CPG-2-8-11 FEBRUARY 1977 Doc:. '6-I\ MANAGEMENT OF MEDICAL PROBLEMS RESULTING FROM POPULATION RELOCATION VOLUME Ill THIS REPORT IS PART OF A SERIES OF DOCUMENTS WHICH PROVIDES BASIC PLANNING GUIDANCE AND RESOURCE DATA TO DCPA AND STATE PERSON NEL IN DEVELOPING PLANS FOR NUCLEAR CIVIL PROTECTION. DEPARTMENT OF DEFENSE DEFENSE CIVIL PREPAREDNESS AGENCY __9 734..J !3/!~Y AT BUFFALO DEi[ LIBRARIES . . OSITnov ,..,..,,...•• CPG-2-8-11 Management of Medical Problems Resulting from Population Relocations VOLUME III February 1977 Prepared for Defense Civil Preparedness Agency by The American National Red Cross by George B. Berke and Elizabeth Robertson under Contract No. DCPA-01-75-C-0297 DCPA Review Notice This report has been reviewed by the Defense Civil Preparedness Agency and approved for publication. Approval does not signify that the contents necessarily express the views and policies of the Defense Civil Preparedness Agency. Approved for Public Release; Distribution Unlimited PREFACE This report was prepared as a part of a research program being conducted by the Defense Civil Preparedness Agency (DCPA) to evaluate crisis relocation as a strategy for protecting populations threatened by large-scale disasters. Prepared under contract DCPA-01-75-C-0297, the research objectives were: 1. Define the prob,.em--that is, "What are the relevant circum stances for which a requirement exists for the promulgation of health, medical and safety information to the general public?" Primary conRideration will be given to potential nuclear crises. 2. Identify the various elements of the problem, their interrelationships and their probability of occurrence both in terms of chronology and significance. 3. Develop a logical, uniform and simple format for the effective use of the derived elements and information in population relocation situations. This format will be coordinated with the Research Triangle Institute in order to assure its ready incorporation into the "Crisis Relocation Plan--Medical Annex" as directed by previous DCPA guidance. In addition, the data may be used all or in part by ANRC or other disaster assistance and relief agencies in their respective missions. 4. Review, test, and evaluate, in light of Red Cross experience in population movement, congregate care facilities and other related or appropriate disaster environments, the draft report prepared by the Research Triangle Institute. i This report will be Volume III to the Management of Medical Problems Resulting From Population Relocation as developed by the Research Triangle Institute. This report is in two sections: Section One, Guidance for Crisis Relocation Planners, contains situation statement, information for the development and distribution of general population handouts, suggested contents for a general population handout and reference lists to serve as backup guidance for the handout. Section Two, General Population Handout, contains a sample general population handout. ii ACKNOWLEDGEMENTS The authors wish to acknowledge the guidance and support provided by Dr. Dean E. Ewing, the Contracting Officer's Technical Representative. In addition, the assistance and-advice of DCPA personnel including: Mr. Herbert E. Kunde -Special Assistant to Deputy Director Dr. James M. Ridgeway -Education Advisor Mr. Wilfred M. M. Minton -Emergency Medical Services System Coordinator Mr. James W. Kerr -Staff Director Mr. Stephen Birmingham -Research Systems Analyst Mr. Ralph Garrett -Research Social Scientist Mr. George Van den Berghe -Operation's Research Analyst American National Red Cross personnel who provided advice and assistance were: Mr. Robert M. Oswald -Administrator, Community, Education and Health Programs Mr. William J. Phillips -National Liaison Officer Kathy Behrens -Assistant National Director Disaster Services C.P. Dail -National Director, First Aid, Safety Programs Jeanne Durr -Assistant National Director, Disaster Health Services Heather Lynskey -Office of Program Development, Safety Programs Wes McKenzie -Program Operations Assistant, Safety Programs Roy Popkin -Assistant National Director, Disaster Services Don Sleeper -Program Specialist, First Aid~ Safety Programs iii The authors are especially appreciative of the efforts of the following individuals who participated in testing the guidance and prototype handout: Frank J. Mollner -Defense Civil Preparedness Agency, Region Six, Denver, Colorado Frank J. Hubka -Colorado Division of Disaster Emergency Services, Denver, Colorado James Peterson -Defense Civil Preparedness Agency, Region Six, Denver, Colorado John K. Hamrich -Red Cross Advisor, DCPA Region 6, Denver, Colorado John Cunningham -Red Cross Advisor, DCPA Region 6, Denver, Colorado Robert L. McWilliams -Deputy Civil Defense Coordinator, El Paso County, Colorado Springs, Colorado William A. Giordano -Fremont County Civil Defense, Canon City, Colorado Madeleine Randall -Fremont County Nursing Service, Canon City, Colorado Paul A. Masar -St. Thomas More Hospital, Canon City, Colorado Steven Hill -Deputy Civil Defense Coordinator, Fremont County, Canon City, Colorado iv TABLE OF CONTENTS Preface • . • • . i Acknowledgements iii SECTION ONE GUIDANCE FOR CRISIS RELOCATION PLANNERS A. Situation Statement ••.••.•..