I’m the vice president of emergency response at AmeriCares. I parachute into disaster zones all over the world to help people in crisis. I’m currently in Nepal working on earthquake relief efforts. AMA!

What kind of training does one need to have to do your job? Is there an age limit?

I have an Master of Public Administration degree and have taken a number of courses, but experience is the best teacher, I've found. No age limit.

Hi there! Nice work in Nepal. The UN relief faced some delays due to import policies in Nepal. Did you also face any such difficulties or any logistical problems?

Thanks. We have faced some challenges but by planning the size of our airlifts, working closely with local governments, and only bringing in critical supplies, we have been able to avoid most of the problems that some organizations have reported.

I read your comment about AmeriCares staying incountry for another year or so. What kind of long-term recovery does your organization engage in after immediate response has been handled? Additionally, I'm very curious about interorganizational efforts and communications, do you meet with other NGO's regularly and discuss your efforts and where people are working so as to fill all gaps that occur over such a large area as the Kathmandu Valley and beyond? What's your interaction, as an NGO, with the government of Nepal? Thank you for being there and helping a country that I love! I wish I could help in more tangible ways. Keep up the good work!

In terms of our long-term recovery focus, we usually focus on restoring health care services, often by rebuilding health care facilities; addressing long-term health needs, including mental health and psychosocial issues; and helping build the preparedness of resilience and preparedness of health care institutions and communities. In terms of coordination, the UN Cluster system is designed to help ensure that the efforts of international NGOs, the national government, and multilaterals are all coordinated and aligned. Our team members regularly participate in Health cluster meetings, which are jointly chaired by the Nepal Ministry of Health and Population and the World Health Organization.

do you find people appreciate your efforts?

Yes, people are extremely appreciative, both at home and abroad. Sometimes I am surprised that people find time to be thankful even when dealing with terrible crisis.

How would you suggest someone start a career in emergency response/humanitarian relief? How did you start?

Happy cake day! There are lot of different ways to get into the field. I started working on domestic disaster recovery after I received my MPA, and then eventually branched out into international response and recovery. Many of my colleagues started as volunteers for humanitarian response organizations. Some roles require very specialized medical or public health education and experience. If this is your passion, I would start volunteering and learn more about what the job is really like. Good luck!

Hello Garrett, firstly I would like to say I appreciate and thank you for the work you do. Is the Ebola outbreak becoming under control or is it still a big problem?

Thanks! The situation is still bad in Sierra Leone and Guinea, but Liberia has been declared Ebola free. However, the crisis won't be over until the whole region is Ebola free. When that happens, these countries and the international community have to focus on strengthening health systems in West Africa so this doesn't happen again, and so that people in these countries get decent health care.

Lots of people look to find ways to help during disasters, but often don't have the necessary skills to be of use. I think the worst fear of any decent person who wants to help is that they would just get in the way/waste money that could go to helping people. What do you look for in a good, worthy volunteer?

I think it's important to connect with organizations that you might be interested in working with before a disaster occurs. This way you understand what they need and you understand your skills. Please don't be discouraged and do try to volunteer.

Thankyou for being one of those amazing people who do good in the world! What was your day like today? and whats the craziest thing youve seen lately?

Hi. It's tough but rewarding work. Today was a bit slower than past days-- we met with some local relief organizations and planned out the next phase of our response. Yesterday we toured damage north of the capital and saw whole health facilities and homes reduced to rubble.

What is the toughest disaster that you've ever faced? How do you break down the challenges you face and make a plan to overcome them?

Each disaster presents its own unique set of challenges. For example, Typhoon Haiyan in the Philippines was challenging because it affected scores of islands, which created tremendous logistical problems. The Ebola crisis was difficult because it struck at the very health care providers that were needed to combat the crisis. And this earthquake in Nepal is extremely difficult because of the sheer number of displaced people, the difficult terrain, and the impending monsoon season.

I can understand Nepal may lack in supplies, but why can't they deliver the aid themselves? Why doesn't their gov't have the resources to do what you do?

