Abstract The original intention for the Partnership Community Worker (PCW) project in 2006 was for it to be an extension of the Pegasus Health General Practice and furthermore to be a bridge between the community and primary healthcare. It was believed that a close working relationship between the Practice Nurse and the PCW would help the target population of Māori, Pacifica and low income people to address and overcome their perceived barriers to healthcare which included: finance, transport, anxiety, cultural issues, communication, or lack of knowledge. Seven years later although the PCW project has been deemed a success in the Canterbury District Health Board annual reports (2013-14) and community and government agencies, including the Christchurch Resettlement Service (2012), many of the Pegasus Health General Practices have not utilised the project to its full extent, hence the need for this research. I was interested in finding out in the first instance if the model had changed and, if so why, and in the second instance if the promotional material currently distributed by Pegasus Health Primary Health Organisation reflected the daily practice of the PCW. A combination of methods were used including: surveys to the Pegasus Health General Practices, interviews with PCWs, interviews with managers of both the PCW host organisations and referring agencies to the PCW project. All the questions asked of all the participants in this research were focussed on their own perception of the role of the PCW. Results showed that the model has changed and although the publications were not reflecting the original intention of the project they did reflect the daily practice of the PCWs who are now struggling to meet much wider community expectations and needs. Key Results: Partnership Community Worker (PCW) interviews: Seventeen PCWs of the 19 employed were interviewed face to face. A number expressed interest in more culturally specific training and some are pursuing qualifications in social work; for many pay parity is an issue. In addition, many felt overwhelmed by the expectations around clients with mental health issues and housing issues now, post-earthquakes. Medical Practice surveys: Surveys were sent to eighty-two Pegasus Health medical practices and of these twenty five were completed. Results showed the full capacity of the PCW role was not clearly understood by all with many believing it was mostly a transport service. Those who did understand the full complexity of the role were very satisfied with the outcomes. PCW Host Community Manager Interviews: Of the ten out of twelve managers interviewed, some wished for more communication with Pegasus Health management because they felt aspects of both the PCW role and their own role as managers had become blurred over time. Referring organisations: Fifteen of the fifty referring community or government organisations participated. The overall satisfaction of the service was high and some acknowledged the continuing need for PCWs to be placed in communities where they were well known and trusted. Moreover results also showed that both the Canterbury earthquakes 2010-2011 and the amalgamation of Partnership Health PHO and Pegasus Health Charitable Limited in 2013 have contributed to the change of the model. Further future research may also be needed to examine the long term effects on the people of Canterbury involved in community work during the 2011-2014 years.
Christchurch has experienced a series of over 13,500 earthquakes between September 2010 and January 2012. Some children who have been exposed to earthquakes may experience post-traumatic stress disorder symptoms (PTSD) including difficulty concentrating, feeling anxious, restlessness and confusion. Other children may be resilient to the effects of disaster. Western models of resilience relate to a child’s social support and their capacity to cope. The Māori model of wellbeing relates to whanau (family), wairua (spiritual connections), tinana (the physical body) and hinengaro (the mind and emotions). Children’s concepts of helping, caring and learning may provide insight into resilience without introducing the topic of earthquakes into the conversation, which in itself may provoke an episode of stress. Many researchers have studied the effects of earthquakes on children. However, few studies have examined positive outcomes and resilience or listened to the children’s voices. The objective of this study was to listen to the voices of children who experienced the Canterbury earthquake period in order to gain a deeper understanding of the ideas associated resilience. Individual interviews were conducted with 17 five-year-old participants during their first term of primary school. After the interviews, the teacher shared demographic information and reports on the children’s stress and coping. Six children were identified as New Zealand European and eleven children identified as New Zealand Māori. Children had different views of helping, caring and learning. Themes of resilience from Western and Kaupapa Māori models were identified in transcripts of the children's voices and drawings. Māori children voiced more themes of resilience associated with the Western model, and in the Tapa Whā model, Māori children's transcripts were more likely to be inclusive of all four components of well-being. How five-year-old children, having experienced an earthquake disaster during their preschool years, talk or draw pictures about helping, caring and learning can provide insight into resilience, especially in situations where it is not advisable to re-traumatise children by discussing the disaster event. Future research should interview parents/caregivers and whānau to gain further insights. Considering information from both a Western and a Tapa Whā perspective can also provide new insights into resilience in young children. A limitation of this study is that qualitative studies are not always free from a researcher’s interpretation and are, therefore, subjective.
