Appendix 1 Chronology of the Okanagan Mountain Fire Events Extracted from Castanet.Net Okanagan Mountain Fire Watch 2005

Health, Safety and Workload Challenges of the Okanagan Mountain Fire 2003

Submitted to the Vancouver Foundation

Faculty of Health and Social Development School of Nursing

September 2005

Funding Vancouver Foundation BC Canada

Research Team Principal Investigator Dr Penny Cash RN (Vic.Aust), DipAppSci (NsgEd), BEd, MEdAdmin, PhD, FRCNA. Associate Professor, School of Nursing, University of British Columbia Okanagan

Co-Investigators Ms Linda Daviss RN, BSN, MSN. Associate Professor, School of Nursing, Okanagan University College, Kelowna

Ms Donna Kurtz RN, BSN, MSN. Associate Professor, School of Nursing, University of British Columbia Okanagan

Ms Susan Van Den Tillaart RN, BSN, MSN. Assistant Professor, School of Nursing, University of British Columbia Okanagan

Research Assistants Ms Anne Bregeda RN, BSN. Ms Rhonda Croft RN, BSN. Ms Jean McKenzie RN, BSN.

Advisory Committee Dr Joan Bassett-Smith RN, BSN, MA, PhD. Director School of Nursing, University of British Columbia Okanagan

Dr Claire Budgen RN, BSN, MSN, PhD. Director Campus Health, University of British Columbia Okanagan

Dr Colin Reid BA, MA, PhD. Senior Fellow, Centre for Population Health and Social Services, University of British Columbia Okanagan

Ms Sharon Wammer RN, BSN, MNS. Director Community Care, Interior Health, Kelowna, British Columbia

Dedication The Research Team would like to gratefully thank HCOs who participated in this research. The legacy of the challenges and success of your work is deeply reflected in the community's healing. It is your courage and dedication that has made recovery possible for many people.

Acknowledgements Mr Sid LeBeau Deputy Chief, Emergancy Operations Team, Kelowna Fire Hall, Kelowna

For contributions to the early stage of the project Ms Fay Karp RN, BSN, MNS. Associate Professor, School of Nursing, University of British Columbia Okanagan

For generously allowing us to use her photographic work Ms Fern Helfand BFA, MFA. Associate Professor, Department of Creative Studies, University of British Columbia Okanagan

Public Consultations with Key Informants Mr Phil Bond BC Fires Recovery Manager, Canadian Red Cross, Kelowna

Mr Cyril Chalk Fire Relief Coordinator, Salvation Army, Kelowna

Ms Hazel Christie Community Development and Real Estate Department, City of Kelowna

Dr John Dorward Psychologist, Kelowna

Mr Dave Goertz Executive Pastor, Willow Park Church, Kelowna

Mr Randy Horne Principal, Okanagan Mission Secondary School, School District 23, Kelowna

Ms Beryl Itani Director, Emergency Social Services

Mrs Doreen Klassen and Mr Gerald Klassen Mennonite Disaster Services, Kelowna

Ms Delora Kuyvenhoven Administrator, Trinity Baptist Church, Kelowna

Dr Peter Molloy Director of Instruction: Student Support Services, School District 23, Kelowna

Mr Ross Morgan Psychologist: Mental Health, Interior Health, Kelowna

Ms Sandra Sellick Principal, Ann McClymont Elementary School, School District 23, Kelowna

Ms Louise Shirley Senior Account Manager, Interlock, Kelowna

The research team would like to offer their sincere thanks to the above people for making publicly accessible information available.

TABLE OF CONTENTS

EXECUTIVE SUMMARY...... 4 PREPARING FOR THE FUTURE ...... 5 Organizational Preparedness...... 5 Co-operation and Communication ...... 5 Recovery ...... 5 PURPOSE AND SIGNIFICANCE OF THE PROJECT...... 7 BACKGROUND ...... 7 THE PURPOSE OF THE STUDY AND WHY IT IS IMPORTANT...... 9 BEGINNING THE STUDY ...... 10 CAPTURING THE EXPERIENCES OF HCOS ...... 11 UNFOLDING THE STORIES...... 11 THE PHYSICAL ENVIRONMENT OF THE OKANAGAN MOUNTAIN FIRE...... 12 HEALTH SERVICES ...... 13 Recognizing vulnerable groups ...... 15 EMPLOYMENT AND WORKING CONDITIONS, AND PERSONAL HEALTH PRACTICES AND COPING SKILLS 16 Employment...... 17 The Impact on self ...... 18 The Insights of Past Experience ...... 18 WORKING CONDITIONS ...... 19 'We had to get out' ...... 19 'The location in which I worked'...... 20 'I didn’t know…'...... 20 'We didn't have an emergency plan'...... 21 ' 'We didn't know what the demand would be'...... 22 'Who made the decisions' ...... 23 'I couldn't find them'...... 24 'The many, many hours' ...... 24 INCOME AND SOCIAL STATUS...... 26 VULNERABLE PEOPLE ...... 27 Vulnerable people in the community...... 27 The stress created by the fire...... 27 Dealing with difficulties and creating new relationships to assist vulnerable populations...... 28 REFLECTIONS ON THE EXPERIENCE ...... 29 Expectations from the public once the crisis was over...... 29 The personal impact ...... 30 CONCLUSION...... 31

REFERENCES………………………………………………………………………………...…………34

APPENDIX 1 ...... I

CHRONOLOGY OF THE OKANAGAN MOUNTAIN FIRE ...... I EVENTS EXTRACTED FROM CASTANET.NET OKANAGAN MOUNTAIN FIRE WATCH 2005...... I

Executive summary The wind-driven fire would swirl in the trees and in a blaze of flame a tree would be gone, from the ground up…it sounded like a freight train "it just roared in the bush above you"… Steeves 2004, p.A3

The immediacy of major wild fires (forest fires) leaves little time for communities to act. What occurs during and following a disaster is unique to each community and depends upon the community’s ability to respond. How well they are prepared determines their ability to prevent harm and disease, and successful recovery.

The Okanagan Mountain Fire began in August 2003, and lasted several long hot weeks. During the height of the disaster 30,000 people were evacuated. It was the largest evacuation ever in British Columbia and the second largest in Canadian history. The fire destroyed 238 homes, agricultural land, forest and parkland.

During the crisis, urgent and non-urgent health care services were organized by a variety of people and agencies loosely described as Health Care Organizers (HCOs) in this report. A qualitative interpretive design was used to illuminate in-depth and detailed information about the challenges, successes, activities and working environments experienced by HCOs during and following the emergency response to the Okanagan Mountain Fire.

The HCOs that participated in the project were recruited by word of mouth (a snow ball technique) and through the receipt of participant information packages circulated by the Emergency Planning Group at the City of Kelowna Fire Hall. Twenty participants engaged in audio-taped interviews. Participants reviewed and edited their transcripts and notes to validate the data. Interviews occurred from the winter of 2003 to the spring of 2005 and were approximately 1 to 1.5 hours in length with several lasting longer. Public consultation with key informants also took place to confirm, qualify and add to the richness of information collected.

Data analysis began and continued throughout the process of data collection. The original intent of the study was to map the health care issues experienced by HCOs. During the data analysis phase it became evident that to map the experiences would have resulted in fragmentation of information, a loss of contextual richness of the data with the exclusion of some categories. Instead, major themes were identified and core ideas or essences were illuminated from the themes. The data were then examined, grouped and re-examined within the determinants of health framework to facilitate opportunities for knowledge transfer and dissemination.

The determinants of health were used as an organizing framework to convey the HCOs' experiences. The determinants that emerged from the data are Physical Environment, Health Services, Employment and Working Conditions, and Personal Health Practices and Coping Skills, Income and Social Status and Child Development.

The realities of the HCOs' experiences during and following the fire are best described in the context of their work and the challenges created by fragmented and disrupted systems, uncertain roles, lack of emergency preparedness, along with new, altered or increased demands. Their stories revealed the ways they coped with the challenges, found creative solutions to complex difficulties, and sought alternatives to each situation they confronted.

Based upon the data collected from the HCOs' experiences during the fire, the following information was offered by participants to prepare for the future.

Preparing for the future Organizational preparedness All organizations (and individuals as well) should have emergency and disaster plans with evacuation plans that are practiced and reviewed regularly.

Descriptions of emergency and disaster response plans as well as evacuation plans should be included in all policy manuals and staff orientation programs in all organizations.

All emergency and disaster team members must have roles that are clearly defined and understood to avoid duplication of activities and services.

An appropriately qualified organizational 'champion' should be appointed as the designated person in the organization to maintain and appropriately deliver updated disaster planning information to all members of the organization.

Co-operation and communication During and following crisis situations, co-operation between all sectors of health must be systematized or standardized to reduce and prevent health service delivery gaps.

To ensure gaps in services are minimized, those designated as members of emergency response teams should be high-level decision makers who are frontline clinically based practitioners or intimately familiar with practice.

To enable seamless health service delivery and to ensure those at risk are taken into account during and following an emergency response, it is imperative that the emergency response team is composed of high-level members from all areas of health including community care, acute care and social services.

Standardized communication between all sectors of health and social services must be established with the potential for developing an integrated data-base to track the health service needs for clients/people in the community.

To provide better communication with the public, telephone call centres need to be established and staffed by appropriately qualified people to answer the public's common health related questions concerns.

Recovery Crisis debriefing must be offered and available in a multilevel, multi-site, multi-targeted strategy for all people in communities especially those involved in the emergency response or those experiencing fear or loss particularly for the elderly and other vulnerable populations.

Following disasters, those involved in the response need time to recover. Provision for a recovery period should occur as part of the disaster plan.

Further research needs to be undertaken in the areas of emergency response environments, the long term effects of exposure to air pollutants generated from wild fires, and the long term effects on health following relocation and/or rebuilding life after loss and change to one's environment.

…[t]he super heated air from the bolt of lightening caused an explosive expansion of air [and] a crash of thunder was almost immediately heard by anyone awake in the area around the park. Most didn't realize the importance of what they had witnessed, but they reported the fire, which by 3 a.m. had spread rapidly in the dry lichen, and grasses on the open slopes over an area of 5 hectares. Although there was no wind by 5 a.m. it had tripled in size, to 15 hectares in steep, rugged, rock terrain, with no road access…and the next morning it was at 900 hectares...

That Friday night was the worst day of my life. Embers flew three to four kilometers ahead of the fire and they dropped like fire bombs as they flew over. It was a crowning fire and the winds were blowing it far ahead of the main fire.

Temperatures were 1,000 degrees in the forest and 2,000 in the urban areas. Houses were popping. Things were disintegrating…

Steeves 2004, p.A3

Fern Helfand 2003; 'Okanagan Mountain Fire'

Purpose and significance of the project Background Natural disasters take hold of communities and shatter them. Through destruction and initial chaos and confusion, communities scramble to organize an emergency response. The immediacy of natural disasters can leave little time for communities to act. What occurs during and following a disaster is unique to each community and outcomes depend upon the type of disaster and the community’s ability to respond. How well communities are prepared for disasters determines their ability to recover, prevent disease, and minimize loss of life.

