Houston Academy of Medicine, Texas Medical Center Library

Deborah Halsted, Associate Director, Public Services and Operations, Houston Academy of Medicine, Texas Medical Center Library in Houston, Texas, discusses flooding issues in the academic health sciences library resulting from Tropical Storm Allison in June 2001.

Interview date: June 5th, 2007

Questions:

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

Between June 8th and 9th, 2001, Tropical Storm Allison circled over the Houston metropolitan area for the third time, dumping a lot of rain over already saturated ground. One of the most heavily hit areas of the city was the Texas Medical Center, which is home to over 40 health-related institutions. Hardest hit were Memorial Hermann, Methodist and Ben Taub Hospitals, The University of Texas Medical School and Baylor College of Medicine. The Houston Academy of Medicine-Texas Medical Center (HAM-TMC) Library is situated right in the middle of these institutions. The morning of June 9th the library had 4.5 feet of water in the street level, which meant the one-level parking garage under the library was completely full of water. The street level housed the computer classroom and lab, the offices of the National Network of Libraries of Medicine South Central Region, and the Archives of the John P. McGovern Historical Research Center.

While the flooding in the Library was devastating, the damage in the other institutions was more drastic. Both Hermann and Ben Taub Hospitals (the only Level I trauma hospitals in Houston) had to be evacuated. Yes, even the patients. Hermann was closed for 6 weeks. Methodist lost all their patient records. UT and Baylor lost years and years of research, both in laboratories and laboratory animals. The south side of the TMC campus was saved due to two huge construction sites (pits) which served as retention ponds.

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

The HAM-TMC Library is unique in that it is a private library which rents 72,000 square feet of space from the Houston Academy of Medicine (HAM). Due to this arrangement, HAM was responsible for recovery and restoration of the actual facility and Library staff members were responsible for the contents. Both of us had prior relationships with Munters, a recovery firm, and they were on the scene the morning of June 8th. Library staff could do nothing until the water was pumped out, so our recovery efforts began on Sunday, June 10th.

Did library staff do non-traditional roles? Yes! Digging muck, contaminated with sewer water might be considered “other duties as assigned.” But, loyal library staff arrived on Sunday to do what they could to save anything we could, especially the archives.

The Library was one of the few institutions in the northern part of the TMC with water still running, so we became a popular spot since we had working restrooms. We also had to post a TMC security officer at the front door, since some people displaced from their offices in other building thought they would just come to the library to “photocopy some articles.” The security guard had to explain that the Library, too, had no electricity.

Although the entire TMC was affected, the Library staff were really only responsible for recovery of the Library. Staff members were not called upon to assist other institutions or departments, as was the case after Hurricane Katrina in New Orleans. In our case, local librarians not affected by the flood, as well as some library clients displaced from their offices and unable to work, arrived on our doorstep offering help.

With a lot of work and many thanks to the HAM staff, we had electricity and phone lines (although spotty on both accounts) back on by Wednesday. We opened our doors with limited hours and services on Thursday. Recovery efforts on the building continued until January 2002, when we finally opened totally, with a renovated street level. Over 850 boxes of wet archives were shipped off to freeze-dry facilities, and returned in October 2001. It took many months to process the materials that returned. We have since relocated the archives to a warehouse facility about 3 miles from the TMC campus that is not in a known flood zone.

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

The first change would be the location of the archives. Renting the warehouse facility is expensive, but necessary. Now, clients needing access to the archives can go to a lovely facility with free parking. We have also co-located our proxy server to a remote location, so in the event of another storm (we do live on the Gulf Coast), clients will still have access to needed resources. We are in the process of having key staff test working from home to ensure that if needed, we can continue to offer library services remotely.

