Illuminating Inequities: Caring for Vulnerable Populations During COVID

How can we best serve our vulnerable populations? Through conversations with Carlito Rayos, the Hazardous Materials and Critical Infrastructure Coordinator for the Clark County Fire Department, and Arash Ghafoori, the Executive Director Nevada Partnership for Homeless Youth, we explore the impact COVID-19 has had on underserved individuals.

Welcome to Season Two leading Las Vegas entitled eliminating inequities caring for underserved and vulnerable populations through COVID-19 and times of crisis. In the first days and weeks of 2020, the COVID 19 crisis unfolded rapidly. On January 9 2020, the World Health Organization announced the outbreak of 59 cases of mysterious Coronavirus related phenomena in Wuhan, China. Less than a month later, on February 3, the president of the United States declared a public health emergency. By March 11. The president declared COVID-19 and National Emergency and the first travel bans were issued just a few days later on March 7 2020, as the United States reported its 100 deaths from COVID 19. The President asked Congress to expedite emergency relief checks to Americans as part of an economic stimulus package. On April 28 2020, a public opinion poll found one in seven Americans would not seek care for a dry cough or fever symptoms of COVID-19 due to financial hardship. By the end of April, 5 million Americans have filed for unemployment. To date, 762,000 people in the United States have died from COVID.

In this episode of leading Las Vegas, we examine how COVID-19 impacted our most vulnerable and underserved communities, including youth experiencing homelessness and the Moapa band of Paiute. We will hear from two experts Arash Kafoury, Executive Director of Nevada partnership for homeless youth and Carlito Rios hazardous materials and critical infrastructure coordinator for the Clark County Fire Department, both of whom have been working on the frontlines during the pandemic. With their insight we explore how to best serve our vulnerable populations during times of crisis and beyond. Our leader Rios has served in law enforcement, fire, EMS, and emergency management for 25 years. His intrinsic drive to serve people comes from his roots in East Las Vegas, here's Rios describing the experience.

Right? I grew up in East Las Vegas, which was very rural at the time, and very well integrated and slightly segregated. I saw as a child, we experienced two floods in the 80s pretty dramatic ones, and we were impacted directly. This is well before we spend a dime on regional flood control. And the east side was kind of just devastated every single time. And I remember even as a kid, seeing which families bounce back, and which ones just really could not right, or they they did and then just in time for another flood to hit. So I'm biracial. My father is a I'm a first born Americans. My father was a naturalized citizen from the Philippines and experienced tons of devastation, right? There's volcanoes erupting are a real thing, tsunamis a real thing. So he would, he would tell me what that experience was like. And, you know, people were just wiped off the face of the earth and never really accounted for, you know, there was a modest shrine built for an entire village. But there was no Family Assistance group or unification that was going on there. Right. And so in comparison, he was appreciative of the systems that we had in rural East Las Vegas and in what was traditionally remains traditionally identified as an underserved community. He was appreciative of the services that we had, so it's all relative.

We also have the privilege of speaking with Raska for you. Before he is a first generation Persian and Nicaraguan American. He began his academic career studying international relations. His early interests was combating inequities that exist between countries, regions and different nationalities. After obtaining a master's in economics, one of his mentors talked to him about leveraging his business and economics skill sets to assist underserved populations and the nonprofit sector. He rose to the challenge and is passionate about creating new best practices to further their mission. Here's Mr. Euphoria on his mentors advice.

And that kind of really sparked something in me that really kind of challenged me to think really outside the box. And to really think differently, and how it can leverage all these skill sets, I learned in a very different environment in a nonprofit environment. So looking back, that mentor really helped create the pathway that I that I've been on and continued to be on in the nonprofit sector, and I couldn't imagine myself anywhere else.