During the early hours of the morning on Friday, 16th August, 2003, a bolt of lighting hit a tree close to Rattle Snake Island igniting an enormous forest fire that seized the Okanagan Valley of British Columbia, Canada. Ground crews could not control the fire and by 1 pm the fire was regarded as rank 5 (the highest score is rank 6). By 8.30 pm the hills 'across from Peachland were ablaze' and the fire was moving rapidly towards houses on the outskirts of Kelowna (Harding et al 2003, p.2).

Fern Helfand 2003; 'Disaster as Spectacle'

The Okanagan Mountain Fire was a natural disaster that immobilized the community and surrounding area. The entire community was affected both during the fire and for a considerable period afterwards. Many watched from a distance as the giant flames leaped into the air consuming all in its path. Houses imploded and trees became huge torches. The fire was clearly visible from the opposite side of the lake. People congregated together and watched in shocked amazement as the wildfire threatened the city of Kelowna and surrounding area of over 150,000 people (BC Stats, 2001). As it moved closer to the city, temperatures soared. Spontaneously ignited spot fires generated new fronts to the fire well ahead of the fire wall (Steeves 2004, p.A3).

Nearly 30,000 people were evacuated in a few days making it the largest evacuation in the history of British Columbia and the second largest evacuation in Canadian history (City of Kelowna, 2004, p.5). One report suggested that the evacuation of 26,000 people by the 23rd August 2003 was the greatest number of people evacuated in the shortest period of time in Canadian history' (Castanet.net 2003, August 23, p.146). Emergency evacuation included the evacuation of urban residents, farming communities as well as domestic and wild animals. They all required emergency services for safety and security.

Gary Nylander 2003; 'Evacuation Centre' Fire Storm: Images from an unforgettable summer. The Daily courier September 29 2003, p.5

Extremely dry conditions, combined with the volatile forest environment, the magnitude of the fire, and the speed at which it traveled, resulted in homes and farms, highways, airports, and recreation land being threatened. Emergency prepared personnel were reported as commenting that they had never experienced anything like this wildfire, a wildfire with such dangerous consequences (Castanet.net 2003, August 23, p.146). As the fire escalated, the images captured provincial, national and international attention. The local community, provincial organizations along with national and international assistance provided an overwhelming response to the crisis situation. While emergency preparedness in Kelowna already existed, the enormity of the Okanagan Mountain Fire and the scope of the disaster and services needed was unprecedented.

Health care services were provided by a variety of people and agencies during the crisis. Broadly described for the purposes of this study as Health Care Organizers (HCOs), HCOs were drawn from the diverse areas of emergency services: crisis workers; volunteer services; Royal Canadian Mounted Police (RCMP); church organizations; educational institutions; neighborhood/community groups (including adolescent, senior, aboriginal, homeless and chronic health support); local government - Regional District of Central Okanagan, City of Kelowna;

Interior Health Authority (IHA) including Continuing Health Services, Community and Acute Care. The purpose of this study was to explore HCOs' experiences as they organized and implemented health care services for the community during and following the Okanagan Mountain Fire.

As they spoke about their roles, the activities in which they engaged, and the complexities of their work, HCOs shared many powerful stories that exposed their passion for what they did and their fundamental concern for the wellbeing of the community. Because they cared for the community they worked tirelessly, their fervent concern was revealed time and time again as they described their experience. Although the stories were unique to the Okanagan Mountain Fire, it is anticipated that the information contained in this report will be relevant to other crisis situations in communities elsewhere.

The purpose of the study and why it is important The study considers the HCOs’ responses to changing situations as the Okanagan Fire advanced towards the city of Kelowna and its surrounding communities. The study addresses the challenges and successes HCOs experienced as they provided health care services during and following the Okanagan Mountain Fire. HCOs gave indepth and detailed information about their actions and the supports needed in response to the fire. As data was gathered, it became evident that further research would be needed to more fully understand the complexities of emergency response environments. In addition, priorities related to health issues resulting from the short- and long-term effects of exposure to environmental hazards such as smoke are vital in order to better manage the disaster period and the long term health of communities.

Prior to beginning the investigation, an extensive literature search including accessing databases from different disciplinary fields was conducted. A very noticeable absence of information about the perspectives of those whose role it was to organize direct care service delivery was evident. Over two hundred sources of information were accessed (articles, reports, conference proceedings, media releases, minutes of meetings, and personal communication with local organizations).

The literature was grouped into five main areas – crisis response; victims' experience of disasters; affects of fires (disasters) on health; debriefing and trauma counseling, and ecological restoration. Stress and coping comprised a considerable body of work particularly the experiences of victims and the effect of the disaster on their health. Challenges such as short term exposure to forest fire smoke (for example Duclos, Sanderson and Lipsett 1990; Schollnberger, Aden and Scott 2002; and Mott et al. 2002) the impact of the disaster on frontline workers such as fire fighters, nurses, ambulance attendants, and search and rescue people (such as Hytten and Hasle 1989; Raingruber and Kent 2003) and front line workers reluctance to accept their vulnerability to the trauma of events during the disaster response (Firth-Cozens, Midgly and Burges 1999) was documented. Little data appeared to exist on the longer-term implications of sensitization to bushfire smoke that leads to long-term health challenges.

Data was abundant on the areas of crisis response to disasters (and fires specifically) especially from the perspectives of those directly affected by the fire and focuses on the victim's experience (Tobin & Whiteford 2002; Cox and Holmes 2000; North & Hong 2000; Henderson & Gamble 1998; Cox 1996) rather than the experience of those who organized health care services. One article of particular note was a comparative study by Stein (2002) who concluded that official documentation often omitted vital details that might assist people in making meaning out of their

10 suffering during and following a disaster. Uncovering the HCOs experiences during the Okanagan Mountain Fire will help to fill in some of the gaps and address various details of the HCOs work during disasters.

The literature review clearly highlighted the lack of information around the experiences of HCOs and what their role was in supporting the health of the community(ies) during and following the Okanagan Mountain Fire. While inferences from the literature can be used to better understand what happened in more general terms, the breadth and scope of the HCOs work is clearly missing. It was this absence of information about the experiences of HCOs that this study seeks to address. The aims of the study have sought to illuminate their experience, expose their challenges, highlight their actions and identify the services needed during and following the crisis. It makes visible the breadth and depth of health care services that involved interagency cooperation during the Okanagan Mountain Fire and the short period thereafter. The study offers some important insights about the HCO's experiences, knowledge that can be used to facilitate disaster preparedness.

Beginning the study The Vancouver Foundation funded the study. They were keen to learn from the Okanagan Mountain Fire and how the community mounted such a successful community response to the disaster. The research process started with ethics approval from Okanagan University College Research Ethics Board. To capture the lived experiences of the HCOs during the fire a qualitative interpretive design was used. HCOs were invited to tell the story of their experience. Initially what emerged was analyzed and mapped, highlighting the effects and implications of a disrupted life space (Cox 1996; Seamon and Mugerauer 1985). The mapping process gave rise to essences (van Manen, 2002) in which 'being there', 'communication', and 'reflection' rooted and connected HCOs' embodied experiences during the fire period. These essences comprised the central phenomena of the HCOs' experiences. While the essences offered insight into the phenomena of the experience, it did not fully represent HCOs' knowledge of their response to the fire.

Returning to the data, ideas were re-clustered according to the determinants of health and further analyzed from a population health perspective (Health Canada, 2002). Details of HCOs' experience were documented in different ways and this made it possible to categorize the data, make explicit health service activities, and enable knowledge transfer. Subheadings included health concerns; effects of the fire on populations; health and wellbeing supports; and priorities for future studies and policy development. The determinants of health were used as a framework to explore the influence of the fire and the impact that the fire had on individual and community health and wellbeing. The implications of the Okanagan Mountain Fire were considered under specific determinants of health to gauge the impact on health and wellbeing. As the categorizing process proceeded, the data within the determinants of health categories framework caused fragmentation, loss of the richness of the participant’s experiences, and exclusion of some health issues. The interconnectedness and wholeness between themes was apparent making it impossible to map the health care issues as was initially conceived. As a result, there has been some fusing of categories from the determinants of health to enable the reader to better appreciate the HCOs' experiences.

Capturing the experiences of HCOs Given the size of the community (population of 150,000 according to BC Stats, 2001) and also because the project sought insights from local health services, a snowball technique was used to recruit participants. Information packages containing a description of the study, and an invitation to participate were distributed through the local emergency response team auspiced by the Main Fire Hall, Kelowna. Members of the team were requested to circulate the packages to interested HCOs. Those responding to the invitations were asked if they knew any other HCOs who may be interested in taking part in the study. If so, the potential participant was given additional information packages and asked to give them to other HCO colleagues.

Twenty-one adult HCOs consented to participate. One withdrew prior to being interviewed, leaving an equal representation of male and female participants. Participants represented a wide range of health services. All participants engaged in an audio-taped interview, they reviewed their transcript, information they had shared in the form of interview notes, and had an opportunity to validate the record of their interview as accurate.

Data saturation was achieved early when the reiteration of themes and ideas occurred time and time again. In other circumstances, the research team might choose to stop interviewing, however the interviewing process continued to try and get representation from a wide variety of different services. In addition to the interviews, the research team sought further information by meeting with key people (key informants) in the community to access public documents, reports, other research and media releases. The information obtained from theses sources substantiated and clarified ideas expressed by the participants.

Interviews occurred through Winter 2003 to Spring 2005 in locations of the participants' choice (homes, workplaces, and cafes). The researchers asked reflective open-ended questions and invited the participants to tell the story of their experiences during and following the fire. Most interviews lasted 1 to 1.5 hours although several lasted longer. During the interview, researchers made field notes contributing to the data gathered.

Numbers rather than pseudonyms were assigned to participants to prevent disclosure of their identity. In the context of this report, the participants will be identified as P.1, P.2, et cetera.

Unfolding the stories To capture the depth of the HCO’s experience, the study focused on the roles and experiences of the HCOs. The determinants of health pertinent to the HCOs' experiences were Physical Environment, Health Services, Employment and Working Conditions, Personal Health Practices and Coping Skills, Healthy Child Development, Income and Social Status, and Health Services (Canadian Health Network, 2005). To maintain the integrity of the HCOs' voices and to allow a fuller picture of their experiences, Employment and Working Conditions and Personal Health Practices and Coping, were integrated.