• 1 B. Development and Distribution of General Population Handout 1 c. Content of General Population Handout • 5 D. General Population Handout Preparational Instructions • 7 1. Preparation for Relocation . .• . . . . . .. . . 7 a. Supplies • . • • • . . . • • • 7 (1) Food, Water and Utensils . 7 (2) Medications 7 (3) Clothing . • • . 8 (4) Personal HYgiene 8 (5) Personal Effects 9 (6) Tools • . . • . • • •••. 9 (7) Communication and Lighting • • . • • 10 b. Valuables ••.•. 10 c. Pets . . . . . . . . . . 10 d. Loading Vehicles 11 e. Safeguarding Dwellings .••. 12 2. Relocation • . • . . • • . 13 a. Accessing Official Information 13 b. Exit Routes •••.• 13 c. Highway Emergencies • 13 (1) Medical ..•• 14 (2) Mechanical • 14 (3) Supplies . 15 (a) Fuel 15 (b) Flags • 16 3. Arrival at the Host Area 16 a. Housing and Parking Assignments • . 16 b. Accessing Medical Services 17 c. Illnesses • • • • . • . • • • • 17 d. Health and Safety Precautions • 18 4. Preparation for Return • • . • . 19 v 5. Return . . • • • . • • 19 6. Arrival at Home •.•. 19 a. Safety Precautions • . •.• 19 b.. Sanitation and Health Problems • 20 E. Reference Lists .••••...•... 21 SECTION TWO GENERAL POPULATION HANDOUT A. Introduction . 29 B. Sample Handout • 30 vi SECTION ONE GUIDANCE FOR CRISIS RELOCATION PLANNERS A. SITUATION STATEMENT In a crisis relocation situation, where the population is being relocated from HIGH RISK AREAS to HOST AREAS, a maximum time of three days will be needed for the evacuation and relocation process. As soon as the governor receives word from the President, the risk and host areas will be notified to begin relocation. Because medical and safety personnel are essential workers, their evacuation, and that of their families, should be completed during the first twelve to twenty-four hours. It is assumed that these workers will be well aware of their responsibilities and be prepared to relocate at almost a moment's notice. While the relocation of essential personnel is going on, the general population should be informed by radio and/or television that those people living in risk areas must be prepared to relocate to host areas within twelve to twenty-four hours. Included in this notification should be an announcement that information and directions will be provided and distributed, with the method of distribution indicated. This volume is a direct extension of the Management of Medicial Problems Resulting from Population Relocation, Volume II and the scenario used is the same as that described on pages II-1 to II-4 of that volume. B. DEVELOPMENT AND DISTRIBUTION OF GENERAL POPUlATION HANDOUT It is suggested that preplanning include the development of a handout which will provide the general public a health/medical/safety inventory of 1 information applicable to crisis relocation. This handout need not be printed pre crisis/disaster, but should be predesigned and ready for production and distribution. An example of a general population handout can be found in Section Two of this volume. The pre-production of a videotape using graphics in addition to verbal information should also be considered. These may be used in place of or in addition to the printed materials. The handout format used in this volume is not meant to be a specific model for all local planners. Your format will be determined by your local situation and resources. The format of the sample handout included in this volume is used to confor.m with the physical constraints required in pub lishing this guidance. The planner should consider the production capabilities available to him in the preparation of crisis relocation information. The variations in presentation could range from print (verbal) material, to a document featuring all visuals (pictorial as well as graphic, and simple line drawings) or a combination of both. This suggest.ed brochure must reach every household in time for them to act prior to actual evacuation. The method of distribution of this handout will depend on local facilities, and the size of population. The following are suggestions which may be modified to meet local needs. The preprinted handout could be: 1. delivered door to door by scouts and/or newspaper route personnel. 2. dropped from airplanes. 3. printed in the .local newspaper and delivered to every household by newscarriers. 2 4. wrapped in plastic and placed on one corner of each intersection with radio and television instructing the population to pick up a copy. This information must be available within easy walking distance. It is extremely important to produce a brochure that is easy to read, contains only essential information presented in brief and concise manner, and is pleasing to the eye. Directions that are too specific may cause concern to those who do not happen to have particular items on hand. This point should be remembered in giving directions concerning all types of supplies and other matters involving relocation. The planner should keep in mind that people will be trying to use this document under extremely stressful situations and is intended for all reading levels. Thus the vocabulary used should be simple and direct, probably not above the sixth grade level. In certain locales, because of the diversity of the population, consideration should be given to providing multi-lingual handouts. For your convenience in using this document the authors have used identical letters and numbers for corresponding paragraphs in each of the following parts: 1. Table of Contents page v· 2. General Population Handout Preparational Instructions page 3. Sample Handout page 7 29 Additional guidance can be found in the following reports: 1) Communications Strategies for CRP prepared for DCPA by 3 Michigan State University. Especially note Section VI on page 31. 