responds to wave of violence
When Hurricane Floyd roared through eastern North Carolina, it left devastating flooding in its wake. Fifty-two people were killed. Homes, businesses and entire neighborhoods were destroyed across a 6,700-square-mile region. Even now -- almost three years later -- many families are still displaced and living in temporary housing.
Perhaps one of the most lasting impacts of the flood -- even more disruptive and devastating than the loss of homes and jobs - is the skyrocketing incidence of domestic violence. In Sampson County alone, domestic violence rates are up nearly 40 percent over the past year, and six people have lost their lives.
Pam Frasier, a research assistant professor with the School of Medicine's Department of Family Medicine, has had an up-close look at the problem. Through a CDC grant to the Center for Health Promotion and Disease Prevention's (HPDP) Health Works for Women project, Frasier was asked to focus on intimate partner violence and its effect on the workplace.
According to Warren Newton, chairman of the Department of Family Medicine, the timing positioned Frasier to collect "remarkable data about the impact of disaster on social pathology.
"Because the Health Works for Women staff was working in the community before the flood, they now have before-and-after data that demonstrate the impact of a natural disaster on human relations -- something to keep in mind as we work through other devastating events, like September 11 and the outbreak of anthrax," Newton said.
In many ways, the problems in eastern North Carolina mirror the experiences of other communities in the aftermath of a natural disaster.
"The steady rise in reported incidents of domestic violence after Hurricane Floyd is typical," Frasier said. "Homes, transportation and child care resources are disrupted. People feel lost and powerless. Before the flood, victims could seek shelter with a friend or family member. After the flood, friends and family members were homeless, and victims often had no place to go and no way to safely leave."
Contrary to the experiences of other communities, though, the rise of domestic violence in eastern North Carolina has not leveled off over time.
According to Pamela Gonzalez, executive director of the UCARE Domestic Violence and Sexual Assault Organization in Sampson County, the loss of shelter and basic necessities has been compounded by local plant closings and layoffs. "Adding the loss of jobs to the other outcomes of the hurricane has compounded the stress that people are living with daily," she said.
To help combat the problem, Frasier has conducted workplace training for businesses ranging from Carolina Turkey and its 2,600 employees to Cordset Designs with 120.
"I'm especially amazed at what these smaller workplaces have done to demonstrate support for their employees," Frasier said. "Cordset Designs, for example, asked us to train every employee in the plant. They did this on company time during a tough period economically."
Frasier said that Cordset`s human resources manager, Rose Walker, helped her organize small group sessions that were offered in English and Spanish, with information tailored to the company's policies and employee needs. At Carolina Turkey the company supported her efforts to offer language-specific materials to employees who spoke Spanish, Chinese and Korean.
Expanding the effort, involving others
As Frasier worked with the nonprofits who deal daily with the problem of domestic violence, she realized that the very organizations being barraged by new clients were also victims of the flood.
"Two of the shelters had direct damage from the hurricane," Frasier said. "Staff members had friends and family who lost their homes." Even the rise in domestic violence struck a personal note, with a shelter manager in Sampson County losing her daughter in a homicide.
Frasier's experiences staying at UCARE's shelter while she conducted training in the workplace and broader exposure to the problem led her to believe that even more needed to be done. With seed money from the Carolina Center for Public Service and student and staff volunteers from the University, she partnered with nonprofits in Duplin and Sampson counties to launch a community-wide domestic violence awareness campaign.
Posters and brochures originally printed for workplace training were reprinted for broader use. Carolina students and community members identified highways with the highest traffic count, and billboards went up in each of the three counties. Frasier also helped launch a "friendraiser" on April 19 and a fundraising effort to benefit the domestic violence agencies. Promotional banners were hung across city streets, and articles and editorials appeared in local newspapers to draw attention to the continuing rise in domestic violence.
The broader effort turned into a true family affair for Carolina.
Department of Family Medicine staffers Janet Newcity, Teresa Brooks and Fay Gibson were actively involved.
School of Public Health students Matt Streng and Carla Carrillo co-authored a proposal with Frasier that led to support from the Carolina Center for Public Service.
School of Nursing student Jill Parker joined with Margo Karriker from the School of Pharmacy and University affiliate Young Hee Jang to conduct blood pressure and diabetes screenings at one of the shelters. As an Interdisciplinary Rural Health Team class project, the three spent the night in the Sampson County UCARE shelter and went through the intake process as a "client." They established a small medical aid room in another shelter, Sarah's Refuge in Duplin County, where they worked with a part-time nurse and a community outreach staff member.