The physical environment of the Okanagan Mountain Fire The physical environment is an important determinant of health. At certain levels of exposure, contaminants in our air, water, food and soil can cause a variety of adverse health effects, including cancer, birth defects, respiratory illness and gastrointestinal ailments. In the built environment, factors related to housing, indoor air quality, and the design of communities and transportation systems can significantly influence our physical and psychological well-being Public Health Agency of Canada 2005

During the extremely hot, dry summer of 2003, hundreds of forest fires burned throughout the province of British Columbia, the most significant being the Okanagan Mountain Fire in the Central Okanagan Valley. Starting from a lightning strike in remote inaccessible terrain, the fire burned for several months covering 25,912 hectares of protected parkland, agricultural and urban areas, and the Kettle Valley railroad trestles of historical significance.

Okanagan Valley taken from space. The pink area is the fire; the lake is dark blue and the light blue is smoke

(Adapted from http://earthobservatory.nasa.gov/Newsroom/NewImages/Images/okanagan_ast_2003245_lrg.jpg.)

One hundred and fifty thousand people in Kelowna and surrounding area were affected by the fire (BC Stats, 2004). Two of the three major transportation routes (highways) through the valley were closed for periods of time. The airport located at the edge of the evacuation area remained open although on evacuation alert.

Fern Helfand 2003; 'Home'

The fire destroyed over 238 homes as well as power lines and a cell phone/radio communication tower. Volatile chlorine storage tanks for water purification were threatened and had to be removed (Castanet. net 2005 p.151). The concern was that the heat from the fire could damage the storage tanks, causing them to rupture and leak toxic gas (P.4 and P.20). Other toxic substances were contained in the smoke in the valley that lingered throughout the fall and early winter 2003. The enormity of the fire, the speed at which the fire traveled, and the impact on communities are portrayed in a chronology of events (See Appendix 1). Health services Health services, particularly those designed to maintain and promote health, to prevent disease, and to restore health and function contribute to population health. The health services continuum of care includes treatment and secondary prevention. Public Health Agency of Canada 2005

Throughout the fire period, HCOs were challenged with an exceedingly complex role of maintaining the health and wellbeing of the Central Okanagan Valley population. HCOs established what the organizational priorities were for evacuation strategies, emergency services, traffic management, and environmental safety including factual information about safe resources such as food, water, and air. HCOs also had other work obligations such as providing advice and information to the community regarding accessing health services, supporting those confronting losses and those coping with environmental changes. Their pivotal work was dependent on collaborating with a wide range of people in the community.

They worked with services such as community agencies, acute care, long-term care, community health, and public health services, local government, provincial government and non-government

14 institutions and organizations including pharmacies, medical gas providers, hospitals, schools, churches, hotels, restaurants, day care facilities, family group homes, and animal welfare service providers. In some instances, their work was enhanced by public announcements through the media such as information about clean water, or requests for the general public to use walk-in medical clinics or their local medical practitioner to enable the local hospital emergency room (P.5 and P.15) respond fully to any crisis. Even though health information for the community was provided through the media (radio, television, papers, internet), HCOs were inundated with inquires about concerns such as smoke in the valley.

People were worried about a range of issues such as the amount of outdoor physical activity they could engage in and whether breathing masks were required; how they might reduce exposure to smoke; whether there were special instructions for individuals with heart or lung conditions, asthma or other chronic illness; what should they do in the event that they developed severe symptoms to smoke exposure; and making sure they increased their intake of fluids to keep cool and hydrated. Interior Health responded to these concerns with information posted on their website (@Interior Health, September 2003).

HCOs conveyed information to the public and to individual clients about the cancellation of elective surgeries and the delivery of home support services. There were difficulties delivering health services without the appropriate resources (such as equipment, medications, oxygen), accessing physicians, or contacting the pharmacy for medications for relocated clients (P.15 and P.19). The relocation of people and their animals was logistically challenging yet successfully managed by HCOs with the pooling of resources between sectors (P.13, P.16, P.17, P.18 and P.19). In spite of much interagency cooperation, not all HCOs were privy to this level of collaboration. One HCO stated that there were few inter-sectorial links established between their sector and others (P.12).

Older adults were profoundly affected being out of their home environment, the need to cope with change, how the smoke triggered their fear, and how these losses may have contributed to a declined mental status (P.9, P.10, and P.19). One person receiving end of life care at home died on route to another location; another fell and fractured a femur, dying not long afterwards (P.13). The constant changes and relocations resulted in further stretching of home health care support services required by clients and families. An HCO commented that clients with dementia did not manage well with the change of services or with an evacuation (P.13). 'I had a client with a mini- mental of 22/30 before the fire and had a phone call from the spouse ten days later saying [the caregiver couldn't] deal with it any longer and request[ed] urgent placement. The loved one’s] mini-mental was down to 10 [out of 30] three weeks later…"I can't deal with this any longer and request urgent placement", [the loved one] never did go back and had to be placed' (P.9). HCOs wondered about whether a changed environment may have resulted in premature death of clients with dementia (P.9, P.12, and P.13). As one HCO described, there were immense details to ensure seamless services were provided, 'each household had a different story so there were 164 different stories' (P.9).

The research team was surprised that most HCOs did not speak about children or acknowledge their vulnerability. Those that did comment were astonished at the resilience of children explaining that they did not seem to be greatly affected by the fire. Actions taken by HCOs to support children were to: • share information with parents and other child care providers about how to support children during the time of the fire and through losses associated with the fire;

• keep families together physically in their accommodation, and at public forums where losses from the fire were being discussed; • promote open, honest discussions with children about the fire; • encourage families to monitor the amount of information and televised images of the fire; • provide activities designed to divert children's attention away from the fire; • involve the School District teachers, counsellors, and administrators in planning and implementing activities designed for children to share their experience on their return to school in the fall; and, • provide a soft toy such as a teddy bear to help the child deal with the dramatic events that were taking place around them. School District 23 remained concerned about the children's welfare. They provided opportunities for support and assistance to staff, families, and children. Letters were sent home to parents outlining the availability of counselling. Teachers were available to assist children to better understand their reaction. Times were also scheduled for children and parents to gather and get reconnected with friends and neighbors, some families with whom they may have lost contact with because of their evacuation and relocations.

The extent to which these opportunities were taken up by parents and families and the success of the innovation remains unknown. One HCO speculated that the timing of the fire during school holidays influenced the way in which children were affected. They concluded that because children were with their families spending time together, parents were able to provide the support they needed during the disaster (P.18). Nevertheless, questions remain about the lasting effects of the impact of the fire on children.

Recognizing vulnerable groups HCOs recognized that part of organizing health services (physical, psychological, social, spiritual and economic), was to provide safe environments for staff, clients, and the public. Given their role, most HCOs were very aware of the vulnerability of staff, clients, and the community and took steps to ensure their health needs were addressed. In some instances social needs required sensitivity when organizing care for older clients. As one HCO stated, 'How do we evacuate middle to advanced dementia people? We do not have anywhere to send these people. We do not have a plan to where to take people. They can't go to a hotel…they have care requirements special to the clients. Orientation is a huge issue. There is a large number of cognitively impaired people living in the community…[It's the] taboo issues…trying to provide a bath for someone with 5-6 grandchildren [around]' (P.9).

Even though many people were successfully moved to alternative accommodation, the HCOs remained concerned about the appropriateness of the venue and whether these places were safe environments. Specific areas included making sure the accommodation had the appropriate aids such as hand-rails, accessible showers and toilets, wheel chair access, and access to appropriate food and a location to eat (P.1, P.11 and P.19). Knowing what the accommodations' facilities included proved a helpful strategy for some HCOs. Inside or local knowledge was a major advantage securing additional resources needed for elders plus helping to minimize the effects of relocation and other major changes that happened so abruptly (P.9).

Some clients were relocated to local family members’ homes or institutions, while others were sent to different geographical areas. Organizing somewhere to stay proved to be exceptionally complicated for HCOs because many clients were relocated several times (which may have been due to multiple evacuations) and health care services had to be arranged no matter where clients were relocated. Services needed by clients that required reorganization included arranging alternative service providers, reducing services or re-routing services to clients in temporary locations (P.9). Occasionally, continuity of care was interrupted because clients were sent to another catchment area with staff who were unfamiliar with their plan of care.

HCOs worked with caregivers in organizing health service requirements for clients. They commented that caregivers needed more support from mental health services to help them cope during and following the Okanagan Mountain Fire. HCOs were concerned that the strain on all caregivers could lead to burnout. This was especially evident when the evacuation came at such short notice, and where there was very little opportunity to prepare (P.9 and P.10). Not all HCOs were involved in organizing care requirements for those in the community. There were HCOs who were responsible for maintaining the health of firefighters and volunteers, work that included health assessment, monitoring the need for rest, the provision of nutritious food and safe drinking water. Hypertension was one health concern identified in firefighters (P.5). Physical illness of firefighters, evacuees, or volunteers due to exposure, exhaustion or lack of food-safety measures were regarded as significant threats to sustaining the health of the community during the crisis (P.4, P.11 and P.20).

Organizing the billeting of people to private homes was another area of apprehension. HCOs were uneasy about the safety of evacuees as well as the home-owners who volunteered to accommodate evacuees for at least one night. These concerns were related to insufficient screening of both evacuees and billets, primarily because of the urgent need for accommodation during the disaster (P.8, P.11 and P.14).

In summary, HCOs' activities focused on maintaining health services, preventing disease, and organizing health service provision. Their work was diverse and it profoundly affected them. Interestingly not one HCO acknowledged that they were also a vulnerable population and as a result their reflections offer some of the deeper emotional and coping responses seen through the sections to follow. Their words depict their experiences as 'being in a war' (P.1 and P.12), 'it was bedlam' (P.9), 'sense of tension…hyper-vigilance, anxiety, anxiety' (P.12). HCOs noted the tremendous efforts they made to maintain health service delivery (P.1, P.9 and P.19). Local knowledge of their community was an invaluable strength in the successful provision of health care services during the Okanagan Mountain Fire disaster. The successes and challenges that HCOs faced are reflected in their experience of employment and working conditions and in how they coped. Not only is it possible to imagine the disrupted work and home lives, one can really feel the complexity of rapidly changing situations with which they were confronted. The impact of multiple evacuations, the eerie lingering smoke, the visibility of fire and its path of destruction, and then the efforts of the firefighting crews, ancillary services, the commitment of the community to community provided a complex set of circumstances that formed the context of their work.

Employment and working conditions, and personal health practices and coping skills Employment has a significant effect on a person's physical, mental and social health. Conditions at work (both physical and psychosocial) can have a profound

effect on people's health and emotional well-being…Personal Health Practices and Coping Skills refer to those actions by which individuals can prevent diseases and promote self-care, cope with challenges, and develop self-reliance, solve problems and make choices that enhance health Public Health Agency of Canada 2005

Employment Several HCOs had documented and clearly defined emergency response roles. There were however, other HCOs who were required to extend their work activities to take into account the demand for health services due to the enormity of the evacuation. To accommodate the demand for services, HCOs involved in the health service sectors provided additional services to assist people cope with the emergency of the fire. During the fire events, HCOs relied on their intuition and previous experience to identify what they saw as priorities. They also developed unique strategies, used disaster templates (work plans) and consulted with colleagues. They relied heavily on their own expert opinion as was well as specialist decision-making.

