GaIN (Georgia Interactive Network network and this has been an excellent resource in the past and is more so even now. Our doctors and employees have access to such databases as MD Consult. This gives 24 hours access to knowledge based literature. I am doing literature alerts and have offered a table of contents service for the journals we take. These journals are in my current “library” which is really an office in a modular building across from the hospital. An interim hospital is being built now and there will not be a place for much more than clinical service. I face about three years of keeping the library viable for the physicians and employees so I will be constantly seeking ways of reaching those in need and helping in any way I can. As the interim hospital is built I will look for ways to create awareness and offer services.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

Clinical needs become so acute when a disaster strikes, so the librarians have to be ready to help meet information needs that arise. As people stay focused on survival and rebuilding, look for ways to helpfully respond and offer information resources. Librarians should serve on disaster and recovery committees. Awareness of the work of these committees can help you meet their information needs as well.

Wake-up Call!

Check this out!  Did we think that our procedures are fine for shelter-in-place?  Take a look at this document from the “Redefining Readiness” work group, authored by some very well-spoken people from the New York Academy of Medicine.  Having any procedure is better than none, I suppose, but the questions raised by this document are as good as “lessons learned” before the event happens!  Back to the drawing board we go!

University Library for California State University, Northridge

Susan Curzon, Dean of the Oviatt Library at California State University, Northridge, talks about the earthquake that affected the academic library in January 1994.

Interview date: June 27th, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

A 6.7 earthquake struck. The center was six miles from campus. Our Library was badly damaged. The Library had been built in two stages (1973 and 1991). The newer part had to be completely torn down and rebuilt. The older part had to have asbestos removal and a great deal of repair. During the six years between the earthquake and full returning to the building, we provided services partly out of the older part of the building, partly out of trailers, and partly out of plastic domes with concrete bases (Sprung Structures). The collection survived but rescue work was necessary because of rain and debris damage. It was very hard going for a long time first to find all of our personnel, rescue the collection, restore what services we could, set up temporary buildings, work on our new building, and document, document for FEMA. Some of our staff was also in very difficult circumstances with loss of their homes or considerable damage.

It is difficult to describe the unceasing labor that was necessary of so many but especially of someone like me as the dean of the library — my shoulder was to the wheel for years — the amount of effort, strategy, and work night and day is indescribable. I am sure it took years off my life.

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

We responded very well although it was a hard go. First, we had to figure out our new “landscape” and knew that nothing would be the same. Initially, a small group of us were standing in an open, muddy field in the rain. Most of the staff had to stay home for the first two weeks because there was nowhere for them to be on so dangerous a campus (hazmat conditions, asbestos, loose pillars, glass and debris everywhere, buildings unstable.)

I had a two pronged approach — first try to provide library service in any way that we could (because our President determined that we would start the semester on time no matter what) and then focus on restoring the building — the latter was very challenging because of the damage. The former very challenging because we had no library. The students and faculty voted for the library to be the number one building restored on campus. It really is impossible to run a university without a library.

(3.) How has the library (or the services provided) changed as a result of these events?

Well, at that time, libraries used technology but not on the scale of today. However, we really took a leap forward in the first year because we decided since everything had radically changed to just go ahead and make the changes we intended to anyway in our strategic plan. There was no point in going back. I am just glad we had a strategic plan we could implement.

I think the changes would have come in time anyway. However, most of our librarians and staff now were not here during the earthquake so the corporate memory of the event is slowly eroding. This was one reason why I wrote the Library Journal article so that somewhere our experience was recorded and with the urgency and voice of yesterday.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

Needless to say, I am not naive about disasters. The truth is you don’t know what the disaster will be, what the scale will be, what the impact will be, or even who will survive. You can do the best you can with having plans, having key people know the plans, having emergency training and emergency supplies but for the rest, we just have to survive on our wits and abilities. It does help to have a strong team going in though; the personality, courage and attitude of the individual were the most important factors – especially courage and a positive attitude.

I think in looking back that we do need to recognize post-traumatic stress more – it is far more powerful than people think. I think the campus started back too early; people should have been given time to get their homes and families in order. I do agree with the importance of starting that semester because people were terrified they would also lose their jobs. It was some months before we needed all of our staff, so they went to serve in any area they could, most especially in the Information Trailer (unfortunately with the name and number, “Trailer 666″). People were so happy to hear a live voice and someone who could actually help them.