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

This question can be answered on so many different levels, depending on the type of library. The roles for public libraries after a disaster are obvious, and I am proud to say that the public libraries in Houston and surrounding areas really responded to the needs of the evacuees. What is not so evident is the importance of the medical library. After Katrina, physicians in the Astrodome and George R. Brown found themselves treating patients and cases not in their usual area of expertise. These patients had no medical records with them, were taking medications the physicians were not familiar with, and the doctors found their greatest need was a PDR (Physician’s Desk Reference). For example, pediatricians were treating geriatrics, since they took whatever patient was next in line. For that reason, staff members at the HAM-TMC Library have become totally ingrained into the disaster planning at the TMC as a whole. Librarians have sat on the Inter-institutional Council, Katrina and Rita Lessons Learned Task Force, and disaster planning committees. At first, the TMC staff wondered why we were there, but now has come to conclusion that librarians are integral to the process. I have been invited to participate with TMC staff in NIMS Incident Command System training. These courses, designed by FEMA, offer a standardized command system and terminology to respond to disasters. They will soon be required for any institution to received FEMA funding in the future. The Library has now incorporated the ICS system into the newly named Business Continuation and Recovery Plan formerly known as our Disaster Plan. Our main goal in all this was to been seen as first responders, which we now are. TMC will be issuing key library staff sticker to be among the first responders the next time a major disaster strikes. This designation is a mixed blessing, since this means we now will be expected to be among the first on hand, not part of the general population asked to stay away until the area is safe!

Houston Academy of Medicine, Texas Medical Center Library

Dr. Elizabeth Eaton, Director of the Houston Academy of Medicine, Texas Medical Center Library in Houston, Texas discusses the effects of Hurricane Katrina and flooding at the academic health sciences library in 2005.

Interview date:

June 5th, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency) and how did your library respond?

Between August 31st and September 4th, 2005, Hurricane Katrina devastated the Gulf Coast including New Orleans. Many thousands of the evacuees were brought to the two large conventions center in Houston: the George R. Brown (5,000) and the Reliant Center (11,000). The evacuees arrived several days after the levies broke. They came with the clothes on their backs, sans prescriptions, no medical records, no schools records. The convention center grouped the arrivals by families, single male, single female. The facility was clean, accommodated all for sleeping, eating, medical, computer stations, clothing selection, and school study areas for the students. The two medical schools opened medical centers to treat the evacuees. Baylor College of Medicine (BCM) ran the Reliant medical center; The University of Texas Health Sciences Center-Houston, the George R. Brown Medical Center. The UT Dental School moved their mobile van into the GR Brown Convention Center. We heard about this arrangement and immediately found the UTH organizer. The Library supplied needed information to the George R. Brown medical triage area. It took several visits, the first to inquire about their information needs. The physicians were volunteers and worked shifts. They saw a random assortment of patients. One Internal Medicine physician said he wanted infectious disease texts, another said he wanted the PDR, another wanted access to the library’s online journals. We engaged our serials librarian and the IT Systems person. The Convention Center had an IP address, all we had to do was locate the person who knew it and receive permission to give it to vendors to allow access from the convention center. In all cases, the vendors gave us 30-60 days permission from machines we identified at the convention center.

September, 2005: Hurricane Rita, the second Class 5 Hurricane in the Gulf heading toward Houston resulted in mass evacuation of Houston and the surrounding communities. The Library battened down the hatches and evacuated the premise from Wednesday to the following Monday. Fortunately no damage was inflicted upon Houston.

(2.) How did the library support the regional community of health information professionals?

2005 August 31-Sept 4 Hurricane Katrina

Houston watched as Hurricane Katrina wrecked havoc with New Orleans. LA is in our NNLM (National Network of the Libraries of Medicine) SCR (South Central Region), the academic health sciences libraries and the hospital libraries in New Orleans were flooded; Oschner Hospital was surrounded by water but remained open, with a helicopter pad on the roof. The worse part for all of us was not knowing where the LSU and Tulane staff had gone. The NNLM SCR staff within 60 days had contacted all affected libraries and determined their needs and what the costs would be. Contacting persons and confirming that they were OK was a lengthy and arduous procedure. Home phones were down, work phones down and many cell towers inoperable. We contacted friends of friends and NNLM SCR set up a blog which was a great way to deliver and receive information. We were on the phone to the SER (South Eastern Region) as well, trying to assess damage in Alabama and Mississippi.

