(Adapted from the Crisis Management Handbook: A Guide for Overseas Staff, Peace Corps Volunteer Safety Council)

1. INTRODUCTION

1.1 CRISIS MANAGEMENT

A crisis is any significant event with potentially severe consequences that requires immediate action or response. For the purpose of this Handbook the focus will be on crises of a regional or national scope. The types of regional or national crisis posts may encounter include:

• Accidents
• Natural Disasters
• Civil Unrest
• Political Uprisings
• Environmental Catastrophes

All of these crises have several aspects in common:

• They can result in a disruption or early termination of the program, or the closing of the study abroad center or university in the country.
• They usually cause significant emotional stress to the individuals involved, resulting in predictable cognitive, physical and behavioral reactions.
• They can be managed.

Crisis management is the process of preparing for, mitigating, responding to and recovering from a crisis situation. It requires (1) an organized plan to ensure the safety and survival of self and community, and (2) an understanding of the human response to stress. Crisis management is a dynamic process that begins well before the critical event and extends beyond its conclusion. As all those in the field know, there are many kinds of crises, from natural disasters to accidents and injuries to civil unrest, riots, and military coups. Each stage before, during and after a crisis presents special challenges and requires different strategies for effective management.

• There should be on-site staff and/or faculty in each country responsible for supporting the safety and well being of all students. To that end, that person or group of people should do whatever is necessary and possible in a crisis to protect students. This responsibility may, at times, appear to conflict with the values or respect for the student's individual autonomy and independence. In matters relating to personal safety, the authority of the governing body (e.g., college or university study abroad program, the U.S. State Department, Program Administrator, Embassy, national policy) will supersede the individual wishes of students. While every person responds to and deals with crises uniquely, there is little time "in the heat of the moment" to negotiate the handling of a crisis. Students must quickly heed all orders to respond. Therefore, they need to understand the reality of "autonomy vs. authority" before an emergency occurs so they are prepared to follow the procedures designed to help them.

Experience has shown that preparation, communication and certain administrative procedures are essential in managing a crisis. The same experience has also highlighted the importance of creativity, innovation and the exercise of sound judgment in the face of chaos, absurdity and human frailty. This handbook provides crisis management guidance based on considerable research and decades of Peace Corp experience. It is intended as a resource for the study abroad program administrators in the US and abroad to augment decision making and management skills. The core for the Handbook is presented in three chapters titled Before, During and After the Crisis.

The first chapter, Before the Crisis, will provide strategies to help:

• Develop an Emergency Action Plan (EAP)
• Rehearse the Plan
• Implement a warning system
• Continue to test and update the Plan

The second chapter, During the Crisis, will discuss how to:

• Mobilize and activate the plan
• Coordinate with other agencies
• Support students and staff

The third chapter, After the Crisis, will give advice on how to:

• Debrief all victims (direct, indirect, hidden)
• Return to normal
• Continue counseling and support as needed
• Reassess hazards
• Revise the Emergency Action Plan

1.2 BARRIERS TO PREPAREDNESS

A number of barriers may arise to challenge preparedness efforts. The following are some examples.

There is often a general apathy toward emergency preparedness. Lack of public awareness of the threat and a tendency to underestimate the risks involved are major contributors to apathy about preparedness. Competing priorities with daily demands, lack of confidence in the effectiveness of preparatory actions, and ambiguity about who is responsible for preparing also contribute.

Disasters and crises are different form routine emergencies. Program administrators and staff are assigned new and unfamiliar duties in a crisis. Everyday procedures and priorities are altered as are divisions of labor and resources. In addition, different agencies are required to work together in ways not previously required.

Good communication is essential and almost always a problem. The amount and types of information people need before, during and after a crisis increases significantly form the norm. Lack of standard terminology and everyday "people problems" can lead to misunderstandings, inaccurate information, and misinterpretations.

The "Paper Plan Syndrome" can give people a false sense of security. The Emergency Action Plan is an illusion of preparedness unless accompanied by training and practice.

1.3 STRATEGIES TO OVERCOME THE BARRIERS

Overseas staffs with crisis experience have suggested some strategies that can be effective in overcoming these barriers to preparedness.

Plan for the most likely hazards or crises. Use recent experience to fight apathy. Preparation for more common crises is more likely to receive public support and be cost effective. People pay attention to what they see as relevant. Preparing for likely hazards also provides a training ground for dealing with other emergencies.

Develop a basic Emergency Action Plan with response requirements that would be applicable in any situation. While it is impossible to prepare for all contingencies, basic steps must be taken in all emergencies that can be practiced and perfected. Examples are communications, health concerns, information management, transportation, prioritization and coordination, and food and water resources. Key roles must also be defined and assigned to specific individuals or groups.

Develop a flexible Emergency Action Plan that progresses in stages with clear indictors for progression from one stage to another.

Practice, practice, and practice the Emergency Action Plan.

Integrate emergency actions into normal routines. Reporting procedures, communication practices, prioritization and coordination can all be integrated in a standard set of procedures so that they are second nature in times of emergency.