(5.) Photographs

(1.) This shows structural damage to one of the steel support beams that supported the West Wing of the Oviatt Library. The severity of damage shown was typical throughout the Oviatt’s structure.

Structural Damage

(2.) & (3.) This shows the effects of the earthquake on the inside of the Oviatt Library. Books, furniture, etc… were thrown and scattered everywhere.

Earthquake Effects in the LibraryEarthquake Effects in the Library

(4.) This photo shows the debris that fell from the Oviatt near the front entrance and portico.

Fallen Debris

(5.) Photo 5 shows earthquake damage to the rear side of the Oviatt Library.

Earthquake Damage to Rear Side of Library

(6.) After the earthquake, temporary tents were set up at the North end of the campus. Here meetings, communications, planning, first aid, security, etc. were coordinated as the campus began to recover and plan for the new semester.

Temporary Tents

(7.) The earthquake took quite an emotional toll on the members of the campus community. Here 2 people console each other up at the tent area during the first few days after the earthquake.

Two workers consoling each other

(8.) This photo depicts one of the many trailers that were set up after the earthquake on campus. They were used as temporary classrooms, office and meeting space, and storage.

Trailer

Robert M. Bird Health Sciences Library, University of Oklahoma

Marty Thompson, the Director of the Robert M. Bird Health Sciences Library at the University of Oklahoma, discusses how the library was involved in the aftermath of the bombing in Oklahoma City in April 1995.

Interview date: June 26th, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

The bombing of the Alfred P. Murrah Federal Building in Oklahoma City was the first terrorist attack on US soil. Now, I think of it as being very minor compared to others – but at the time, it was the most horrible thing we could imagine. The car bomb just ripped the building apart. We waited for news of survivors, but there weren’t many after the first afternoon. It was devastating for the community; most people knew someone who died (or knew someone who knew someone). There was a huge impact on children too.

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

The library system always jumps to help, but there wasn’t much we could do during the initial response phase. First responders were concentrating on finding survivors. And we just waited to hear.

Personally, my first priority was helping our staff members cope with the grief. Every staff member had a different situation as a result of the disaster. I had to treat them all as individuals and handle each of them appropriately. Only when the library staff members were able to move forward did we re-focus on the health professional community. We were very lucky as no one on our staff was directly involved. But we all knew families that were. Some staff found it very difficult to pull certain library materials (psychiatry and pathology). I believe that it was harder on the paraprofessionals than on the professional staff. The professional staff members were wonderful; they did everything possible to serve our community. Our reference staff acted very professionally and they were able to deal with any question. For the most part, the paraprofessional staff was shielded from medical cases.

But, everyone needed to find a way to deal with the constant reminders of this terrible event. The State Medical Examiner’s office is only one block from the library. Of course, all of the bodies went there. The building was roped off for a long time and our staff had to see it every time they came to work. I didn’t think beforehand about how this would affect them, but it was terribly upsetting. I had to suggest to some people that they take another route to work. It wasn’t obvious to some people that they had to change their regular routine in order to deal with the stress and the emotional impact.

Support came from everywhere. We received many calls from other libraries. They asked if we needed help with ILL (interlibrary loan). Vendors called to offer support. From just a few comments, they started to send us pathology and psychiatry resources. They suggested databases that might be turned on for a period of time. Everyone wanted to help; and I swiftly came to realize just how small and tightly knit the library community was. The headquarters for the Metropolitan Library System was only four blocks south of the explosion. Technically speaking, they were “inside the yellow tape,” for several days. The force of the explosion blew out all of their windows. As much as possible, we tried to support them and to solicit help on their behalf.

We had a strong desire to do more, but the reality was different. People will tell you to find your niche and fill in. But, it is a hard prospect. We tried to help everyday. But when disasters are happening; it is all about first responders. What we discovered was that our primary role was in the aftermath. The pathology department at the university became involved and we supported them through reference, literature searches, etc… The psychiatry department also was very active dealing with the aftermath of the disaster. The work that was done after the attack turned into numerous research projects. The university departments became first-hand experts with valuable knowledge for communities that had suffered due to terrorist attacks. Our people have been around the world helping others and the library has always been involved with supporting these efforts.