2) Public Communications to Support CRP prepared for DCPA by System Development Corporation. Especially note Chapter II, pages II-1 and Chapter IV, page IV-1. 4 C. CONTENT OF GENERAL POPULATION HANDOUT The content of the general population handout should cover the following points. 1. PREPARATION FOR RELOCATION a. Supplies (1) Foqd, Water and Utensils (2) Medications (3) Clothing (4) Personal HYgiene (5) Personal Effects (6) Tools (7) Communication and Lighting b. Valuables c. Pets d. Loading Vehicles e. Safeguarding Dwellings 2. RELOCATION a. Accessing Official Information b. Exit Routes c. Highway Emergencies (1) Medical (2) Mechanical (3) Supplies 3. ARRIVAL AT HOST AREA a. Housing Assignments 5 b. Accessing Medical Services c. Illnesses d. Health and Safety-Precautions 4. PREPARATION FOR RETURN (Refer to PREPARATION FOR RELOCATION Section) 5. RETURN (Refer to RELOCATION Section) 6. ARRIVAL AT HOME a. Safety Precautions b. Sanitation and Health Problems 6 D. GENERAL POPULATION HANDOUT PREPARATIONAL INSTRUCTIONS 1. PREPARATION FOR RELOCATION a. SUPPLIES (1) FOOD, WATER AND UTENSILS The instructions for the general population should stress the need for packing drinking water for use en route and especially a three day supply of nonperishable foods that are easily stored·. and do not require cooking. Perishable foods that have been out of refrigeration more than two hours are suspect, even if they do not "smell" spoiled, because bacteria and their toxins have developed. The local planner may want to specify certain types of food. However, the population should have as much freedom of selection as possible. Planners anticipate that the food system to be established in the host area will probably not be in place for the first three days. Thus, the individual food supplies are intended to sustain the relocatees during this period. (Refer to Food System Supper: of the Relocation Strategy, Volume I, Analysis and Case Study, Exhibit 3.8, "Suggested Shipping Guidelines for Wholesalers Supplying Host Area Retail Outlets" for lists of items that will and will not be provided during relocation. OCPA Publication, CPG-2-8-1.) (2) MEDICATIONS The family first aid kit is a critical item to be included in the supplies packed for relocation. Persons taking special medications and drugs should be urged to remember to bring what they have on hand, along with any prosthetic devices they '{ need. Experience has shown that these items are often forgotten in the concern and excitement of relocation. Most likely, persons forgetting their supplies will survive for awhile even in the most severe cases. However, they will be better able to function if their pills, prosthetic devices and eye glasses accompany them. (3) CLOTHlll"G The brochure should tell the relocating population what type of clothing should be packed. It must be suitable to the type of activities to be expected while living in the host area. Sturdy work clothes would be the most appropriate. There will be little need for high heel shoes and office type clothing for anyone. The prevailing weather conditions must be considered. Relocation could occur during a period of the year when sudden changes in temperature would require both heavy and lightweight garments. This information should be included somewhere in the instructions, if not in the printed material, then on TV or radio. Babies, young children, and the elderly need special clothing and the public should be instructed to consider the wardrobe needs of every member of the family group. (4) PERSONAL HYGIENE Persons will feel more comfortable and consequently function better if at least some of their personal hygiene items accompany them. In fact some items such as toothbrushes, body lotions and body powder and toilet paper may decrease the possibility of minor physical irritations that could 8 develop into more serious problems. (5) PERSONAL EFFECTS It is appropriate to encourage relocatees to bring their selections There will be periods of free of small entertainment and hobby items. time when the use of these personal possessions will bring comfort, relax ation and moral support. (6) TOOLS It may be necessary to upgrade the fallout protection of some facilities in the host areas which would, necessitate the use of various tools. When people are told to bring .tools, they probably think of wrenches, screwdrivers and pliers. Since the upgrading of facilities could range from building temporary walls to transporting dirt to forming shielding around buildings or rooms, the relocatees should be specifically instructed to bring digging tools, such as buckets, picks, and shovels, if they are available in the household. The need for work gloves should be emphasized_ to protect tender hands from blisters, splinters and other minor injuries. In some locales it may be necessary to have relocatees bring certain power tools and equipment for use in upgrading shelters. However, from a safety point of view, the planner must consider that the use of power tools will probably increase the accident rate resulting in additional medical problems. We urge the local planner to consider these factors before encouraging the use of power tools. (Refer to DCPA Publication" H-14, In Time of Emergency.) 