Within a week of the flood, the entire Tulane Medical School, including faculty, staff, residents and medical students were relocated to BCM, one of the two medical schools which we serve. So while the NNLM SCR stayed with the project of polling all members, assessing damage and prioritizing services needed, the Library staff was welcoming yet another medical school to its services. We phoned vendors trying to include the Tulane medical students as our students for assessing resources. The Tulane students had dual resources, those already paid for by Tulane and also this Library’s online resources. The vendors agreed to allow Tulane students, staff, residents and faculty access from our IP addresses. The Tulane Medical School Library Director and a librarian who had relocated to Houston were given desks and became members of our Library staff while helping their students. Although the move of Tulane to Houston was not prearranged, the BCM faculty and staff accommodated them and made the transition smooth. Medical School classes began 3 weeks after the storm; Tulane faculty taught their medical school classes; residents were placed in appropriate units.

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

Now, we have much better emergency numbers sharing. All cell phone numbers are shared with key people and departments. Email accounts with a national carrier (Yahoo!, Google, AOL, etc…) are encouraged for all staff, as one can usually use the national email if local and home computers are unable to function.

To ensure continuing online access, we have co-located our authentication server and have encouraged the region’s libraries to do the same.

We updated and reviewed the disaster plan, re-stocked emergency supplies and prepared vendors’ contact information. Those details will be available and we will contact them ASAP. We have agreed ahead of time on the process for accessing information during such emergencies.

We worked with community libraries, the city, and TMC (Texas Medical Center) to be better integrated into the emergency response teams.

What became crystal clear after Katrina and Rita is that it is most important to evacuate. Leaving early is the priority – in front of moving furniture, computers or even putting plastic sheeting on books, stacks, etc…

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

Librarians’ roles are to be absolutely in charge of the library. Do not even dream that you will have help. ‘All we have is ourselves.’ Some staff members do not want to participate in recovery and that has to be known in advance.

Librarians must be integrated into the local and regional disaster preparedness and recovery operations. We have knowledge, space and can help in many non traditional ways.

Librarians’ roles are also to collect contact information. Keep all home email address in your emergency manuals. Try and have as many regional and national numbers as possible. Librarians should also keep records of everything before, during and after the flood. FEMA demand receipts.

The role of National programs, such as GoLocal, should be emphasized. The sister-system of RMLs (Regional Medical Libraries) is absolutely vital. In the SCR (South Central Region), the network sponsored a disaster seminar that raised awareness. We encouraged more seminars on regional levels. The NNLM played a key role in promoting awareness at the regional and national levels. The network and the National Library of Medicine need to continue their leadership in promoting preparedness.

In every disaster, the needs are different. But, money will always be needed by the institutions affected. The willingness of vendors to allow for permissions will always be needed. National and regional efforts are required to enable quick response on behalf of the vendor community. Access should be available to wherever the point of care happens to be. Librarians can aid in the provision of these service.

Since Katrina, TMC Inc. (Texas Medical Center, Incorporated) forged a relationship between the medical library and disaster agencies. Now, the agencies will think of the library. The next step will be to get ingrained with the city planning force. The library is much more visible now and they expect to be called. Staying connected with the city is critical. Librarians should be out of the library, making contacts and connections.

University of California San Diego

Julie Page, Head of the Preservation Department at the Geisel Library at the University of California San Diego, talks about the flood that affected the neighboring academic library at the University of Hawaii at Manoa in October 2004 and the library’s participation in the recovery efforts.