Before we dive into how COVID-19 impacted vulnerable populations in Las Vegas. Let's establish a baseline by answering the questions Who are our vulnerable and underserved populations? And what are the inequities impacting them? underserved populations face barriers, obtaining or accessing services, language barriers, age, financial hardship, and geographic location are all examples of potential obstacles to accessing services. While this podcast examines disparities faced by youth experiencing homelessness, and the more upper bound or Paiute. It is important to recognize they are only two examples of many populations facing inequities. Mr. rayos described underserved populations as a microcosm of society who lack representation.

So I don't think anybody sets out to underserved people right or to try to be inequitable. I think that underserved communities are born out of a lack of understanding or or an under appreciation of a group or a subset or region. I also think it comes from a lack of knowledge even from that subsection itself, right. A lot of times subsets don't even know how to be represented. This, I think, is generally born out of a lack of under representation from that sub sector and also the larger society that is that has a governance responsibility for them. And I think that the information is is the key power is a key and communication just like everything, I think very rarely is the under service intentional.

As we mentioned earlier in the podcast, a public opinion poll found that one out of seven Americans said they would not see testing for COVID symptoms due to financial hardship. Mr. Godfrey explains Barriers Youth experience homelessness face and accessing health care and how inequities can compound

inequities can be very different in defined very differently depending on what you're talking about, depending on whether you know, it's a population, whether it's an equity and health access, whether it's an equity because of you know, being bipoc, you know, black, indigenous or a person of color. There's a lot of different ways that we can look at inequities. So, what I look at for inequities in the population, iser, you know, young people experiencing homelessness in our community, it's really that young, certain young people, unfortunately, are dealt a bad hand early in life to no fault of their own. And this creates inequities between them and other peers that may be housed or may have access to education and access to health care. And of course, when certain populations are marginalized, or experience inequities, those negative outcomes associated with those inequities exacerbate quickly. So for example, young people experiencing homelessness are more prone to having medical issues or having negative health risk factors associated with being on the streets, etc. Those things compound, but it's not just that inequity. It's an inequity of how different parts of our populations also have different types of access to health care, some have more, some have less, some can't afford it, some cannot. So there's a lot of different ways that we can look at inequities. And I think that depending on the lens of who you are, and what you're looking at your your definition and how you see inequity may be different than someone else.

How's the pandemic continued through 2020 and 2021. households across the nation faced challenges with finances, jobs, health care, housing, transportation, caregiving and wellbeing. Surveys reported that eight in 10, Americans said their lives had been greatly disrupted due to Coronavirus. These results were evenly distributed across age, education and income. Most states issued stay at home orders as well as businesses and school closures. While physical or social distancing is one of the best ways to stop or slow the spread of COVID 19. Isolation took a toll on the nation's mental health as well. In our interviews with Mr. Ghaffari and Mr. Rouse, they both discussed how COVID-19 disrupted built in resiliency or safety nets within both communities of the Moapa band of Paiute and youth experiencing homelessness. While many of us missed close connections with friends and family, schools and businesses being closed, meant youth experiencing homelessness lost access to Wi Fi, and even just a place to wash their hands. Mr. Godfrey explains the impact of closures on youth experiencing homelessness.

So young people are newer to experiencing homelessness in our community at a time when social services were shuttered. At a time when schools closed. When young people experiencing homelessness. They have a couple lifelines. One is school Believe it or not, for those that are lucky enough since we enrolled in schools free reduced lunch, there's a place to go and be and also for street youth or youth even after school would have nowhere to go what to do, going to McDonald's places like you know parks and recs, locations, you know, terminals, other areas that can access free Wi Fi or they can you know go to the bathroom real quick whatever those is. A lot of those were shuttered or closed if you remember McDonald's is doing takeout only they closed all their Are there restaurants except for Drive Thru, and schools were closed. So all those free reduced lunches were gone all that access to Google or access to teachers access to peers access to counselor, all that work gone. So for a young person who's just newer to experience homelessness, the world was much more closed off than it was before. COVID started in a very negatively impactful way for young people. Also, other young people also, when young people experiencing homelessness, you know, they tend to couch surf, they may go sleepover at their friend's house or another friend's house, you know, as a form of hiding their homelessness but still surviving it, right. So the parents that are you know, hosting this sleepover may not realize that Johnny or Susie is experiencing homelessness, they just think it's a you know, normal sleepover, whatever the case may be. So young people were, their abilities to survive were were significantly limited in these situations.

