Presentation: BiBS study recommendations
Presentation in Support of NOM23/002 - UPGRADES TO EVACUATION CENTRES - to Eurobodalla Shire Council on 25th July, 2023
Australian Breastfeeding Association’s Community Protection for Infants and Young Children in Bushfire Project - BiBS study recommendations
Presented by Dr Michelle Hamrosi
Project Lead - Dr Karleen Gribble
Community Engagement Officer - Dr Michelle Hamrosi
Local Project Officer - Kate Turtiainen
Good morning Mayor, Councillors, General manager and executive members of council. Thank you to Councillor Mayne for inviting me to speak today. I have some important research findings to share with you today, that if implemented will help families be better prepared and supported in the event of disaster in Eurobodalla Shire.
My name is Michelle Hamrosi. I am a GP, and the Community Engagement Officer for the Australian Breastfeeding Association’s Community Protection for Infants and Young Children in Bushfire Project (we call it ABA’s Bushfire Project for short). This project is funded by a federal government grant and was supported by the previous GM as well as the mayor and many councillors. Thank you for your support and for the councillors who have been part of our project so far.
ABA’s Bushfire Project was set up after it was identified emergency planning in Australia for families with babies and toddlers in disasters was lacking. As a mum with three kids, I witnessed firsthand how challenging it was to evacuate on my own during the 2019-20 bushfires. I remember thinking ‘What do I need to bring, where do we go that’s safe and how are we going to get there together?’ My youngest was just learning to walk. My head was foggy from stress and sleep deprivation. I had never been through anything like this, most of us hadn’t.
As a doctor, I was aware of how vulnerable children are in emergencies, especially babies and toddlers - due to their stage of physical and emotional development, specific food and fluid requirements, heightened susceptibility to dehydration and infection, extreme heat and toxic smoke exposure, as well as total dependence on others for care. Parents, like myself, needed support keep their very young children safe, but support was not always available. In the weeks after I returned to work, I heard countless distressing stories, of loss, of near misses, of desperate families trying to keep their infants and young children safe. I have treated many bushfire victims over the past few years, many with ongoing physical and psychological issues. I am deeply committed to making sure we are all better prepared next time. Now, we are facing another hot dry summer, we need only to look overseas to see what’s possibly around the corner for us.
Until now, the experiences and needs of families with very young children during emergencies have been largely invisible and overlooked. Our new research, a collaboration between the Australian Breastfeeding Association and Western Sydney University, has changed this. Forming the first part of ABA’s Bushfire Project, the Babies and Young Children in Black Summer Bushfires (or BiBS) study identified the challenges faced by the parents of very young children in emergencies, and what can be done to improve emergency responses in future to better support families.
In the BiBS study, we surveyed and interviewed 256 parents of children from newborn to four years old at the time of the Black Summer bushfires, and 63 emergency responders. Specifically, 23 of the interviews were focused on families in our shire.
The study revealed that caring for infants and young children during the bushfires had a profound effect on caregivers' experiences. Preparing to evacuate became more complex and logistically challenging, leaving many caregivers underprepared. The lack of evacuation plans and difficulties in packing essentials resulted in delayed evacuations and insufficient resources to care for children. Mothers, in particular, often found themselves alone with multiple small children and elderly family members during evacuations, while partners stayed behind to protect property or engage in emergency response activities.
Families that attended large evacuation centres faced challenges of keeping their children safe due to overcrowding, the presence of strangers and animals, and because there were limited resources for caring for children. Mothers prioritised their children’s wellbeing over their own and often did not eat or drink properly. This was particularly concerning for pregnant and breastfeeding women. Two of the five pregnant women we interviewed fainted while queuing for food and assistance.
Emergency responders acknowledged the vulnerability of children and their caregivers in such centres, citing child protection concerns and unsafe practices because of a lack of planning and training for children in disasters. Caregivers who were able to seek refuge with family or friends or smaller ad hoc evacuation centres, like a local preschool or bowls club, had a more positive experience.
The study also highlighted the challenges faced by breastfeeding mothers during the bushfires. While they were relieved not to rely on external resources like electricity, they had concerns about milk supply because of infant fussiness and frequent feeding. Emergency responders recognised the need for breastfeeding support for evacuated mothers but acknowledged the difficulty in accessing such services. Formula feeding caregivers faced obstacles in obtaining supplies, including specialised formulas, during the fires. The process of providing infant formula in evacuation centres lacked consistency, with excessive and outdated donations and insufficient attention to caregivers' needs for washing and preparation facilities.
Pregnant women faced restricted access to healthcare and expressed concerns about the effects of smoke and stress on their unborn babies. The study emphasised the necessity of providing resources to pregnant women in case they had to give birth alone during emergencies.