(3.) How has the library (or the services provided) changed as a result of these events?

In conjunction with the Metropolitan Library System, we started offering courses on disaster response. We also became very involved with the Memorial Institute for the Prevention of Terrorism. Initially, we helped them build up their collection of health resource. But since then, we have established a decade-long working relationship with their library director, Brad Robison. He made me realize that we had never reached out to the first responder market. Brad worked to create databases to help responders in their work. As an indirect result of this disaster, we discovered a new market of first responders as library clients.

From a grant offered by the CDC, the Southwest Center for Preparedness was opened and is now located on the university campus. We have done a lot of direct training for the center.

The attack changed research directions for the entire campus. And, as a result, the library now collects more in the areas of emergency medicine, disaster planning, response, recovery, grief counseling, etc… In the weeks and months after the attack, we saw victims’ families coming into the library looking for information. This was just another indication of how dramatically our user group had changed.

The changes to our collections and services inspired an awareness that the library didn’t have before. Tornadoes are a regular occurrence in Oklahoma and now we are ready for them. We have learned to prepare for natural disasters that are likely to happen in our area; and we’re doing what we can to avoid being caught off-guard and to help other institutions do the same. But, as much as we can predict and plan, real preparedness is more about attitude than anything else.

One of my favorite stories about libraries helping was from Lee Brawner who was the director of the Metropolitan Library System (he has since passed away). We called him the “Consummate Library Director.” After the attacks, a church just north of the library headquarters was being used as a morgue. First responders were facing horrible and grisly work pulling bodies out of the rubble and bringing them to the church. Lee asked the responders what he could do to help. They told him that they needed a place to wash their dogs. Lee took care of it right away; he offered the staff lounge and the shower room at the library. It became the refuge for those responders. It was a place to relax, away from the mayhem. They could just wash their dogs and sit in peace.

Lee’s story isn’t about being at the site, acting the hero. It was about doing what you could, about being on the periphery and finding a way to offer effective help, even in the most non-traditional ways.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

Teaching is the first role that comes to mind. My first class was organized with Brad Robison at the Memorial Institute for the Prevention of Terrorism and the Southwest Center for Preparedness (with some financial support from the CDC). We taught Bioterrorism 101, which is now called “Disaster Planning.” I teach people that it doesn’t make a difference what the disaster is; you have to learn to cope with the unexpected. I’m not a “paper person.” I don’t think that a manual on a shelf is going to be much help when the time comes. Preparedness is more about knowing what you can do and how you can react. Recently, I became very frustrated with my night students. Instead of reacting during a tornado warning, they called to find out what to do. I told them to get below ground and to take the patrons downstairs. They all knew what to do, but they needed instructions. Real preparedness teaches us to act, not to wait around for someone else to tell you what to do.

In our classes, we present situations and ask the students what to do. If you were to ask me, I would tell you that my first priority is to take care of the staff. Then work on reestablishing the library. This is a lesson I learned from Lee: the library is an important constant for the community. Let them know that you are OK; and it will give them the confidence to move forward.

One of our scenarios involves an infectious outbreak in the community. The first reaction is always to go home. But, we have to think about opening again and establishing normalcy. Library is the touchstone and we set the tone for the campus.

Librarians have to know who to call; know who is in charge; know what to do. They have to be able to answer questions like: where are the freezers for the books?

A lot of the people that you need to know in a disaster won’t be part of your everyday lives (police, fire people, maintenance, etc…). However, they become immediately important in a disaster. It is very important to change your normal routine and get to know these people.

After the bombing, there was a heightened sense of awareness. People were really excited about teaching disaster planning. But then there was a drought for many years. People forget when everything returns to normal. It would seem that we all need some event to wake us up. However, now is the time for revival and retraining.

Tulane University Medical Library, Louisiana

William (Bill) D. Postell Jr., Director of the Tulane University Medical Library, talks about Hurricane Katrina, which directly affected the academic health sciences library in August 2005.

Interview date: June 25th, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

Hurricane Katrina had passed and three of my staff members were still in New Orleans. I suppose they thought the worse was over; and most everyone in the city was lulled into a sense of security in the hours before the levees broke. When the terrible flooding began, the three of them all sought refuge in the medical center. Each of them had to travel between two and three miles to get there. Two of them made it and one of them didn’t. One rode in on a bike with his wife. Another managed to get there on foot. The third drowned. He was a library assistant; we called his position a “porter,” and he had been with the library for 37 years. His mother and his teenaged son both lived with him. They evacuated the city and he decided to stay behind.