Well, school and business closures drastically disrupted the lives of youth experiencing homelessness. Carlito rayos spoke with us about how travel bans and quarantine policies disrupted the Moapa band Piute

the resilience was built in because people took care of people, neighbors took care of neighbors. But now you're telling me I can only go to the grocery store twice a week. And I have so much room in my car and only have so many funds available on Tuesday and Saturday that I can only buy for myself. And also we saw it here. I mean, everybody hoarded the toilet paper and water the first day. So how how philanthropic can you be now? Right? Like, I need water and toilet paper for myself. I can't take care of Mrs. Jones down the street who doesn't drive. Right. So I think almost some of the policy hindered the resilience that was already in in place. We also saw a lot of members who were on the reservation, decided to go to their second home or to rent or lease property off the reservation because they didn't want to be they didn't want to uphold those those additional restrictions that the tribal councils was putting on them. So that was interesting, very interesting. And then now my neighborhood now the neighbor who takes care of my mom usually has gone to St. George and rented an apartment for the foreseeable future until COVID goes away. And I relied on them to feed my mom and her cat and her dog. So some, like I said some of that resilience that was in place was eliminated because of the policies that were implemented.

So far. In this podcast, we've defined underserved populations and examined how COVID-19 disrupted resiliency among youth experiencing homelessness and the Mapa bounder Piute. Throughout the pandemic leaders faced challenges relaying timely, relevant and scientifically accurate information while remaining empathetic. successful management of a crisis is critical for gaining public support, trust, and specific to COVID-19 compliance with health and safety recommendations. Mr. rayos shared his thoughts on compassionate and service oriented leadership.

I truly believe that people don't care how much you know, until they know how much you care. If you cannot do that, they will not care what you're saying. I also believe once you do that, I know that we in emergency management understand that if you give people credible, timely, reputable information that they will proceed to increase their chance of quality of life or life safety, that they will follow it. Right. But you have to be credible first, and in order to be credible people have to believe that you care, then they don't even really care how much you know, I think that's more important that they know that you care than it is for them to believe that you know a bunch of stuff, right? I believe that the inverting the organizational chart, right. It's not like if you're at that, if you're the top block, the incident commander or their commanding general, or the commanding officer or the director, all that those people exist to serve you, I think that is completely inverted. And then if you are the president of the university, or the general of an army division, you exist to serve all of those people that that are under you. I tried to do that regularly. I physically turn I always ask for. I've changed jobs a few times in case you haven't heard John B. And the first thing I asked for is the organizational chart. And it's not to see who works for me or who I work for. Its to see who serves me and who I'm supposed to be serving.

Mr. Godfrey expanded on leadership styles, the necessity of adaptability and understanding various roles within an organization.

I don't have one style. I think it's really important for a leader to be adapted to the situation to the population to who they're talking to, to who their clients are to who stakeholders are. You have to be really sort of adaptive and be able to pivot to certain situations and use different leadership skills. was at different times. And I think another way of describing leadership was kind of like boots on the ground, very participative leadership style. So I don't believe sitting somewhere and calling the shots so that that's very effective for some people. I think that one needs to be in the trenches once in a while, wants to be humbled by what they're doing once to be reminded what they're doing. And to to show that in order to be successful, or working at a nonprofit, or working and in whatever you're doing, that there can be nothing that's above or beneath you. And there's nothing that you should walk by, because that's someone else's job or something. And I think a leaders job is to understand what other people are supposed to be doing, understand the limitations they have, try to help with those things, but also be on the ground as much as possible, so you can actually see the challenges.