9 (7) COMMUNICATION AND LIGHI'ING C.onsideration should be given to providing information on the type and availability of communications for the use of relocatees. This is very dependent on locale and resources. (Refer to Direction and Control Communications in Support of CRP prepared for DCPA by Systems Development Corporation. b. VALUABLES The instructions for packing valuables should state that bringing small valuables such as jewelry, cameras and money,-is permissible, put the family china and large pieces of silver will be safer at home. More detailed instructions will depend on the security capabilities of the local host area. Planners anticipate that the police will secure and guard valuable items. Valuable documents such as deeds, stocks, bonds, certificates, etc., may be brought. This would be left to the discretion of the individual relocatee. Money and credit cards should not be overlooked. The items necessary to sustain life will be provided by the government, but any luxury item such as ice cream or a hamburger from a fast food establishment will require personal funds. (Refer to Public Safety Support to CRP by Mission Research Corporation.) c. PETS The planner is cautioned to pay specific attention to the problems 10 of relocating pets. In all probability,a certain percentage of people will not relocate without their pets. Also the problem of leaving pets behind is almost insurmountable since they should not be turned loose and cannot be destroyed both from a practical logistics point of view and the pet owners point of view. The housing and feeding and medical care of pets in the host area would also be a major problem but must be planned for. Therefore,the planner must call upon the local veterinary practitioner and association as well as the humane societies and/or appropriate government agencies to assist in planning for this situation. d. LOADING VEHICLES Although the relocatees have been told to bring many items, they have not been instructed concerning specific quantities. To simply say "Don't overload your vehicle" might create more problems than it would solve. Many people are not aware of the condition of their vehicle's springs and shocks, nor of the load capacity. A simple directive could be included saying "Don't pack your vehicle with a greater load than you would take on a vacation. It is better to leave some things behind than to have your springs break half' way there." It is possible that some vehicles barely did make it home from the last vacation with the burden they were carrying and could possibly collapse on this relocation trip. That is a chance that has to be taken and the "vacation load" directive will generally be a safe rule to follow. Emergency tools and first aid equipment should be packed in a readily 11 accessible location. Heavy items should be packed first with lighter ones on top. The backseat floor space up to seat level can be utilized to accomodate supplies without creating undue discomfort for passengers. Items such as blankets consume little space if placed flat on the seats and treated as cushions. Canned goods and other small items can be packed loose in spaces surrounding larger items and placed in paper bags or like containers when unpacking at the host area. e. SAFEGUARDING DWELLINGS Instruct relocating households to drain water heaters, and slightly open water taps in the winter months to prevent frozen water lines. Disconnect electrical appliances except alarm systems and food storage equipment. Shut off all appropriate gas appliances. The above guidance may well be tempered by the additional considerations of utility, availability, and the need for some of the home utilities to remain intact for possible return, e.g., potable water would be available in water heaters if they were not drained. Doors and windows should be locked and it would be advisable to secure outdoor items before leaving. It is anticipated in most jurisdictions that normal sanitation pick-up will be provided after population relocation in order to remove trash, garbage and other debris which may cause proliferation of rodents and insects. If it is impractical for the sanitation pick-up to be provided, an alternative is to notifY the population that they stow their 12 perishable food and trash in refrigerators and.freezers. If quantities of waste materials are such that pick-up is impractical because of its abundance, the population should be encouraged to put out only that which is degradeable. Don't put out cardboard boxes, tree trimmings, glass containers, etc. (Refer to Prototype Plans for Production and Maintenance of Electric Power in Crisis Relocation, United States Department of Interior, Defense Electric Power Administration, DCPA Publication, CPG-2-8-6.) 