Beyond Textbooks and TV: Team Epi-Aid Learns Through Experience

It is one thing to read or hear about the aftermath of a hurricane in the news or to study field epidemiology in class. But it is something else to experience the mayhem and distress firsthand – as a team of volunteers from the University of North Carolina at Chapel Hill School of Public Health did when they headed to southern Florida Oct. 31 after Hurricane Wilma hit the state as a Category 3 storm.Through Team Epi-Aid, a program of the North Carolina Center for Public Health Preparedness, a UNC team of one student, two recent graduates and a staff member joined other North Carolina public health professionals, the Centers for Disease Control and Prevention, and the Florida Department of Health to assess community needs in two southern Florida counties.

Dr. Keith Henderson, incident commander for the North Carolina team and an epidemiologist in Fayetteville, credits the volunteers for the mission’s success. “We had a good mix and combination of state and regional people and some local health department personnel,” he said.

The team spent several days visiting a sample set of homes to ask occupants about their access to food, water, and other necessities. Handheld computers equipped with a Global Positioning System (GPS) directed the group to select addresses and allowed them to immediately enter interview data.

Henderson said Team Epi-Aid added strength to the team. “The students asked very interesting and probing questions,” he said. “It was exciting to have them, to see all that energy. They were able to make us think about things that we wouldn’t ordinarily have thought about.”

And he thought the experience was a good learning tool “because being able to go out in the aftermath of a hurricane is real practical disaster epidemiology.”

Sandi McCoy, a second-year doctoral student in the Department of Epidemiology, agreed. “It’s a great opportunity to augment my classroom studies with real-world experience,” she said.

Heather Keith and Morgan Johnson, who recently completed a master’s program in the Department of Health Behavior and Health Education, joined McCoy to represent Team Epi-Aid. Jennifer Horney, assistant director of the North Carolina Center for Public Health Preparedness, accompanied the team.

Johnson is concerned about the long-term needs of the people she met. “The intention of the needs assessment was based on the needs that had arisen from the hurricane,” she said. “But we were uncovering chronic problems that need to be dealt with. At what point do officials decide they’ve met the current needs?”

The teams began their assessments October 31 – one week after Wilma roared through southern Florida with 125 mph winds. Johnson better understands the system of health preparedness and would like to become more involved with disaster preparedness in the future. “North Carolina has an excellent system of rapid needs assessment,” she said. “A lot of states could learn from us.”

The Florida Department of Health couldn’t agree more. Mitch Stripling, preparedness education coordinator for the Division of Environmental Health, said, “We’re hoping to use them as a model to build our environmental strike teams . . . both in terms of training and experience of the members and the technology that they were able to leverage.”

The extra manpower from North Carolina and the data collected helped responders find places that didn’t have access to water, transportation and other necessities. Teams visited urban Broward County and rural Hendry County, identified by the Florida Department of Health as the most severely affected rural area.

“We had to drive about two hours out there from where we were based,” said Horney. “There were hundreds and hundreds of lots and trailers on a grid of dirt roads.”

Despite the rural landscape, the Florida Department of Health and county health departments provided same-day and next-day response, following team reports.

One woman, who had stepped on a nail while walking through the rubble of her damaged home, had been told by paramedics to get a tetanus shot, but the nearest treatment center was closed. The team called Stripling, who made arrangements for a county nurse to go administer the shot.

Another woman with two toddlers and no transportation needed diapers. “We were able to get on the phone while we were there visiting her,” said Horney. The health department responded by delivering diapers the next morning.

Horney said the disruption of the economy was a problem because people couldn’t get back to work. “The people who live in this community are OK as long as nothing unexpected happens,” she said. “This is when you really see the differential health impacts on people.”

The North Carolina Center for Public Health Preparedness is a program of the North Carolina Institute for Public Health at the UNC School of Public Health.

For more information about Team Epi-Aid, visit /unc-center-for-public-health-preparedness-2/, or contact the North Carolina Center for Public Health Preparedness at (919) 843-5561 or

For more information about the North Carolina Institute for Public Health, contact Bev Holt at (919) 966-6274 or bev_holt@unc.edu.

For further information please contact Ramona Dubose either by phone at (919) 966-7467 or by e-mail at ramona_dubose@unc.edu.