Interview date: June 1st , 2007

Questions:

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

I was called in to help the University of Hawaii at Manoa when a flash flood caused a stream to jump its banks in the hills above the campus. The flood affected the medical and science buildings and their labs and around 20 other buildings including the library. The first floor library building was below grade and it completely filled with water. Water poured into one side of the building and out the other. Inside, the water sloshed around like a washing machine.

The library had a disaster plan but the university did not. It took them a long time to get back on their feet. Everything took forever; it took two and a half months for generators to get hooked up to provide power to the four story library building that was affected. Getting supplies and services to the island was difficult and time consuming. About 25 staff members were displaced from their offices and work spaces. Luckily, aside from the university campus, there was very little damage done to the rest of the community.

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

The University Librarian at UC San Diego was well-known to the library administration at the University of Hawaii at Manoa. He offered assistance right away. During the first week, the library staff salvaged as much as they could of the collection. I went over to help out 15 days after the flooding occurred. Observing the disaster first hand provided me with on-the-ground experience in a disaster situation. But, before that point, they weren’t ready to deal with the myriad of insurance, psychological, and preservation issues; they needed time to get back on their feet.

Initially, I was there for four days and then went back two months later. I was sent back to help the University Librarian. It was a complicated situation since there were problems to deal with on both the campus level and the library level. To some extent, the library had been overlooked. I went back to UHM two and a half years later to take part in follow-up assessments of the recovery and evaluation of affected materials. A big plus was that the Preservation Librarian used the UHM experiences as a learning experience to be shared with the rest of the preservation community – through articles, symposia, and other collaborative efforts.

The expectation at first was that I would help to deal with the insurance issues. Priority materials had been put in freezers; luckily the library had established priorities ahead of time. They were only able to salvage about 15% of the first floor collections. Maps and photographs and some book collections were saved. They focused their attention on preserving priority materials important to the campus and Pacific region.

Cargo container freezer storage was acquired from Matson (shipping company) as soon as possible, in accordance with the library disaster plan. There were five large freezers parked around the library for several weeks. Then Matson wanted their containers back. The university kept one cargo freezer with materials that they were going to preserve in their own conservation lab. Many other objects had to be moved to cold storage, and I helped them evaluate and transfer the materials. The disaster recovery company BELFOR, headquartered in Ft. Worth, TX was hired to handle the recovery of the priority materials including setting protocols for treatment, shipping from Hawaii to Texas, vacuum freeze drying and cleaning the maps, photographs and books, as well as shipping them back to Hawaii.

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

The university learned a couple of important lessons. The first was never to keep collections on first floors, in basements, or in below-grade buildings. The second was about leadership. If you don’t have enough administrative depth — not enough people at the higher levels — it is very challenging to make good decisions in a crisis. You do the best you can, with the information and staff you have. You need a strong leader and administrative depth. In general, they discovered the importance of flexibility. In order to deal with any disaster event, you need to be capable of constantly evaluating and changing your course of action.

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

Libraries can offer emergency assistance in their area through regional centers with preservation services. They can also offer training to other institutions to pass on the knowledge for dealing with emergency situations.

Every library should have a disaster plan; the institution should know how it will communicate and what their priorities will be. They should exercise the plans through practice so that they are prepared when the time comes.

Librarians should build relationships with emergency responders and understand ICS (Incident Command System). Collaborations should also be developed with volunteer organizations, particularly those who are distributing medical information. Libraries can help a great deal by establishing communications, developing collaborative relationships, and effectively training staff to respond to an emergency or disaster.

Department of Library Science and Informatics at the Medical University of South Carolina

Tom Basler, Director of Libraries and Learning Resources Centers and Chairman on the Department of Library Science and Informatics at the Medical University of South Carolina in Charleston, South Carolina, discusses hurricanes, flooding, civil unrest, and radiological and toxicological events at the library.