2. RELOCATION a. ACCESSING OFFICIAL INFORMATION Both radio and television are acceptable means of airway communication during the preparation phase of relocation; however, only radio can be of value while the relocatees are en route. During preplanning, the planner must decide which information will be presented by both media and which must be reserved for radio only. The actual script for radio broadcasts should precisely state whether the message is intended for the relocatees who are actually en route, or those preparing for departure. b • EXIT ROUTES Instructions for the general population should emphasize that only designated routes may be used by the relocatees. Emergency and official personnel will not be available on backroads for those who encounter problems. c. HIGHWAY EMERGENCIES 13 (1) Medical For sudden critical medical emergencies in which the relocatee finds it impossible to proceed, instructions should indicate that the vehicle should be driven completely off the highway and a colored flag attached to the antenna or door to indicate that help is urgently needed. In a crisis situation it is assumed that people vmuld be willing to render assistance to those in distress. Included in the official directives should be the suggestion that persons render emergency first aid according to their capabilities but should seek professional help if need be. Considering the number of people passing the victim, it is highly probable that a trained first-aider will be available in a relatively short time. He/she should certainly be encouraged to help. (2) Mechanical In crisis relocation situations, the driver. should be told to make every effort to proceed to his or her destination, even when minor mechanical problems develop. As with a medical emergency, move completely off the highway, if at all possible and attempt to repair the malfUnction. If the problem cannot be handled by the occupants of the vehicle, they should, in addition to raising the hood, place a white flag in plain view indicating they have a mechanical breakdown and cannot proceed. Persons with mechanical ability should be encouraged to stop and help. The use of citizen band radios is increasing daily and the planner should consider this a valuable resource in any relocation effort. The 14 relocatees should be cautioned to monitor broadcasts and to use their radios only to report emergencies. (Refer to Direction and Control Communications in Support of CRP, System Development Corporation; Public Safety Support of the Crisis Relocation Strategy, Volume I, Research and Volume II, Guide for Preparation of Public Safety Crisis Relocation Plan, Mi£sion Research Corporation; Impacts of the Crisis Relocation Strategy on Transportation Systems, Volume I, Analysis and Case Study, Volume II, Planning Guidelines, Systan Inc.) (3) Supplies a. Fuel Consideration should be given to the problem of fuel; the following information may be useful to the general population. 1) In an emergency situation, an engine designed to use unleaded gas will operate on leaded gas and v(ce,versa. 2) Gasoline and oil in limited quantities, will be available from patrol personnel. 3) Gasoline and oil will probably be available en route for those vehicles traveling greater distances. 4) Gasoline will be available in limited quantities in the risk are.as and will probably be a controlled or rationed item in the host area. (Refer to Impacts of the CRP Strategy on Transportation Systems, Systan Inc • ) 15 b. Flags It may be advisable to produce and distribute flags for signaling highway medical and mechanical emergencies. These can easily be made part of the General Population Handout by diagonally perforating one sheet thus forming two triangular flags; one printed red and the other white. Two holes placed at the large end of each triangle will provide a means for displaying on the automobile. / / / / / RED / WHITE / / / / The first printed page of the instructions of the handout can be produced in the appropriate colors and used as flags. 3. ARB.IVAL AT HOST AREA (a) HOUSING AND PARKING ASSIGNMENTS Directions to housing and shelter assignments should be ready for the relocatees upon their arrival at the reception center of the host area. Verbal instructions will suffice if the route can be easily followed. For more complicated situations, a simple map may be necessary. Be specific 16 in describing landmarks for city dwellers. Often they do not recognize the difference between such landmarks as an oak and a maple tree. (Refer to Prototype Reception/Care Plan to Meet the Welfare, Shelter and Related Needs of Populations Affected by Crisis Relocation, DCPA Publication CPG-2-8-4 and Reception/Care Plan for Fremont County, Colorado, DCPA Publication CPG-2-8-3.) Vehicle parking and/or impoundment areas should be ready in coordination with public safety guidance plans. (Refer to Law and Order Services For Host Area: Fremont County and Canon City, Volume VI, page 103. Mission Research Corporation.) (b) ACCESSING MEDICAL SERVICES Depending on the system established for the local area, guidance for accessing the medical system must be given to the relocatees during all phases of relocation and especially during the relocation phase itself. While the relocatees are at the reception center, they can be informed of the types of medical facilities available (hospital, clinic, first aid station, etc.) and the proper procedure for accessing these services. The procedure might involve a simple phone call to a central office to set up appointments or a call to gain admittance to the area hospital. If only a phone number is involved, it could be written on the handout by the relocatees. However, more complicated or lengthy steps would probably require the printing of handouts, unless local radio is adequate. c. ILLNESSES In order to prevent a frantic rush to medical facilities for minor illnesses and to insure that adequate service is available for critical 17 emergencies, the relocatees may be given a few general guidelines for determining the need for professional help. However, the guidelines are not meant to transform lay persons into diagnosticians. Symptoms can be listed according to three categories: 1) critical, requiring immediate professional help. 2) serious, requiring professional help as soon as available. 