Both caregivers and emergency responders stressed the need for targeted resources and communication strategies to better prepare families with very young children for emergencies. This included providing guidance on what items to include in evacuation kits. Parents expressed their desire for better preparedness and an earlier evacuation.
The BiBS Study Report makes 16 recommendations to improve emergency response, including evaluating existing planning with a ‘young child lens’ to see how they can be improved, creating emergency preparedness resources targeted at parents, and having a separate and supportive space in evacuation centres for families with very young children.
Particularly relevant recommendations to council include:
Planning for families for in emergency response and recovery
Identifying suitable evacuation centres dedicated to families with very young children:
The needs of very young children should be considered in evaluation of venues for suitability as evacuation centres. Based on our findings, council may wish to consider making available a number of smaller centres, with rooms or separate spaces for families with very young children.
Factors to consider include whether the building has rooms or spaces that could be used as a child-friendly space or as separate space for families with very young children as well as safety considerations related to roads, gates, steps and balconies.
Making large evacuation centres more child friendly:
• Evacuation centres should provide a space for parents and caregivers of very young children separate from the general population. These spaces should be resourced with: a private space for mothers to sit and breastfeed or express milk, snacks and water for breastfeeding mothers, infant formula, a clean space for infant formula preparation, washing and sterilising supplies, access to hot water for washing, complementary foods and feeding implements; nappy changing facilities, safe sleep spaces, and an appropriate play space for babies to crawl, sit and play along with suitable clean toys. These spaces should be staffed by volunteers/workers who have received basic training on breastfeeding, formula feeding, hygiene, sleep safety, and psychological first aid and aim to provide an environment where caregivers are able to be responsive and reassuring to their children. Mothers experiencing breastfeeding challenges should receive breastfeeding counselling onsite or via the National Breastfeeding Helpline.
• Safety of children in evacuation centres should be prioritised. Walkthroughs should be regularly undertaken to ensure that the environment is safe for children. Evacuation centres should have clear signage directing parents and caregivers to assistance and signs in toilets stating that baby bottles should not be washed in toilet sinks.
Considering needs of young children in evacuation and recovery centres:
• Child Friendly Spaces should be provided in evacuation and recovery centres so that children of all ages can be cared for and play while parents and caregivers attend to important needs and conversations on their own.
• Immediately following the emergency, a space should be provided for mothers and other caregivers to come with their infants and very young children to be with one another, to support one another, and to allow children to play. Over time, this space should be augmented with more formal supports, with the intent being to facilitate mothers and other caregivers to remain connected to and to provide sensitive and responsive care to their very young children.
Clear communication prior to disaster
• Emergency preparedness materials and initiatives for families with very young children should be developed with detailed information on what to pack, and emphasis on early evacuation and prioritisation of evacuation to homes of family and friends rather than evacuation centres.
• Parents should be informed about which evacuation centres are more suitable for families with very young children.
• Social media messaging addressing the broad spectrum of possible emergency related issues for families of very young children should be prepared and shared via council social media channels.
• Communicating the above information prior/during disasters with parents/caregivers via social media as well as other avenues including council related newsletters, parent groups and other child-related organisations such as playgroups and preschools/childcare centres will assist in maximising parental engagement.
Note: as part of the project we are creating resources such as evacuation centre check lists, walk through safety checklists, evacuation kit checklists for families, relevant emergency messaging for families with infants etc
We need to do better in future emergencies
Our study highlights how it takes a village to care for each other in emergencies and after. It also highlights the importance of individual and community preparedness.
Now the BiBS Study has been completed, the second part of ABA’s Bushfire Project is underway, that is working to implement the findings in Eurobodalla to increase community resilience. We have already connected with SHASA, the Red Cross, CWA, family support organisations, preschools and parents and have commenced discussions with them about how we can support them to improve their emergency planning and response. Given the central and vital role of local government in emergencies, we would very much like to work with the Eurobodalla Council also.
As we move forward in the Community Protection for Infants and Young children in Bushfire Emergencies project, I welcome continued collaboration with council and organisations working in disaster preparedness and management. We will be running some workshops in the coming months and we welcome your involvement. I believe, with some relatively small changes, a large improvement in emergency response to the very young and their caregivers can be achieved.
(Note: if you or your organisation would like more information about our coming workshops, or to register your interest, please follow this link: https://forms.office.com/r/nup1YFZ3N1)
If you’d like to read the full report or watch the report webinar, you can access them here: https://www.breastfeeding.asn.au/resources-community-protection-infants-and-young-children-bushfire-emergencies-project
Note: This site will be regularly updated to include our resources as they developed.