Practicing harm reduction in a climate of disasters

Harm reduction has multiple sides according to Christine Rodriguez, the executive director of Higher Ground Harm Reduction. On the surface, there are “practical strategies and interventions that [are] put in place for folks to stay safer when they’re using drugs or trading sex.” She further specified that they’re “interventions that were created by people who use drugs and people who trade sex and were later researched and found to be effective.”

But for Rodriguez, and other harm reduction practitioners, like Rafael Torruella, the executive director of Intercambios Puerto Rico, it’s also a social movement.

Torrulella shared his belief that “harm reduction is not just service delivery, it’s not just a set of techniques, it’s not just a viewpoint of how to engage problematic drug use or sex or whatever have you it’s also part of a social movement that looks for a more just world for drug users, sex workers — that population. It has a social critique saying, no [expletive], this is not right.”

And that population is not small. According to the Substance Abuse and Mental Health Services Administration, in 2019 over 20 million people in the US experienced substance use disorder (alcohol use disorder, illicit drug use disorder, or both).

As we mentioned in an article last week, for the past 9 months, our team at Shareable has been working with Christine Rodriguez to research how community-based harm reduction programs (and people who use drugs) are responding to climate-related and other systems-disrupting emergencies.

In the spring, we conducted a series of interviews with practitioners as part of the development of a national needs assessment which surveyed community-based harm reduction programs to learn:

  • how their work has been impacted by disasters
  • what adaptations they’ve made
  • and what they need to be better prepared to respond in the future

Today, we’re releasing a new episode of The Response podcast exploring what harm reduction looks like in a climate of disasters. The 40-min audio documentary features interviews with Rafael Torruella, Justin Kunzelman (executive director and co-founder of Rebel Recovery Florida), and Savannah O’Neill (associate director of capacity building at the National Harm Reduction Coalition).

Co-leading this research project has introduced harm reduction to our entire team and we hope this will serve as a window into this relatively unknown movement.

Our report on disasters and harm reduction will be found on Higher Ground Harm Reduction’s website:

Practicing Harm Reduction in a climate of disasters” episode credits:

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The Response from, is a documentary film, book, and podcast series exploring how communities are building collective resilience in the wake of disasters.

Below is a transcript of the episode, modified for your reading pleasure.

Justin Kunzelman:  Like, I say it all the time and people think I’m joking, but I really did. I thought I invented harm reduction. Just because I had never been exposed to it at all.

Tom Llewellyn: Justin Kunzelman is the executive director and co-founder of Rebel Recovery Florida, located in West Palm Beach.

Justin Kunzelman: We provide recovery support services. Really, it’s really kind of a broad term, I guess. We pretty much provide any support that a person who is impacted by drugs needs. Anything from system navigational support to — help getting food stamps, help getting Social Security cards, I.D., stable housing, stable food supply, sterile using equipment, education about safer use practices, naloxone distribution. We have our recovery supports operate from a harm reduction principled base, it’s the driving force, for the entire agency.

Tom Llewellyn: Justin and his team provide services to over 500 participants a month. And that number doesn’t include many of those reached through their street-based program, which doesn’t require formal intake. I asked Justin what inspired him to get involved in this work.

Justin Kunzelman: I used a whole shitload of drugs and I was just really tired of seeing my people in my local community dying. I’m from Palm Beach County, Florida, which is like the treatment capital of the fucking world, or was at one time and most of the facilities that were here to provide services to people like me who were seeking recovery at the time or to people who use drugs had questions about drugs, all of those services were dominated by a privatized treatment industry.

So there were no services for people who use drugs. You had to have insurance, private insurance, so if my friends were overdosing in Lake Worth next to a fucking treatment center that’s feeding kids from Jersey lobster and steak, and making billions off our local economy, and not putting anything back into it, right? And then the people that I grew up with and the people in my local community and people from my culture are dying. And nothing’s being done except telling people like, well, they weren’t ready, call me when you’re ready to stop forever. And, I don’t know, man, I just felt like I could do a better job. So, I started distributing naloxone and syringes, information to the people that I grew up with, essentially just in our local community, but I didn’t know that it was harm reduction, I didn’t know that people did it elsewhere.