Involve the users of the Emergency Action Plan in its development and implementation. Users of the plan are not limited to program administrators, staff, and faculty both at home and abroad, but also other agencies, local government officials, and anyone who might have a role or responsibility in carrying out some part of the plan. The importance of a coordinated process in developing the plan cannot be over-emphasized. It facilitates coordination during the crisis itself.

The Emergency Action Plan must look at the big picture. The Emergency Action Plan must take into account all the organizations and persons involved in coping with a crisis. These might include the US Embassy, host country governments, police and military, airport officials, telecommunications, travel agents, news media, missionaries, local hospitals and clinics, etc., and of course, the college or university/study abroad program offices. This is the time to look at the effect of an evacuation on host country nationals and contractors, so that they can be aware of what the college or university/study abroad program can and cannot do for them, and plan accordingly.

In summary, emergency action planning and crisis management are processes involving an entire system of people and organizations.

2. BEFORE THE CRISIS: PLANNING

Planning is a critical component in crisis management. A comprehensive planning process includes not only creating a plan, but training, rehearsing, coordinating with other agencies, and periodically evaluating and updating the plan. The EAP provides a framework for contingency planning and defines the communication network to be used in an emergency. The college or university/study abroad programs should have an EAP to provide for the safety and orderly withdrawal of staff and students. The EAP is "living document" that will require regular revision as staff and students come and go, or as the general conditions within the country change. The following sections provide guidelines for the process of Emergency Action Planning.

2.1 DEVELOPING AN EMERGENCY ACTION PLAN

The Peace Corps EAP is usually a single document that contains 1) an introduction, 2) the basic plan itself, 3) modular extensions or "pull-out" sheets, and 4) any supporting documents or reference materials. There are four basic steps to creating a plan. These are:

• Establishing a planning team
• Analyzing the hazards in country and the capacity to respond
• Developing the plan itself
• Operationalizing the plan

Each of these steps is outlined below.

2.1.1 Establishing a Planning Team

While the Program Administrator(s) has/have the ultimate responsibility for developing, updating and implementing an Emergency Action Plan (EAP), the plan is part of a larger system that includes the college or university, the study abroad program office abroad and in the U.S., the US Embassy (the Regional Security Officer or RSO), and the larger community. It is therefore most effective to coordinate emergency planning efforts with the Embassy and RSO as key team members.

The Emergency Action Planning team should include the users of the plan and representatives from each group or organization that would have a critical role in its implementation. Key members should include the following:

• Program Administrator
• Other Administrators
• On-site Health Provider
• On-site Counseling Provider
• Insurance Representative
• 24 Hour Assistance
• U.S. college or university/Study abroad program support team
  - student affairs administrators
  - study abroad administrators
  - campus security officer
  - risk manager
  - legal counsel
  - health center
  - counseling center
  - public relations
  - president or chancellor's office
• Embassy representative
• Student representative

Any document produced should be given broad staff and student review. This will help ensure that all factors are taken into account, and enable staff and students to consider their own contingencies.

The primary task of each member of the planning team is to define his/her respective role and responsibilities in carrying out the EAP, including coordination with U.S. Embassy, college or university /study abroad program in the U.S. or abroad, host country government and other agencies and resources. The planning team will also need to define clear lines of authority and their responsibilities to each other in implementing a coordinated effort.

To the extent possible, planning team members could also be members of the task force that responds to the crisis. They will already be familiar with the EAP and will have had experience working as an effective team.

2.1.2 Analyzing the Hazards and Capabilities

The next step toward creating an EAP involves gathering information about probable emergencies and environmental hazards, and assessing the current capabilities of the system to respond. The following tasks will help you decide what information should be included in the EAP.

1. Review the country's history of recent experiences and identify the potential hazards and emergencies, and where appropriate, when they are likely to occur, in the following areas:

• Natural disasters (hurricanes, typhoons, earthquakes, floods, fires, etc.)
• Environmental (nuclear hazards, pollution, water and air contaminants)
• Medical (accidents, injuries, epidemics)
• Technical (communications system failures, power failures)
• Socio-political (civil and political unrest, riots and demonstrations, military coups)

2. Review Program policy and any relevant site documents, such as those focused on:

• Medical emergencies and evacuations
• Family emergencies
• Safety and security precautions
• Country Evacuations
• Emergency travel and allowances
• Insurance and reimbursement for property damage or loss
• Emergency Action Planning

3. Assess internal resources and capabilities

• Staff and Faculty- know the strengths and capabilities of team members and other staff (public contacts, information access, special skills, etc.)
• Equipment (fire protection, radios and communication systems, medical equipment, emergency power supply, etc.)
• Transportation (vehicles, drivers, trucks, planes, helicopters, fuel, etc.)
• Facilities (meeting places, safe havens, shelters, storage areas for food and water)

4. Identify external resources and outside contact groups

• Host country government officials and ministries
• Police and Fire Departments
• Host country military commanders and facilities
• Airport authorities and travel agents
• Telephone and other utility companies
• Hospitals and clinics
• International Red Cross and U.N. offices
• Other embassies or consulates
• Other U.S. study abroad programs/organizations
• Other local universities/colleges
• NAFSA: AIE/SECUSSA
• Other NGO's and volunteer agencies
• Missionary groups

2.1.3 DEVELOPING THE PLAN

Developing the plan involves:

• Drafting, revising and finalizing the document
• Developing supporting documents (checklists, maps, sample letters, cables, administrative forms, reports, memorandum of agreements, etc.)
• Obtaining approval from appropriate authorities and collaborators
• Printing and distributing the final documents

Following is a sample format outline to guide you through the process of drafting your Emergency Action Plan.