Social and natural capital are fundamental to people’s wellbeing, often within the context of local community. Developing communities and linking people together provide benefits in terms of mental well-being, physical activity and other associated health outcomes. The research presented here was carried out in Christchurch - Ōtautahi, New Zealand, a city currently re-building, after a series of devastating earthquakes in 2010 and 2011. Poor mental health has been shown to be a significant post-earthquake problem, and social connection has been postulated as part of a solution. By curating a disparate set of community services, activities and facilities, organised into a Geographic Information Systems (GIS) database, we created i) an accessibility analysis of 11 health and well-being services, ii) a mobility scenario analysis focusing on 4 general well-being services and iii) a location-allocation model focusing on 3 primary health care and welfare location optimisation. Our results demonstrate that overall, the majority of neighbourhoods in Christchurch benefit from a high level of accessibility to almost all the services; but with an urban-rural gradient (the further away from the centre, the less services are available, as is expected). The noticeable exception to this trend, is that the more deprived eastern suburbs have poorer accessibility, suggesting social inequity in accessibility. The findings presented here show the potential of optimisation modelling and database curation for urban and community facility planning purposes.
A natural disaster will inevitably strike New Zealand in the coming years, damaging educational facilities. Delays in building quality replacement facilities will lead to short-term disruption of education, risking long-term inequalities for the affected students. The Christchurch earthquake demonstrated the issues arising from a lack of school planning and support. This research proposes a system that can effectively provide rapid, prefabricated, primary schools in post-disaster environments. The aim is to continue education for children in the short term, while using construction that is suitable until the total replacement of the given school is completed. The expandable prefabricated architecture meets the strength, time, and transport requirements to deliver a robust, rapid relief temporary construction. It is also adaptable to any area within New Zealand. This design solution supports personal well-being and mitigates the risk of educational gaps, PTSD linked with anxiety and depression, and many other mental health disorders that can impact students and teachers after a natural disaster.
The Evaluating Maternity Units (EMU) study is a mixed method project involving a prospective cohort study, surveys (two postnatal questionnaires) and focus groups. It is an Australasian project funded by the Australian Health and Medical Research Council. Its primary aim was to compare the birth outcomes of two groups of well women – one group who planned to give birth at a primary maternity unit, and a second group who planned to give birth at a tertiary hospital. The secondary aim was to learn about women’s views and experiences regarding their birthplace decision-making, transfer, maternity care and experiences, and any other issues they raised. The New Zealand arm of the study was carried out in Christchurch, and was seriously affected by the earthquakes, halting recruitment at 702 participants. Comprehensive details were collected from both midwives and women regarding antenatal and early labour changes of birthplace plans and perinatal transfers from the primary units to the tertiary hospital. Women were asked about how they felt about plan changes and transfers in the first survey, and they were discussed in some focus groups. The transfer findings are still being analysed and will be presented. This study is set within the local maternity context, is recent, relevant and robust. It provides midwives with contemporary information about transfers from New Zealand primary maternity units and women’s views and experiences. It may help inform the conversations midwives have with each other, and with women and their families/whānau, regarding the choices of birthplace for well childbearing women.