3) other illnesses generally not requiring professional services unless symptoms worsen. Emotional illnesses must be considered in accessing medical services. Generally, in the host area, the police should be called to help handle persons who become emotionally distraught and are endangering others. The police are best equipped to handle these emergencies and to obtain such professional medical help as might be needed. (Refer to Standard First Aid &Personal Safety, The American National Red Cross, 1975.) d. HEALTH AND SAFETY PRECAUTIONS The p~anner should not assume that city dwe~~ers are aware of hea~th and safety hazards of the host area. The re~ocation of populations from large cities to rural areas will pose problems for the medical services if relocatees are not advised to take simple precautions when encountering living conditions which may be totally foreign to them. For example, check daily for ticks and take proper precautions concerning insects, snakes, poisonous plants, wild animals, local diseases such as Rocky Mountain Spotted Fever, plague, and also precautions against area weather conditions such as flash floods, tornadoes, wind sQoms, hail, etc. that are common occurrences in some areas. 18 4. PREPARATION FOR RETURN The preparation steps for returning will be very similar to those for relocation preparation, and reference can be made to that section of the handout. In addition, everyone should be urged to leave the area as clean as possible. Call attention to any specific health problems that arose during the relocation period. Alert the returnees to be aware of them and to follow precautionary instructions in order to prevent or at least control their spread. Instructions concerning anticipated health problems and the return home may be printed prior to the crisis and distributed during preparations for return. Any unexpected health directives can be handled by radio broadcast. 5. RETURN In the interest of conserving space and time, the planner may refer the returnees to the RELOCATION section of the handout. Also, official radio instructions should be followed. 6. ARRIVAL AT HOME a. SAFETY PRECAUTIONS Authorities will probably be aware of any unusual problems that occurred in the risk area during the relocation period but the returnees 19 should be prepared for additional mishaps that may have occurred in their absence. All persons should be aware of these general safety precautions upon entering any building: 1) Check for gas leaks before turning on lights and/or appliances. Coordinate with the local utilities and obtain guidance before instructing returnees about turning on residential utilities. 2) Be aware of the possible presence of rodents and insects and take proper precautions. 3) Check fuses and circuit breakers. 4) Check valuable items left behind and within a reasonable period of time report any burglary to the police and insurance companies. b. SANITATION AND HEALTH PROBLEMS Information concerning any problem should be broadcast by radio or television along with all related problems pertinent to the local area. Medicines do not tolerate sudden temperature changes very well and should be destroyed. Staple foods, with the exception of flour and other grain products, should not be a problem. Check for contamination by bugs (ie. weevils in flour, etc. ) Water, plumbing and sewage will probably cause no local problems, however listen for official guidance concerning area-wide problems. Relocation has greatly disrupted the normal daily functions of all localities. Take this obvious fact into account and remind everyone that a 20 return to normal will not be accomplished overnight. This may be especially true of health services. E. REFERENCE LISTS These lists are intended to serve as a guide and reference section for the development of a General Population Handout for your local area. Use only the items which are pertinent to the needs of your people. Do not make your brochure a detailed "Checklist". Be specific only where it is absolutely necessary, Too much information will defeat the purpose of the handout. People will not spend much time reading when they are preparing to relocate so develop your brochure accordingly. FOOD, WATER AND UTENSILS CANNED fruit and vegetable juices milk hash spaghetti dinners salmon tuna chicken baked beans meat spreads peanut butter corned beef vegetables 21 fruit soups cheese spreads POWDERED fruit and vegetable juices milk instant breakfast coffee tea DRIED meats vegetables fruits MISCELLANEOUS dry cereals crackers cookies jelly jam spices beer ale gum tea condiments syrup salt pepper sugar snacks wine cigarettes soft drinks 22 