As we've mentioned, throughout this podcast, the entire nation faced challenges due to the COVID 19 crisis. However, underserved populations faced compounded disparities. For example, as previously mentioned, Las Vegas youth experiencing homelessness lost access to free and reduced lunches when schools closed, Mr. Godfrey elaborates on challenges faced by youth experiencing homelessness, including the absence of parental consent for minors, limited experience of independence, and enhanced feelings of isolation.

What we noticed, is a huge barrier, which is a lot of medical organizations, you know, places that were doing tests, and eventually vaccines. When it became a minor experiencing homelessness, and they couldn't get someone to sign as parent or legal guardian, it became very iffy if a young person could even get tested for COVID. And this became a huge problem, because there's huge risks there. If you're not testing a younger population, around COVID, for themselves, for others, you're transmission into shelters that could shut down shelters and entire systems designed to serve them. So this is a really, really big barrier. So when young people are in the streets, it is not the same as being an adult experiencing homelessness that knew what independence was like, these young people have never experienced independence, they've never had to try to take care of themselves. And they haven't had the opportunity to learn how to even do that. And their natural support systems all went away, because they're experiencing homelessness. This creates an environment that when a young person is newer to experience homelessness, they don't know where to go and what to do. So back to what I was saying earlier, when COVID shut down a lot of things in our community. We as an organization, couldn't go do outreach in schools couldn't go to outreach, many of the same places that young people were and young people were not going to those places anymore, because they knew they could not get access to what they needed there. Therefore, it became much harder to find these young people and connect them to services, we thought that when COVID hit youth, emergency shelters would be flooded with demand. That wasn't necessarily the case. They didn't want to go into shelter and be segregated or or you know, be told that they have to live in a bubble because they already live in a bubble. They're already in situations where they already feel disconnected from everything. And COVID was all about bunkering down and separating yourself from everyone and staying put. But these young people fortunately experienced that by default. So we had to talk to them to figure out that, you know, they were scared about emergency shelter. During these times they were scared, so much scared because they didn't want all this invasiveness. So we're scared because they didn't want to eat COVID

The Mapa Bandipora you also face challenges unique to their culture and community. Carlito Reyes explained some of the challenges he met while serving them more up up and up how you during the COVID-19 health crisis, including high risk populations and distrust.

The reason why I accepted it was this, they told me they had about six elders, that were still fluent in their native tongue. And, and those elders had already pre pre existing medical conditions. And we're highly susceptible to COVID-19. And if they perished, an entire culture would perish with them. Because much of their spoken word had not been captured in writing much of their stories and not been captured. Their stories were still going and that wasn't being captured, let alone their early days. And I thought that would be an absolute travesty, unequivocally throughout this underserved communities, history of existence, and their at least their interaction with the federal government has caused a lack of trust, right? misinformation and like gross, gross human rights violations. I think that the decision to go with the federal Support System was born out of their need to protect and preserve their, their parody with the state. Right. So they view themselves as peers of the state. And the next level of government that they would ask for help or coordination or permission. Most importantly, from would be that would be the federal government, right? So you can't be a peer and ask for that peer to take care of you. Because there's real consequences for that, right business, legal governance issues that go along with that, some real and some proceeds. But if you have self accept that help and the stipulations that come along with that help and the oversight that come along with a health, they view that as a slippery slope, it's a legitimate argument, right?

Distrust, fear, isolation, high risk populations. These are feelings and challenges universal to the COVID 19 crisis, which were also reflected in vulnerable populations as a microcosm of society. So how can we best serve our vulnerable populations? We asked both puffery and rayos. And their answers were nearly identical. We need to examine our own biases, engage with empathy. And most importantly, we need to listen, Mr. Ghaffari explained his goals when engaging stakeholders and stressed the importance of emphasizing the impact not serving vulnerable populations could have on society.