2.2 EMERGENCY ACTION PLAN OUTLINE

2.2.1 INTRODUCTION

The EAP is usually a single document that contains an introduction, the basic plan itself, modular extensions about specific crises, and any necessary supporting documents. The introduction should:

• State the purpose of the Emergency Action Plan
• Identify the users of the EAP
• Designate where the EAP is kept
• Identify to whom the EAP had been distributed
• Briefly describe the development of the EAP and acknowledge its contributors
• Instruct on the use of the EAP

The EAP should be formatted in such a way that footers are included that indicate the most current review date. Pagination allows for accuracy if the plan is being discussed with administrator(s) or others and/or portions need to be referenced or faxed. Pages should correspond with the table of contents.

To guide you through the process of developing in this section, the Emergency Action Plan Checklist is included. The checklist is also used by the program administrator(s) to review the EAPs as they are revised and submitted each year.

2.2.2 Core Content

The following are only suggestions for the basic content of an Emergency Action Plan. Each institution within each country/ region, etc. must choose the most relevant information to present and the best way to present it.

a. Types of Emergencies Covered. The EAP can cover a range of emergency situations including medical emergencies and evacuation, family crises, accidents and injuries, physical and sexual assaults, natural disasters, environmental hazards, civil unrest and political uprisings, or country evacuations. These emergencies can affect single individuals or the entire group.

b. Roles and Responsibilities. It is important to define the chain of command and decision making process in an emergency. This includes the role of the on-site administrator, U.S. college or university/study abroad program administrator(s), the US Embassy and others in responding to a crisis. The functions and responsibilities of each staff member should be clearly defined. It is most useful to refer to positions rather than individuals in defining roles and responsibilities.

A Crisis Task Force (often composed of, but not limited to, the members of the EAP planning team) should be established at this point. The task force can help process information, develop contingency plans and provide:

• Liaison with the U.S. Embassy
• Liaison with the U.S. college or university/ study abroad program administrator(s) at the U.S. home campus
• Communication with students
• Liaison with host country government, police, military, etc.
• Information gathering and processing (including media relations)
• Logistics coordination (transportation, supplies, housing, etc.)
• Financial and administrative advice
• Medical Advice
• Communication with parents, family, etc.

Finally, the students need to know what is expected of them as individuals and members of a group.

c. Communication. Effective communication is the key to any crisis management system. Experience indicates that effective communication must operate on several levels: on-site program administrator, host country nationals, country/regional, and U.S. -side institutional administrators. Creating and developing these networks prior to an emergency reduces the chances of breakdown and misunderstanding at the moment of crisis. Students can play a major role in developing a working communications system by:

• Identifying the resources in their respective communities
• Developing liaison with other agencies, university study abroad programs and host country nationals
• Keeping the office informed of their whereabouts
• Following procedures stipulated in the EAP
• Staying in touch with other students and using the buddy system

Explore all possible methods of communication, using local and national resources. It is not unusual for telephones to malfunction during a number of crisis scenarios.

Radio stations and government radio networks can be very helpful. Whatever information is provided in the EAP should be complete, specific (who, what, how) and up-to-date.

An agreed upon time and schedule for telephone or other contact should also be established and maintained. The frequency of contact will depend on the acuity of the situation and developing circumstances. It is not only important to determine who, where and how communications should take place but what kind of information is needed and the relative urgency of the message. Checking to see if the message was accurate is also very important, especially under conditions of stress. Having the person repeat or write down the message assures better accuracy and reliability.

Sending messages via a third party to the U.S. college or university/study abroad program in crisis situations is also important. When sending an emergency message through a third party, keep the following in mind:

In any emergency contact where an operator or message taker is involved, please be prepared to provide the following information:

1. Your name
2. Where you are
3. Nature of the emergency
4. Tel. Number and where administrator(s) may contact you
5. Until when/for how long
6. When you will call back if you have not been called

Be sure to stress that this is an urgent or emergency situation!

