Ben Rock for the National Health Care for the Homeless Council by Ben Rock

SURVIVING THE STREETS IN SEVERE WEATHER & DISASTERS

INTRODUCTION Having a home is one of the most important ways to protect yourself form severe weather. Unfortunately, millions of people find themselves without housing every year. Life on the streets or in places not meant to be a home can leave you at risk to harm. This guide will give you practical tips and advice for surviving the streets and wilderness during severe weather and disasters. It can also be used to help you and others talk about you own experiences in preparing and protecting yourself from these emergencies when you live outdoors. If you would like help setting up a group discussion, let us know! You can call or email the National Health Care for the Homeless Council. With your permission we will invite local emergency planners and public health officials so they can also learn from your experiences.

THINK AHEAD LISTEN TO WEATHER REPORTS. A small radio is the best way to find out about severe weather watches and warnings. Battery-operated radios are less expensive but require an ongoing supply of batteries. Hand crank and solar power radios are worth the money if you spend a lot of time outdoors. Learn about any emergency notification system in your community, such as tornado sirens or cold weather alerts. KNOW WHERE TO GO WHEN YOU NEED SHELTER IMMEDIATELY. Think about the closest business to you and when it is open. Check for a library or another public building nearby and find out its operating hours, too. Make sure you know the quickest way to get there. KNOW YOUR SURROUNDINGS AND WHAT TO DO WHEN YOU CAN’T GET TO SHELTER. Each section of this guide has tips on what to do if you don’t have time to get to shelter. HAVE AN ESCAPE PLAN. If you are in the woods, figure out the safest way to get out. Be aware of the direction of flash floods, the fire line (determined by the direction of the wind and any flammable ground matter in its path), and landslides. FOLLOW EVACUATION PROCEDURES. Your local emergency management agency may warn everyone to leave an entire area. Most counties develop evacuation routes that are the safest way out of the area. Find out if any evacuation pick up points are nearby and how you will get to them. What number can you call to get evacuation information?

SOME FACTS ABOUT THE WEATHER EXTREME HEAT • Heat kills by pushing the body beyond its limits. In extreme heat and high humidity, the body must work extra hard to maintain a normal temperature.

EXTREME COLD • Hypothermia does not occur only when the temperature becomes very cold. Other aspects of the weather, such as wind and precipitation, lower the perceived temperature and cause the body to lose heat more quickly. • The risk of developing hypothermia is raised substantially when you use alcohol, nicotine, street drugs, and some medications.

TORNADOS • Tornado winds can reach 300 miles per hour. • Every state is at some risk of tornadoes. • Occasionally, tornadoes develop so rapidly that little, if any, warning is possible. • Before a tornado hits, the wind may die down and the air may become very still.

FLOODS • Tropical storms and hurricanes, spring thaw, heavy rain, and failed levees and dams can cause floods. • A flood can develop slowly or within minutes with no visible sign of rain.

EARTHQUAKES • 45 states and territories in the U.S are at moderate to high risk for earthquakes. • Aftershocks that follow a main earthquake can be strong enough to cause additional damage.

HURRICANES • Hurricanes can cause catastrophic damage along coastlines and several hundred miles inland. • Hurricanes can produce winds exceeding 155 miles per hour along with tornadoes. Excessive rainfall from hurricanes can cause floods and trigger landslides.

LANDSLIDES • Landslides occur in all U.S. states and territories and can be caused by a variety of factors including earthquakes, storms, volcanic eruptions, fire, and human modification of land. • A landslide can occur quickly, often with little notice. • A landslide can travel several miles from its source, growing in size as it picks up trees, boulders, cars, and other materials.

WILDFIRES • While lightning causes some wildfires, people are to blame for most wildfires.

IF YOU ARE OUTDOORS, • Spend the warmest part of the day in public buildings such as day shelters, libraries, movie theaters, shopping malls, and other community facilities. • Drink plenty of water, even if you do not feel thirsty. If you have epilepsy or heart, kidney, or liver disease; are on fluid-restricted diets; or have a problem with fluid retention should consult a doctor before drinking more. • Limit caffiene and alcoholic beverages; these can make you dehydrated. • Dress in loose-fitting, lightweight, and light-colored clothes that cover as much skin as possible. Avoid dark colors because they absorb the sun’s rays. • Protect your face and head by wearing a wide-brimmed hat.