One of the great challenges facing human systems today is how to prepare for, manage, and adapt successfully to the profound and rapid changes wreaked by disasters. Wellington, New Zealand, is a capital city at significant risk of devastating earthquake and tsunami, potentially requiring mass evacuations with little or short notice. Subsequent hardship and suffering due to widespread property damage and infrastructure failure could cause large areas of the Wellington Region to become uninhabitable for weeks to months. Previous research has shown that positive health and well-being are associated with disaster-resilient outcomes. Preventing adverse outcomes before disaster strikes, through developing strengths-based skill sets in health-protective attitudes and behaviours, is increasingly advocated in disaster research, practise, and management. This study hypothesised that well-being constructs involving an affective heuristic play vital roles in pathways to resilience as proximal determinants of health-protective behaviours. Specifically, this study examined the importance of health-related quality of life and subjective well-being in motivating evacuation preparedness, measured in a community sample (n=695) drawn from the general adult population of Wellington’s isolated eastern suburbs. Using a quantitative epidemiological approach, the study measured the prevalence of key quality of life indicators (physical and mental health, emotional well-being or “Sense of Coherence”, spiritual well-being, social well-being, and life satisfaction) using validated psychometric scales; analysed the strengths of association between these indicators and the level of evacuation preparedness at categorical and continuous levels of measurement; and tested the predictive power of the model to explain the variance in evacuation preparedness activity. This is the first study known to examine multi-dimensional positive health and global well-being as resilient processes for engaging in evacuation preparedness behaviour. A cross-sectional study design and quantitative survey were used to collect self-report data on the study variables; a postal questionnaire was fielded between November 2008 and March 2009 to a sampling frame developed through multi-stage cluster randomisation. The survey response rate was 28.5%, yielding a margin of error of +/- 3.8% with 95% confidence and 80% statistical power to detect a true correlation coefficient of 0.11 or greater. In addition to the primary study variables, data were collected on demographic and ancillary variables relating to contextual factors in the physical environment (risk perception of physical and personal vulnerability to disaster) and the social environment (through the construct of self-determination), and other measures of disaster preparedness. These data are reserved for future analyses. Results of correlational and regression analyses for the primary study variables show that Wellingtonians are highly individualistic in how their well-being influences their preparedness, and a majority are taking inadequate action to build their resilience to future disaster from earthquake- or tsunami-triggered evacuation. At a population level, the conceptual multi-dimensional model of health-related quality of life and global well-being tested in this study shows a positive association with evacuation preparedness at statistically significant levels. However, it must be emphasised that the strength of this relationship is weak, accounting for only 5-7% of the variability in evacuation preparedness. No single dimension of health-related quality of life or well-being stands out as a strong predictor of preparedness. The strongest associations for preparedness are in a positive direction for spiritual well-being, emotional well-being, and life satisfaction; all involve a sense of existential meaningfulness. Spiritual well-being is the only quality of life variable making a statistically significant unique contribution to explaining the variance observed in the regression models. Physical health status is weakly associated with preparedness in a negative direction at a continuous level of measurement. No association was found at statistically significant levels for mental health status and social well-being. These findings indicate that engaging in evacuation preparedness is a very complex, holistic, yet individualised decision-making process, and likely involves highly subjective considerations for what is personally relevant. Gender is not a factor. Those 18-24 years of age are least likely to prepare and evacuation preparedness increases with age. Multidimensional health and global well-being are important constructs to consider in disaster resilience for both pre-event and post-event timeframes. This work indicates a need for promoting self-management of risk and building resilience by incorporating a sense of personal meaning and importance into preparedness actions, and for future research into further understanding preparedness motivations.
For the people of Christchurch and its wider environs of Canterbury in New Zealand, the 4th of September 2010 earthquake and the subsequent aftershocks were daunting. To then experience a more deadly earthquake five months later on the 22nd of February 2011 was, for the majority, overwhelming. A total of 185 people were killed and the earthquake and continuing aftershocks caused widespread damage to properties, especially in the central city and eastern suburbs. A growing body of literature consistently documents the negative impact of experiencing natural disasters on existing psychological disorders. As well, several studies have identified positive coping strategies which can be used in response to adversities, including reliance on spiritual and cultural beliefs as well as developing resilience and social support. The lifetime prevalence of severe mental health disorders such as posttraumatic stress disorder (PTSD) occurring as a result of experiencing natural disasters in the general population is low. However, members of refugee communities who were among those affected by these earthquakes, as well as having a past history of experiencing traumatic events, were likely to have an increased vulnerability. The current study was undertaken to investigate the relevance to Canterbury refugee communities of the recent Canterbury Earthquake Recovery Authority (CERA) draft recovery strategy for Christchurch post-earthquakes. This was accomplished by interviewing key informants who worked closely with refugee communities. These participants were drawn from different agencies in Christchurch including Refugee Resettlement Services, the Canterbury Refugee Council, CERA, and health promotion and primary healthcare organisations, in order to obtain the views of people who have comprehensive knowledge of refugee communities as well as expertise in local mainstream services. The findings from the semi-structured interviews were analysed using qualitative thematic analysis to identify common themes raised by the participants. The key informants described CERA’s draft recovery strategy as a significant document which highlighted the key aspects of recovery post disaster. Many key informants identified concerns regarding the practicality of the draft recovery strategy. For the refugee communities, some of those concerns included the short consultation period for the implementation phase of the draft recovery strategy, and issues surrounding communication and collaboration between refugee agencies involved in the recovery. This study draws attention to the importance of communication and collaboration during recovery, especially in the social reconstruction phase following a disaster, for all citizens but most especially for refugee communities.