The responsibility of communicating with the families of the students can rest with various administrators. As soon as the evacuation is confirmed, the families of all students should be contacted. It is important to maintain regular contact with students' families throughout the crisis, apprising them of developments as they occur and providing appropriate support.

d. Travel and Transportation. Information on travel methods and routes must also be as specific as possible (overland, air, sea, private, commercial, and/or military). Maps demarcating pick-up points, potential landing sites for aircraft and/or helicopter, and estimated travel times under normal circumstances should also be included. Guidance about border crossing should also be provided, crossing and making contact with appropriate authorities in third country. Most importantly, alternative methods of travel and routes must be presented and prioritized in the event that the usual routes are no longer safe or feasible. Student and staff sites should be clearly located on the maps.

e. Safety and Health Concerns. The EAP should address basic safety and health precautions, including information about:

• Safe water and food supplies stocked at safe havens
• Medications and first aid supplies
• Safe shelter
• Dealing with military, police, other officials

f. Administration. The EAP should specify what administrative responsibilities require attention in the event of a crisis. To fulfill these responsibilities it is recommended to have response systems in place before the crisis occurs. The Administrator should:

• Keep student rosters up-to-date
• Prepare student withdrawal documents
• Procure lodging and food supply for assembly location
• Assure adequate fuel supply and road worthiness of vehicle
• Coordinate evacuation transport with Emergency Action Committee
• Collect inventory of student personal effects left in country (Attachment I)
• Prepare travel plans
• Provide travel advances to students, staff

g. Contingencies. Even the best laid plans cannot factor in all possible contingencies. Yet probable scenarios that impact on communications (no telephone lines), transportation (public transport strike), or coordination (capital city destabilized) should be addressed.

2.2.3 Planning for and Managing Evacuations

Most Peace Corps programs use a three stage model to identify alert status based on the standard established by the US Embassy. Stages should be clearly defined, along with the criteria for progression to the next stage in coordination with appropriate college or university/ study abroad administrator(s) and the Embassy. Specific action plans should be developed for each stage so that students know what to do and what to expect at each step.

Stage I	Standfast-impending emergency, remain at site
Stage II	Consolidation-go to prearranged assembly point, prepare for withdrawal
Stage III	Evacuation-leave as a group for safe haven

It is absolutely essential to be clear about:

• How students will be notified of what stage is in effect and when it changes (specific languages that can be transmitted over public airwaves that alerts the students without creating further panic)
• What they must do (or not do) at each stage
• What to bring, what to leave behind
• What to say to local nationals, friends, colleagues
• Main office procedures for notifying students' families
• How to prepare (stock supplies, pack evacuation bag, etc.)
• Instructions on how to move form one site to another
• Alternatives/contingencies if plan fails (communications, travel, safe havens)

2.2.4 Planning for and Managing Specific Crises

These could be prepared as separate stages or "pull-outs" to cover different types of emergencies or disasters such as:

• Medical emergencies (Attachment II)
• Family emergencies
• Accident and injuries
• Student death
• Physical or sexual assault
• Political/civil unrest
• Natural disasters (hurricane, floods, earthquakes, fires)

"Pull-outs" have the advantage of being readily accessible and containing situation-specific information and action plans. Countries that are at high risk for certain types of natural disasters (hurricanes, earthquakes, nuclear accidents) should consult the appropriate local department for emergency preparedness and obtain technical assistance in preparing for and responding to these hazards.

2.2.5 Checklists

Checklists are invaluable in planning and implementing an Emergency Action Plan. They assure completeness and greatly increase efficiency. The following checklists were found to be essential or very helpful by the Peace Corps:

• Rosters of all students and their addresses
• List of passport numbers, expiration dates and location of passport for each student
• Names of students with special medical needs
• Complete information on assembly points, who should go where and when
• Maps and locators for each student (Attachment IV)
• Contacts where each student is housed and for each excursion
• Maps, travel routes and modes of transportation from each site to assembly points and capital or evacuation point
• Communication networks (telephone numbers, radio locations, frequencies, operators, hours of operation, etc.)
• Emergency telephone numbers for local police, fire, hospital, Embassy, etc.
• List of other agencies, missionaries, government offices, private citizens who could be a resource during an emergency (including names, addresses and telephone numbers)
• Locators for all staff (addresses, telephone numbers, maps)
• List of food/water/emergency supplies to be kept in student homes, study abroad centers, assembly sites and safe havens
• List of essential items to include in an emergency evacuation pack
• "To do" list if student has to leave home in a hurry
• Schedules for testing and updating EAP

2.2.6 Supporting Documents

Supporting documents may include:

• Budget for developing, testing, and maintaining an operational EAP
• Policy statements from the college or university/study abroad program relevant to emergency planning and evacuations
• Sample communications, letters and cables
• EAP summary pull-out for each student for quick reference (this can be included in the medical kit)

Country:

Date:

Content	yes no	comments
Table of contents, appendix Purpose of Statement Types of emergencies Staff roles and responsibilities Student roles and responsibilities Embassy warden system Procedures for three phases (standfast, consolidation, and evacuation) Collaborative Arrangements with Host Government Cooperation with embassy and embassy EAP Emergency communications system Alternative communication methods and contacts in event of telephone failure (e.g., other agencies with radios) Transportation methods and routes Strategies for localized emergencies Short version (2-3 pages) Safety precautions for specific emergencies, i.e. natural disasters Standard forms, i.e. student contact sheet, vehicle emergency supply list Supporting Documents Student rosters and locators, passport numbers Maps Emergency telephone numbers and radio frequencies and locations

Content	yes no	comments
Assembly points and how to get there Local resources (hospitals, clinics, police, Embassy officials, missionaries, other study abroad programs, local university representatives) Emergency supplies at assembly points, housing, study abroad centers, vehicle) List of other resources (medical evac. guidelines, student handbook, etc.) Instructions if students must cross border and points of contact in neighboring countries