'Not my normal work', 'a unique experience' (P.4 and P.8) 'once in a lifetime' (P.1), 'baptized into the fire' (P.20) were common themes highlighted when HCOs spoke about employment and working conditions. As the disaster magnified, HCOs' roles and responsibilities blurred with the urgent need for 24-hour emergency services. They all talked about the role and the responsibility during the fire as unlike anything they had ever done before.

Most HCOs spent a significant amount of time with activities related to public relations. Accessing current evacuation information and responding to community inquiries was accomplished over and above the usual workload. Because of this unprecedented disaster situation, their roles and responsibilities evolved (P.2 and P.15). As they sought to provide services, HCOs found themselves addressing questions about the Okanagan community that would have an impact on resource allocation. These questions included: • Who was affected - individuals, families, family pets/ animals, communities, et cetera? • How were they affected? • When would they become affected? • What services did they need? • Could the service(s) be provided? • How could the service be provided? • Who could deliver the service? • Do services need to be reduced in order to accommodate for the new needs? • Who was available to help? • Who needed to be notified? • What records and documentation were required? • Who might have services changed as a result of the reallocation of resources? • Who is responsible for responding to public inquires?

HCOs spoke about the fear for clients and colleagues. Commitment, to clients, colleagues, and the community was evident. They were sensitive to staff wearing out, becoming exhausted and

18 the need to offer support and opportunities for time off. In several situations HCOs relieved staff and provided client care (P.5 and P.10). Those HCOs with caseloads of over 160 clients, contacted each client and their significant care giver (P.1, P.9, P.13 and P.6) to check on them and make sure they were managing satisfactorily. One HCO regularly visited the central registration area recognizing that dementia clients might be evacuated and require alternative services (P.9).

The impact on self HCOs were deeply affected by their experiences. They expressed an appreciation of the opportunity to tell their stories and share their emotional response to the fire. P.1 said '[t]here was a mixed bag of emotions and thoughts in responding to the events…excitement of the moment and then it was over…intense let down'. Some went on to say '[i]ts difficult every time I see a video or some planes…It is still right there you know' (P.18). Another HCO spoke about the 'acknowledgement of the destruction and its impact on [my] self; [it] took time before [I] could go and look' (Participant 11).

All HCOs expressed deep concern about the community and the magnitude of the fire, those not directly involved in the lives and stories of the evacuees were able to stand back, reflect and work from a broader perspective of the totality of the emergency response. HCOs not directly engaging with the public talked about how the distance between themselves and the community at large made a difference. It enabled them to focus on their work without the distraction of noise, confusion, and fear that were part of the community’s response to the fire. As one HCO said, 'the distance was a buffer' (P.11). 'Our contribution was not that much; we felt guilty in a way; they [the firefighters] were putting it on the line; I felt good about what we did but felt very humble' (P.6).

HCOs spoke about how important it was to have their work valued by people in key planning and organizational roles. They felt that it was significant to be recognized by the upper management of their own organization. Not all HCOs were acknowledged for their contributions by their workplace or in a public arena. They questioned the worth of their work and were saddened and hurt by the lack of recognition. As one HCO commented, 'it felt like a critical incident…[I] kept working anyway…feeling that [I] should be satisfied with a job well done but [it] seemed not to be 'as good as could be expected''(P.1). Yet in other circumstances, '[s]omebody wrote something…it was a newspaper article…it’s a nice article somebody wrote thanking [us]. So, that was nice' (P.19).

The insights of past experience No matter where HCOs worked or whether or not they were acknowledged for their experience, previous knowledge in disaster preparedness for paid and volunteer HCOs, was a major advantage. There were a number of HCOs who were apprehensive about how to manage the situation when the fire moved into residential neighborhoods and encroached on chlorine tank storage areas. It was times such as this that HCOs spoke of as demonstrating their lack of knowledge and experience to deal with potentially disastrous consequences. As one HCO said, 'we were initiated with no experience' (P.20). Those with past disaster training readily credited the importance of previous experience to knowing what the demands might be. They shared what was learned from their work during the fire and what they would do the similarly or different in future disasters. They spoke about: • Their role and how it intersected with the community-wide emergency response.

• Knowledge of procedures and protocols and how to establish new ones. • Familiarity with local resources. • Lines of authority for decision-making. • Setting up the physical space, preparing, and organizing their work. • The need for dedicated emergency telephone lines and numbers. • Conflict and mediation skills for staff, volunteers, and management. • Care of self and staff (ensuring nutritious food, taking breaks, getting rest, allowing time to recover from the 'adrenaline rush') • Preparing staff for their emotional and physical response to the events and the impact afterwards. • Valuing and recognizing the need for debriefing by encouraging the discussion and sharing of their emotions. • Frequent review of their challenges and actions, and how to avoid recurrence of problems/conflicts while honoring their successes (self and staff).

P.17 commented that while they continued their health care organizing activities, 'there needs to be some work [clarity] done around the roles of paid and unpaid workers, their relationships, and their perceptions of who is doing the work' (P.17). Clear direction around these points would have facilitated smoother working conditions and a better understanding of roles.

Working conditions Even though their personal lives families and homes were being threatened by the Okanagan Mountain Fire, HCOs continued to work under extremely difficult conditions. As HCOs recounted their experiences during the fire, loud and clear themes resonated through all of their stories. These include 'we had to get out', 'the location in which I worked', 'I didn’t know', 'we didn’t have any emergency plan', 'we didn’t know what the demand would be', 'who made the decisions', 'I couldn’t find them', and 'the many many hours'. Each of these themes are described below.

'We had to get out' The fire mesmerized the community. People had to see the damage to the physical landscape for themselves. Several HCOs commented on their shock that the fire threatened homes and families as it moved rapidly toward the city. Their vulnerability and disbelief was evident – '[I] don’t think anyone ever thought it would get to that' (P.16), ' [You did] not even hav[e] a moment to worry about your own family' (P.19). One HCO arrived at their home to discover evacuation orders had been issued, 'I went home on the Friday and the RCMP were at the garage telling [my family] we had to evacuate' (P.9). There were instances where children or other family members received the evacuation orders before the HCO knew about it; 'my son came up and said "mom they told us we had to get out of our house"'(P.19). A couple of HCOs were immobilized when they received their evacuation order. As one HCO said - 'After ten minutes (of attempting to pack) I thought - what did I tell my clients all week?' (P.16). For one HCO, home matters became very disorienting 'I went blank…couldn't get organized…didn't know what to take or what to pack' (P.9); 'We ended up moving twice' (P.8). There were HCOs who evacuated their families themselves (P.16) whereas several others asked family or friends to assist them (P.10). Some HCOs received evacuation orders not only for their home but their workplace as well. As

20 one HCO stated 'It all happened so quickly…within an hour, the [facility] and our home we were told to evacuate' (P.19).

At times, the HCOs' focus remained on their work rather than on their home due to what was happening at their workplace - 'my home isn’t a big thing with either my [partner] or I' (P.8). HCOs talked about the difficulty keeping the family connected and supported especially when family members were threatened by the fire such as those who may have been on the frontline fire fighting. Some HCOs did not know where family members were and worried about them. '[My daughter] was upset and concerned about [the family member]…[I] need[ed] to help [my] daughter with her emotions' (P.10); 'I didn’t even know where he [the son] was going to stay…For a 24 hour period I couldn’t find [my partner]' (P.19); '[I was] unable to reach my [partner] for 2 full days' (P.10). For example, HCOs whose family member(s) were involved in frontline fire fighting activities or at the fire’s edge, maintaining power, water and supplies, tried to make contact with family members - 'My [partner] had the cell phone…I didn’t know where they were…up there that night…in the fire…for a 24 hour period, [I]couldn’t find [my partner]…the fire department…could get the message to [my partner]…I said, "let [my partner] know where I am"' (P.19). HCOs said that where possible, keeping family members with them was an important coping strategy to ensure family safety, 'I kept my [child] with me at work … picked up my [other child] from home on the way to [relocation site]' (P.10); 'I took my mother with me and left' (P.9).

To deal with the uncertainty about home and/or the workplace, HCOs tried to stay informed about the progress of the fire by listening to local media, talking with frontline workers, or seeking information from websites. No matter where they worked, the timely release of accurate updated broadcasts from emergency response, was crucial to HCOs as they organized their personal lives and their professional responsibilities.

'The location in which I worked' HCOs spoke about where they worked during the fire and some of the difficulties they experienced. The absence of necessary technological equipment available for use, getting details from people in public spaces, storing information in public areas, and working in a smoky conditions all proved to be some of the more tricky worksites. Confidentiality of evacuee information was raised by several HCOs especially where the workplace was located in a pubic place.

Locations from which HCOs operated included their regular workplace, alternative buildings and offices, outdoors, or from their vehicles. The smoke from the fire affected HCOs health (vision and respiratory function) especially when they worked outdoors. Several HCOs mentioned that they could not work as efficiently because of the air quality during the fire, and wondered about the long-term health effects (P.1, P. 2 and P.17). In instances where HCOs were evacuated from their worksite, new premises or locations needed to be established along with all the necessary communication and record keeping systems for evacuees.

'I didn’t know…' In order to do their work, HCOs wanted to know where to go to get information. Due to the urgency and demands created by the fire, there was very little time to get all the details they needed and then share it. Making plans and mobilizing resources required specific information based on their role. Some HCOs had to get details from emergency planning groups in order to meet the demand for services. They found that they did not receive all the crucial information in a timely manner. Occasionally information that was received was outdated and potentially

21 unreliable. 'We never did get accurate information from…' (P. 9). 'There is a lag time, a rolling calculation…[people were] wondering what was going up when all of a sudden there were no more advisor[ies]' (P.20).

Inconsistencies in the exchange of information, was also apparent so HCOs used a range of tactics to access and share information including: • strategizing with other health care service providers; • holding discussions with members of the emergency response groups; • consulting with other HCOs; • talking with front-line workers including fire-fighters; • listening to the local radio stations; • accessing the website dedicated to the fire; and • using a 'fan out' strategy for disseminating information.

HCOs sought out their emergency plans because they were worried about the possible demand for services given the rate at which the Okanagan Mountain Fire was expanding and moving into the urban areas. In the absence of a plan, a few HCOs were involved in creating emergency preparations. One HCO was involved in detailed strategic planning and response: 'I was asked to sit on the fire planning conference calls. There were two to three conference calls a day…it was a lot of planning; it was the biggest thing I did. It was an intense effort…' (P.15).