All of my staff members knew to check in. The lack of communication from my porter was a signal. I knew something was dreadfully wrong when he failed to get in touch.

A forensics lab was set up with experts to identify the bodies. My porter had a university identification card, but that was his only ID. We were initially called because of his ID, but the final confirmation came a full four months later. It was a terrible loss.

One month after the storm, I was back in the city as part of one of the earlier waves back. My brother-in-law was a building contractor. He helped get me into the city when security was still tight. There was a sense that the response was thrown together at the last minute. No one knew what to do. People were making up rules as they went. And the rumors about the city were just wild! When I went through security, the personnel asked if I was armed. When I said yes, the guard replied, “good,” and let me through. But the level of lawlessness was nowhere near as high as it was reported. That the death toll was as low as 1700 was remarkable.

The change to the landscape and to the city was just awful; the devastation was immense. It looked like a battle zone. My home is smack dab in the middle of the city. Contrary to public opinion, not all of New Orleans is below sea level. But, my house was very low and it filled with seven and a half feet of water. The lower half of the house was completely destroyed.

Even though the students were gone, my library was being used as a dormitory by hospital and medical school staff and faculty in the aftermath of the storm. Despite there being nearly three feet of water above street level, the university hospital was still running. The medical school is connected to the Tulane Hospital via an overhead bridge. Staff members who were on the ground helped with patients at the hospital. Tulane’s patients were evacuated via helicopter, then staff and physicians, then everyone else. The Charity Hospital, located right across the street (but not accessible by bridge), was not so lucky. Their patients were essentially abandoned. As the water started to recede, the National Guard brought Charity patients over to Tulane via truck.

As of today, some of the city is still deserted. Rebuilding will take a long, long time. Luckily, the level of damage at the library was not too severe. The medical library is on the second floor but we also manage a public access computer lab on the first floor. Fortunately, two people who were there during the storm helped maintenance and security to move the computers up to the library on the second floor. Staff saved any other records that they could grab and brought them up to the second floor. There was a big fear of mold in the building. A team came through to look at the ventilation system and then they returned to the library mid January, 2006. At that time we were given the OK to return to the library; it was nearly 6 months after the storm.

Hurricane Katrina was unique in many ways. It would be false to make too many comparisons to other storms, like the ones that happen annually in Florida. In New Orleans, the water didn’t have an escape route. It became trapped and needed to be pumped out. It is almost a blessing when the water recedes quickly because it leaves a clean landscape. New Orleans suffered greatly because of the length of time that the water filled the city. People couldn’t respond because the city became impenetrable.

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

Eighteen of my staff members had evacuated the city and I was in Houston. I’m a native of New Orleans and I’ve been through many hurricane seasons. For the most part, evacuations were well planned in advance. However, others were not so lucky or well-prepared. People ended up roaming around the south for weeks. A lot of them were sheltered by churches along the way. The church groups were amazing; across the whole region, their level of response was astonishing.

I found out about the flooding the morning the levees broke. And I was contacted by one of the university officers of administration quite quickly. The sharing of cell phones was going on between senior officers. Ten other administrators and I were invited to a meeting at the home of the president of Baylor’s College of Medicine. There, we were de-briefed on the status of Tulane.

I was constantly trying to call all of my staff members to find out where they were. My node for cell phone service was New Orleans (504). My advice for people developing disaster plans is to get a cell phone with a “safe” area code. All the re-routing equipment for 504 was destroyed. I was able to get through one out of three times in the first week.

A comprehensive list with all the staff and all of their phone numbers was prepared beforehand and kept up-to-date through constant revisions. But, we did not have remote contact information (friend or family outside of the area). Now, we include information about one person close by and one more than 150 miles outside. University communications were down for quite a while and alternative methods had to be established. IT staff was very good at getting people to set up backup email accounts (Yahoo, Gmail, etc…). Within 10 days, they had found everybody and had backup emails in place for communications. One third of Tulane’s people were not traveling with lap tops. However, the provision of public access to computers was excellent.