In this paper we outline the process and outcomes of a multi-agency, multi-sector research collaboration, led by the Canterbury Earthquake Research Authority (CERA). The CERA Wellbeing Survey (CWS) is a serial, cross-sectional survey that is to be repeated six-monthly (in April and September) until the end of the CERA Act, in April 2016. The survey gathers self-reported wellbeing data to supplement the monitoring of the social recovery undertaken through CERA's Canterbury Wellbeing Index. Thereby informing a range of relevant agency decision-making, the CWS was also intended to provide the community and other sectors with a broad indication of how the population is tracking in the recovery. The primary objective was to ensure that decision-making was appropriately informed, with the concurrent aim of compiling a robust dataset that is of value to future researchers, and to the wider, global hazard and disaster research endeavor. The paper begins with an outline of both the Canterbury earthquake sequence, and the research context informing this collaborative project, before reporting on the methodology and significant results to date. It concludes with a discussion of both the survey results, and the collaborative process through which it was developed.
Cities need places that contribute to quality of life, places that support social interaction. Wellbeing, specifically, community wellbeing, is influenced by where people live, the quality of place is important and who they connect with socially. Social interaction and connection can come from the routine involvement with others, the behavioural acts of seeing and being with others. This research consisted of 38 interviews of residents of Christchurch, New Zealand, in the years following the 2010-12 earthquakes. Residents were asked about the place they lived and their interactions within their community. The aim was to examine the role of neighbourhood in contributing to local social connections and networks that contribute to living well. Specifically, it focused on the role and importance of social infrastructure in facilitating less formal social interactions in local neighbourhoods. It found that neighbourhood gathering places and bumping spaces can provide benefit for living well. Social infrastructure, like libraries, parks, primary schools, and pubs are some of the places of neighbourhood that contributed to how well people can encounter others for social interaction. In addition, unplanned interactions were facilitated by the existence of bumping places, such as street furniture. The wellbeing value of such spaces needs to be acknowledged and factored into planning decisions, and local rules and regulations need to allow the development of such spaces.
School travel is a major aspect of a young person’s everyday activity. The relationship between the built environment that youth experience on their way to and from school, influences a number of factors including their development, health and wellbeing. This is especially important in low income areas where the built environment is often poorer, but the need for it to be high quality and accessible is greater. This study focusses on the community of Aranui, a relatively low income suburb in Christchurch, New Zealand. It pays particular attention to Haeata Community Campus, a state school of just under 800 pupils from year one through to year thirteen (ages 5-18). The campus opened in 2017 following the closure of four local schools (three primary and one secondary), as part of the New Zealand Government’s Education Renewal scheme following the Christchurch earthquakes of 2010/11. Dedicated effort toward understanding the local built environment, and subsequent travel patterns has been argued to be insufficiently considered. The key focus of this research was to understand the importance of the local environment in encouraging active school travel. The present study combines geospatial analysis, quantitative survey software Maptionnaire, and statistical models to explore the features of the local environment that influence school travel behaviour. Key findings suggest that distance to school and parental control are the most significant predictors of active transport in the study sample. Almost 75% of students live within two kilometres of the school, yet less than 40% utilise active transport. Parental control may be the key contributing factor to the disproportionate private vehicle use. However, active school travel is acknowledged as a complex process that is the product of many individual, household, and local environment factors. To see increased active transport uptake, the local environment needs to be of greater quality. Meaning that the built environment should be improved to be youth friendly, with greater walkability and safe, accessible cycling infrastructure.