Rafael Torruella: It’s almost like dating myself, right? Like how long I’ve been doing this stuff. So I would say harm reduction work I’ve been doing for, maybe 15, 20 years or something like that. Something crazy, something like that. I started mostly here in Puerto Rico.

Tom Llewellyn: Rafael Torruella is the executive director of Intercambios Puerto Rico in San Juan, a peer led organization that provides direct harm reduction services to people who use drugs, homeless individuals, and sex workers. They also advocate for drug policy reform on the island. There was a multiplicity of factors that led into harm reduction work.

Rafael Torruella: Well, there’s a multiplicity of factors. I mean, individually, personal drug use and just knowledge of drug user networks and — remembering the feeling and knowing the feeling of this is not right. So if I go to the core rather than just saying, well, because of my drug use, I’m here. It’s a broader sense of social justice that is rooted in injustice that I’ve known both from firsthand and just getting into pro-social justice movements.

Tom Llewellyn: Rebel Recovery Florida and Intercambios Puerto Rico are part of a larger movement of groups doing harm reduction work that’s rooted in a belief in the dignity of drug users and respect for their rights.

Savannah O’Neill: I’m Savannah O’Neill and I’m the capacity building and community mobilization manager at the National Harm Reduction Coalition based in Oakland, California.

Tom Llewellyn: Savannah is a licensed social worker and addiction treatment counselor. She’s been working in harm reduction for about 12 years, and has been with the National Harm Reduction Coalition since 2018.

Savannah O’Neill: We’re a national capacity building and policy organization and we have staff all over the country and sort of the most in Oakland and New York, and we do a bunch of different stuff. We do very minimal direct service work — we do do some through a Naloxone access program in the city of San Francisco, but mostly do sort of statewide and national training, policy work — so legalizing syringe access in states, doing naloxone access, tracking federal policy and its impact on people who use drugs. And I’ve been involved in statewide budget campaigns to fund syringe service programs and then also put out lots of resources — so put our resources on safer injection and overdose, Hep C and then we run sort of local or more deep campaigns in certain states. So in California, we have various funding to support really deeply doing work with the syringe service programs, doing training, doing technical assistance, hosting community convenings and also putting out publications and then we host conferences —  so regional conferences and a national conference. So that’s broadly the work that we do.

Tom Llewellyn: The National Harm Reduction Coalition provides support and resources to many organizations that operate with similar structures to Rebel Recovery Florida and Intercambios Puerto Rico. This type of health care has been made significantly more difficult by the pandemic, as well as other major societal disruptions and disasters.

Savannah O’Neill: Yeah, I mean, I think that all of our work is disrupted in this current moment. Right. So we have had huge disruptions due to covid-19 — we’ve canceled all in-person trainings and convening. I personally had two scheduled in Salinas and in San Diego to really bring people together to look at what harm reduction work looks like. I’m not doing any traveling for policy work. So this California state legislature has a lot of bills on hold. Our budget process is totally truncated, so we’re not able to do the same level of policy work that we’re doing.

But over the years, I mean, I first kind of got interested in this conversation and what it means for people who use drugs, people who access syringe services or harm reduction programs or low barrier services in general during times of disaster. When Hurricane Maria happened and looking at what happened to service provision and really even thinking back to Hurricane Katrina and what I heard from friends who use drugs who were there and people who were incarcerated and sort of the lack of intentionality in ensuring that those people were considered in disaster planning. So that was sort of when I started thinking through this and hearing stories about it.

And then I grew up in Santa Rosa. And so my family was evacuated for two weeks during the first set of fires in that region — The Tubb’s fire. And so I saw the disruption with syringe service programs that they were still trying to find people but some of the spaces actually burned down. People were not in regular touch. How do you have contact information with people you normally see anonymously and don’t use their phone numbers? How do you let people know what are the systems of communication? And then so I was really personally deeply impacted by the Tubbs fire.