'We didn’t have an emergency plan' The rate at which the fire spread, its extent and duration caught people ill-equipped for the emergency. Between agencies, the level of preparedness varied, ranging from organizations that had no disaster plans to those organizations with detailed evacuation and disaster plans that were used successfully. However where no plans were in place difficulties emerged: '[I] don’t think anyone ever thought it would ever get to that' (P.16), and '[w]e had no plan in place' (P. 9). There were instances where HCOs reported that disaster plans may not have included sufficient information about evacuation, a situation especially evident where HCOs worked with clients in the community. Most HCOs were clear about their roles and referred to them as being available to assist and participate in organizing services. Nevertheless, there were several HCOs who talked about not knowing what their role was or if they even had a designated job or position description. Their uncertainty is illustrated in statements such as, 'Who is responsible?' (P.11); 'What is our role and where does responsibility end when the client is living in the community?' (P. 1); '[I] needed to trust my gut and respond earlier' (P.12); and 'thinking, is there something I have not thought about that I should be doing?' (P.20).

Agencies without emergency and/or evacuation plans developed them as the situations evolved. 'We were developing as we were going…we had no plan in place…we did not have anywhere to send these people. We should have a plan [of] where to take these people. [We] cannot take [them] to a hotel' (P.9).

HCOs working with clients living in the community managed the situation by responding to telephone calls and inquiries from clients and care-givers. Crisis emergency plans were discussed with each client or care-giver with the conversation including: • preparation for evacuation; • new accommodation if evacuated;

• transportation; • referral services (meals delivery, personal care providers, oxygen delivery, medication delivery, physician services, and animal rescue and care); • arrangement for special accommodation where needed; • identification of personal items and assistive devices; and • contacting family members to inform them about relocation of the client.

There were also unanticipated dilemmas presented to HCOs as they sought to enact emergency plans. Examples included an increased demand for telecommunications to enable contact with clients, families and emergency personnel; sufficient safe and appropriate accommodation for group housing and accommodation for seniors; and alternate transportation routes to enable safe passage to evacuation areas.

‘We didn't know what the demand would be’ To assess the client demand for health services, HCOs went to key areas such as evacuee registration sites, fire halls, and city hall. Interventions for community-wide health services were established using protocols such as '…you start to assess the emergency, identify the needs of the community to help its citizens. You enter the needs into a [central data base] and then people can respond to the need…' (P.8).

HCOs did not always know what was available to clients nor could they anticipate the ever- changing requirements produced by the fire. Organizing health care services was difficult in these circumstances. 'Where were they going and how do we provide services?' (P.9). Some HCOs were overwhelmed with what the community required during the emergency. 'We can't do 45,000 people, we have already done 30,000 and I don't know what we would do with 40,000 people' (P.18). As one HCO said 'I would not wish that on anybody. It was incredibly overwhelmingly…the responsibility…on you, to provide the support and to provide the [care]…' (P.19).

In some cases the HCO knew how to organize health care but did not know how to access the resources. One HCO spoke about 'trying to get a hold of doctors…trying to access physicians…find the medications…and try to meet the needs without the resources right at hand' (P.19). As one HCO mentioned, it would have been helpful to have mental health involved to assist with supporting clients with evacuation, relocation and loss (P.9). 'Counsellors were there, we just needed to know how to call them' (P.11).

The disruption in health service, created by the fire, resulted in changes in the demand for care. P. 9 spoke passionately, '[you] cannot take [people with advanced dementia] to a hotel…[because they] have care requirements special to the clients…There isn't a place…an empty location for these people'. P. 16 explained, 'if the power went out…there is no backups for their ventilators to last over a very long period of time…nobody had any idea of how long those things [power outages] would last'. There was an additional impact on HCO’s as they tried to work more closely with significant caregivers especially where the client was evacuated to a loved ones’ home without the ability to provide privacy. 'How do you go to the family home with children when grandma or grandpa cannot control their body functions?' questioned P. 9.

The early loss of power lines, a cell phone tower, along with the volume of calls and unreliable computer systems, interfered with HCOs ability to do their work (P.1, P.5, P.9, P.10, P.11 and P.16). 'We were having difficulty with computers and if the computers quit working, the

23 communication [stopped]…we rely so heavily on computers' (P.9). To cope with the situation, HCOs used fax machines, cell phones, internet, walkie-talkies, short wave radio clubs, broadcast radio, communication books and boards, news letters/bulletins, and hard copy information.

Most of the HCOs were responsible for the challenging task of resource allocation during the disaster, 'how are we going to get [people] to [place]?' (P.19); '[I] am a department of one and [need] to find people able do the job' (P.11); and '[We need someone] to work with large animals' (P.17) were some of the difficulties experienced. To manage their situation and provide services HCOs: • networked with one another; • reviewed their practice area’s disaster preparedness; • established emergency response plans/protocols for staff to enable them to prepare for possible demands such as mass casualties, explosions and burns; • locally directed collaborative planning and coordination of streamlined services that include regional, provincial, and federal levels; • searched within and beyond the region the for such things as accommodation; • activated existing contracts including accommodation and food services; • negotiated with the public and private sectors for resources such as food, bedding, personal care items, transportation of people, equipment, pets and livestock; • created new service contracts with food and accommodation providers; • located coolers of various sizes (for food storage and delivery); • developed resources for themselves such as contact lists and communication books; • joined with agencies to coordinate disaster relief and recovery services; • recruited volunteers; • reviewed and restructured health care service delivery in non-emergent areas; • requested the public use alternate services (walk-in clinics instead of emergency rooms; limit power consumption and telephone use); and • developed emergency response protocols (working behind evacuations lines or service agency referrals).

HCOs clearly identified significant issues affecting their ability to address the health of the local community and population at large. In order to ensure population health and safety, the HCOs managed the challenges by finding innovative and creative solutions in a volatile environment. There were clear collaborative efforts among certain health sectors as P.14 mentioned - 'I think some of these areas needed to be incorporated…it was a real mix of people…where we had everyone, we had private, we had the psychologists, then you had the clinical counsellors, the private counsellors and mental health, children and adults, some others, Red Cross, Salvation Army…a real mix and we tried to get everybody with in reason'. These efforts typified HCOs attempts to meet the demand for services created by the fire.

'Who made the decisions' HCOs, senior managers, and middle managers, at local and provincial levels, made complex decisions. Most of these decisions resulted in successful outcomes however, a few decisions were questioned by HCOs such as the cessation of broadcast air quality alerts or advisories These alerts are crucial for people living with illnesses such as breathing disorders. Air quality advisories are designed to inform people with respiratory conditions so they can implement strategies to prevent further illness and respiratory distress. There were also gaps in the release

24 of fire related health information causing difficulties for HCOs in providing health care advice. As one HCO stated, 'it was frustrating trying to get a message to our [clients]…and having a disagreement at the [higher] level' (P.15).

There were times when HCOs felt that they were working in isolation. A few senior managers were sent to other areas to assist leaving HCOs with little or no direction and support. Frustration was evident in a comment 'what was …[the] role and the senior administrator's responsibility? Whose responsibility was it to inform us?' (P.5).

'I couldn’t find them' Due to the large scale evacuation of the community, HCOs had difficulty locating staff, volunteers, clients, physical space, supplies equipment, and caregivers. Many evacuees did not know where they would be relocated and this had an effect on staffing, planning and provision of health services. HCOs spent considerable time and energy trying to contact people (P.1, P.5, P.9 and P.10). P.11 stated, 'knowing where to contact people as well as staying in touch, being reachable…[and] others being able to contact you' was crucial. Many people could not provide contact information to HCOs or their staff and this resulted in confusion and difficult tracing people. The enormity of registration records for those evacuated presented a further barrier to finding people. For example there were '20,000 people [registrations]…found in boxes, not files, just put in boxes' (P.8).

Adopting unique and innovative ways to track clients/families was not unusual for HCOs: 'I had an old fashioned way of keeping track of my clients and this involved detailed paper records' (P.9). HCOs tried to ensure continuity of care, safety and support by: • contacting clients/caregivers daily; • reviewing contact information at each encounter; • maintaining paper records with demographic information; • developing and maintaining computer generated contact lists on a daily basis; • contacting staff, family, or friends; and • sending verbal messages via colleagues.

There remained ongoing difficulties with keeping up to date with clients' changing locations throughout the fire period.

'The many, many hours' HCOs described their work as overwhelming and exhausting. 'To get through each day… [I] found myself for 6 days you didn’t sleep and you didn’t eat, and you just went, went, went because everybody was depending on you to make sure that you know there was enough staff, that people were getting back and forth to work’ (P.19). HCOs managed to cope by implementing moment to moment strategies dealing with the challenges as they emerged. Most HCOs talked about working long hours with statements like - '…I logged 400 to 500 hours of overtime' (P.8); '24 hours of needing to be there' (P.1); or 'I worked six night shifts as well as…during the day' (P.10). This was common for those providing services in high demand areas where HCOs normal activities were required to continue over and above the essential crisis related work. The long hours were also attributed to the opportunity created by the experience. Two HCOs wanted to work because it was a ‘once in a lifetime’ event (P.1 and P.11).

One of the issues that prompted the long hours was staffing whether people were paid, unpaid, or volunteers. Staffing numbers were described as being adequate to areas of shortage. A few HCOs talked about being inundated with people who wanted to volunteer. 'So we put out call for volunteers and we had volunteers coming out of the woodwork' (P.18). 'I asked for 4 and got 44' (P.18). Differences in the numbers of staff was due to people taking leave during the crisis to evacuate or to deal with personal/family requirements. Circumstances around the lack of transportation also caused problems when staff's vehicles were left behind evacuation lines. Difficulties contacting staff and management, and staff not knowing where to go when the worksite had been evacuated were also sources of confusion. HCOs talked at length about the importance of supporting staff by arranging for rest breaks, ensuring staff had nutritious food available, and providing emotional and psychological support throughout the fire period.. Each of these areas were deemed critical (P.1, P.3, P.5, P.6, P.10, P.11, P.14, P.15, P.16, P.17, P.18, and P.19) in preparing staff for the 'adrenalin rush and the exhaustion after' (P.17).

Another contributor to the long hours of work emerged from HCOs reluctance to leave the worksite because they were concerned about workplace safety during the emergency response (P.4, P.11 and P.20). Make-shift equipment was occasionally used instead of purpose designed apparatus and in some areas specified guidelines for the use of equipment was not followed. Dangerous situations also existed where staff worked behind evacuation lines, or where constant sustained exposure to smoke over long periods, presented risks to health. Safe practices with food handling and appropriate food storage (keeping hot foods hot and cold foods cold) remained contentious. The efforts of the local community trying to assist in anyway they could, resulted in large donations of prepared foods for emergency workers. It was a contribution many women in particular, felt they could make to assist in the emergency response.