Claudia Gana, accepted in the School of Social Work for fall 2002, joined the effort as a volunteer and worked the entire weekend.
Through the undergraduate service-learning program, APPLES, journalism students Christina Hayes and Allison Strong authored public service announcements and press releases that ran in local media.
Teams from the University have been involved with the broader flood relief effort from the beginning. In fact, the Carolina Center for Public Service sponsored a two-year initiative to help with the recovery effort, supporting faculty, staff and students volunteering in the area.
"What we've been able to accomplish would not have happened without the support of the Carolina Center for Public Service and the Department of Family Medicine," Frasier said. "And the Community Advisory Committee for HPDP's Health Works for Women project really saw the problem and invited us to the community."
"We've all learned from the experience," Frasier added. It's easy to step in and think that we're there to fix something. But to borrow from Rachel Naomi Remen's Kitchen Table Wisdom, when we `fix' we don't see the wholeness in other people or trust the integrity of their lives. As representatives of the University, we are there not to fix -- but to serve, to respond and to collaborate at the invitation of the community."
It was a clear, sunny day when Warren Newton drove into the small, eastern North Carolina town of Bethel in the summer of 1999 -- a sharp and ironic contrast to what he saw around him. Hurricane Floyd had just drenched the area with 22 inches of rain, and homes and businesses were under water. Roads and bridges were washed out, making travel a challenge.
"It was clear that there was enormous disruption, and I began to get a sense clinically of what we were going to encounter," said Newton, William B. Aycock chair of the Department of Family Medicine. "It was apparent there would be both short-term and long-term problems."
Newton's instincts couldn't have been more accurate. As the third-year anniversary of the flood approaches, his department still is actively engaged in public health issues in the area, long after public attention has moved on to other issues.
"It's the mission of the Department of Family Medicine to promote public health through clinical practice, medical education, research and community service," he said. "The department has a special commitment to the underserved -- mothers and children, the elderly and other populations at risk. That's what we found in eastern North Carolina. It was those who were the poorest and who lived closest to the river banks who were hit, as though the disaster selected the neediest for destruction."
In the immediate aftermath of the flood, Newton headed up clinical outreach in the area, partnering with East Carolina University to establish acute medical care coverage. Carolina set up two clinics -- one near Princeville and another south of Greenville, staffed by multidisciplinary teams from the Schools of Medicine, Nursing, Pharmacy and Public Health, the Department of Pediatrics and UNC Hospitals.
Working 18-hour shifts for five to seven days at a time, they provided a much-needed service to flood victims, many of whom lost their prescriptions and medications during the flood and were unable to reach their routine sources of medical care.
A good two-thirds of the volunteers from Carolina who helped with the effort were students, Newton said. "Service learning is something we believe in very strongly. We particularly drew on upper level residents who could work fairly independently in a clinical setting," he added.
In addition to the clinical work that Newton coordinated, dozens of departments and organizations across the University were involved in the relief effort, supported by the Carolina Center for Public Service. Volunteers back at home took over the responsibilities of their co-workers, freeing them to spend extended time in the flood zone.
"The real experience of our institution is the power of working across disciplines," Newton said. The flood relief effort was a case in point.
Three years later
Nearly three years after the flood, hundreds of eastern North Carolina residents are still in temporary housing. They struggle to make a living in an area where businesses have closed and the unemployment rates are among the highest in the nation. And instances of domestic violence have soared by nearly 40 percent.
Newton himself witnessed children being beaten in the aftermath of the flood -- a function, he believes, of the stress people experienced as their lives were disrupted. "The social pathologies associated with that disruption are still taking their toll," he said.
In addition to ongoing wellness work in eastern North Carolina, the Department of Family Medicine is actively involved in addressing the domestic violence issue -- leading workplace training programs, conducting community awareness campaigns and supporting local domestic violence organizations.
For Newton, the work is central to his department's public service mission.
are people in eastern North Carolina who are among the poorest in the
country," he said. "For me, one of the lessons learned over the past
few years is that despite the economic gains we've made in the state,
the number of people who are vulnerable has changed very little. They
are no longer on the public radar screen, and we have an important role
to play in making certain they get the support they need."