UTENSILS paper plates plastic plates plastic cups measuring cup bottle opener can opener stainless steel knives, forks and spoons thermos bottle with water MEDICAL SUPPLIES aspirin alcohol cold tablets nose drops eye wash vitamins laxatives anti-diarrheals petroleum jelly calamine lotion analgesic jellies analgesic inhalents antiseptic sprays antacids or lotions mole skin burn ointments jells and sprays cotton swabs tweezers thermometer hot water bottle ice bag snake bite kit colored flag -red preferred immunization records .First Aid Kit 1" adhesive compresses 2" bandage compresses 3" bandage compresses 4" bandage compresses 23 3" x3" plain gauze pads· gauze roller bandage eye dressing packet tourniquett square yard plain absorbent gauze scissors 24" x 72" plain absorbent gauze tweezers 40" trian~ar bandages CLarHING All clothing selections should be made on the basis of expected seasonal weather conditions and their suitability to an outdoor rural environment. sleeping bags dungarees overalls coveralls slacks shirts -long sleeve to protect bodyfrom elements coats jackets sweaters sweatshirts raincoat or waterproof poncho hat -protection from sun and/or cold boots two changes under clothing six pair socks and/or stockings, adequate supply of socksfor frequent change shoes -appropriate -sturdy, comfortable well-fitting, low heels inappropriate -tennis shoes, sandles, high heels, patent leather WORK GLOVES 24 General PERSONAL HYGIENE deodorants tooth paste body powder razor and blades hair dryers dry shampoo tampons contraceptive devices dental floss TOOLS crowbar hammer wrench bucket shovels pliers axe nails fire extinguisher tape measure 25 feet rope 25 tooth brush body lotions soap shampoo hair lotion comb and brush sanitary napkins cosmetics toilet paper spirit level square knives plumb line pick broom screwdriver screws short rubber hose or siphon coil of wire Auto Phillips screwdriver bumper jack spark plug gapping gauge ball battery tester VALUABLES radios sterling flatware money check and saving books stocks birth certificates deeds wills PEl'S wrenches spark plug wrench tire pressure gauge anti-freeze tester jewelry cameras credit cards certificates of deposit bonds marriage certificates social security cards grooming aids -combs, brushes, nail clippers beds -if practical feeding dishes food medications traveling containers leashes collars with identification tags harnesses chokers clothing consideration might be given to external parasite collars. PERSONAL EFFECTS books magazines games toys writing materials clock calendar playing cards sewing kit COMMUNICATION AND LIGHTING radio -battery operated with extra batteries flashlight and batteries candles and matches lantern and fuel RECREATIONAL VEHICLE REFERENCE LIST Items Outside of Trailer coupler breakaway switch water inlet pressure relief inlet 110 volt electrical inlet sewer hose bumper holder water hose Items Inside of Trailer butane refrigerator heater water tank air valve (inside) dolly butan bottle or bottles water tank fillpipe freeze drain water heater folding step septic tank valve and tank operation ice box butane light (electric light) air compressor battery 27 beds toilet and shower 12 volt light system license and registration awning roll baggage comp. doors Items on Automobile hot line fuse brake line resister brake control unit electrical connector hitch and safety chain AUTOMOBILE ITEMS TO CHECK BEFORE YOU RELOCATE gas gauge (fill up in risk area if possible water level in battery automatic transmission fluid level power steering fluid level fan belts for cracks and/or breaks oil level radiator water level brake fluid level 28 SECTION TWO GEN"ERAL POPULATION HANDOUT INTRODUCTION Local officials have informed you of the need to relocate to a safer area as a result of the present crisis. This brochure is intended to assist you in accomplishing this relocation as rapidly and safely as possible. As soon as possible,read the sections which are applicable to your area and follow the directions as carefully as possible. If you do not have some of the particular items listed do not waste valuable time Pack what you have and be ready to depart at the appointed getting them. time. If you are handicapped and need assistance or if you do not have your own transportation, contact ---------------------------for directions for your time and place of departure. 29 GENERAL POPULATION HANDOUT 1. PREPARATION FOR RELOCATION STAY TUNED TO RADIO AND TV ********* ********** a. SUPPLIES Pack these supplies in ,car, camper, trailer, etc. (1) FOOD, WATER AND UTENSILS Three day supply of non-perishable CANNED, POWDERED, DRIED food that will require no cooking. Special diet and baby foods. Don't bring anything that will spoil without refrigeration. Water for dr5~king en route. Paper and/or plastic plates, cups and eating utensils for each person. Bottle and can openers Pocket knife Measuring cup Thermos bottle or plastic jug (2) MEDICATIONS Remember your prescription and other medicines, thermometer, prosthetic devices (eyeglasses, hearing aids, artificial limbs), first aid kit, and emergency medical identification cards and/or bracelet. FOLLOW OFFICIAL ' INSTRUCTIONS AT ALL TIMES 30 (3) CLCYrHJNG Bring changes of STURDY WORK-CLOTHES and footwear suitable to expected host area weather conditions. WORK GLOVES Any