The scale of the disaster is simply overwhelming. The number of trauma patients, the need to shelter thousands before monsoon season, and the need to rebuild over a thousand health facilities and tens of thousands of homes would stretch the capabilities of any nation. It's difficult for a relatively under-resourced country like Nepal to stockpile all the supplies needed to respond to such a rare and terrible event. That's why the international community has responded to help the people of Nepal.

Thank you for all the good work you're doing. Appreciate it.

What's the most common recurring problem you've had to face in your various missions around the world?

Also, everyone appreciates the relief and aid efforts, the media always highlights them.. But what are some of the behind-the-curtain facts (problems, struggles, cultural disconnect or anything else) that aren't widely known to the common people around the world??

I'll identify two common problems: 1) Challenges associated with in-country distribution of resources. Often we are able to get the right supplies into the country, but lack of infrastructure, disaster damage, and volume of people and supplies make in-country transport difficult. 2) There is a lot of focus on the immediate response, but sometimes the attention and resources flag after a few months, leaving the recovery under-resourced.

The scale of damage from the Nepal earthquake must be staggering. How do you keep from being overwhelmed by the size of the challenge you are facing?

The scale is pretty daunting and it's easy to get overwhelmed. I just try to stay focused on what our organization can do and execute as best as I can.

How important is the cultural context in shaping a response to a disaster? For example, changing the burial practices in Liberia appears to have been a key to slowing the Ebola outbreak.

It's critically important, and your example from West Africa is a good one. Along similar lines, many of the strategies that have gotten Liberia to zero cases have not been as successful in Guinea. It's critical for the UN and international aid organizations to work closely with national governments and community groups who truly understand the culture of affected country/region, and can help modify the response to work effectively in this context.

What actionable change do you think could be implemented so Americans can better empathize with seriousness of disasters (especially in poor regions of the world) that don't directly impact them?

The change you are describing is desperately needed, but I am not sure I have a great solution. I think better coverage of international news by US media and more US citizens traveling overseas would help US citizens be more sympathetic to plight of people in far-off parts of the world.

What's the biggest mistake you can make in your life?

Wow. This is a very tough question. I'd have to say not being prepared and not putting faith in your colleagues.

Has there been many times where you have regretted not taking such opportunities? If you could go back in time and change this, what would you do differently/would you take the opportunity to go back?

Sure, I look back and can think of times when I could have seized an opportunity. I think the key is learning from each response. For example, over time I have learned that planning is never perfect, and speed is critical, so I try to move quickly with the best available information.

What are the first things that happen at AmeriCares when a disaster strikes? How do you start planning your response?

We spend a lot of time planning our response to disasters, so when one occurs each of us on the team know what to do. We contact partners in the affected country, we start planning the deployment of staff, we identify which medicines and supplies are available, and we start identifying needs.

Does the bad infrastructure in Nepal(and West Africa I assume) slow down relief supplies and make it an extra difficult challenge? or are (your) emergency responses equipped with the right tools and transportation to avoid it?

Yes, the small airport and dirt roads make the importation and distribution of supplies in Nepal very difficult. This is compounded by the challenging terrain and disaster damage. We try to bring to bear the right resources to overcome these challenges-- the right sized planes to land in a crowded airport, helicopters to reach remote villages-- but lack of infrastructure does slow things down.

What’s a typical day been like for you in Nepal? How does it compare to other disasters?

Each day is different. On some days we are distributing supplies to local partners or district health offices, other days we are assessing damage, other days are spent in coordination meetings, which can be frustrating but are critical to avoiding duplication of effort and identifying areas of greatest need.

How long does disaster recovery take, and how long do you anticipate working in Nepal?

The recovery from this disaster will take years. AmeriCares will be here until we have implemented our plan to support the people of Nepal with medicines and supplies, mental health and psychosocial support, and restoration of health facilities. That will take one year minimum, likely more.

A French TV news channel recently did a whole reportage about how devastated cities -even at less than 20km of the capital- are now deserted both by people helping and by humanitarian organizations, and people there are on their own now that the whole drama coverage by medias/shocking news has settled down.