Additional staffing challenges faced by HCOs that contributed to their long hours were when staff or volunteers: • worked outside organizational policies; • were unaware of the skill sets and/or learning needs of other staff or volunteers; • had concerns about appropriate safety of health care delivery; • came from other areas and imposed their protocols on local organizations; • demonstrated stress due to the fire events; • expressed not feeling valued; • were being directed by individuals who had no awareness of local conditions; • lacked clarity about their preparedness for the emergency response; and • were selected, orientated, and trained workers new to emergency response.

To assist with coping, HCOs stated that opportunities for staff, volunteers, and themselves to debrief, varied. Most debriefing was accomplished in the context of evaluating how organizations/agencies responded to the fire rather than personal and group debriefing opportunities designed to surface emotional responses. One HCO attended a debriefing session for the community; 'after the fire…the fire department put on a debriefing session…I went with my husband…I broke down…it was the first time I actually broke down (P.19). Another HCO said '[it] affected me…from a stress perspective…I know that in my own household [there was an] uneasiness…[we] lost our innocence' (P.9).

Reflecting on the challenges of their work, HCOs identified many critical questions that were left unanswered and for which they require clear and formal responses in preparation for future disasters: • How are the various health sectors, programs, organizations, government ministries linked? • Who can be mobilized in the community and what are the services they can provide (volunteer and paid human resources)? • Who in the organization will ensure the implementation of debriefing for staff beyond the formal organizational emergency response evaluation? • What disaster relief agencies can be accessed and how to access them? • Where accommodation can be made available for clients/residents? • What special requirements/needs (if any) do evacuees have and who can accommodate those requirements/needs? • What personal assistive devices are required and where can they be found (mechanical lifts, hospital type beds are examples)? • Where to access personal care supplies and comfort items for young children (cuddly toys)? • Where to accommodate and care for both wild and domestic animals? • What sources of energy or power can be provided to supply equipment for evacuee’s special health care needs? • Where to obtain safe and nutritious food? • Who can be recruited (and where necessary trained) to prepare meals? • Where to store food that meets the food safety requirements? • How will a reliable supply of safe drinking water be secured? • How to provide accurate public health announcements (for example air quality alerts and water safety advisories, highway closures) and through what mediums? • How to create and mobilize provincial, and national databases and virtual warehouses for resources? • Under whose mandate is it to centralize records to promote seamless delivery of health care services during disasters?

Income and social status Considerable research indicates that the degree of control people have over life circumstances, especially stressful situations, and their discretion to act are the key influences. Higher income and status generally results in more control and discretion. And the biological pathways for how this could happen are becoming better understood. A number of recent studies show that limited options and poor coping skills for dealing with stress increase vulnerability… Public Health Agency of Canada 2005

The impact the fire had on HCOs' social and financial status and their professional standing varied considerably. Some people's careers were greatly influenced by public recognition during the disaster. Appreciation of their contribution by the community, municipal, and provincial governments has provided many HCOs with an opportunity to share their knowledge in the field at conferences, and in other forums. Some have been recognized as leaders. Through their organizations and/or as part of their work, several HCOs have moved on to spear-head disaster preparedness activities. Several have become involved locally in future disaster events with the development of protocols and identification of resources.

There were HCOs who returned to their former work with little or no recognition or change in their social status or income. In one instance, a thoroughly disenchanted HCO whose employer failed to acknowledge their volunteer work, chose to resign.

Overtime was paid to a couple of HCOs, while many donated time without compensation. Whether HCOs acted as volunteers and lost financially because of the time away from employment, remains unclear. There were several that gained new clients as a result of their volunteer work, clients who sought their services once the evacuation and crisis of the Okanagan Mountain Fire was over.

Regardless of changes to income and social status, or whether they were recognized for their contribution, the fire had a significant impact on the lives of HCOs. As one HCO put it 'I felt an obligation to contribute, a real deep desire to help in any way I could' (P.6).

Vulnerable people Vulnerable people in the community Two participants (P.1, P.13) expressed concern about what appeared to be a lack of visibility of community care as one of the stakeholders involved in the emergency response team. Given the increasing number of people living in the community requiring care through the community care programs, it would seem that greater consultation with the community care sector needs to take place to support emergency preparedness. Those with respiratory conditions should have 'moved out of the area sooner, some were very compromised and required extra assistance…palliatives needed help to move…'(P.13) Clients with dementia were also regarded as vulnerable - the 'fire situation highlighted the neediness of these people particularly in emergency situations - from the caregiver's perspective, the change was very difficult for them when you move a family member out of their environment - [we] saw people decompensate sooner' (P.13). Care-giver burnout was a concern (P.9). There was also a comment that 'bringing in mental health support earlier, and to inform the community's understanding of their response to the disaster, would have been helpful (P.12) to assist people with loss and change.

The stress created by the fire Mental Health was connected with the local hospital, Red Cross, and Provincial Emergency Social Services and the Recovery Centre. These services were needed at the Emergency Centre to assess people and identify those at risk (P.1, P.12, and P.14). Mental Health professionals walked around the fire fighters, emergency workers and those at the reception centres to provide easily access to mental health support (P.6). Strategies were put in place to assist with services targeting evacuees and firefighters in particular. Several HCOs spoke about stress and how important it was that the community understood that symptoms such as insomnia, tearfulness, plus an inability to concentrate were all part of a normal reaction. These messages assisted the ways in which the HCOs worked with others, however it did not necessarily inform how the HCOs understood their own experience.

The psycho-social impact of disasters has received a lot of attention since 9/11. Diversity of opinion continues to exist on the nature of debriefing and its importance. Wooding and Raphael (2004) explored the relationship between the degree of exposure (severity and persistence) and the impact of trauma especially on children. Debriefing conducted in children's school environments was found to be beneficial (Gurwitch 2004) but Stallard and Salter (2003) claim that there are optimal times when debriefing should occur to prevent post traumatic stress disorder (PTSD) and maladaptive behaviour. Questioning the usefulness of debriefing Noy

(2004) claims that peoples' resilience enables them to successfully move on without untoward socio-emotional effects. Despite these comments, individuals' vulnerability is increased with relocation and there is a tendency for the stress of a changed environment to compound the stress of the disaster (Glass, Kasl, and Beckman 1997; and Hawkley and Cacioppo, 2004) effecting mental health. These findings support the comments made by HCOs particularly with regard to assisting elders to maintain health when relocated to different or unfamiliar environments.

Through public consultations questions about the mental health was raised not only in relation to those with long standing mental health challenges but also with regard to assisting people with loss and grief. It appears that those who sought assistance may have done so as a 'one off' appointment often to better understand what they were experiencing. Other examples of ongoing counseling or access to services were provided for a small number of people. Services were available to several individuals who had difficulties in their personal lives prior to the fire, the evacuation serving to exacerbate the situation resulting in ongoing counseling and support. Any difficulties experienced by those with pre-existing mental health challenges remains unknown. It is clear that those with mental health issues are very vulnerable and often invisible. The response to the fire may have overshadowed the ways in which mental health might have been addressed differently by the HCOs during the emergency response.

There was no time for front-line staff to be debriefed. Many staff found the emotional nature of working with those affected by the fire very draining. 'Staff felt that they were over their heads in dealing with the emotional impact of the emergency on the individuals and families affected…have at least one highly trained resource person in the Recovery Centre right from the beginning' (City of Kelowna 2004, p. 8). Relocation and reorganized health care was emotionally tough for managers especially when the health of clients or residents were affected as a result of the fire and evacuation. For example, 'one resident fell and broke his hip and passed away'. (P.19), while another's mental status had significantly declined: 'I had one client who had a mini-mental of 22/30 before the fire and I had a phone call from the spouse 10 days later saying" I can't deal with it any longer" and requested urgent placement. His mini-mental was down to 10 three weeks later. He never did go back and had to be placed…' (P.9).

Dealing with difficulties and creating new relationships to assist vulnerable populations The majority of staff other than mental health professionals were not trained to recognize critical stress levels and know when people needed counseling. In a document titled ' Okanagan Mountain Park Fire Recovery Plan Review' (City of Kelowna 2004, p.8) it was acknowledged that …there is a need to change relationships between social services providers responding to an emergency and the staff in an urban centre…it is important to find a way to make the recovery team take a lead role in coordinating services. Response to citizens would have been much quicker if there had been a trained social worker or someone skilled in dealing with families and individuals at risk on board from day one.

Whereas several agencies managed to organize and deliver health care services well during the fire period, there were a number of HCOs who remained concerned about mental health support to clients in the community during the fire period (P.1, P.8, P.9, P.12, and P.13). Given the number of people evacuated, it was anticipated that community care clients would comprise many of those who were relocated. The impact of changed environments on elders in particular, remains largely unknown. HCOs wondered about the opportunities for community care evacuees to access mental health services. Interestingly, mental health professionals had fewer requests for

29 services then expected (Morgan, Personal Communication, 2004) and perhaps this was related to the ways the community acted to support one another during the crisis (P.5, P.6, P.7, P.8, and P.12). Part of the success of the support was what HCOs described as having as people with multiple skill sets and training, for example, volunteers with a little education in counseling, to people with PhD's, to assist during and following the crisis (P.9, P.11, and P.18).

Preparing now for next time was a clear concise message from HCOs. Practising disaster response, engaging in larger scale mock disasters; annual open book examinations around disaster protocols and procedures; evaluation and review of what happened last time – what went well or what did not, were some of the suggestions. As lines of communication appeared to be an issue for several HCOs attention to organization, intersectorial and communication with the community needs further exploration. As one HCO said 'front-line managers need to be kept informed; communication needs to be filtered down' (P.5). P.5 went on to say that there were times when HCOs expressed feelings of isolation by not being kept in the loop with frequent updates of the fire's progress to enable discussions about pending health care service needs.

Disaster preparedness with the availability of courses and individual educational sessions were regarded as essential components of staff orientations, and be included in a separate section of orientation manuals. Nominated individuals who act as 'champions' need to be hold responsibility for disaster planning in their work place/organization, any in-service education for employees and ensuring that updates on preparedness are made available to senior administrators (P.5).

Reflections on the experience Reflecting on the experience of the Okanagan Mountain Fire, participants recommended additional forward planning at all levels and across all sectors of social organizations and health (P.3, P.5, and P.14). Planning referral systems well in advance was believed to assist all sectors of the community to access health services such as community care and mental health (P.3). Establishing emergency teams comprising people with a skill mix to enable holistic care (physical, mental, spiritual) who have prearranged roles prior to a crises, will add to the community's ability to respond (P.1 and P.14). Most HCOs talked about the importance of getting together as a group to plan for future emergencies; share information; establish clearer communication links; increase the number of trained volunteers; developing adequate evacuation protocols, that include access to supplies, accommodations, and meals to help being be better prepared (P.5 and P.19). One HCO (P.17) suggested that an individual in a team should be assigned to care for the team, making sure they got adequate rest and appropriate nutrition to help sustain them during the emergency response.