IF YOU ARE OUTDOORS, • Wear several layers of loose-fitting, lightweight, warm clothing rather than one layer of heavy clothing. The outer layer should be water repellent. • Wear mittens, which are warmer than gloves. • Wear a hat. Up to 50% of your body heat can be lost through an uncovered head. • Cover your mouth with a scarf to protect your lungs. Mittens • Keep dry.

SLEEP INDOORS AT NIGHT! IF YOU MUST SLEEP OUTDOORS, FOLLOW THESE TIPS:

Gloves

• Find a place to sleep that is out of the wind. • Insulate yourself by wearing as much clothing as possible, especially around your core (stomach, back and chest). Make sure your clothing is loose. • Put something under your sleeping bag to prevent ground moisture from seeping in. • If your sleeping bag is too big, fill up empty space with extra clothes. • Keep your face outside your sleeping bag so that the moisture from your breathing does not get into the bag. Wear a warm hat and scarf to keep your head and neck warm. • Avoid drinking a lot of fluids at night, so you won’t have to go to the bathroom in the middle of the night. • If you can, eat a big dinner with lots of calories. Calories are a unit of heat. Keep a snack with you for the middle of the night, so if you do wake up cold, you can replenish lost calories. • Avoid drinking alcohol.

CONDITION HEAT CRAMPS

SYMPTOMS Painful spasms, usually in leg and abdominal muscles; heavy sweating.

HEAT EXHAUSTION

Heavy sweating but skin may be cool, pale, or flushed. Weak pulse. Normal body temperature is possible, but temperature will likely rise. Fainting or dizziness, nausea, vomiting, exhaustion, and headaches are possible.

HEAT STROKE (a severe medical emergency)

High body temperature (105+); hot, red, dry skin; rapid, weak pulse; and rapid shallow breathing. Victim will probably not sweat unless victim was sweating from recent strenuous activity. Possible unconsciousness.

FROSTBITE

HYPOTHERMIA (a severe medical emergency)

The skin looks white or grayish-yellow, is very cold and has a hard or waxy feel. The skin may also itch, burn, or feel numb. Severe or deep frostbite can cause blistering and hardening. As the area thaws, the flesh becomes red and painful.

Shivering; slowed speech; slow breathing; cold, pale skin, loss of coordination; fatigue or lethargy; confusion or memory loss

FIRST AID Get to a cooler location. Lightly stretch and gently massage affected muscles to relieve spasms. Take sips of up to a half glass of cool water every 15 minutes. (Do not drink liquids with caffeine or alcohol.) Stop drinking liquids, if nauseated. Lie down in a cool place and elevate your feet. Loosen or remove excess clothing. Apply cool, wet clothes, if possible. Fan or move to air-conditioned place. Take sips of water. Be sure water is consumed slowly. Drink half glass of cool water every 15 minutes. Stop drinkin water, if nauseated. Seek immediate medical attention if vomiting occurs. Have someone call 9-1-1; you need to get to a hospital immediately. Delay can be fatal. Ask someone to help you move to a cooler environment. Remove clothing and, if possible, put a wet sheet or wet T-shirts on top of you.

If you’re outside, warm your frostbitten hands by tucking them into your armpits. Protect your face, nose, or ears by covering the area with dry, gloved hands. Don’t rub the affected area and never rub snow on frostbitten skin. Get out of the cold. Once you’re indoors, remove wet clothes. Don’t walk on frostbitten feet or toes if possible. This further damages the tissue. If there’s any chance the affected areas will freeze again, don’t thaw them. If they’re already thawed, wrap them up so that they don’t become frozen again. Get emergency medical help. If numbness or sustained pain remains during warming or if blisters develop, seek medical attention.

Have someone call 9-1-1; you need to get to a hospital immediately. Delay can be fatal. If you find someone with symptoms of hypothermia, help them move to a warmer environment. Remove wet clothing and cover with dry clothing keeping the chest area warm. Do not apply direct heat to the body. Do not rub or massage the body. Do not give the person alcohol.

THE BEST THING TO DO IS FIND SHELTER. • • • •

Go to the closest public building. Stay on the lowest level (a basement is best, especially in abandoned buildings). Go to the center of the room, away from any windows, doors, and corners. Get under a sturdy table and use your arms to protect your head and neck.

IF YOU CAN’T GET TO SHELTER, • Lie flat in a nearby ditch or depression and cover your head with your hands. Don’t get in a ditch if is near water, because it could flood. • Do NOT get under an overpass or bridge – these become wind tunnels, and you can be sucked out. • Stay out of cars, trucks, and other vehicles. • Watch out for flying debris.