Tom Llewellyn: When it happened in 2017, the Tubbs Fire was the most destructive wildfire in California history, having a huge impact on many communities. Sadly, disasters like that are becoming the norm now not just in California or the US, but all over the world.

Both Justin and Rafael’s organizations are no strangers to natural hazards. Their communities are both hit by hurricanes quite often, and as we’ve discussed in previous episodes, these disasters disproportionately impact vulnerable communities and only exacerbate existing problems.

Justin Kunzelman: I think another large issue with specifically natural disasters or disasters of  —  I don’t even what the fuck they’re called like virus disasters, right? Biological events or whatever — is that any helpful spirit or understanding that the community may have had towards our people previous is now wiped away. Because given the option of helping people who use drugs and are experiencing homelessness versus being able to help my rich neighbor down the street cut down his palm trees, most people are going to go and be like, oh, well, fuck, I can just feel good by helping my neighbor cut up his palm trees, right? It’s like an easy out for their, I don’t know, charitable ego or whatever the fuck, so we’re just further displaces our participants.

You have obvious issues with, like law enforcement, heightened presence of law enforcement in areas that traditionally are encampments for our participants experiencing homelessness — can cause heightened anxiety when there’s already a fear of the unknown, uncertainty about the future. We have curfews that are put in place that people who are experiencing homelessness obviously can’t fucking abide by, right? Like, “yo, I live in the park.” And they’re like, “well, curfews nine o’clock.” And they’re like, “cool, I’m at home” and they’re like, “you’re in the public.” So it’s just an ongoing issue that it really just compounds all of the issues that we deal with day to day and so many different aspects, and I mean, it’s a rabbit hole that we could continue to go down. Detail, detail, detail. But I think that’s really the hardest part is that resources are already scarce and in times of emergency, they become even scarcer because the resources that people were willing to give to our participants or people like them, now they are keeping for themselves or giving to others that they see as more worthy.

Tom Llewellyn: It’s important to note that disruptions and disasters don’t only impact the communities being served — they also impact harm reduction organizations internally.

Rafael Torruella: During the hurricane, we had communication and then right after we had communication problems. Right. We don’t have short wave or good radios for staff to make contact with each other. At that time, we were seven of us and cell phone towers were down and heavily damaged. So, for example, on the eastern side of the island, didn’t communicate with San Juan. So I was in San Juan and people were here and in Fajardo, but we couldn’t communicate because literally things would cut off at about Cirujanos. Loiza, Rio Grande area. So there were big areas that could communicate among themselves, but not across. So that left for communications to be difficult for harm reduction organizations that cover big areas. Right. I can only imagine what other people have gone through, you know if you’re statewide or half a state bigger than Puerto Rico, then I don’t know how you can make it with staff and with participants.

Tom Llewellyn: Harm reduction organizations have come up with a number of innovative responses and adaptations to deal with many of these major disruptive events. And now, during the global pandemic, they have been forced to adapt in new ways that allow their work to continue.

Justin Kunzelman: We’re never going to stop providing services. I’m from Florida. I don’t give a fuck about a hurricane. I’ll go out in a hurricane if somebody needs services, that doesn’t affect my ability to provide services to somebody. But the agency’s protocols — I think because we’re a peer led agency — we developed our policies and our protocols, one, very rapidly because we had a vested interest in ensuring that people like ourselves were going to be taken care of. And two, that we understood what a lot of the natural needs would probably be, and were able to get ahead of the curve on setting up a lot of those services. So a lot of the services that you would traditionally need for a participant population in an emergency like that, we already provide.