Expectations from the public once the crisis was over The expectation of people receiving health care service demonstrated a tolerance for changes to their service during the fire but expected services to return to pre-fire levels immediately following the disaster. 'Clients just wanted their services back' (P.9 and P.13) and this expectation of resumed services following the end of fire was very apparent (P.13). The 'adrenaline rush' that kept some of the workers going during the fire, was followed by exhaustion. HCOs continued their long hours with minimal down time to recover. 'Many were facing their own losses, bereavement and staff tragedy and the demand to re-order life' (P.13). Staff also experienced illness - '…physical illness, chronic illness such as fibromyalgia, low back pain and those types of illnesses were certainly exacerbated' (P.12).

'Getting the…health services in earlier - I needed to trust my gut and respond earlier' (P.11) was not an uncommon experience. Many HCOs worked through their contributions and were able to identify gaps and overlaps. P.13 recognized the layers of urgency - working out what the immediate requirements were and then project on-going client or service needs. '…many people from our town would often say that "I am not convinced that our town would pull together like this", or "I am not sure this would work in our community". I tried to reassure them that it probably would [work] if they…did a bit of research…and get a plan in place…but I think for us it was a learning experience and it got certain groups working together but it also forced the community that we do have to look at some other areas that we have to ensure…[we] are prepared (P.14). The corporate co-operation was enormous (P.15), with assistance from commercial businesses providing core health resources such as medications, to restaurants and supermarkets providing food and personal items. Community service, animal services, church and community organizations also assisted.

The personal impact Concerned about being sensitive to staff situations, many HCOs found it hard to speak about the impact of the fire on themselves until their experiences were affirmed. Opportunities to normalize individuals' responses to emergency situations are vital to supporting people through their distress, loss and change (P.6, P.7 and P.14). Sharing experiences with colleagues or using different types of debriefing also serves to assist in better understanding what happened and to help create meaning from the devastating effects of a disaster. Debriefing for most HCOs took place. However, it seems that the nature of participants debriefing was emergency response evaluation, not the debriefing that surfaces one's feelings about self and the meanings of one's experiences. It is important that opportunities are provided for debriefing to occur, not only immediately following the emergency period, but also at some future time. In addition to debriefing, those involved in the response need time to recover. Provision for a recovery period should occur as part of the disaster plan.

During the course of this project, HCOs shared many personal and professional insights that were deeply seated impressions of their experience. They were committed to the community and were pulled between their home and work. 'I was at home alone so I could be totally dedicated to this event…It’s hard to sit at home when your community is on fire. I should be doing something…You want to help your community…[yet] I got pulled away from the volunteer site to the worksite to ensure there were plans in place in case anything happened' (P.5); 'I wanted to do something for the fire so I volunteered' (P.8).

The success of the HCOs' work is depicted in the voice of managers and staff: 'The staff was so supportive and so wonderful…' (P.19); 'Everyone was on edge. They just buckled down and did their jobs…the whole community came together. Talking to each other. Staff were welcoming other staff into their homes. People came together. Supporting each other. Everyone was concerned about how to help the community' (P.5).

The field of ecological restoration offers insights into the importance of communities engaging in constructing new understandings of their changed environment (Cox and Holmes, 2000; and Cox 1996) following disasters such as the Okanagan Mountain Fire. In seminal work on 'Place and Placelessness', Relph (1976) emphasizes that place (environment, home, neighbors and community) is profoundly embedded in one's sense of identity and feeling of belonging. Any changes to place requires the rebuilding of meaning about one's altered environment, and the creation of activities that connect the old with the new. To feel a part of the place helps as the transition from one's old environment to a new burnt landscape occurs. Strategies to support the

31 community's connectedness with one another and with their environment through these transitions is critical to recovery and to the socio-emotional wellbeing of members of the community and their feeling of belonging longer term. As they recounted their lives during the fire, it was not uncommon for HCOs to express their raw emotion through tears, laughter, and silence.

The personal impact of the Okanagan Mountain Fire disaster was a life changing experience: 'How does one go back to the regular routine?' (P.2); 'it just virtually took a year out of your life to deal with it…it was a wonderful experience…[there are no bad] comments about it other than it takes its toll on you and it takes its toll on your family' (P.8). Another HCO spoke candidly about how the experience had given the HCO's life deeper meaning saying, 'I would like to do this all year round' (P.1).

Several HCOs expressed feelings of privilege to have been involved in the community response. The depth of HCOs' experiences was palpable across their personal and professional lives. They were amazed and gratified by the efforts in such challenging circumstances (P.1, P.10, P.11, P.16, P.18 and P.19). The fact that during the crisis '[t]here was no loss of human life' (P.6) was remarked upon, as was the comment that if their had been loss of life, then maybe their experiences would have been different.

Conclusion Using a qualitative interpretive approach, this study has unfolded detailed information from 20 HCOs who were instrumental in responding to the changing situations as the Okanagan Fire advanced towards the city of Kelowna and its surrounding communities. HCOs recounted their experiences during audio-taped interviews which they later authenticated. Data was analyzed, initially by illuminating essences in which 'communication', 'being there' and 'reflection' comprised the central phenomena or essences. The data was analyzed further using the framework of the determinants of health to support knowledge transfer to other disaster environments.

The study highlighted the challenges and successes HCOs faced as they organized health care services for the community during and following the Okanagan Mountain Fire. In-depth and detailed information about HCOs' activities was evident. They spoke frankly about the environment, the working conditions and coping. They identified what worked well and made suggestions for changes to areas where there were gaps. HCOs talked candidly on the impact of the disaster and the strategies they used to ensure that health services were available to the community. Difficulties became obvious for HCOs as they identified vulnerable groups. Worry about the health of the public with poor air quality, risks of contamination to the water supply and food safety for emergency workers as the fire advanced towards the city of Kelowna, was part of their experience. Throughout the fire period, there were ongoing concerns with regard to accessing up-to-date and accurate information, being prepared for what was to come, knowing what the health service demand might be, locating resources, and then working long hours.

Looking back on their experience, HCOs were able to make suggestions about what they would do differently or where they thought some further work on preparedness needed to occur. By far the most common comments were the importance of having disaster plans that included evacuation plans and that plans are practiced regularly; better communication using a fan out approach was thought to be critical to keeping people informed with accurate and timely details of what was occurring; and increased cooperation between sectors to enable holistic approaches

32 to health services to assist the community were the most widespread suggestions. Local control over all aspects of the response was fundamental to facilitating community involvement and maximizing resources in the community and facilitating its recovery, loss and change.

HCOs also talked about some of their personal and professional challenges as well as reflecting on the areas that could be enhanced in the preparation for emergency response. Many experienced that 'adrenalin rush' and then the exhaustion afterwards. This aftermath of disasters is an area for future research. As data was gathered, it also became evident that additional research is needed to more fully understand the complexities of emergency response environments. There were many priorities related to health issues that HCOs had to address; the longer term effects of the fire on population health, exposure to environmental hazards such as smoke comprise just two examples of many health concerns that remain.

As they spoke about their roles, the activities in which they engaged, and the complexities of their work, HCOs shared many powerful stories that revealed their deep concern for the wellbeing of the community. The stories were unique to the Okanagan Mountain Fire, but they will resonate in the experiences of HCOs elsewhere. What we have attempted to do is to make these stories visible and helpful to communities who are working on their disaster preparedness or are in the process of recovery.

… Brian Tutt was a Kelowna firefighter during the Firestorm on Friday 22nd August 2003, the peak of the disaster. He describes the experience to Judie Steeves (15th August, 2004). 'The heat alone from the advancing blaze starts new fires 50 metres in front of itself.' The intensity of the heat was enormous.

Sparks were blowing horizontal to the road…suddenly the houses around are in flames…he and the crew he was with, elected to move down to the Kettle Valley subdivision where they found themselves surrounded by fire…"We weren't trapped. We just had nowhere to go."…He remembers they got down on the grass with their noses to the ground where the air was cooler and they could breathe. The wind- driven fire would swirl in the trees and in a blaze of flame a tree would be gone, from the ground up…it sounded like a freight train "it just roared in the bush above you"… Steeves 2004, p.A3-4

The Okanagan Mountain Fire started on the 16th August 2003 with a lighting strike. Almost one month later on the 13th September when it was finally 90% contained 238 homes were destroyed, 30,000 people were evacuated at the height of the danger, and approximately 27,000 hectares burnt. Steeves 2004, p.A3

Kip Frasz 2003; ‘Aerial’ view of the forest around Chute Lake. FireStorm; The Daily Courier, September 29, 2003. p.20

'Every time you talk about it…every time you see something about it…I don't think that…there will ever be a time when you won't remember it. Everybody will remember August 2003…a defining moment in Kelowna's history' (P.18).

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Appendix 1 Chronology of the Okanagan Mountain Fire Events extracted from Castanet.net Okanagan Mountain Fire Watch 2005

Date Event Area Effected

Monday The fire has changed moving south as well as • Parkinson Emergency Center 18th Aug 03 north (2,200 hectares now burnt). has been set up • Several cabins in Chute Lake area (south) evacuated • So far 45 homes at South end of Lakeshore Rd evacuated; • The fire is approximately 1 km from closest homes.

Tuesday • Chute Lake Resort and area 19th Aug 03 80 firefighters are now on the scene double the cabins evacuated along with Morning. number from last week. Army has been called in the communities of Indian as well. Rock and Glenfur (North of Naramata). • Radio listeners and cell Afternoon Fire covers 2,800 hectares, increased by 600 phone users affected since hectares. the transmission tower for the GIANT 100.7 has been knocked out. • Naramata on evacuation alert (2,000 residents).

Wednesday Overnight fire continues to expand now 6300 • 2,000 people remain on 20th Aug 03 hectares to the South. evacuation alert in the Upper Morning Mission area (Okaview, Kettle Valley and Uplands) Evening Fire Chief Gary Zimmerman says 'situation of Kelowna. fairly stable for Kelowna…unfortunately not too • Residents are told to 'gather good for Naramata'. Jim Goosen says 'winds are essential items such as dying down'; fire has consumed 13,000 hectares medications, glasses, (95% of the park and is a level 6 fire) Level 6 is valuable papers, and the highest rating. keepsakes such as pictures'. Officials are scaling back operations tonight; • Pets and livestock are to be 80 people registered at the at Kelowna (167) 'moved to a safe area'. map. A major power line has been damaged, 'de- energized [or]… turned off'; the line supplies Summerland, Naramata, West Bench, Kalden and Penticton affected.

Thursday Winds calm at present 'as long as the winds • Air quality 'poor all day' 21st Aug 03 remain calm it is expected to be another good rated at 150 on provincial fire fighting day'. Air Quality Index Scale (100 or greater is very poor) • Residents ordered to leave 2049 hrs Flames jump the fire guard near Timberline but 'asked to do so in an Subdivision. orderly fashion .not to panic'. Parkinson Rec. centre now fully dedicated as (3,800 homes approx. 9,000 the evacuation center for the Okanagan -10,000 people). Those Mountain Fire. already out of the evacuation area will not be allowed to 2230 hrs All South Mission homes to evacuate. return for their 'things'. (Belcarra Estates) a number of homes reported to be lost (15 approx -17 threatened but saved) - 17,000 hectares burned at present.