SIGNS OF A TORNADO Dark, greenish sky

Large, dark, low-lying cloud Large hail (ocassionally)

Rotating clouds

IF YOU ARE OUTDOORS, • Move to higher ground. • Be aware of streams, drainage channels, canyons, and other areas known to flood suddenly. • Do NOT walk through moving water; six inches of moving water can make you fall. Walk where the water is not moving. Use a stick to check the firmness of the ground in front of you. • Do not get in a vehicle if it is in floodwater. • Do not camp along streams, rivers, or creeks during threatening conditions.

When camping outdoors during rainy weather, always stay above the flood plain - the area along a stream or river that is likely to flood.

Flood Plain

IF YOU ARE INDOORS, • Drop to the ground; take cover by getting under a table or desk and hold on until the shaking stops. If there isn’t a table or desk near you, cover your face and head with your arms and crouch in an inside corner of the building. • Stay away from glass, windows, outside doors and walls, and anything that could fall. • Don’t stand under a doorway unless you know it is strongly supported. • Stay inside. Do not exit a building while it is shaking.

IF YOU ARE OUTDOORS, • Stay outside; don’t try to run into a building. • Move away from buildings, streetlights, and utility wires.

IF YOU ARE TRAPPED UNDER DEBRIS, • Do not light a match or ignite a lighter because there might be a gas leak nearby. • Don’t not move around or kick up dust. Cover your mouth with a handkerchief or clothing so you don’t breathe in dust. • Tap on a pipe or wall so rescuers can locate you. Only shout as a last resort. Shouting can cause you to inhale harmful amounts of dust.

TRY TO FIND SHELTER. • Weather stations will alert you when a hurricane is coming. If you know a hurricane is coming, find shelter as soon as possible. • Follow the same precautions for tornadoes.

IF YOU ARE OUTDOORS, • Try to find shelter in a stable building. Being inside a temporary structure like a tent can be especially dangerous. • Get away from any coastal areas, floodplains, rivers, or inland waterways. • Do not be fooled if things calm down. It could be the eye of the storm, and winds will pick up again.

WATCH OR WARNING? WHICH IS WHICH? • During a Hurricance Watch, a hurricane is possible within 48 hours. Seek shelter in a stable building where you can access updated weather information. • During a Hurricane Warning, a hurricane is expected within 36 hours. If advised to evacuate, do so immediately.

Areas Most Effected by Hurricanes

PRECAUTIONS TO TAKE WHEN CAMPING • Avoid camping near steep slopes, close to mountain edges, near drainage ways, or along natural erosion valleys. • Become familiar with the land around you. Slopes where debris flows have occurred in the past are likely to experience them in the future. • Be aware of dead trees that have started to fall but are held in place by other trees. There’s a reason some people call these “widowmakers”.

LANDSLIDE WARNING SIGNS • Changes in the land such as patterns of storm-water drainage on slopes, land movement, small slides, and progressively leaning trees. • Slowly developing, widening cracks appear on the ground, in paved areas, or on the walls of nearby buildings. • Bulging ground appearing at the base of a slope. • A faint rumbling sound that gets louder.

IF YOU ARE CAUGHT IN A LANDSLIDE, • Move away from the path of landslide as quickly as possible. If escape is not possible, curl into a tight ball and protect your head.

PRECAUTIONS TO TAKE WHEN CAMPING • Create a 30- to 100-foot safety zone around your sleeping area. Clear all flammable vegetation, leaves, branches, and rubbish. • Do not build a fire in dry conditions. • Dig a pit that is at least 15 feet away from tent walls, shrubs, and trees (beware of low-hanging branches overhead). • Dig a one-foot-deep pit in the dirt. Circle the pit with rocks. • Clear away all flammable leaves, branches, and rubbish within 10 feet of the campfire pit. • When putting out the fire, wait for the wood to burn to ash, if possible, and then pour lots of water on the fire until the hissing sound stops. If you do not have water, use dirt.

IF YOU ARE CAUGHT IN A WILDFIRE, • If a road is nearby, lie face down along the road cut or in the ditch in the uphill side. Try to cover yourself with something to protect against the fire’s heat. If in the backcountry, seek a depression with sparse leaves or other flammable materials. Lie face down in the depression and cover yourself.

15 ft. 15 ft.

30 - 100 ft.

RECOVERY AFTER A DISASTER APPLY FIRST AID AND GET HELP FOR ANYONE INJURED AFTER A DISASTER. • Check for injuries. Do not attempt to move seriously injured persons unless they are in immediate danger of death or further injury. If you must move an unconscious person, first stabilize the neck and back, then call for help immediately. • If the victim is not breathing, carefully position the victim for artificial respiration, clear the airway and start mouth-to-mouth resuscitation. • Maintain body temperature with blankets. Be sure the victim does not become overheated. • Never try to feed liquids to an unconscious person.