A total of four staff members were in Houston with me. During the post-Katrina recovery period, Tulane’s Medical School was sheltered by Baylor College of Medicine and the School of Public Health was hosted by the University of Texas School of Public Health. The city of Houston and their academic institutions really came to the aid of the people of New Orleans and the students, faculty and staff of Tulane.

The Tulane people who were in Houston joined the staff of HAM (Houston Academy of Medicine) and worked to support the medical school which was there for a whole year. The librarians and other displaced workers did as much as possible to relieve the burden on HAM.

Library people who were on the ground in New Orleans helped in many “non-traditional ways.” Those who were at the medical school helped to evacuate patients from the hospital. They assisted in every kind of physical and surgical procedure you can imagine. The hospital workers were completely exhausted after two days. Anyone available was called in to help.

Many of Tulane’s people who stayed in New Orleans ended up working or studying with the Ochsner Health System (a large hospital group). Some of the librarians at the Houston Academy of Medicine went to help out at the evacuation centers in Texas. But, the magnitude of the destruction in New Orleans made it impossible to respond in the same way. The infrastructure had completely collapsed. People could not return for weeks and weeks. Hundreds of thousands of people were displaced across the south.

I spoke with vendors and found them to be very cooperative. They provided free access for Tulane people who could not connect through the university servers. We now have duplicate, off-site servers to help serve displaced users. Some vendors were hesitant because the whole situation was so strange. But, in less than a day, they were calling back with solutions.

I returned to the library at Tulane on December 17th, 2005. We ended up operating out of a conference room in an adjacent building. But we were still able to serve our users remotely. The students came back to the school in June, 2006. The library returned to regular service at that time. Faculty came back piece by piece. We lost one quarter of the faculty because the university couldn’t afford to keep everyone anymore. The library lost one third of our staff. Despite these cutbacks, the student body stayed the same and we needed to find ways to continue serving them as before.

(3.) How has the library (or the services provided) changed as a result of these events?

In terms of service and resources, we have made significant collection changes. Prior to Katrina, 65% of our collection was online. Once communications were working again, we could operate remotely and still serve our users. And it was possible because so much of the collection was online. Katrina taught us a lesson about serving a displaced group of users. We are now about 95% online. To be honest, we didn’t really see a need for print resources at the time or afterwards. You couldn’t get around the city anyways, so print was out of the question. People adapted to use what they could.

Physical traffic in the library had been in decline before the storm in any rate. Our gate count was going down, so were our circulation statistics, ILL requests, etc… The numbers diminished ever further after Katrina. Many reasons contributed to the changing patterns of use. Remote access meant that libraries could operate in an automated mode. The technology has altered the library experience. But the decreased foot traffic meant that our reduced staff was able to cope.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

At the time, our staff continued to fill professional roles at a distance. There was an effective working radius from Houston through a huge semi-circle around the coast. Everyone was pitching in from all over. Libraries were used for a lot of non-health-sciences related activities: finding families, filling out insurance forms, etc… Public libraries were very good at providing for people with basic computing needs.

Our physical library became a base of operations for the security force. The staff lounge became the armory; our fax line in the conference room was heavily used as it was one of the longest functioning phone lines in the whole facility. To a great extent, the physical location was commandeered for other purposes, but library services were able to continue because of the prevalence of electronic information resources.

Librarians can help support these services by building redundancies into the system. We need to build backups into all of our data. The issue of maintaining access has overshadowed preservation of paper. We don’t have to protect the paper anymore.

But the primary issue was getting people out well in advance. Our contact lists are now much deeper than they were before. Along with the contact information, we learned other lessons that have been essential in rebuilding. Many institutions have moved to higher ground. Electrical systems have also moved to higher levels in the buildings. Institutions are drilling their own wells so that they can get their own water supply.

Needs were very basic. Consumer health and public health issues were vitally important: basic sanitation, disease control, housing, and clean water, etc… The situation was akin to a mission to a third world country. People were concentrating on survival.

Toronto Public Health, Ontario, Canada

Bruce Gardham, Senior Librarian for Toronto Public Health in Ontario, Canada, discusses his personal experiences with the SARS epidemic in 2003 and the special library.