On 4 September 2010 the Magnitude 7.1 'Darfield' Earthquake marked the beginning of the Canterbury earthquake sequence. The Darfield earthquake produced strong ground shaking throughout the centralCanterbury Plains, affecting rural areas, small towns and the city of Christchurch. The event produced a 29km long surface rupture through intensive farmland, causing localised flooding and liquefaction. The central Canterbury plains were subjected to a sustained period of thousands of aftershocks in the months after the Darfield earthquake. The primary sector is a major component of the in New Zealand economy. Business units are predominantly small family-run farm organisations, though there are increasing levels of corporate farming. The agribusiness sector contributes 20 per cent of real GDP and 47 per cent of total exports for New Zealand. Of the approximately 2,000 farms that are located in the Canterbury Plains, the most common farming sectors in the region are Mixed farming (mostly comprised of sheep and/or beef farming), Dairy farming, and Arable farming (cropping). Many farms on the Canterbury Plains require some form of irrigation and are increasingly capital intensive, reliant on built infrastructure, technology and critical services. Farms are of great significance to their local rural economies, with many rural non-farming organisations dependent on the health of local farming organisations. Despite the economic significance of the sector, there have been few, if any studies analysing how modern intensive farms are affected by earthquakes. The aim of this report is to (1) summarise the impacts the Darfield earthquake had on farming organisations and outline in general terms how farms are vulnerable to the effects of an earthquake; (2) identify what factors helped mitigate earthquake-related impacts. Data for this paper was collected through two surveys of farming and rural non-farming organisations following the earthquake and contextual interviews with affected organisations. In total, 78 organisations participated in the study (Figure 1). Farming organisations represented 72% (N=56) of the sample.
Worldwide turbidity is a huge concern for the health of aquatic ecosystems. Human activities on the land such as construction, deforestation, agriculture, and mining all have impacts on the amount of particulate solids that enter the world’s waterways. These particulate solids can pose a number of risks to aquatic life, but primary among them is the turbidity that they create in the water column. The way suspended solids interact with light creates cloudiness in the water which interferes with the vision, and visually mediated behaviours of aquatic organisms, particularly fish. The Avon-Heathcote estuary of Christchurch, New Zealand, is one such body of water that is subject to tremendous variation in turbidity, no doubt exacerbated by the destruction of Christchurch in the 2010 and 2011 earthquakes, as well as the subsequent ongoing rebuild. The yellow eyed mullet, Aldrichetta Forsteri, is one species that is common with the estuary, and uses it as a habitat for breeding. Though very common throughout New Zealand, and even a part of the catch of commercial fisheries, the yellow eyed mullet is a largely unstudied organism, with virtually no published scientific enquiry based on the species. The present work assesses how several behaviours of the yellow eyed mullet are effected by acute turbidity at 10, 50, 90, 130 and 170 NTU, finding that: 1) The optomotor response of mullet to 2.5 mm stripes drops to insignificant levels between 10 and 50 NTU, 2) The swimming activity of the yellow eyed mullet is highest at 10 NTU and drops to a significantly lower level at higher turbidities, 3) The grouping behaviour of small groups of yellow eyed mullet are unchanged by increasing turbidity levels, 4) that yellow eyed mullet do not exhibit significantly different behavioural response to a simulated predator at any of the tested turbidities, and 5) that yellow eyed mullet to do significantly alter their oxygen consumption during exposure to the turbidities in an increasing series. The results presented in these studies indicate that turbidites above 50 NTU pose a significant risk to the lifestyle of the yellow eyed mullet, potentially impacting their ability to perceive their surroundings, feed, school, and avoid predation. Future work has a lot of ground to cover to more precisely determine the relationship between yellow eyed mullet behaviour and physiology, and the turbidity of their environment. In particular, future work should focus more closely on the turbidities between 10 and 50 NTU, as well as looking to field work to see what the predominant predators of the mullet are, and specifically whether turbidity increases or decreases the risk of mullet being subject to avian predation. There is also considerable scope for studies on the effects of chronic turbidity upon mullet, which will add understand to the predicament of escalating turbidity and its effects upon this common and yet mysterious native fish.
