THE UNSEEN SIDE OF DISASTERS

   In 1972, the Pittston Coal Company, in Buffalo Creek, West Virginia, dumped mine waste into Middle Fork, a branch of Buffalo Creek, creating a series of three large blockages. Days of heavy rain over the blockages caused one to break, unleashing a flood of water, pieces of rock, timbers, and coal sediment. One hundred twenty-five adults and children died and the disaster permanently disrupted the lives of the more than 4,000 survivors. Several years later, researchers found that the trauma of that event was still devastating the community.

   “Buffalo Creek sparked the first of a series of studies about acute stress reactions, depression, and survivor guilt,” says Dr. Margaret Pepe, a 1984 graduate of Penn State’s doctoral program in psychology and now a mental health administrator for the American Red Cross. ”These studies focused on the socioeconomic and psychological impact of disasters on communities. The public attention they received motivated the creation of the Federal Emergency Management Aid (FEMA) several years later.”

   The American Red Cross added a mental health program to their Disaster Relief Services in the early 1990s. Although often initially overshadowed by the more spectacular physical devastation, mental and emotional trauma can last a long time—often much longer than it takes to physically rebuild an area.

   The Red Cross Mental Health Program, Pepe says, takes a pragmatic approach to an emotional toll of disasters and consists of boosting morale and helping people regain their problem-solving abilities.

   “If there’s a tornado, the role of the disaster worker is to help victims focus on prioritizing their needs and working on systematically meeting them,” she explains. “The first step is to make sure the person is out of harm’s way, physically; second, make sure they and their families have food and clothing; and three, focus on the emotional state and determine if people have the ability, on their own or with the support of their family and friends, to help themselves and their families or decide ifthey need professional support. Throughout this process Red Cross disaster relief workers provide emergency assistance with basic needs and information about all aspects of disaster recovery.”

   After earning a bachelor’s degree from Georgetown University and a law degree from Dickinson School of Law, Pepe became a graduate student in Penn State’s Department of Psychology. She completed a post-graduate residency at Johns Hopkins, and stayed on to work in Hopkins’s Sex Offender Unit. When her husband joined the board of the Red Cross in Harrsiburg, Pepe decided to enroll in a wide range of disaster training courses which eventually led her to a full time commitment to Red Cross Disaster Services.

   Since then, she’s been involved in relief efforts around the country in natural and man-made disasters, including floods, tornadoes, wildfires, earthquakes, ice storms, hurricanes, and aviation accidents. On the morning of September 11, 2001, she was dispatched to Somerset County to coordinate mental health support for family members of the victims of Flight 93. Subsequently she was transferred to New York City where she directed all American Red Cross mental health support services for family members of victims, survivors, and recovery workers. The sheer scope of the attack, she explained, created unique and challenging problems for the Red Cross and prolonged the normal grieving process substantially. Red Cross provided services at a Family Assistance Center, two Respite Centers for recovery workers, and eight Service Centers throughout the metropolitan area. During these efforts Pepe daily directed the services of over 300 professional mental health workers.

   The type of disaster, says Pepe, determines the psychological stages survivors undergo.

   “In a disaster such as the tsunami in Asia, people are initially happy to survive and downplay the impact their physical losses,” she says. “But very quickly, people begin to understand what they’ve lost and start to fear they can not recover. These feelings of being overwhelmed by the enormity of their losses engender hopelessness and demoralization.”

   Mental health workers’ main focus then becomes building morale to maximize coping skills, she explains. By breaking recovery activities down into a series of small steps, the entire scenario becomes less overwhelming.

   During 9/11, the emergency relief infrastructure within the United States sprang into action. But one of the biggest obstacles facing relief workers in Asia right now is the lack of consistent, well-trained emergency workers—and the availability of technology.

   “Most people there don’t even have phones—and if they do, there’s no power,” says Pepe. “Our challenge in Asia now is to develop a hard-wired approach of inquiry. So we put post pictures of loved ones in public places, and make individual attempts.”

   Working only in the immediate aftermath of a disaster, Pepe leaves once the emergency phase is over—generally after a month or six weeks. She also provides extensive support for other Red Cross training and management programs between disaster assignments. For her work, earned the Disaster Services Department Volunteer of the Year Award in 2001.