Interview date: May 31st, 2007

Questions:

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

South Carolina has hosted three different kinds of disasters/emergencies: hurricanes, flooding and civil unrest. A fourth type could also be added: radiological and toxicological events.

Hurricane Hugo was the worst storm in recent memory, but there are warnings all the time. I wasn’t there at the time; but I know a lot about Hugo through second hand sources.

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

The Medical University of South Carolina (MUSC) Library is in a very central location between research and hospital areas. My staff serves a wide user community.

During the civil unrest and the 1980s hospital strike, the library concentrated on securing the building and making sure that their staff and patrons were safe.

In a hurricane, the library tries to do basically the same things. But, flooding generally occurs with a hurricane or storm; the two go hand-in-hand. In Charleston, the water comes up and the wind comes down. But the water stays. In preparation for the inevitable flooding, no collections are housed below the second floor. Planning has also resulted in changes to the electrical system; the library is now on the back-up electrical system for the hospital. Computer technicians (OCIO) at MUSC have ensured that data is backed-up and protected.

But, hurricanes provide the best example of library response. In preparation for a hurricane, the library informs their patrons by posting information on the library web-site. They also provide links to MUSC’s Emergency Page. At times, the library has served as a “gathering or command center.” In one instance, foreign students sought shelter in the library while they waited for buses to evacuate.

Library staff prepare by gathering the necessary supplies (plastic bags, clean-up materials, flash-lights, batteries, etc…). Librarians have been given emergency permission to be on campus. The library has prepared information resources that include emergency staff telephone contacts. This “calling tree” is constantly being updated. They also gathered key contact information for the university – weather, public safety, computer center information, etc… Further, they prepared a list of potential locations for staff during a storm that gives information about family members too.

Digital photographs have been taken of key equipment and emergency settings for micro-labs, servers, etc… The photographs show how the wires look and how things are placed. They have been very helpful.

The library developed staff leaving procedures. The procedures are very detailed and include a countdown of events. They outline when the micro labs and classrooms can be shut down, what order staff members can leave (Tech Services are first, Systems and the Info Desk are last). But they also outline exceptions. Some staff live in “vulnerable” areas. These include the beach, high-flood zones, over bridges that will “officially” close to traffic. Staff who live in these high risk areas, and those with children are the first to go. I remember flying into Miami during a hurricane when I worked there in the 1960s. I had to decide whether to go to work to help out or to go home. It was a hard decision. But, the right thing is to take care of your family. People come first. So, the first priority for the library is to evacuate the staff. Collections are left in place with no coverage or protection. Computers are moved and then protected with plastic coverings.

During the storm, servers are kept live as long as possible. Contact numbers provide information on personnel needed to restart them. I’m working to get a substitute URL which will provide access when the main library site goes down.

I remember being told that reference questions jumped after Hugo. But, that was in the pre-web area; other forms of information just weren’t available.

The plan is to completely evacuate all staff and all users. Physical access to the campus is denied until the “all clear” message is received. Library is now part of the Emergency Information Telephone System. The “first person in” relays “first findings” to key staff.

In the past, the library has served after a crisis as a “digging out center.” The library was a place that could function. They were connected. They were open.

But, in one case, the library had some unexpected problems to deal with as a result of the water damage. Years ago, the library suffered from water in the walls and floors. Moths ended up infesting the whole building, including the air conditioning system. They were everywhere! Exterminators had to come and take care of the moth infestation.

After the storm, the library was instrumental in forcing the computer center to make plans for future disasters. Planning at the university started with Hugo. At the time, all of the university records were backed up on tapes, which were housed on site. When Hugo was about to hit, Steve Burns from the computer center grabbed all of the tapes and put them in the back of his van and started driving away from the storm. Unluckily, Steve drove in the wrong direction and the storm chased him for hours. In the end, the tapes were saved and his actions saved the university records. But, the experience taught the university a valuable lesson. Now, all of their copies are kept out of town.