“One of the most basic and fundamental questions in urban master planning and building regulations is ‘how to secure common access to sun, light and fresh air?” (Stromann-Andersen & Sattrup, 2011). Daylighting and natural ventilation can have significant benefits in office buildings. Both of these ‘passive’ strategies have been found to reduce artificial lighting and air-conditioning energy consumption by as much as 80% (Ministry for the Environment, 2008); (Brager, et al., 2007). Access to daylight and fresh air can also be credited with improved occupant comfort and health, which can lead to a reduction of employee absenteeism and an increase of productivity (Sustainability Victoria, 2008). In the rebuild of Christchurch central city, following the earthquakes of 2010 and 2011, Cantabrians have expressed a desire for a low-rise, sustainable city, with open spaces and high performance buildings (Christchurch City Council, 2011). With over 80% of the central city being demolished, a unique opportunity to readdress urban form and create a city that provides all buildings with access to daylight and fresh air exists. But a major barrier to wide-spread adoption of passive buildings in New Zealand is their dependence on void space to deliver daylight and fresh air – void space which could otherwise be valuable built floor space. Currently, urban planning regulations in Christchurch prioritize density, allowing and even encouraging low performance compact buildings. Considering this issue of density, this thesis aimed to determine which urban form and building design changes would have the greatest effect on building performance in Central City Christchurch. The research proposed and parametrically tested modifications of the current compact urban form model, as well as passive building design elements. Proposed changes were assessed in three areas: energy consumption, indoor comfort and density. Three computer programs were used: EnergyPlus was the primary tool, simulating energy consumption and thermal comfort. Radiance/Daysim was used to provide robust daylighting calculations and analysis. UrbaWind enabled detailed consideration of the urban wind environment for reliable natural ventilation predictions. Results found that, through a porous urban form and utilization of daylight and fresh air via simple windows, energy consumption could be reduced as much as 50% in buildings. With automatic modulation of windows and lighting, thermal and visual comfort could be maintained naturally for the majority of the occupied year. Separation of buildings by as little as 2m enabled significant energy improvements while having only minimal impact on individual property and city densities. Findings indicated that with minor alterations to current urban planning laws, all buildings could have common access to daylight and fresh air, enabling them to operate naturally, increasing energy efficiency and resilience.
Access to clean and safe drinking water is a fundamental human requirement. However, in many areas of the world natural water sources have been impacted by a variety of biological and chemical contaminants. The ingestion of these contaminants may cause acute or chronic health problems. To prevent such illnesses, many technologies have been developed to treat, disinfect and supply safe drinking water quality. However, despite these advancements, water supply distribution systems can adversely affect the drinking water quality before it is delivered to consumers. The primary aim of this research was to investigate the effect that water distribution systems may have on household drinking water quality in Christchurch, New Zealand and Addis Ababa, Ethiopia. Water samples were collected from the source water and household taps in both cities. The samples were then tested for various physical, chemical and biological water quality parameters. The data collected was also used to determine if water samples complied with national drinking water quality standards in both countries. Independent samples t-test statistical analyses were also performed to determine if water quality measured in the samples collected from the source and household taps was significantly different. Water quality did not vary considerably between the source and tap water samples collected in Christchurch City. No bacteria were detected in any sample. However, the pH and total iron concentrations measured in source and tap water samples were found to be significantly different. The lower pH values measured in tap water samples suggests that corrosion may be taking place in the distribution system. No water samples transgressed the Drinking Water Standards for New Zealand (DWSNZ) MAVs. Monitoring data collected by the Christchurch City Council (CCC) was also used for comparison. A number of pH, turbidity and total iron concentration measurements collected by the CCC in 2011 were found to exceed the guideline values. This is likely due to structural damage to the source wells and pump-stations that occurred during the 2011 earthquake events. Overall, it was concluded that the distribution system does not adversely affect the quality of Christchurch City’s household drinking water. The water quality measured in samples collected from the source (LTP) and household taps in Addis Ababa was found to vary considerably. The water collected from the source complied with the Ethiopian (WHO) drinking water quality standards. However, tap water samples were often found to have degraded water quality for the physical and chemical parameters tested. This was especially the case after supply interruption and reinstatement events. Bacteria were also often detected in household tap water samples. The results from this study indicate that water supply disruptions may result in degraded water quality. This may be due to a drop in pipeline pressure and the intrusion of contaminants through the leaky and cross-connected pipes in the distribution network. This adversely affects the drinking water quality in Addis Ababa.
