Transcript

Derek Smith:

Hello. Welcome to Baylor Connections, a conversation series with the people shaping our future. Each week, we go in depth with Baylor leaders, professors, and more discussing important topics in higher education research and student life. I'm Derek Smith, and our guest today is Dr. Benjamin Ryan. Dr. Ryan serves as clinical associate professor of environmental science at Baylor. He's an expert in communicable and noncommunicable diseases, community resilience, humanitarian assistance, and disaster risk reduction. Dr. Ryan has worked with organizations like the World Health Organization and United Nations on issues related to COVID-19 and other challenges. He's a member of a variety of organizations, including the World Association for Disaster and Emergency Medicine, World Health Organization's Thematic Platform for Health Emergency and Disaster Risk Management Research Network, National Environmental Health Association, the Society for Medicine and Public Health Preparedness, Texas Environmental Health Association, and he's president-elect for the Association of Environmental Health Academic Programs. He's hosted workshops this year for the United Nations office for disaster risk reduction and more, and he has authored numerous articles in a variety of scholarly journals on these subjects. It's been a very busy time and he's with us here today on Baylor Connections. Dr. Ryan, it's great to have you here on the program, Happy New Year to you, and thank you so much for joining us on the program today.

Benjamin Ryan:

Thank you, Derek. It's great to be here and Happy New Year to you as well.

Derek Smith:

Well, thank you. And Dr. Ryan, let's dive in. We gave an overview here of what you do, many different organizations that you're involved with, and it's clear that your work, your research is very multifaceted. So let's start by boiling it down to its its essence here. What aspects of disaster relief and risk reduction most motivate you? And when there's a challenge somewhere, where do your thoughts immediately go?

Benjamin Ryan:

My thoughts immediately go to the most vulnerable populations. The reason I say that is, if we can support the most vulnerable populations, we can then support the whole of society. And working in this field in environmental health, it's a very broad field focused on population perspectives as opposed to patient centered care, which has a bit more clinical focus. So in environmental health, we're thinking populations. So that's where, when I dive down, it's really thinking about the most vulnerable populations, and that's really lessons learned from some mentors I've had. Also, working in the field because I've worked in the field, for example, in disaster response in Australia, doing assessments for public health assessments at that community level. And we weren't able to identify any communicable disease issues. This was after a major hurricane or cyclone hit Australia. And what we found was people with diabetes, other noncommunicable diseases, were the people most at risk. So for example, we were seeing a threefold increase in presentations to the ER or emergency department. And this was generally for people needing basic treatment and care for their chronic disease, such as diabetes, hypertension. So any chronic disease you can think of, and this is also an issue, and this is what goes to my mind with COVID-19 was straightaway, what are we going to do to maintain that treatment and care, particularly in the United States where approximately 60% of adults have a chronic disease, 40% have two or more chronic diseases? And then when we overlay COVID-19, the risk factors are amplified. The same goes for any type of disaster that interrupts treatment, care, and services. And this is not just a developed or wealthy country issue. This is also an issue for refugees in different parts of the world. For example, some studies that were done in Jordan of Syrian refugees found approximately 50% of Syrian refugees had a non-communicable disease which required treatment and care. So really focusing in on these most vulnerable people is a key focus of my thinking whenever there's a disaster, a disease outbreak, or a pandemic.

Derek Smith:

So as you describe that, it sounds like, you know, you're in environmental science, but there there's aspects of sociology and logistics, supply chain. So many different disciplines that correlate with what you do.

Benjamin Ryan:

That's correct, and that's where it's really systems of systems thinking. And I think my students hear that a lot throughout the semester, and when I'm teaching courses, I'm highlighting you need to think systems of systems thinking, for every cause, there's effect. So if we take this intervention to this event, there will be something that will result. So this is where we really need to have that systems of systems thinking so we can help the vulnerable populations. So for example, if there's disaster and before that disaster, let's say it's a hurricane, which we saw in 2020 in Texas, where we're evacuating populations out of Houston or areas that may be at risk. It's the most vulnerable people being evacuated. So that's why we need to think about those people because the people who are less likely to need treatment and care can self evacuate, book a hotel room, they can make the arrangements they need to. Those people on the buses are the people that are most at risk. And that's where my mind goes to. And we saw after Hurricane Katrina, which was really the seminal type of disaster event, around 33% of people that were evacuated in that event had their chronic disease exacerbated in some way as they arrived at a shelter. And I know talking to colleagues as we were planning for this in 2020, that was their plan was, how are we going to cater for those with chronic conditions or non-communicable diseases, they arrive in shelters, for example, in Dallas?