So our policies now are to — we developed an emergency follow up form, so in the case of any emergency — covid, a tornado warning, a hurricane warning, flash flood warning, anything — we immediately bring everybody into the office and off the street and divide up our participant list, our outreach list, all known contacts, people who are not participants, but we have regular interactions with, and call them. And if we can’t call them, then we go find them and we sit down and we do the assessment with them. Hey, this is what’s coming. We want to ask you about a few things that we have found through community experience and doing services that are pretty vital to being comfortable or at least being safe during an event like whatever’s happening, make sure that they have access or have all of those things. If they don’t, then that’s notated and that’s the support worker’s task, is to take all of their participants on their participant list and do an in-depth personal follow up to really ask them like, “hey, what are you going to need to be safe through this? Is it a phone? Is it stable food supply? Is it stable living? Is it clothes? Is it batteries?” What can we do to put you in a comfortable and as safe a position as we possibly can while still being able to try to deliver the services during the course of this thing? So that’s just standard for any emergency.

For covid specifically, we did that and then developed safety policies and procedures for our staff to continue to engage in outreach. And based on the feedback from our participants and from the community members that utilize our services, we built out many versions of whatever they needed. So if, you know, probably if twenty or twenty five of our participants out of out of 250 said that they needed a stable source of food coming in, then great. We set up essentially like a food bank, a mini food bank, and just say for any of our participants who may need food, this was a requested service. Here you go. If it’s clothes, same thing. If it’s naloxone — whatever it is that we see a high need for, then we’ll just set those services up as ancillary services during the course of the emergency. And they may or may not be absorbed into our day to day programming depending on the usefulness and ease of delivery. Right.

So during covid, one of the first things we did was know that, OK, we need to go online and do online support groups. So we had to go and get individuals communication devices. Right, to be able to reach out to us if they needed something or to join a group or to be able to get text or phone support. So we generally set up our services to be able to continue regardless of anything, except probably like the end of the world and even then, we’ll probably provide services until like the absolute end.

Tom Llewellyn: The diversity of disasters these days is quite a challenge when it comes to creating protocols for organizational responses. Savannah and the National Harm Reduction Coalition understand this and have been gathering as much information as possible to help a wide variety of service providers.

Savannah O’Neill: So I’ve now sort of, in this role, been playing the part of gathering information of what people are doing and sharing that back out. And so we saw that happen through the fire seasons and I’ve definitely heard about it nationally through floods or hurricanes or other disasters of what systems people have started to build. And it’s been cool to support programs during the reality of covid because it’s different than how it’s impacting our work, right, so I’m working from home, we’re still able to kind of convene information, to host virtual meetings, to do a lot of our work without being exposed. But the syringe service programs that I provide we work with them and those people are having to radically change their work.

And it’s been incredible to see how creative and resilient people are. People are doing things like closing their Drop-In centers, but setting up tables in the doorway so that they can still give out supplies. They’re doing home deliveries. They’re doing no contact deliveries — the way people are doing food for safe injection materials for naloxone. Almost no programs have shut down. And the ones that have is because of public health employees being reclassified. So people have really fought in this moment of social distancing to ensure that people who use drugs in California still have access to the baseline materials, but they’ve had to respond really quickly to change services. And so that’s sort of the work that I’m doing to support folks right now. And it’s looked different in different disasters. So I think part of this thought process for me is like how do we plan for hugely different realities but identify the things that have been helpful across them. So I think we’ve already seen some of the things that have been helpful for programs in this moment in California.

Tom Llewellyn: The National National Harm Reduction Coalition has been collecting stories and best practices of how organizations have been able to adapt to maintain service provision during the pandemic. They’ve hosted and recorded weekly office hour calls and compiled short videos of what’s working now.

Savannah O’Neill: Our first call that we had after the shelter in place got announced statewide was — or it might have been actually the shelter in place was announced for the Bay Area and was sort of starting to happen in other regions in the state of California. We had 70 something people on our call, which our California syringe service program calls, probably normally thirty, thirty-five. And so many people were just ready to share what they were doing, ready to check if what they were doing was the right thing to do. Like, oh, we started having our volunteers work in shifts so that this group of volunteers isn’t exposed to this other group of volunteers. And we can have people tap out if someone gets symptoms. Just really creative, innovative stuff that they were sharing out together.