Background: We are in a period of history where natural disasters are increasing in both frequency and severity. They are having widespread impacts on communities, especially on vulnerable communities, those most affected who have the least ability to prepare or respond to a disaster. The ability to assemble and effectively manage Interagency Emergency Response Teams (IERTs) is critical to navigating the complexity and chaos found immediately following disasters. These teams play a crucial role in the multi-sectoral, multi-agency, multi-disciplinary, and inter-organisational response and are vital to ensuring the safety and well-being of vulnerable populations such as the young, aged, and socially and medically disadvantaged in disasters. Communication is key to the smooth operation of these teams. Most studies of the communication in IERTs during a disaster have been focussed at a macro-level of examining larger scale patterns and trends within organisations. Rarely found are micro-level analyses of interpersonal communication at the critical interfaces between collaborating agencies. This study set out to understand the experiences of those working at the interagency interfaces in an IERT set up by the Canterbury District Health Board to respond to the needs of the vulnerable people in the aftermath of the destructive earthquakes that hit Canterbury, New Zealand, in 2010-11. The aim of the study was to gain insights about the complexities of interpersonal communication (micro-level) involved in interagency response coordination and to generate an improved understanding into what stabilises the interagency communication interfaces between those agencies responding to a major disaster. Methods: A qualitative case study research design was employed to investigate how interagency communication interfaces were stabilised at the micro-level (“the case”) in the aftermath of the destructive earthquakes that hit Canterbury in 2010-11 (“the context”). Participant recruitment was undertaken by mapping which agencies were involved within the IERT and approaching representatives from each of these agencies. Data was collected via individual interviews using a semi-structured interview guide and was based on the “Critical Incident Technique”. Subsequently, data was transcribed verbatim and subjected to inductive analysis. This was underpinned theoretically by Weick’s “Interpretive Approach” and supported by Nvivo qualitative data analysis software. Results: 19 participants were interviewed in this study. Out of the inductive analysis emerged two primary themes, each with several sub-factors. The first major theme was destabilising/disruptive factors of interagency communication with five sub-factors, a) conflicting role mandates, b) rigid command structures, c) disruption of established communication structures, d) lack of shared language and understanding, and e) situational awareness disruption. The second major theme stabilising/steadying factors in interagency communication had four sub-factors, a) the establishment of the IERT, b) emergent novel communication strategies, c) establishment of a liaison role and d) pre-existing networks and relationships. Finally, there was a third sub-level identified during inductive analysis, where sub-factors from both primary themes were noted to be uniquely interconnected by emergent “consequences” arising out of the disaster context. Finally, findings were synthesised into a conceptual “Model of Interagency Communication at the Micro-level” based on this case study of the Canterbury earthquake disaster response. Discussion: The three key dimensions of The People, The Connections and The Improvisations served as a framework for the discussion of what stabilises interagency communication interfaces in a major disaster. The People were key to stabilising the interagency interfaces through functioning as a flexible conduit, guiding and navigating communication at the interagency interfaces and improving situational awareness. The Connections provided the collective competence, shared decision-making and prior established relationships that stabilised the micro-level communication at interagency interfaces. And finally, The Improvisations i.e., novel ideas and inventiveness that emerge out of rapidly changing post-disaster environments, also contributed to stabilisation of micro-level communication flows across interagency interfaces in the disaster response. “Command and control” hierarchical structures do provide clear processes and structures for teams working in disasters to follow. However, improvisations and novel solutions are also needed and often emerge from first responders (who are best placed to assess the evolving needs in a disaster where there is a high degree of uncertainty). Conclusion: This study highlights the value of incorporating an interface perspective into any study that seeks to understand the processes of IERTs during disaster responses. It also strengthens the requirement for disaster management frameworks to formally plan for and to allow for the adaptive responsiveness of local teams on the ground, and legitimise and recognise the improvisations of those in the role of emergent boundary spanners in a disaster response. This needs to be in addition to existing formal disaster response mechanisms. This study provides a new conceptual model that can be used to guide future case studies exploring stability at the interfaces of other IERTs and highlights the centrality of communication in the experiences of members of teams in the aftermath of a disaster. Utilising these new perspectives on stabilising communication at the interagency interfaces in disaster responses will have practical implications in the future to better serve the needs of vulnerable people who are at greatest risk of adverse outcomes in a disaster.