Derek Smith:

Visiting with Dr. Benjamin Ryan, and Dr. Ryan, it's obviously a big undertaking when you talk about a disaster or a pandemic like we're in now. What practically does your work look like? When you're on the ground or if you're going somewhere where there's a challenge, what do the actions, the steps you take look like?

Benjamin Ryan:

So the actions that are taken, it's really, again, thinking about those most in need, and then applying the principles of really, risk assessment or health assessment models, where you want to identify the risks, understand what's going on, then do risk characterization and working on strategies to do things safely. So the field of environmental health is really focused on enabling society the functional things to continue. An example I think of is COVID-19. The work that I got involved in with colleagues was setting up alternate care sites. So what we engaged in, and this is working with the US Navy and other experts in the field, we developed plans as sitting about alternate care sites, where we actually walk the locations. And we're thinking about the water, foods, sanitation needs, donning and doffing processes. So what I mean by that, donning is where people put personal protective equipment on before, let's say, they go into care for people who've got COVID-19 or any other infectious disease. And then doffing is where you take that personal protective equipment off. And it is that doffing processes where most disease transmission occurs. And the colleagues I was working with were involved with the Ebola outbreak as well. Most specifically in that outbreak, I worked in the United Kingdom with the MSF, the World Health Organization, the UK military. We were developing strategies for ramping up services in West Africa. But most importantly, we are experimenting with the donning and doffing processes to make sure they're as safe as possible with the personal protective equipment that would be available in West Africa. So that's really where this spilled in practice when you're in this field, that's what it looks like in a disease outbreak scenario working an alternate care site. We also published a paper on how to do that for COVID-19. So that's a paper that's out there, that came out in late 2020, which colleagues have a in different parts of the world. So when you overlay that, you can then extrapolate that to a community setting where you're looking at all the same factors for a disaster that occurs. So it's that process that happens, and then you recommend intervention measures or safety measures to mitigate the risk of people getting sick. Local governments are really front and center. They're the front lines, and working with local governments is vital. And some of the work I've been privileged and blessed to do at local, state, national, and international levels is really about supporting front line local governments, because they know best and they also reflect community needs. And that was part of this seminar. So what we did in the seminar is we went through a process of this public health system resilience tool that colleagues that I have developed, which include a consultation with representatives of the World Health Organization, United Nations, private sector, public sector, and it's really a systematic process to assess your public health system resilience. It's based on a methodology used for broader disaster resilience for cities, which has been applied in over 4,300 cities around the world. So that shows you this methodology is accepted at that local level. And then the beauty of this tool is, it provides a systematic process for those local communities, emergency committees, for example, to work through what do we need to do to prepare better? An example I think of is when I was working in Australia at one of the hospitals I was supporting is we did a similar process. We followed a similar sort of framework. Didn't have this methodology bedded down, but I was familiar with the disaster resilience for cities methodology. What we're able to identify is the greatest risk to our hospital was the sewage pump station. You naturally would not think of that, that that's the biggest risk to your hospital functioning. You'd normally think power, water, et cetera. The sewage pump station was lower than the hospital, so it was more susceptible to flooding and storm surge. And if that went offline, that means the hospital wouldn't be able to function. This was only identified because we engaged county engineers, so working with the local people. So this is where we're very much local government focused. And this is really used in the United States and around the world. Local knows best, reflects community needs. And these seminars, it was amazing. We had over 1100 participants from 120 countries attend. So it shows you the desire and interest in this. And most of those were local government people that were engaged in part of the seminar series.

Derek Smith:

We are visiting with Dr. Benjamin Ryan, clinical associate professor of environmental science at Baylor. And Dr. Ryan, when we talk about resilience, I think you paint that picture, but I want to ask you specifically what resilience, the definition's the same in every community, but do they look different in different communities? When we talk about resilience, what does that mean to you when you look at a community and say, you know what, I think they've built that resilience that we want to see?