Savannah O’Neill: And so I think that has now been a space that we can offer those protocols without having to be an expert from the beginning. It’s just having rapid touch with people who are responding. And then some folks called us after that call and said, like, “oh, we actually closed services because we weren’t sure how do we reopen safely.  Our staff are really immunocompromised, how do we make sure that they’re protected?” So asking really challenging questions. Right. It’s not only like you should absolutely stay open, it’s like how do you stay open that’s safe for you and participants? And I think that was true during other disasters. When you think about the fires all the staff were really impacted, right, so even they lost their homes or they were displaced and didn’t have anywhere to go. And so how do we have a system for people who can pick up that kind of work in these moments able to do it?

Justin Kunzelman: Yeah, you know, some things we I did have to mandate just for the safety of the agency and the safety of people around my staff. We gave folks who were doing outreach the option to continue to do outreach or not, but we do require that whatever decision you make, if you are coming into contact with anybody in the public, anybody outside your household, your other staff members, we asked them to follow CDC guidelines. Don’t come to work if you’re not willing to wear a mask, if you can’t follow CDC guidelines, then just stay home and do your job and get paid from there. But we have a nurse, she’s a doctor nurse,  which I didn’t even know that was a real thing, but she is one of our board members and wrote out covid-19 safety guidelines, protocols for engaging with participants, engaging with family members, with other staff, with other agencies. We did everything that we could within the first two weeks that any of this was announced to prepare our staff and give them the tools and the resources that they needed to be safe.

But, probably the thing that’s affected the most is the ability to operate some of our programs — like our jail program. It’s a program that I did not feel safe sending my participants, I mean, my staff into. I would not go and I am not going to ask my staff to do anything I wouldn’t do. And for outreach, which unfortunately is our most vulnerable population, but we were able to, within a week of stopping outreach, create policies and safety protocols that would allow our workers to perform outreach with their participants as safely as possible, and still be able to continue for the most part with most of our services. It’s just been an adjustment period. But thankfully we are very fluid, and a lot of that comes from harm reduction and the stuff that people have taught me, that the people who came before me have taught me in harm reduction, is that things are consistently changing. They’re going to change, be prepared for change. And, you know, that’s what we did.

Tom Llewellyn: Another important aspect of adaptation comes in the form of partnerships. Many harm reduction groups have deepened their relationships with other organizations, nonprofits, and government agencies to help ensure that services and funding continue to flow during periods of crisis.

Justin Kunzelman: So the way our state’s funded is through managing entities, which are like third party contracting agencies for the state. So our managing entity, shockingly, stepped the fuck up in huge ways. They provided PPE for almost every agency that they contract with in as reasonable a time as they possibly could, given everything. Churches have been invaluable as far as food drives, all the food that we get was donated from churches. And probably the most surprising thing is that the state and the county allowed a lot of the requests that we made that were off the wall, probably eight weeks ago, you know what I mean, like before covid, they’d have been like, “fuck no, you can’t buy everybody who doesn’t have a communication device, a track phone.” But during this, a lot of those regulations got loosened, and simply by saying, “hey, this is a need like this is honestly a need for our participants right now,” and they didn’t fight us on it.

I think most of the other support has just come in the form of resources and relationships we had already built with other folks in the community — other agencies where we had these pre-existing relationships and some of those just got more and more expanded, specifically like grassroots community-led organizations around that are doing family therapy, youth therapy — we’ve been able to partner with community health clinics and med schools, med students. And you know, I think those relationships have really built a pretty comprehensive network of care for our participants that allows a level of oversight, case management.

We built relationships with them that really allowed for an expansion of any services that we were already providing, but perhaps those agencies were more cautious of diving fully into previous to this. I think it’s like the entire community of network of providers kind of came together to develop the best possible system regarding what’s going on currently and has been actually really incredible about sharing resources, information and tricks of the trade for how they’ve been getting around some of the issues that have come up that are unprecedented in helping us develop very creative ways to solve really stupid problems.