	Please explain
How it is used Where is it kept Who has copies How it is presented/used in training

	last date	next date
Testing of plan Updating of plan

2.3 OPERATIONALIZING THE PLAN

Operationalizing the plan involves more than implementing it at the time of the crisis. It includes:

• Informing the staff and students about the plan
• Securing the resources (people and things) necessary to implement the plan
• Integrating the plan into normal program operations (budget, reporting requirements, student and staff training, etc.)
• Orienting and training staff and students on use of the plan
• Developing a system for testing, updating and revising the plan

2.3.1 Training

In order to avoid the "paper plan syndrome" the Emergency Action Plan must be put to use through training and periodic testing. Everyone will require some sort of training on the Emergency Action Plan, but one person or committee should be given the responsibility for planning, implementing and evaluating the training program.

The purpose of the training is to:

• Maintain an appropriate level of safety/security awareness
• Familiarize the staff and students with the plan
• Make sure everyone understand their part in the plan (roles and responsibilities)
• Become familiar with the mechanics, equipment and procedures necessary to implement the plan (e.g., use of radios, first aid equipment and alarm systems, etc.)
• Convert an abstract plan into concrete actions
• Provide an opportunity for questions and concerns

At the end of training, trainees should know:

• Whom to contact
• How to make contact
• What to do
• Where to go
• What is expected of them

Staff training about crisis management should occur at all levels, with personnel in the U.S. and abroad. Once in country or on-site, staff needs to develop specific knowledge and familiarity with people, equipment, geography and procedures in order to implement the plan.

Student orientation most often is initiated in the pre-departure orientation program in the U.S. and reviewed at the on-site orientation abroad. However, each program needs to determine who receives the training, who does the training, when and where it should occur, and how to best get the information across.

There are a few basic concepts that might prove helpful in designing effective training (training officers will be extremely helpful here:

• Make sure you have their attention (avoid distractions)
• Repeat key concepts (repetition is the key to retention)
• Make it relevant (indicate how EAP affects them personally)
• Translate abstract concepts into concrete actions (use simulations, role play)
• Participatory learning is more effective than passive learning
• Review the EAP after critical incidents when interest and motivation are high (timing is crucial)
• Use senior staff as trainers (the best way to learn something is to teach it)

2.3.2 Testing and Rehearsal

Testing and rehearsal serve a training purpose as well as a check on the appropriateness and efficacy of the EAP. It can range form a simple review of procedures to a full scale exercise. While conducting a full scale exercise may often prove impractical, many countries have implemented a system of testing certain components of the EAP such as:

• Student locator system
• Communication systems and contingency plans
• Medical alerts
• Resource inventory and testing
• Safety and security tests
• Simulations and on-site drills
• Information gathering and processing

Regardless of how the testing is done, the important thing is to DO IT! The results should be documented and used to revise, update or reinforce the existing EAP.

3. DURING THE CRISIS: ACTION

When a crisis occurs, adrenaline begins to pump and energy levels mount. It is important to channel this energy into constructive course so as to avoid conflict and confusion. Delegating functions and tasks into which staff members and students can channel energy include:

• Gate keeping--ensuring orderly access to crisis management team
• Material support--ensuring food, water, stationery, etc. are on hand
• Emotional support--providing relief and support to crisis workers as stress increases
• Recording--maintaining a daily log and updates as the crisis develops

The optimum leadership style will be determined by the personal characteristics of the team leader and what the crisis dictates. Successful crisis team leaders have been those who have been open, supportive, flexible and still decisive and directive when the moment warrants. The ability to manage varying levels of conflict-among staff and students, with the media, and demands from U.S. college or university/study abroad program--will be essential.

3.1 EVACUATION

As the crisis develops, the country staff will constantly assess the nature and extent of the emergency. If withdrawal appears imminent, the on-site administrator(s) must devote more attention to ensuring the safety of students, staff and dependents.

• Inform the on-site administrator and home campus college or university/study abroad program regarding the crisis situation and student safety and whereabouts. The initial communication should include general comments as to the safety factor, plus specifics as to student whereabouts. For those students out of the town, the following format is suggested:

The following Students are away form their assigned posts:

Name	SSN	Location	Status
Joe Fraser			Emergency leave
Stella Kowalski		Frankfurt	Medevac
Betty Crocker		Capital City	In-country travel

• Seek guidance/advice from the Embassy on evacuation decisions;
• Establish a central communications contact, coordinating communications with all agencies involved;
• Identify student responsibilities and provide them with descriptions of specific emergency evacuation conditions and plans;
• Communicate specific instructions to students and staff (in writing where appropriate);
• Coordinate up-country transport of students and their belongings where conditions permit such travel;
• Ensure lodging and support arrangements at pre-disembarkation points;
• Coordinate planning and travel arrangements to safe haven countries with US Embassy and Region;
• Limit movement of personnel to essential travel associated with emergency;
• Emphasize the importance of staying in familiar territory during an emergency;
• Maintain a daily log of actions taken.