special clothing needed for babies and the elderly. (4) PERSONAL HYGIENE Health and beauty aids Soap, toothbrush and paste, deodorants, etc. Assorted sizes of PLASTIC BAGS. Paper towels, and/or moist towelettes, and toilet paper. Any small personal item necessary for comfort. ( 5) PERSONAL EFFECTS playing cards hobby materials books toys games sewing kit magazines writing materials FOLLOW OFFICIAL JNSTRUCTIONS AT ALL TTh1ES 31 (6) TOOLS If you have them bring necessary tools, especially for digging. Shovels, buckets, picks Don't bring power tools (7) COMMUNICATION AND LIGHTING Battery operated radio with batteries Candles and book matches Flashlights and batteries Lanterns and fuel b. VALUABLES Bring any small readily packable item such as cameras, radios, jewelry, sterling flatware. Bulky valuable household items will be safer at home. Money, credit cards, check and savings books Any valuable document, usually kept at home, including deed, wills, stocks, bonds, birth certificates, immunization records and social security card. Provisions will be made for receiving and storing of valuables by police. Don't remove any items kept in a safe deposit box. c. PETS BRING YOUR PETS with a good supply of dry food if readily available. FOLLOW OFFICIAL INSTRUCTIONS AT ALL TIMES 32 Don't forget their leashes, dishes, bedding, grooming aids, pet carriers and any other necessary items. DON'T TURN THEM LOOSE. d. LOADING VEHICLES Emergency tools and First Aid equipment should be instantly available. Utilize back seat floor space for packing. Pack heavy items first. Load limit should not be heavier than carried for a vacation. DO NOT OVERLOAD. e. SAFEGUARDING DWELLINGS If possible, shut off water and open all water faucets slightly. If water shut off is not possible, open appropriate water taps to prevent freezing during cold weather. Drain water heaters. Shut off gas appliances. Disconnect all electrical appliances except food storage. Prepare garbage for normal pick-up to minimize rodent-insect problems. Lock doors and windows. 2 . RELOCATION a. ACCESSING OFFICIAL INFORMATION Stay tuned to RADIO broadcasts for official information while en route. FOLLOW OFFICIAL INSTRUCTIONS AT ALL TIMES 33 b • EXIT ROUTES Travel only on planned relocation routes which will be patrolled by emergency personnel. Help WILL NOT be available on other roads. c. HIGHWAY EMERGENCIES (1) Medical If possible -proceed to nearest designated aid station or telephone If not possible, hang colored flag from car to indicate immediate need for emergency medical aid. Render assistance within your capabilities and obtain further assistance as required. (2) Mechanical Continue to drive if at all possible. For major breakdowns, when continuation is impossible, move as far off the highway as possible, raise the hood and hang a white flag on the vehicle. If you have mechanical ability stop and help. Listen to your CB radio. Use it only to report highway emergencies. (3) Supplies (List or discuss items covered in the guidance as appropriate to locale and conditions.) FOLLOW OFFICIAL INSTRUCTIONS AT ALL TIMES 34 3. ARRIVAL AT HOST AREA a. HOUSING AND PARKING ASSIGNMENTS Stop at RECEPTION AREA for directions to your temporary home and assigned secured parking area. b. ACCESSING MEDICAL SERVICES WHILE at RECEPTION AREA you will be told how to obtain medical services. If you have a severe medical condition and are traveling alone, notify persons near you of the nature of the problem. c • ILLNESSES Serious illnesses with these ~toms need IMMEDIATE MEDICAL ATTENTION. pains in chest and upper abdomen, going down left shoulder and arm with nausea and vomiting. heavy and/or prolonged bleeding. swallowed and/or inhaled poisons. severe burns covering large portion of body. paralysis or weakness on one side of body. difficulty breathing and swallowing, slurred speech or unconsciousness. unconscious diabetic. Illness with these ~toms need medical attention. fever frequent and heavy vomiting and/or diarrhea FOLLOW OFFICIAL INSTRUCTIONS AT ALL T:mES 35 rashes and/or sore throats accompanied by fever. Most other illnesses can be self-treated, but seek medical attention if symptoms worsen. d. HEALTH AND SAFETY PRECAUTIONS Follow official instructions. Ask for and take advice of host area residents concerning rural living. Obtain police help to handle persons with severe emotional disturbances which could affect the well-being of others. They will obtain medical support if required. 4. PREPARATION FOR RETURN Follow official instructions concerning health and other problems. Clean up your mess. Follow appropriate directions given under PREPARATION FOR RELOCATION. 5. RETURN Follow official instructions and appropriate directions given under RELOCATION. 6. ARRIVAL AT HOME (a) SAFETY PRECAUTIONS CHECK for GAS LEAKS before turning on lights and/or appliances. FOLLOW OFFICIAL INSTRUCTIONS AT ALL TIMES CHECK for rodents and insects and exercise appropriate caution. CHECK fuses and circuit breakers. CHECK on valuable items left behind and report any theft to police and insurance companies. (b) SANITATION AND HEALTH PROBLEMS Dispose of any spoiled foods. Dispose of all medicines left behind. They could have spoiled due to sudden changes in temperature. FOLLOW OFFICIAL INSTRUCTIONS AT ALL TIMES 37 DISTRIBUTION DCPA Regions and Staff College