There was basically a woman having to clean herself and eat on top of her house's ruins.

Can you confirm that? What organizations are left in Nepal? What are the one that left "a bit" too quickly, if there are?

Some organizations have left because their specific tasks are complete-- for example, most surgical teams are no longer needed, so they have left. There are still many organizations here working on response and recovery, and, unfortunately, there are still many people that are going to need help for a long time.

Are there same set of problems that each disaster has so you can hit the ground running?

Yes, based on experience we have a good idea of what supplies and personnel will likely be needed, so we can have these assets ready in advance. Each disaster is different, however, so there is a lot of work required to assess specific needs and crafting our response to meet the unique needs of a specific disaster.

Genuinely interested to know - how much down time do you have? How are you able to take off from rescuing people to do an AMA?

Part of my job is to help raise and maintain awareness of the disaster so that resources do not dry up. It's important to keep these events in the spotlight so that more people are helped.

What sort of individuals do your "emergency response teams" consist of? What types of medical professionals, engineers, etc?

Our teams vary based on the type of disaster and the need, but teams consist of public health experts, logisticians,medical professionals, mental health and psychosocial specialists, engineers, and other specialties. Often we will send in an assessment team first to identify needs, and they will be followed by more specialized teams.

Just had a call with someone else from Americares yesterday talking about donations of medications and medical supplies for domestic and international emergencies.

Can you talk about how that program works? How often does Americares provide medication and supplies to disaster victims, include and aside from Nepal?

AmeriCares responds to 20 or more disasters a year. In addition, we provide ongoing support to over 3,000 hospitals, clinics, and social service organizations around the world in 90 countries.

How do you decide what resources you will send to which disaster? I imagine there's more need than resources, so does this upset you or do you feel good simply for what you are doing?

Yes, the need far outstrips the resources, and deciding how to allocate scare resources is one of the most difficult and heart-wrenching parts of the job. When deciding when and how to respond we look at the scale of the need, our ability to address the types of need, and our available resources. In some cases the disaster is so large that there is no doubt we will have to respond, but in other cases the decision is difficult. We can't respond to everything and we can't always respond in as robust a way as we'd like. But we strive to use our resources as effectively as possible.

Does Americare stage it's airlift out of Kathmandu? What were some unique challenges associated with operating out of that region? How about distribution, are you relaying mostly on contracted or government flights to distribute what you bring or do you guys have your own organic assets? I was just there also and I'd really be interested to hear how the flow of supplies went on your side of the house.

Yes, our airlifts are coming into Kathmandu. We were able to get an airlift in early by chartering a smaller aircraft. Some of the distribution challenges included persistent aftershocks, landslides, and the mountainous terrain. We are mostly distributing our supplies to local organizations, which are themselves sub-distributing to health facilities, or are distributing directly to beneficiaries. We also contracted with an international NGO, MAF, to helicopter people and supplies into remote areas.

I hope this doesnt sound rude. You clearly help a lot of people, and that is great. You say you parachute in to these countries. Not to be rude, but couldn't more get done by local organizations already on the ground? Do you act to support these organizations after you leave, give them structural support?

That doesn't sound rude at all, and it highlights a key component of our philosophy. Our model is built on local partnerships. We usually provide supplies and resources to local organizations who are best placed to implement response and recovery activities. Sometimes its necessary to bring in specialized teams to engage in implementation, but for the most part the local organizations are best paced to do this, with help from organizations like AmeriCares. After every large disaster response, we incorporate some disaster risk reduction/disaster preparedness programming into our plan so that the affected communities are better prepared for the next disaster. EDIT: We just met with a great organization-- Himalayan Healthcare-- that has been working in northern Dahding District for more than 20 years. They are doing great work and we are supporting them with supplies and other resources-- it's a good example of how an International NGO and a local NGO can work together.

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Not to sound self-serving, but one of the best ways people can help is to donate to reputable organizations working on the disaster response. I do not recommend sending items such as clothing or food to an affected country without knowing how it will be distributed and if those particular items are needed.

What does the president do?

Which president?