Tom Llewellyn: Intercambios Puerto Rico has invested a lot of energy in leveraging the opportunities created by the pandemic.

Rafael Torruella: I’m personally not doing that much, but our contractor is meeting with municipalities, letting them know what we do, how we do it and how in moments of crisis we can be of help. Right. So it’s  by offering, not just demanding when it’s coming — whatever coming is, hurricane, pandemic, whatever — but saying we’re here and we can be part of your response. It’s mostly at the municipal level. We operate, I think, now in 13 municipalities — so it’s a lot of conversations with different people at different spectrums of different politics.

That’s one. And then there is responding alongside or in tandem with different organizations that do this work, but didn’t know that we had the strength that we have. For example, homeless coalitions have been our friends throughout the pandemic, and my friend in homeless coalitions, I call him, is going like, “oh, shit, you’re still moving.” And we’re like, “yeah, we haven’t stopped.” He’s like, “oh, OK. Well, that’s useful because I can use your person or how about we do covid testing together and you put your people there so we can provide supportive counseling for homeless individuals.” Perfect, that’s what we do. That’s what our grant is for. That’s what I wanted all along. But now Covid is pushing because, you know, now you know our strengths.

So, both the governmental side is there to insert ourselves in this response — and we have. For example, we met with the municipality of Humacao and he was like, “oh, I didn’t know you were doing this,” it’s like, well, “we’ve been touch with you, but you never pay attention.” I didn’t say it that way, but now, you know, it’s better let’s work together. And he’s goes like, “oh, OK, I’m there now giving food as part of covid response.”

Right. Saying well, you’re giving food to homeless individuals, we provide behavioral health and I have syringe exchange. He’s like, oh, you really? It’s like yes, there’s my team. And then we can integrate services with the services that you’re doing. And then the homeless provision and working coalition with others in the homeless coalition brought in covid testing by the Department of Health. And suddenly you had this beautiful space where there was food provided by the government, we were providing our homeless services for people who use drugs and have co-occurring disorders, we had syringe exchange, and the homeless folks that came in were doing the covid testing and then there was other treatment folks for mental health in addition to that. Suddenly, oh, there’s a co-location of services in this place. And harm reduction was playing a key role in bringing that together. That worked.

So to build collective responses, you need to build collective prior, not during or after. After is beautiful, but they’re not to be sustained because it’s not a quote unquote real daily thing — it’s a spur of the moment beautiful thing that happens among communities that will have its own beautiful life, sometimes it’ll be sustained, but it’s better to do it prior. So any work that we can do prior, as in protocols, as in gold standards of what you want to hit, and as I mentioned before, what language and where are the fissures that harm reduction organizations can insert themselves to not guarantee, but have a better fighting chance for participants to get harm reduction services, whatever defined they are. I would say continuity of service, of bonafide methadone on access to care, access to behavioral health, all that stuff.

So during is a different beast. Right. So it’s also like how to prepare for like how many — and it depends so much on what the occurrence is like, what do you need for hurricanes, how much you need to prepare for participants, how you need to be for staff, what is an adequate employee policy for hurricanes and for all that? Because that’s another thing. I mean, do you give people days off before when you’re preparing? Do you give people days after? Do you stagger them? What do you ask for? What’s a good employee policy for a harm reduction organization before, during and after these times? We don’t know. I mean, we kind of had an idea, we know when hurricanes kind of look like, but I think that we’ve had so many that we can’t give days off. Many times it’s like, federal won’t get days off either. Right? That would be helpful. And then supplies also, of course, would be very helpful. And then supplies, of course — like what is a good way of maintaining supplies and how do you maintain adequate supplies and what is that look like?