As students depart for a safe haven country, the following information about each student should be transmitted to the evacuation support team:

• Students health information, medical reports and necessary medical supplies
• Full name, passport number, place and date of passport issuance; and
• A statement of property losses incurred in the emergency

The respective roles and responsibilities of the various home offices should be clear.

3.1.1 CLOSING A STUDY ABROAD CENTER DURING EMERGENCY EVACUATION

If, as a crisis develops and withdrawal of students appears imminent, the administrator(s) should attempt to follow a study abroad center emergency closing plan.

Advise students of need to close bank accounts and settle debts if evacuation takes place (civil disorder or natural disaster may preclude such action);

3.1.2 SUPPORTING CRISIS WORKER

During an emergency, crisis task force members and crisis workers function at high intensity for long hours. Symptoms of mental and physical fatigue may go unnoticed until people reach exhaustion. Foreign service national staff, concerned for their families, the effects on their country, and the prospect of perhaps losing their jobs, in addition to the increased stress of coping with Student support matters during a crisis, are at particularly high risk.

• "Flameout" is a rapid onset of mental and physical exhaustion resulting form long hours of intense activity. Work efficiency, judgment and efficacy are all negatively affected. Rest and temporary relief from duty will usually bring recovery.
• "Burnout" occurs with prolonged stress and results in chronic fatigue, apathy, changes in attitudes, a loss in self-esteem and depression.

In addition to the physical and mental stress of crisis work, the crisis worker may be subjected to a number of other stresses:

• Personal losses from the crisis situation
• Job stress related to role ambiguity, policy conflicts, communications breakdown, lack of training and resources.
• Traumatic exposure to violence, destruction, death; and
• Grief and outrage at the course of events including mission failures, and human error.

During the operation of a crisis task force, a number of strategies can be used to minimize flameout or burnout.

• A "buddy system" in which peers monitor each other's stress reactions for early warning signs and provide support;
• Close adherence to a schedule of shifts;
• Schedule of periods of rest, food and exercise, and light recreation;
• Any overriding personal concerns (such as whereabouts of family) must be addressed and if necessary, the person should be relieved form duty to take care of these concerns; and
• If the symptoms persist or increase, removal from the crisis scene and professional counseling may be necessary.

According to the Peace Corps, the U.S. Department of State has an excellent video titled Crisis Work-Crisis Worker. It offers a useful discussion about the special problems of the crisis worker and gives very specific guidelines on remedial or preventive strategies. A copy of the video should be available through the U.S. Embassy.

4. AFTER THE CRISIS: RETURNING TO NORMAL

Regardless of the nature and extent of a crisis, it usually has an impact on everyone. The students and staff in the country are profoundly affected by every tragedy and unforeseen crisis that occurs to one of their numbers. The host country nationals and counterparts who work with the students and staff are just as deeply touched by events and will require emotional support and stress relief. The administration and staff of the college or university/study abroad program, students, and family members and friends are all part of the larger community affected by a crisis. All these connections will need continued attention as you return to normal after the crisis. The timely support to students and staff in the immediate aftermath of a crisis is critical.

4.1 DEBRIEFING

Some form of debriefing is absolutely necessary for the students and staff after relief from duty or at the conclusion of the crisis event. Critical Incident Stress Debriefing (CISD) is an organized approach to managing stress response in those who have experienced a crisis situation. It is used with individuals or groups and consists of three basic components:

• Helping crisis survivors vent feelings and assess the intensity of the stress response;
• Instruction, support and reassurance by the facilitator and/or other survivors; and
• Mobilization of resources and return to normal roles with a plan for further assistance if needed.

There are four types of CISD. Each has its own application but the common goal is to provide support and minimize the development of abnormal stress in emergency or crisis survivors.

4.1.1 The On-Scene or Near-Scene Demobilization is the briefest form of CISD. It is a continuous process conducted during the crisis as shifts change or natural breaks in the action occur. An observer (mental health professional, chaplain, other support personnel) functions as an advisor at the scene of the action and during brief rest periods. The observer should not be involved directly in managing the crisis but is there primarily to support staff and students. The observer also assesses and reports any signs of severe stress and recommends appropriate action.

The demobilization process aims to:

• Mitigate the immediate impact of the event
• Accelerate the recovery process
• Assess the need for debriefing and other support
• Reduce cognitive, emotional, and physiological symptoms

4.1.2 The Initial Defusing is the group process (30-45 minutes) provided immediately after a traumatic event, once the individuals are disengaged from the on-scene operations.