The issue of youth homelessness really transcends a lot of socio economic kind of statistics and factors. So this is not just in someone else's backyard issue. This is not just a certain zip codes in our community type of issue. This is not a certain color of your skin, you know, type of issue. The issue of youth homelessness affects all sectors of society. I've seen, you know, children of judges, and celebrities in my shelters alongside children who were born into generational poverty. That is, because some of the reasons why young people become homeless transcend those things, domestic violence, breakdowns in home do not just occur, because you don't have enough money. So we want to try to resonate with people that think this could never happen to my child. Yet, there are upper middle class children being sex trafficked, that are experiencing homelessness in our community today. So you may not resonate with some elements of admission or an underserved population. But you can maybe resonate with what the outcomes would be if something wasn't done for that population. That's why it's really important at mph, why, you know, as much as we tell stories, so people can can can understand the plight and a reality of young people. We also work with UNLV, and other organizations to pump out economics papers, statistical papers, research and academic research, which show what the negative or positive impact would be of having a better intervention around young people or conversely, not having an intervention discuss what's going to happen, loss of civic engagement, loss of productivity and society, loss of your tax base loss of diversified tax revenue, loss of an ability to hire a quality workforce in 10 years, when the majority of your workforce retires.

As leaders, we know that listening to stakeholders is critical for developing and maintaining positive relationships. Establishing positive relationships before a crisis is a necessary tool for surviving a crisis. Mr. Godfrey explains the need to listen to youth experiencing homelessness, as opposed to making assumptions about what is best for them.

There's a concept in youth homelessness, it's called Adult ism, where we as adults think that we know everything that's going to help our population, and that we should say, Oh, this is going to help Susie, this is going to help young people. But then we go to talk to you and people go, Oh, I hate that. That's horrible. They really have to think outside the box to survive. And but there's often situations that you and I can't even imagine. So I don't want to talk about creative and innovative ways because quite frankly, that yes, someone like us may think, oh, that's creative, but a homeless young person may not that's not created as me surviving. That's me having to deal with this, quite frankly, horrible situation I'm in. So it's not creative. It's not innovative. But other things. We need to engage our target population. We need to work with the people that we're serving the ones that are most impacted and understand what they're thinking, what they define as help and what they define as things that they actually need or tools that will help them in this moment. If you are not listening to the voice of those that are impacted the most or those that you're trying to affect positive change for you are still doing a disservice.

Mr. Rios echoes the need to understand our most vulnerable populations, as well as our implicit and unconscious biases. We need to embrace cultural diversity and accept cultural differences.

Well, the you know, the old adage we're only as strong As our weakest link, I'd like to adapt that a little bit and just say that we're as strong as our most vulnerable link. And we have to find the root cause of what that why that vulnerability exists? Is it a lack of connection, a lack of information is a lack of the ability to integrate help. But I really do believe that, first we have to understand our, our cultural biases, right? Our unconscious biases, because we always think that the way that we do things is the only way and that's the right way. And you can't care until you accept your biases and then accept that there is maybe a different way to do life.

As this podcast draws to an end, we hope you have been inspired to practice listening to our vulnerable populations and find solutions to create an equitable society. Attending to our underserved communities will benefit society at large by increasing civic engagement, preserving culture and building a diverse and sustainable workforce. Especially thank you to our interviews I Raschka for you and Carlito rayos for sharing their wisdom and expertise. We hope this podcast has helped you understand the opportunities for learning and renewal the COVID 19 crisis as presented. This podcast was produced by John Beck and dal Lewis coming Peter Mercado, I own Atlanta to Tassie and Kate Ward and as part of emergency and crisis management master's program at the University of Nevada, Las Vegas. sound engineering was provided by Kevin Kroll a special thank you to our professor and executive producer, Dr. Joe Lieberman. Thank you for listening

Illuminating Inequities: Caring for Vulnerable Populations During COVID
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