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

The library has recognized two values and how they’ve changed. The first is the value of collections. MUSC library is not a “library of record,” and they will not replace lost paper collections. They are, however, a utility. And the second value is that of electronic connections and e-resources. They must stay online at all times. The key is to be “up,” and to stay up during preparation, during evacuation, through times when everyone is away, upon return and digging out, and upon return to regular business.

Also, in realizing that the library is the common gathering point for students before the disaster, the library put up a hurricane watch on their website. Collected statistics suggest that this site is also being used outside of the university community as well. In general, MUSC’s website is more open than other university’s. In fact, 10-15% of users were coming in from outside of South Carolina.

More is being done on the web. For example, the library’s community health web site, Hands on Health, (which includes a GoLocal component) has an emergency section with consumer health information about hurricanes and other disasters.

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

Libraries and librarians have both primary and secondary roles. Primary roles are to keep the e-resources available, get the microcomputer labs, classrooms, and testing centers operational ASAP, and get the study-hall values back ASAP.

Secondary roles are more varied and wide-reaching. The library serves as “gathering,” “command” centers (as in the case of foreign students waiting for a bus out of town) both before and after the disaster event. Library always starts to fill up during a hurricane. The library can also be a “sorting-out place” for others (as in the case of people who need Internet access to fill out insurance type forms). Further, the library can act as a computer use area for all staff, students and others in need of a communication port.

The library also houses staff that cannot function in their own areas. And librarians serve during and after the storm in areas of expertise.

Another secondary role is in the area of outreach to the community. Librarians can train preparedness to promote community self-sufficiency.

The reality is that people “don’t think library.” I feel that people should get used to the library first. Then, the library has the responsibility “to be there” during the crisis. People will think to go there, because they already know what the library can provide.

The librarian’s first reaction is personal, then professional, then community oriented. Individuals begin to act as individuals during a disaster. An example is Doug Blands from Georgia Tech. He was able to stay and help with the animals because he had that expertise and availability. He was acting as an individual, not as a librarian. Librarians may just be the type of people who would volunteer anyways.

But, it also depends on the disaster. In the case of a hurricane, there isn’t a lot that librarians can do as professionals. But, if the case were a biological attack then the answer would be different. South Carolina is one of the more “nuclear” places in the world. The library has done a lot with Department of Energy and Environmental Protection Agency (EPA). The library brings in grants and contracts to provide information about environmental health information.

MUSC library also provides information support to the Agro-Medicine Program. In one case, an emergency room doctor called from Greensville. They had received two patients who had been bringing a truckload of peat moss from Canada. The patients had passed out and the doctor wanted to know that cause. Was it something to do with the peat moss? No. Turned out that the cause was the change in temperature coupled with their poor lungs.

I also see a role for librarians in maintaining e-resources through alternate networks. What is the point of paying for all of this proprietary information when you can only access them from the library’s web pages? What if the server goes down? How can we continue providing information if access is entirely based on IP address? It is a problem I would like more people to address. This question of URL displacement will require vendors and libraries to work together. Some possible solutions include: providing passwords for libraries that loose their connectivity, setting up a regional network of e-resources, and creating a fall back center for the institution.

Additional Questions:

(5.) Was there any contact with other emergency agencies, organizations or groups?

For hurricanes, the answer is no. The library has never been on the radar for emergency agencies. But, in a sense, the library is serving them by feeding people to their websites via the library portal.

But, in the case of environmental health issues, then yes. The library works often with EPA, Department of Energy, CDC, and the Department of Commerce.

In fact, many years ago, the library was asked by the Department of Energy to put together a one-stop program that would search multiple databases on environmental health. It was designed for cases like a tritium spill outside a bomb plant. Questions it was designed to answer were: What does the chemical do? What counteracts it? How do you respond in the short term? It was called the One Door Access System (ODAS). Unfortunately, ODAS died because it wasn’t on the web. But it was the impetus for other systems like it.