The process of the defusing aims to:
• Establish non-threatening social environment
• Allow rapid ventilation of stressful experience
• Equalize access to facts and information
• Restore cognitive processing of event
• Provide information for stress survival
• Affirm value of individuals
• Establish linkages for additional support
• Develop expectancies for the future

The defusing components are as follows:

1. Introduction

• Introduce facilitator(s)
• State Purpose
• Invite voluntary participation
• Establish ground rules (not therapy, not investigation)
• When possible assure confidentiality (no notes, recording, etc.)
• Describe process
• Offer additional support

2. Exploration

• Ask individuals to describe what just occurred
• Answer questions of clarification
• Review experiences and reactions
• Assess need for more help
• Reassure participants, as necessary

3. Information

• Accept/summarize their exploration
• Normalize experiences and reactions
• Teach multiple stress survival skills
• Advise diet & nutrition, alcohol/caffeine avoidance
• Pay attention to rest & relationships
• Recommend recreation & exercise

4. Aftermath

• Offer handshake and comment to each participant
• Provide one-on-one follow-up
• Determine whether to proceed with debriefing

The defusing process may provide the necessary support to groups or individuals, however it may happen that the defusing will reveal that need for further support. Indicators that additional support may be necessary include:

• Intense emotions, unusual behavior
• Unfinished business
• A sense (sometimes subtle) of incompleteness
• Excessive silence

4.1.3 The Formal CISD is a guided discussion (2-3 hrs.) of traumatic event occurring 48-72 hrs after the event that aims to:

Prevent stress dysfunction

• Screen and prioritize individual needs
• Identify areas for follow-up support and referrals

The CSID process is delineated into seven distinct stages. It is important to follow all the stages in order to realize optimal effectiveness. The CISD moves the participants form the cognitive level (less threatening to express) through the emotional level (essential to explore and address) and back to the cognitive level (where the participants find comfort). A skilled facilitator or mental health professional is necessary because of the intensity of the emotional content that is often elicited. The seven stages of the CISD process are as follows:

Stage 1	Introduction	Introduce intervention team members; explain process; set expectations
Stage 2	Fact	Have each participant describe the nature of their participation, from a cognitive perspective "What did you see/hear/do?"
Stage 3	Thought Reaction	Solicit cognitive responses to: "What aspect held the most negative impact for you?"-transition from cognitive to emotional processing.
Stage 4	Emotional Reaction	Solicit emotional reactions to or consequences of cognitive responses given in Stage 3. "How has this experience affected you?"
Stage 5	Reframing	Transition from emotional domain back to cognitive. "What lessons could be learned from this experience?" or "What is something positive that you will take away from this experience?"
Stage 6	Teaching	Educate participants to normal reactions (not necessarily shared by everyone) and teach basic stress mangagement, if applicable.
Stage 7	Re-entry	Summarize experience with emphasis on positive learning aspects.

Before debriefing it is important for the intervention team to:

• Review case documents, incident reports, press clippings, etc
• Circulate among the group in order to establish informal contacts, study relationships and individual behaviors, and gather additional background information
• Hold strategy meeting to agree on focus, roles and responsibilities.

After debriefing it is important for the intervention team to:

• Make one-on-one contact with all participants, inviting those deemed needful of further individual support to attend follow-up session.
• Conduct post-debriefing review with team:
  - "How did we do?"
  - "What did we learn?"
  - Coordinate any follow-up
  - Check-in with each team member, "Are you okay?"
• If necessary, write post-action report keeping it general, ensuring confidentiality, and focusing on lessons learned.

The issues likely to emerge for students and staff in the aftermath of an evacuation or program suspension are:

• Coping with the loss of personal belongings;
• Lack of opportunity to say good-bye to friends;
• Inability to bring closure to projects/ coursework;
• Dealing with the sudden need to plan next steps;
• Dealing with previous experience of loss and disappointment that the situation may evoke;
• Loss of control of daily activities and immediate future;
• Abandoning previous goals and aspirations;
• Concerns about status, earning academic credit, refunds, etc.
• Feelings of powerlessness, being manipulated.

The following actions have proven useful to Peace Corps Volunteers who have survived a crisis or had to terminate service prematurely. It may be useful for study abroad students forced to leave a program early.

• Share the experience and feelings generated by the crisis to help with the healing process and prevent delayed stress symptoms. The sharing has proven most effective when it takes place shortly after the event.
• Focus on the time spent in country and what was learned and experienced.
• Realize that even if they are fortunate enough to return to the country, much may have changed. Social relations and the way host country nationals in general view them may change as a result of the crisis, especially those political in nature. Students should be prepared for the differences they may encounter upon return.
• Acknowledge that the recovery process is hard and takes time. Everyone will progress at his/her own pace.
• Take time out before making new commitments.
• Turn to family and friends for support over the long haul.

4.1.4 The Follow-up CISD is often not necessary but can occur several weeks or months after the event to help with closure and re-entry. This process focuses on achieving closure, attending to unfinished business and looking ahead to a return to "normality" for students and staff.

4.2 RETURNING TO NORMAL

Once a crisis event (evacuation, program suspension) has passed, the decision whether to return to the site may arise. Despite the appearance that a critical situation has returned to normal, the crisis may have precipitated many changes, including:

• How host country nationals view United States or individual staff or students;
• The social relations among local individuals, agencies, groups;
• The level of functioning of essential services (water, electricity, public transport, etc.);
• The relative security of once-safe regions of the country;
• The sensitiveness and reactions of individuals or groups to questions or innovations; or
• The viability and/or appropriateness of established programs.

A re-assessment of the post environment and general conditions should be undertaken by the post management team. A determination of the current site can be made through general observations and discussion with the on-site administrator(s), local officials, and other study abroad programs in the area. The decision to return or not to return and the reasoning that supports that decision should be made clear to students and staff, with ample opportunity to discuss concerns and possible consequences.