Benjamin Ryan:

Yes, resilience does look different in different contexts. And it's really reflective of what that community's after. What I saw was, when I was working in the Solomon Islands, for example, was resilience. Coming from a wealthy developed country setting, working in the Solomon Islands, you could look through it through that lens and you could look at it, this is a poor area. But when I was there and looked at it from a local context, it's a very resilient, wealthy area. The reason being is people could go get the food they needed to when they needed to. So they could go fishing for example, and there was food to catch, those fish there. There was alternate food suppliers on land as well through forests. They could rebuild their houses. So you could see the resilience there that they could bounce back better and quicker. So really bouncing back quickly is what resilience is about. And then now, as we've got more people moving into city areas, we're having demographic shifts globally, we were expecting around 60% of people to live in cities by 2030, our focus on resilience needs to adjust to reflect city resilience. This creates an opportunity. That's the beauty of resilience thinking. It's really a positive mindset. How can we overcome this challenge? How can we enable society to function? So as we move into the city settings, there are opportunities there as well. How do we maintain our services? And that can be very simple, such as backup generator power for sewage pump stations, making sure they're storm surge resilient, for example. You can see what's happened in Japan, how earthquake resilient buildings are. So as people move into cities, there are extra opportunities that are presented to achieve resilience, but the only way we can get there, the only pathway, is through a systematic process that engages all members of society to work out what that resilience looks like.

Derek Smith:

You mentioned, Dr. Ryan, that we're moving towards 60% of the world's population in urban areas. And I know from hearing from other colleagues, like Dr. Brian Brooks, your colleague in environmental science and other departments at Baylor, that certainly this shift is on the minds of a lot of people who look to solve global problems and hopefully do it upstream before they start in in a lot of ways. Challenges maybe could be a negative word, but what are the challenges of that urbanization as it relates to your discipline? Maybe the opportunities to create solutions that we might not think about other than just knowing you have a lot of people in these larger cities.

Benjamin Ryan:

Yes. There are plenty of opportunities to work out what the solutions will be. So that's the beauty of people moving into these urban areas is we've got the environmental health challenges, but we'll need creative solutions. So for example, in some areas, air pollution might be an issue. So in environmental health, you'd do some air monitoring and enforcement. But what you can do is come up with unique strategies, and there has been other parts of the world where there's wind corridors, for example, to make sure air pollution goes, it's changing the energy supply that you use to reduce air pollution. So there are strategies from that perspective, right down to food supply chains as well. So one of the foundations of environmental health is food suppliers, so that's from the farm to the plate, is, as people move into cities, there's different layers or critical control points that we need to identify, and environmental health can do that and help them get in there and solve any challenges that may arise to reduce the risk of food poisoning outbreaks, for example. And I've had students that have been involved in these activities. There is one course I teach on disaster risk reduction and disaster management. The students actually develop a disaster plan for their selected city or location. And that can go right down to the local level with one of the key things for society function is a school. Once had a student who developed a school plan for dealing with disasters in Mexico. And this plan also had input through colleagues from the United Nations with following all the different systems and best practices to really maximize, I guess, urbanization, but also maximize their preparedness and resilience to any events that may occur.

Derek Smith:

You know, Dr. Ryan, as you talk about involving students, you're really on the cutting edge of what's going on in disaster relief and environmental health. We talked about this past spring. You led that you were the keynote speaker with the World Health Organization and UN with the global webinar. And, you know, I'm curious, you talked about integrating that into the classroom. What's most meaningful for you and your students about that integration? Because, you know, you have a lot of different organizations you're involved in, a lot of different directions you could go, but you choose to involve students in that and train up that next generation. What aspects of kind of being on the cutting edge of both are most rewarding to you?

Benjamin Ryan:

The most rewarding is equipping our students with the ability to think critically and objectively, and understanding that, for every decision when they're leaders that they make, there are consequences. And once you understand what that looks like, so you can map out the systems of systems thinking, then you can make the best decision possible, understanding there are negative consequences. And this is where I thoroughly enjoy having the students in the classroom. As we were working through COVID-19, we were exploring these issues and I was pushing it, but what intervention strategy would you recommend here? And that allowed the students to really understand the challenges that our local, state, and national leaders facing COVID-19 and other disasters that occur, because it's not a simple decision. There is a whole complex array of consequences if you don't make the right decisions. So really teaching students about that. And we also have students that will be supporting a project that we're doing with the Baylor Collaborative on Hunger and Poverty, which is funded by the US Department of Agriculture. It was some fantastic work the Baylor Collaborative on Hunger and Poverty supported in the role out of food distribution to school children that were without food during the school closures. So this is an example of one of those consequences. If you make the decision to close down, for example, how do we feed our students and children? And this is where the Baylor Collaborative on Hunger and Poverty stepped in, and they're able to deliver food to over 44 states, to schools in 44 states. And we're going to evaluate their programs, develop disaster plans for how that can work into the future, and then also look at strategies to enhance food security to these vulnerable populations. This has local interest as well as interest from colleagues in the United Nations, because globally, food security is an issue just like it is in the United States. So this project has potential, particularly with the students here at Baylor being involved in this, is influencing how we maintain food security for future pandemics.

Derek Smith:

Visiting with Dr. Benjamin Ryan, and Dr. Ryan, you know, on this program, you've mentioned working in the Solomon Islands and Australia, and now you're here in Waco. And I'm curious two things. What brought you to Baylor? You're involved with so many global organizations, what brought you here to Waco and what has it meant to you to be able to apply this? As you know, you're on the task force here at Baylor, working with people, you know, protecting the students at the university and our community. What's it meant to you to be able to apply that locally?

Benjamin Ryan:

Oh, it's been an amazing experience being here in Baylor and Waco. My family, my children, my wife, we all love it here. We feel at home. And just to be able to contribute locally is just so rewarding because it is all about local. What really attracted us to Baylor and the community is really, well, one, Baylor, the Christian mission and the ability to work at a faith based organization and teach through a Christian lens was a big focus. And also the Waco community. We thoroughly love it here. During the recruitment process, I came here, had a wonderful experience, and my wife came over as well later on. We moved here from Hawaii, believe it or not. We felt at home when we're in Waco. And my wife came here and she was very blessed with the experience. Coincidentally, she signed a contract on a house. It all just worked out. And we said, this is home for us. So to build on that, Baylor has provided this wonderful opportunity to support locally and the ability to apply these lessons, to work with so many wonderful colleagues and community members and students, to really apply these so that we could reopen the university in the fall as well as sustain or operations, which is just an amazing experience, while also protecting the health and wellbeing of the community. But also providing the community and our students with an essential service that the community needs. So it's just been an amazing rewarding process to be part of the COVID task force and really successfully get through the full semester. And now, as we move forward through 2021, get back to normal operations as soon as we can.

Derek Smith:

Visiting with Dr. Ben Ryan, and Dr. Ryan, as we head into the final couple of moments, I realize this is a broad question, but based on your training and what you've seen here, we're moving into 2021. We're thinking about vaccines and still being careful, knowing that there's going to be some opportunities ahead figuring out what business looks like, what the spring semester looks like for students. So, as we think about, you know, mitigating the impact of COVID-19 here in Waco and across the US, especially in light of the movement that's taken place here in recent weeks, how should most of us, most of us who are average people, approach the next few months and our role in hopefully moving us forward out of this?

Benjamin Ryan:

Hang in there. We're almost there. As we push through 2021, things will only get better. We've got the vaccines that are rolling out. Following safety measures is vital. It's very important that we socially distance, reduce density where you can, wear face covering. So we're almost there. The thing to remember is that we've had other pandemics. Previous generations have got through pandemics, we'll get through this one. This is the second one of the 20th century. We had two pandemics in the 50's, 60's, we had 1918. We all got through that or the community got through that. And we've had polio challenges as well. So we're almost there, the lights getting brighter every day. So really hang in there and we're almost there. And remember, that light will continue to get brighter as 2021 progresses.

Derek Smith:

That's great. Well, Dr. Benjamin Ryan, appreciate your thoughts. Appreciate your work. I know you've had a busy year sharing with the UN, sharing with your students, other different places. We appreciate you taking the time to share with us today. Thank you so much.

Benjamin Ryan:

Thank you, Derek.

Derek Smith:

Dr. Benjamin Ryan, clinical associate professor of environmental science, our guest today on Baylor Connections. I'm Derek Smith. A reminder you can hear this and other programs online at baylor.edu/connections. Or you could subscribe to the program on iTunes. Thanks for joining us here on Baylor Connections.