Tom Llewellyn: Although specific protocols and resources are an important aspect of disaster response, harm reduction in itself is a response to an ongoing social disaster. Because of the nature of their work, these programs are often well-suited to adapting to rapidly shifting conditions.

Justin Kunzelman: We were prepared, but we would have been prepared for anything. Does that makes sense? And I don’t say that to like — I’m not saying to try to be braggadocious. I think that the agencies that we noticed that were unprepared, were unprepared to deliver services with fidelity in the first place. I think the reason that we were so prepared and I believe that we are prepared for the most part for anything that happens is the way that we provide our services, the way that we approach our services, the mindset that we take, the relationships that we built with our participants, we have had to scrape by and be creative and think outside the box and do with what we we had for so long that in the face of an emergency, like that’s just another day, it’s just a windy, rainy day, right.

Or like, I think a lot of it is owed to the fact that we are a grassroots peer led agency. You know, we, as people who use drugs and experience homelessness and all the things that my experience in life has shown me is that we’re really good at adapting and being fluid. And specifically for our agency in our state, there isn’t another harm reduction agency in our state. There’s no other agency even that was interested in doing the work that we were doing. And we became very fluid in being able to make changes and to implement programs that were very radical to the rest of the community, and try to really pivot based on the feedback from our participants.

I guess it’s a tenet of harm reduction, at least for me, is that there should never be a rigid set of ideals or skill sets for helping any individual person. We have this whole toolbox. And as the person is divulging or we are building that connection in that relationship, we were able to pull a tool out of the toolbox. And if it doesn’t work, just set it down and grab another tool. And if that doesn’t work, then we’ll invent a tool. But for so long, we’ve had to do this work with limited, limited resources and entire communities, entire treatment systems, state leaders, politicians, the police, on and on and on and on, telling us that we couldn’t do it or putting up blockades in front of us or sabotaging us trying to start programs. So we get very good at doing whatever needs to be done and figuring out very creative ways to accomplish those same tasks.

Tom Llewellyn: The lack of community resources during times of “normalcy” has made harm reduction services particularly resilient to working under dire circumstances. And as we’ve explored in previous episodes, these acute disruptions can reveal the chronic disasters that many communities experience on a daily basis.

Savannah O’Neill: something that keeps coming up of like what’s so frustrating during disasters, right, is not only is there collective level trauma, but it’s also that it is showing the intense vulnerability that people already had and that people who are doing on the ground work and doing harm reduction work already see — it’s not new. And yet, like it becomes a new narrative at the societal level. So like people are like, oh, wow, look at the income inequality, look at the issues of people — look people what if people don’t have a place to shelter in place. And folks who are doing work with unhoused folks are like, well, yeah, we’ve been saying that housing is health care, housing is a human right, housing is what protects our health and dignity. And yet in these moments, the conversation kind of bubbles up differently. So I think there is kind of a framework in questions about sort of what is happening during moments where there isn’t active, intense disruption or active violent disaster that either prepare us or put us in vulnerable to the realities of disaster. So I think that’s something I keep coming back to.

And then I think it’s kind of still related to that of who is most vulnerable to disasters are the same people who are most vulnerable to structural violence in general and who are already being really impacted by these things. So also looking at what systems are already in place to support those folks and that those are the infrastructure to respond to disaster. It’s like how do we ask questions about those, like kind of create their ability to do that more robustly?

Rafael Torruella: Another important part of this, that we’re not even talking about because we’re — I don’t want to say too lost in the technical, but we’re focusing on the technical and how to on the preparedness. I think the more of this we have — this defined as occurrences that create disruption. We should also be talking about how to do social movement. I believe that harm reduction is not just service delivery, it’s not just a set of techniques, it’s not just a viewpoint of how to engage problematic drug use or sex or whatever have you, it’s also part of a social movement that looks for a more just world for drug users, sex workers — that population. Right. So it has a social critique saying, like, no shit, this is not right.


This article is part of our reporting on The People’s COVID-19 Response.

The Response: Building Collective Resilience in the Wake of Disasters

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