Friday The blaze is approximately 1.5 kilometers from • People allowed to return 22nd Aug 03 nearest homes in Kettle Valley. from 1000 hrs to 1100 hrs 1044 hrs for medications and pets – must show picture ID. Approx Fire is advancing – a number of spot fires noted • Evacuation orders are given 1600 hrs in the southern end of Kelowna. to Lakeshore Rd West. Dehart on the North, Fire continues to advance. Fire Fighters battling Crawford Rd. on East and 400 ft flames with winds gusting 60 to 70 Barnaby Rd. and Bellevue km/hr. 'like a war zone' states an unknown fire Ck. South. fighter. • A 2nd order is given to residents of Sutherland Hills Rest Home. 1800-2255 In the South Okanagan, OK Falls are put on • Ambulance will assist with hrs 1.hour evacuation alert. evacuation of residents. • Areas include from Hwy 33 Closed traffic is re routed to Hwy. 97. Okanagan Lake to Mission Ck to Hollywood Rd North and then from Hollywood North to Springfield to Hwy 33..North up to excluding the airport east to McKenzie and Old Vernon Rd. • A second evacuation centre is opened. 20,000-30,000 are evacuated. • A strong request is issued - do not use phone lines unless it is very urgent –lines are 'overloaded'; anyone needing ambulance and not able to get through on 911 call 860- 0054.

III

Saturday 203 homes lost in total to this point and fire has • One third of the population 23rd Aug 03 burned 19,000 hectares. of Kelowna has been evacuated at this time; 1345 hrs Largest evacuation in shortest time in Canadian 30,000 people left their History. homes last night and another (www.city.mississauaga.on.ca/library/history/de 8,000 are on evacuation rail.htm) alert. • A 'boil water advisory' Fire continues to burn in east Kelowna to hwy issued. 33. In Crawford estimated, Myra Canyon • Scheduled commercial tracking west along the power line path behind flights on time. Kelowna; small fires popping up in many areas • City Buses continue, are to the east and north servicing areas under On evacuation alert 15,000 people (6,000 evacuation alert. homes). • Additional receptions centers opened in Vernon, Merritt, Kamloops and Salmon Arm.

Sunday Much smoke in most areas but winds 'are quiet. • Hwy 33 re-opened; people 24th Aug 03 Can’t see any raging fires' living on right hand side able 0815 hrs Bear Creek (West side) fire contained. to return except those living one block south (left side) of Hwy 33. Prime Minister (Canada) to visit at 1630 hrs • Iron man in Penticton today. scheduled to continue; • Poor air quality reported this morning. • Intermittent power outages continue due to the Okanagan Mountain fire and 'back up threatened'; because of Vaseux Lake fire. • 'Use flashlights rather then candles advised'; • No day passes for evacuated residents.

Monday Fire now at 20,000 hectares but contained at • 19,400 remain out of homes 25th Aug 03 present. 200 pieces of heavy equipment and 18 and 21,600 on evacuation helicopters 350 military; - 600 personal in total alert. working on the fire • Teachers workshop has been canceled. Vaseux Lake fire 2,300 hectares lots of active • Growing concern about fire behavior. health of fire Fighters. • Orchardists allowed day passes. • Air quality 6- (poor).

Tuesday 'Another good night' fire contained. • Precautionary 'boil water 26th Aug 03 advisory' for Black 0600 hrs Mountain District has been canceled –no infection of 2009 hrs Belleveue Creek fire active, very steep terrain, water occurred so flushing of and localized wind gusts. Conditions remain ice machines not necessary. volatile. • Aquilla, Like others engaged in the battle, has established a war room. • Monitoring Okanagan fires encroaching on transmission lines and substations. • Some of the evacuation centers closed down (Sky Reach Place and Kelowna Secondary School). • Residents tour homes sites.

Wednesday • More escorted tours for 27th Aug 03 residents who lost homes to leave from Trinity Baptist 1205 hrs Vaseux Lake fire spread (2,800 hectares) but Church. control lines held; Conditions remain very dry. • Precautionary 'boil water advisory' for Vaseux Lake 2042 hrs Re-entry maps provided. residents. • Electrical and natural gas services not available immediately. • Day passes for Gallagher's residents to visit home. • All residents returning to homes remain on evacuation alert and boil water advisory. • New boundary for evacuation order established in north east of the city.

Thursday • 1,338 to join the 10,400 28th Aug 03 Fire continues but Kettle Valley trestles 100% allowed back into their intact; 'everything being done to save them'. homes yesterday. • Air quality 38 (fair). 1220 hrs 'Navy coming to help mop up fires'. • Terasan to restore gas to Crawford Estate. • Stage 7 re-entry (Gallagher's and June springs) yet stage 8, homes outside of city remain on evacuation order. • 'Boil water advisory' lifted for Crawford Estates.

Friday Okanagan Mountain Park Fire 70% contained • Air quality 42 (fair). 29th Aug 03 • Safety alerts issued to 0618 hrs Vaseux Lake fire at 3,200 hectares. Fire is 30% returned residents; hazards in contained. surrounding burnt areas. The following are 'particularly dangerous to children'; • Trees branches fall silently • Non-visible collapsed areas • Visible open pits • Hot or burning objects • Downed electrical lines etc. • More boil water advisories lifted. • 'Insurance adjusters allowed access to damages'.

Saturday 20,100 hectares burnt, 678 fire-fighters (350 are • Air quality at 36 (fair). 30th Aug 03 military). 17 helicopters, 247 pieces of heavy • Re-entry to homes continues 0754 hrs equipment. 'good progress being made'. for Southlake Shore, Vaseux Lake 3,300 hectares burnt now, remains Rimrock, Timberline and at 30% contained 250 fire-fighters 7 helicopters Swick Rd residents. and 100 pieces of heavy equipment on site.

Sunday • Air quality 46 (fair). 31st Aug 03 Gallagher's spot fire –extinguished quickly. • Local smoke - high 28. 0815 hrs • Caution I: re-entry areas to Active fire Advisory –winds to 20km residents who are reminded 1241 hrs anticipated later from the west to increased fire of safety issues. behavior. Warning extends from 1300 hrs to sunset - 11 separate reports of fire activity are reported.

Monday 'No cause for concern… crews monitoring • Air Quality 56 (poor). 1st Sept 03 fire… not moving toward city…(fire is) way up • Boaters asked to make way 0500 hrs in the hills'. for aircraft. • Public asked to cooperate 1130 hrs Ministry of forests issue extreme fire warning; with fire fighters and wind predicted to 20 km with stronger gust to reminded fire operations 25km this afternoon and evening. must be first priority. Some public found in way in active fire fighting areas –please stay away.

Tuesday Fire spreads due to winds – Okanagan Mountain • Red Cross seeking additional 2nd Sept 03 Fire remains at 70% contained. Fire is moving volunteer staff resources east and Southeast away from Kelowna; fire is stretched. 4-5miles away from Myra Canyon. Steel trestle • Parkinson Center (first in Bellevue Canyon remains a concern. evacuee reception center to open) no longer acting as a 100 more military flown in to join firefighting reception center. efforts. • June Springs residents (outside city) to return home. • Recovery Center established (central place to access information).

Wednesday $400 million is cost of fire to date. • Evacuation alert reduced. 3rd Sept 03 No significant fire movement 70% contained. • Air quality at 51 (poor). 1822 hrs All control lines holding. • Parkinson Center opens again. 2058 hrs New evacuation order – Gallagher's and Area • 3,200 people on new evacuation order.

Thursday 22,840 hectares burnt in Okanagan Mountain • Air quality 63 (poor). 4th Sept 03 Fire. Fire grew by 1,700 in last 24 hours, 60% • 'Boil water advisory' on 0620 hrs contained. again for Black mountain Two trestles lost with the rest listed as 'at risk'. area. No homes lost at this point. • 9,600 more people now on evacuation alert. Total on alert are 15,100 people. 1729 hrs Five KVR trestles destroyed.

Friday Fire in canyon described as “challenging”. • Air Quality 62 (poor). 5th Sept 03 Six trestles lost at this point. • All evacuation alerts and Wind at 40-60km fire moving East toward Joe orders remain intact today. Rich. 35 other fire teams have 'turned up to help' Kelowna. Emergency Operations Command Director states 'feels like the city is under siege with the fire in the hill threatening to come back at any time'.

Saturday Wind not as severe as expected. • Air quality 51 (poor). 6th Sept 03 Fire active in Myra Canyon. Steep slopes • All evacuation alerts and 1943 hrs impede fire-fighting efforts. orders remain intact today 24,000 hectares burnt. • Over 3,000 residents remain Nine historic railway trestles lost at present. on evacuation orders. One house on fire in Mount Boucherie area another damaged.

VII

Sunday New evacuation orders for Kimatouche Rd. • Air quality 38 (poor). 7th Sept 03 subdivision. • 990 people and 329 0200 hrs properties bring total evacuated to 4,230. 1332 hrs 25,300 hectares now burnt with 650 fire • Plan to evacuate Big White fighters, 20 helicopters and 200 heavy pieces of area. equipment participating in fire fighting • Evacuation orders to Idabel activities. Lake Resort (six families). Four remaining trestles at risk – water sprinkler set up to cover them.

Monday Rain helps with fire control. • Evacuation of 4,250 lifted 8th Sept 03 now only on alert – a total of 1253 hrs. Vaseux Lake 100% contained. 18,360 on evacuation alert at present. • Residents finding fire retardant gel on homes encouraged to leave it there. • Concerns raised about potential natural hazards • Rock falling • Terrain instability • Ash and mud slides

Tuesday Okanagan Fire now thought to be 25,600 • Parkinson Recreation Center 9th Sept 03 hectares in area; Cooler weather has helped in returned to usual business. establishing control lines now 65% contained.

Wednesday Two remaining trestles. • Air quality 50 (fair). 10th Sep 03 600 Fire Fighters and 12 helicopters still • Boil water advisory lifted. working on fire. No further fire 'flare-ups'.

Thursday 'Fire crews have made good progress on fire'; • 18,360 people remain on 11th Sept 03 fire is 80% contained. evacuation alert.

Friday • 'All evacuation alerts lifted'. 12th Sept 03 The 'Province wide state of emergency', in place Plans to deactivate the 1523 hrs since 2nd August 2003, has been removed due to emergency operations center the rain. ‘underway’.

Tuesday The Okanagan Mountain Fire started one month • Loggers allowed back into 16th Sept 03 ago. Fire now 90% contained. the forest today. Armed forces returning home today.