TAKE PROPER PRECAUTIONS TO MAINTAIN YOUR HEALTH. • Be aware of exhaustion. Don’t try to do too much at once. Set priorities and pace yourself. Get enough rest. • Drink plenty of clean water. • Wash your hands thoroughly with soap and clean water often when working in debris.

BE AWARE OF SAFETY ISSUES AFTER A DISASTER. • Watch for washed out roads, contaminated buildings, contaminated water, gas leaks, broken glass, damaged electrical wiring, and slippery floors. • Do not enter a building if you smell gas, if floodwaters remain around the building, or if the building has sustained a lot of damage. • Wear sturdy work boots and gloves if you walking around a disaster site.

COPING AFTER A DISASTER Everyone who sees or experiences a disaster is affected by it in some way. It is normal to feel anxious about your own safety and that of your family and friends. Profound sadness, grief and anger are normal reactions to an abnormal event. Acknowledging your feelings and focusing on your strengths will help you recover. If you continue to feel worse, see a professional or someone you trust.

THE FOLLOWING ARE WAYS TO EASE DISASTER-RELATED STRESS: • Talk with someone about your feelings – anger, sorrow and other emotions – even though it may be difficult. • Seek help from professional counselors who deal with post-disaster stress. • Do not hold yourself responsible for the disastrous event or be frustrated because you feel you cannot help directly in the rescue work. • Take steps to promote your own physical and emotional healing by healthy eating, rest, exercise, relaxation and meditation. Seek wellness services at a nearby health center. • Participate in memorials. • Use existing support groups of family, friends, and religious institutions.

RECOVERY RESOURCES • If you have a phone, always dial 9-1-1 for emergency assistance. • In many cities, you can get information about services by calling 2-1-1. • The Disaster Distress Helpline (1-800-985-5990) provides 24/7, year-round crisis counseling and support. It’s free and confidential. • Remember, Health Centers provide free or low-cost health care based on what you can pay, and you don’t need health insurance. To find a Health Center near you, go to http://findahealthcenter.hrsa.gov.

REFERENCES For more helpful information on any of these situations, vist • www.cdc.gov • www.fema.gov • www.ready.gov 17

ABOUT THE NATIONAL HEALTH CARE FOR THE HOMELESS COUNCIL The National Health Care for the Homeless Council is a membership organization composed of homeless service providers, people who have experienced homelessness, and other advocates who strive to break the link between homelessness and poor health. Together, we recognize and believe that • Homelessness is unacceptable; • Every person has the right to adequate food, housing, clothing, and health care; • All people have the right to participate in the decisions affecting their lives; • Contemporary homelessness is the product of conscious social and economic policy decisions that have retreated from a commitment to ensuring basic life necessities for all people; and • The struggle to end homelessness and alleviate its consequences takes many forms, including efforts to ensure adequate housing, health care, and access to meaningful work. If you are experiencing homelessness or have formerly experienced homelessness and would like to coordinate a discussion group in your community, please contact the National Health Care for the Homeless Council at (615) 226-2292 or council@nhchc.org.

ACKNOWLEDGEMENTS This guide includes emergency preparedness information available at www.ready.gov and www.cdc.gov but has been tailored to be practical for people who lack housing. This publication was made possible by grant number U30CS09746 from the Health Resources and Services Administration, Bureau of Primary Health Care. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA.

A NOTE FROM ACE BACKWARDS In my book SURVIVING ON THE STREETS, I half-jokingly suggest that the best way to deal with the cold and rain is to move to some place warm and dry. But the fact is, no matter where you live, if you are homeless living outside, you will definitely have to deal with the elements. Even in a relatively mild climate like Berkeley, California, where I live, last winter a longtime denizen of the street scene “died of exposure” as they say, at age 50, due to one too many 40 ounces of Olde English and one too many wet, cold nights sleeping in doorways. Last winter we got 32 inches of rain, and virtually every drop landed on my head. There’s no easy answer for dealing with this problem; however, this guide should provide you with some practical tips. Meanwhile, I’ve got to cut this message short and go dry out my socks. Ace Backwards

ABOUT ACE BACKWARDS Ace Backwards is author of Surviving on the Streets: How to Go Down without Going Out, a humorous and practical guide to living on the streets based on his own experiences.