Interview date: June 22nd, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

The SARS (Severe Acute Respiratory Syndrome) public health emergency in Toronto began on February 23, 2003. A woman returned to Toronto after visiting Hong Kong. She had stayed on the same floor of a hotel with an infected person. She got sick and went to her doctor who diagnosed the flu. She went home and died. Then her son got sick and ended up in hospital before dying as well. The person who shared his hospital room got sick. And then that person’s spouse got sick too. The outbreak infected 257 persons in Toronto’s hospitals, occurring in two separate waves. The emergency lasted until the end of June, 2003.

The hospital realized that they had a highly infectious case on their hands and Toronto Public Health started mobilizing. Initially there was a lot of tension and fear. But, not as much as you would expect. A great media system helped. Dr. Sheela Basrur, the Medical Officer of Health for the City of Toronto, was also an extremely capable leader. She worked very hard to keep the population calm.

Everything happened so fast and information constantly needed to be updated. Patients being transferred between hospitals aided the transmission of the disease. Also, it was very common for nurses to work in multiple hospitals and they were traveling back and forth through the infected zone. In the end, more than 23, 000 people had to be quarantined to control the spread of the disease.

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

The Toronto Public Health Library wasn’t very involved in the response to the first wave. I supplied some information that was coming out from The New England Journal of Medicine and The Lancet. Toronto has a pretty tight community when it comes to the medical library field and I knew that hospital librarians were not working in their traditional roles. They were deployed to the front entrances of the hospitals to screen people, take temperatures. During a Code Yellow, all hospital personnel are deployed and whole sections of the hospitals are closed off. All personnel, including the librarians, were deployed to screen.

During the first wave, we monitored journals that were starting to publish electronically. Our library liaison in the government was corresponding with officials. But, in the Public Health Library we didn’t even get asked for anything before people started thinking the whole event was over. And then the second wave hit.

Toronto Public Health had set up an information hotline during the first wave. It wasn’t until the second wave that the managers of the hotline realized they had a problem organizing the information. I was called in to help.

The hotline workers (45 public health nurses) all used these big binders to help them answer the wide variety of questions that were coming in from the public. The binders used in the first phase of the outbreak were not updated before being pressed into service for the second wave. The binders each had three sections with many chapters. The information had been gathered as the staff members went along and attempted to answer the questions that came up. But, there were literally thousands of questions.

When I was assigned to the hotline area. No one knew what information they had or what was right. Information was changing hourly and daily. Public briefings were happening all the time. There were lists of deaths, outbreaks, quarantines, etc… Instructions were issued by the Public Health Department and the hotline number was distributed by the media. Any piece of information released by the media would cause a flood of phone calls. As soon as an outbreak was reported, people wanted to know if they had been exposed. We had to know exactly where each outbreak was located and where the person had been. The entire situation demanded current, accurate data to be distributed to the hotline workers. There were so many calls that — at one point — Public Health was preparing to requisition major call centers if the numbers increased any more.

The first problem was updating the binders. I worked with a public health nurse who had been manning the phones since the beginning. We worked to take out all of the old information. The process I adopted for updating these binders was based on loose-leaf processes used mainly for law library materials Each binder included a master index and ten sections. They were:

  1. Phone Log-in Instructions
  2. What is SARS?
  3. Process for Dealing with SARS Calls
  4. Contact Follow-up and Documentation Forms
  5. Mask Information / Sanitizing with Bleach
  6. Information Regarding Discharged Patients
  7. New / Communication Updates / Travel Advisories
  8. Medical Information for Hospitals
  9. Travel Advisories
  10. Helpful Telephone / Addresses / Websites

I maintained the master binder and there were regular checks to make sure the other 35 binders were the same as the master copy. It took a couple of days to organize the binders.

Then, we began the system of adding updates. Hotline managers attended meetings at about the same time every day. After the meeting, daily updates would be added to the binders. Urgent updates were added as soon as the information was received. The phones were manned every day from 8:30 am until 11:00 pm. There were day and night shifts, but more people worked in the day than during the evening. It would become a problem if someone missed an update. Discrepancies between information resources were also a problem; and there was a lot of information confusion during the emergency. And sometimes small format changes (the date for example) would result in serious problems. All of these discrepancies had to be accounted for before any updates could be distributed to the hotline.

Larger problems in disseminating information were due to Toronto being such a multicultural city. After the fact, I heard from some Chinese friends. They all watch Hong Kong television and were completely in the dark when it came to local public health notices. 110 languages were being spoken in Toronto, but the hotline and the Toronto Public Health website was only translating into six. Even then, it was difficult to have staffing to ensure that all six languages were covered in any given shift.