While getting back to everyday routine tasks is an important step in the return to "normality", one should expect and prepare for symptomatic reactions to the post-crisis reality. Some reactions to watch for are:

• Depression
• Anxiety
• Emotional letdown
• Lassitude
• Task dysfunction

A re-entry program that provides a supportive forum for staff and students shortly after a return to site should provide a forum to discuss and resolve program and adjustment issues.

5. ATTACHMENTS

5.1 STUDENT PROPERTY INVENTORY CHECKLIST

ARTICLE	QUANTITY	WHEN BOUGHT	COST VALUE	INSURED
Dresses Hat/caps Shoes Sandals Skirts Sweaters Sweatshirt Jackets T-shirts Underwear Jeans Pants Sleeping Bag Backpack Camera Radio CD player Compact Discs Computer Jewelry

5.2 Sample Medical Evacuation Procedures

_____1. Consult on-site administrator, local doctor, central administrative office, insurance representative, 24-hour hotline to obtain pre-approval for medical evacuation (medevac).

_____ 2. If administrator office concurs medevac is necessary, determine
a. How soon medevac should occur.
b. If medical or nonmedical accompaniment of patient is necessary.
c. If patient is stable enough to transport to home country/state or will need to have medical care in country abroad with appropriate medical facilities.

_____ 3. Have college or university/study abroad program arrange transportation/medical support.

_____ 4. Inform administrators of any special needs in itinerary such as
a. Destination
b. Special seating arrangements (stretcher, first class)
c. Special airport arrangements (wheelchair, stretcher, ambulance)
d. Special airline medevac or airline's permission in advance to fly
(Usually necessary if you want to bump another passenger, if stretcher needed, if medically accompanied, if IV necessary, or if any other visibly obvious, serious medical problems.)

_____ 5. Ensure the patient has passport and visa needed for departure from abroad and entry into USA or country enroute. If passport is unavailable, contact US Embassy consul to make another passport or arrange for proper documents.

_____ 6. When patient's travel schedule is obtained from administrators, follow-up with the on-site administrator and college or university/ study abroad program. Inform administrator if student wants parents or family notified and /or review pre-departure form to see if student has pre-approved emergency contact(s).

_____ 7. Brief patient about medevac procedure going over medevac checklist and reviewing standard medevac handout with student.

_____ 8. Prepare patient's medical chart and ensure that all results are translated into English. Instruct patient to carry chart, etc in hand luggage. Include any x-ray or lab results.

_____ 9. Make sure patient has any necessary medications or supplies he/she will need along the way.

_____ 10. If patient is traveling alone and will need to overnight in a city enroute, remind patient that airline is usually responsible for providing food and lodging while the patient is enroute to destination. Have patient check at airline desk for lodging voucher.

_____ 11. If patient is traveling with accompaniment, determine if patient will need to go directly to hospital when arriving at destination.

_____ 12. If direct hospital evaluation/admission will be needed, call administrator to determine which hospital and consultants will be used and go there directly from the airport.

PROCEDURE FOR MEDICAL EVACUATION WITH EMERGENCY EVACUATION ASSISTANCE COMPANY

1. Contact the company as soon as the decision to medevac the patient is taken.

a. Contact company by telephone
b. If phones are down, telex
c. If all of above fail, call the U.S. college or university /study abroad program immediately and ask them to contact the insurance company. Be sure to give all information needed

2. Give insurance company the following information:

a. Patient name
b. Age
c. Citizenship
d. Medical problem
e. Medical equipment needed in transport (e.g., blood, oxygen)
f. Medical personnel needed in transport (e.g., anesthesiologist, nurse, other specialist)
g. Name and phone number of local attending physician
h. Place to which you want to medevac patient
i. Central administration and on-site telephone numbers and fax number, Embassy number
j. State U.S. Guarantee of payment: Fiscal Data
k. Whether someone will accompany the patient

3. Develop a medevac checklist in consultation with the insurance company for procedures /practice in case of medical evacuation.

5.3 EMERGENCY SITE LOCATOR FORM

NAME

DATE

LOCATION OF NEAREST TELEPHONE, PHONE #, NAME OF PROPRIETOR SPECIAL CONTACTS & PHONE #'S (BOUTIQUES, MISSIONARIES, GAS STATIONS): POST OFFICE AND PHONE # NEAREST GOV'T OFFICIAL AND PHONE # OTHER STUDY ABROAD PROGRAMS WITH WHOM YOU COLLABORATE, LOCATIONS, NAME OF CONTACTS AND PHONE #'S STUDENT'S LOCATION AND PHONE # (IF APPLICABLE) NEAREST AIRPORT NEAREST HOSPITAL NEAREST OF PHYSICIAN AND PHONE # SPECIALTY: Next of kin (in US): Phone #: (home) (business) In case of emergency-[ ] do [ ] do not-notify the above person.   (Adapted from the Crisis Management Handbook: A Guide for Overseas Staff, Peace Corps Volunteer Safety Council)