Spreading the Word: Standing Up a Public Health Info Center Post-Disaster

Rockport, Texas doesn’t have a public health officer. It didn’t have one before August 26th and it still doesn’t since Hurricane Harvey. The storm turned the entire city inside out, wiping well over half the houses and buildings off the map, flooding those that still stood and leaving the population of both locals and snowbirds flat on their backs.

Emily, a Rockport volunteer firefighter, surveys damage done to her home by Hurricane Harvey two weeks after the storm. ©Christopher Guess/All rights reserved

The CVS, Walgreens, and Walmart were all destroyed. Clinics were shuttered, hospitals had evacuated, and the doctors and nurses that stayed were overworked and overcrowded. Figuring out what was open and what was available, and how to get this out to those who need it most was a problem that Elayne Saejung and myself, of the Field Innovation Team, tasked ourselves with.

Our solution was a system we call the Public Health Digital Brochure. It’s not much more than a basic phone tree. However, where the value lies is in its ease of reach, maintenance, cost, and setup time. To hear or read the brochure a community member does not need a new app, nor do they need a smart phone. The system works equally well off of voice and SMS and all the information is updated in real time by a single Google Sheet. The sheet can be customized and changed in realtime, categories can be added or deleted as needed and what is best for the community can be implemented. For instance, we put up an advisories section when a milk recall came into effect after the initial deployment.

In a post-disaster scenario, information is life. If someone doesn’t know where to get their insulin or their Warfarin they can die, quickly. If someone doesn’t know where to go after getting a nasty scratch from an exposed nail they can get an infection or tetanus. People either double down on panic or ignore issues that would barely register a thought in normal time. Neither of these outcomes tend to turn out well.

Making sure that people can find reliable information after a disaster can save lives and money, but for emergency managers and public officials getting that information out is another logistical mess. TV and radio are the old standbys, but they are all rendered difficult, if not impossible to get when electricity has been out for days. Social media is the newest information stream available to health officials, but this bypasses the elderly at an extremely high rate, especially in impoverished areas where having a mobile phone in general is a small luxury.

These are all true in Rockport. The city has a median age of 49.6, a demographic at risk for both higher medical needs as well as lower technology competency. There was no power for two weeks after the storm, with many houses destroyed and even the habitable ones often not hooked up to the grid because of storm damage.

Though writing the software to support the brochure took a bit of time, we are open sourcing it under the name Recry. This system is still a bit scrappy, and might sag under the load of a very large metropolitan area (though I’m working on that), Recry is ready to be stood up by anyone that might find a need. Since we use industry standard tools, such as Twilio, it only takes about ten minutes to go from nothing to a fully operational system, with an estimated cost of ~$150/month for a region under 50,000 people (our instance of the system is sponsored by the University of Nebraska Medical Center).

Since we stood up the project we have already handed it off to local volunteers to maintain the Google Sheet of information and have quite a number of users from the area already take advantage of the outlet. We’re hoping our work can help others in a similar situations, because we can unfortunately be sure that there will be more.

Christopher Guess — cguess@gmail.com

Elayne Saejung — elayne.saejung@unmc.edu