My role wasn’t conducting typical library work. Public Health had their own information sources so they weren’t coming to the library. Organizing the binders for the hotline was more about my general skills. I was filling a practical role keeping information organized, maintaining an information network and dealing with people. Toronto Public Health was significantly affected as an organization. Many workers were quarantined or had relatives in the hospitals. Areas were closed and it was difficult to get information. As a librarian, I had experience working with people and it helped tremendously.

(3.) How has the library (or the services provided) changed as a result of these events?

After the fact, I worked to evaluate the effectiveness of the binders and wrote a report with recommendations. Some of my recommendations include the following:

  1. A communication binder or manual be produced which would act as a template for future hotline operations. This should include an orientation manual for staff.
  2. An evaluation be carried out on the types of questions coming into the hotline to determine the information needed.
  3. Keep a log of the types of questions fielded by managers and team leaders to ascertain the problem area which may be addressed by having that information in the binders or an electronic system.
  4. All communications produced exclusively for the binder or database has section numbers for the headers, date and time of issue. Time is important since during a single day materials could be issued three times and time is the only way to ascertain the latest version of a document.
  5. Subject indexing be adopted for binder materials using reference manager software. Controlled language subject indexing would have helped to locate materials faster. Subject indexing should be incorporated for any electronic database constructed to handle future hotline communication materials.
  6. Keyword searching is not the best answer to subject access as keywords are produced from titles of documents or the full text of a document. Such keywords may not always reflect the genre of the document or be too confusing to an individual trying to locate information quickly. Subject descriptors would have to be assigned by an information officer or health professional using an authority file.

I also examined the information discrepancies and created a SARS Information Discrepancy Table. My main recommendation was for the creation of an Information Liaison Control Officer to manage the flow of information.

The SARS outbreak in Toronto was the first major outbreak of an illness in our area to happen since the 1950s and 1960s. It really shook people up and a lot of plans were made after the fact. But, disaster planning has really fallen off the radar since. And there is still a lot more we could do.

For example, I really feel that better contact should be established with the non-English speaking communities in Toronto. If another disease outbreak occurred in the area, we could have real problems communicating with these groups. I also think that we need to have a better handle on the social services and agencies in town and how they work. In another disease outbreak situation, this information needs to be at our fingertips.

And there was definitely a need for better access to detailed, military maps. People were calling who had been in a certain section of the building. We needed to see where exactly the outbreak happened and how close they were to it. That kind of building information wasn’t always accessible at the time it was needed.

The library started getting reference questions about SARS after the emergency died down. Suddenly, all of these people were writing reports. I started to assemble what is now that most comprehensive collection on SARS; we probably have every single book ever published on the disease.

The experience made me think about information access in a disaster. I started asking: How would we have access to the electronic information if everything falls apart? What are the core areas? What do we need to have in print? It made me realize that certain things should always be collected in paper. For example, I still buy the new print editions of the CPS (Compendium of Pharmaceutical and Specialties) even though there is an electronic edition available.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

For the library, we developed a specialized collection on SARS. It is one of our roles now to help other institutions, communities, hospitals, libraries, etc… with their information needs on the subject.

But, most of the roles are for the librarian as an individual. In my recommendations, I outlined the needs for an Information Control Officer. I see the librarian’s role as aiding information flow and working between the administrative levels. I can even see an information officer needed on every floor. We need to help our organizations understand how information should be presented, to stress the importance of continuity (in date formats, for example). It was a corporate standard in the city of Toronto not to put a date on websites. This standard had to be changed. Little things make a big difference in an emergency situation because little details have to be confirmed.

Another role for the library is being involved in the community. Sharing vital information with the public will be very difficult in an outbreak situation, especially in the large, multi-cultural city centers. Librarians have to be aware of the whole community and have contacts that they can call on in an emergency.

The following documents were submitted by Bruce Gardham:

Binder Inventory and Audit Control Sheet: binder-inventory-and-control-sheet

Hotline Information Liaison & Co-ordination Officer Report : information-liason-and-co

Toronto Public Health Library Bibliography on SARS: sars-bibliography

Pasco County Library System, Florida

Terri Romberger, Library Systems Application Analyst at the Pasco County Library System in New Port Richey, Florida, discusses hurricane season and how it impacts the public library.

Interview date: June 18th, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

Living in Florida, we have the special experience of Hurricane Season from June 1st to November 30th every year.

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

Library personnel work closely with Emergency Management, manning the phones with citizen inquiries from a minimum of 48 hours prior to impact to well after the storm is over. The actual startup of RIC (Resident Information Center) begins when EOC (Emergency Operations Center) determines they are no longer able to handle the amount of telephone calls to their office. This is sometimes as early as 3-4 days prior to expected storm landfall; often other departments are not yet activated. We have most of our material stored online and updates are constant in our informational document [To view attached files, see menu]. When asked to fill out copious forms for application to SNAPPS (Special Needs Assistance Population Program), we developed the attached PDF to ease the application process. This is now posted on the Pasco County Office of Emergency Management website for public access.

Training of the entire library staff is a prerequisite to our success, for this is an essential job duty as outlined in the attached directive from our library director. The over 100 employees, including 25 supervisors and other county departments and CERT (Community Emergency Response Team) volunteers are trained on basic navigation of the database, policy and procedures in Emergency Management (Emergency Service Functions 1-18), as well as bunker layout and operations.

Through conference calls with the State and surrounding County Emergency Operations Centers, our County Emergency Operations Director decides when it is necessary to open the Resident Information Center. He contacts our liaison to deploy staff to the Resident Information Center. We utilize staff from our Support Services facilities for the first 48 hours of the emergency, with Libraries’ Public Services staffing thereafter. Our “GOKITS,” which contain paper copies of important information and other useful supplies like batteries, are ready and accessible to be transported to the bunker with us at a moment’s notice.

The citizens of Pasco County are the users of this service. As the tropical storm or hurricane is approaching the public is generally glued to their television sets. The broadcast message marquee is running across the top or bottom of their TV screens “For more information or questions, call Pasco County Emergency Operations 727-847-8137″, and that is where we pick up the phone and provide requested information.

(3.) How has the library (or the services provided) changed as a result of these events?

In the beginning of this collaboration, the Resident Information Center was in a room about 10 x 10 feet, with operators manning phones around tables that were pushed together, mounds of paperwork, clipboards, old situation reports, telephone books, message pads, you can imagine. And just remember in 2004 we had a pretty rough hurricane season, first there was Charley, then Frances, Ivan, and Jeanne. Through 2004 alone, the hours Libraries staffed the RIC was over 1,800 with a cost of $42,681.04 (attached 2004 Hurricane Personnel Totals.xls). This is a considerable investment to undertake while still operating the libraries during regular operating hours. We have since been upgraded to better digs.

We now have a larger room with computer access for each operator as well as a laptop for the supervisor. Using the database and online forms has proved to be less stressful and more productive for the operators that take sometimes as many as 40 calls per hour. Now, remember these are not call center employees. They are library personnel, including shelvers, janitors, and couriers who have been trained to use this information to guide our citizens in emergency preparedness.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

As librarians are extremely good at gathering, verifying and disseminating information, it is a natural progression that librarians would be chosen to help in emergency efforts when distribution of that information becomes necessary. As a result, Pasco County Library’s personnel have become the primary workforce for this task, and provide indispensable support to the Office of Emergency Management’s (OEM) Resident Information Center (RIC). Because the Gulf is on the west coast of the county, the Westside RIC is usually activated first. The Eastside RIC, located approximately 65 miles east in Dade City, opens as a backup and handles the overflow of calls. OEM operates out of a bunker-type building, with auxiliary generator power available. The RIC accommodates up to 13 operators and one supervisor per shift, and we generally staff 24 hours a day with three shifts until the storm dissipates or moves on. Concerns from citizens range from sandbag locations, to their particular evacuation level, to SNAPPS pickup time, etc.

I have attached some of the forms that are referred to in this oral history, just to familiarize readers to documentation, also our RICinfo.doc which is a great data source during our shifts at the RIC.

GO KITS Contents: romberger_terri_gokitscontents1

Special Needs Assistance Population Program Evacuation Registration Request Form: romberger_terri_2007-snapform

Interoffice Memorandum in reference to service during emergencies: romberger_terri_li06-122