'Holistic engineering' in the wake of disaster

When Judith Mitrani-Reiser visited Chile days after a massive earthquake hit the South American nation in 2010, what she saw left her shaken to her core.

Apartment towers had toppled. Bridge decks lay scattered. Communications were down in vast areas of the country, disrupting everything from rescue efforts to the transfer of patients to hospitals.


"It was painful to me, as an engineer, to see how badly we had failed society," said Mitrani-Reiser, a professor of civil engineering at the Johns Hopkins University and a leading expert in the field of disaster resilience.

Mitrani-Reiser, 37, has developed a worldwide reputation for helping communities struck by disaster perform better than Chile did that year, and colleagues say she's doing so in ways that are changing the field.


Whereas civil engineers traditionally may limit their investigation of disaster scenes to the performance of buildings, Mitrani-Reiser sees such performance as just one component of a larger concern: the "functionality" of infrastructure.

Even if a building — for example, a hospital — sustains what a civil engineer might define as minimal damage, that damage can be enough to interrupt water or power supplies, hamper delivery systems, collapse communications and more, rendering the institution nonfunctional, often for a long time.

Because chains of human activity support the operations of buildings, Mitrani-Reiser said, it's just as important to study how those chains — the human infrastructure — contribute to resilience as it is to study the resilience of the structures themselves.

"It's about answering the question 'How can we make continuity of care happen?'" Mitrani-Reiser said. "What's missing is a more holistic approach."

When she was asked to travel to Chile, the first of many missions Mitrani-Reiser has led to disaster sites around the world, she surprised the engineering organization behind the project by requesting that she be allowed to add Dr. Tom Kirsch, an expert in emergency medicine and disaster response at Johns Hopkins, to her engineering research team.

Their goal was to study the effects of the 8.8-magnitude quake on 11 hospitals in and around the city of Concepcion and in the Bio Bio region. The pair performed the usual physical assessments but also interviewed scores of hospital administrators, public health officials, nurses, communications workers and others, creating a portrait of how the human infrastructure had been affected.

Kirsch, the co-director of the Center for Refugee and Disaster Response at Johns Hopkins' Bloomberg School of Public Health, is known worldwide for his part in disaster efforts after the 9/11 terrorist attacks in New York, hurricanes Katrina and Sandy, and the 2010 earthquake that devastated Haiti. He said Mitrani-Reiser's mindset and method are unique in her field.

"She's not one of those engineers you sit with and find your eyes glazing over," Kirsch said. "She does the actual hard-core modeling. She looks at broken buildings, but she also asks, 'If broken building X has a broken pipe, how does that affect its ability to do surgical procedures?' and works that into her modeling.


"That's the brilliance of Judy's work. She's at the interface between mathematics, the theoretical, and the everyday working world, exploring how to deliver health care."

Mitrani-Reiser and Kirsch wove the Chile findings into a portable survey — a risk-assessment tool, in industry parlance — that can measure the failures of an institution's disaster-preparedness either before or after the fact.

It can help investigators ask hospital administrators to define their resilience goals — for instance, never losing 20 percent of the hospital's beds or going without power for 24 hours — and suggest both structural and behavioral steps to ensure that outcome.

"You have no control over infrastructure failing, but you might be able to have a plan with a contractor or supplier to be able to deliver tanks and water to your grounds so you'll have clean water," said Mary Comerio, president of the Earthquake Engineers Research Institute in Oakland, Calif., the national nonprofit that has backed most of Mitrani-Reiser's field work.

Comerio said the key to Mitrani-Reiser's achievement has been her ability to use mathematics to work such nonengineering factors into her model.

"She has been able to take these kinds of concepts and translate them into equations," Comerio said.


Mitrani-Reiser and her colleagues have since refined the tool, deploying it at disaster sites in Christchurch, New Zealand, after a pair of earthquakes rattled that city in 2011; in New York and New Jersey after superstorm Sandy in 2012; and in Nepal, where a massive quake killed more than 8,000 people last April.

She recently discussed her methodology and shared the risk-assessment tool with government officials and experts in hospital design during a trip to the western U.S. — including Utah, where a majority of the population lives along a major fault line that one official said is overdue for "the big one."

"We have been heavily engaged in helping our state and local health departments, hospitals, and other entities and agencies prepare for this eventuality, and Judy and her team have created a tool for assessing facility functionality that looks at things like staffing, electricity, water," said Mindy Colling, an emergency preparedness planner with the Utah Department of Health. "It's novel and exactly what all earthquake-prone areas need."

Mitrani-Reiser is in the early stages of working with Johns Hopkins Medicine International to assess the resilience of its health care network, and with the Johns Hopkins Center for a Livable Future and the city of Baltimore to evaluate the security of the city's food supply.

Those who know Mitrani-Reiser say that she comes by her ability to build bridges naturally.

She was born in Cuba; her father was an aspiring civil engineer and her mother a social worker. In 1980, when she was 2, the family came to the United States as part of the Mariel boatlift, a mass emigration that brought 125,000 Cubans to Florida. Her parents were supportive, encouraging their daughter's mathematical talent as well as her love of baseball.


By the time she'd earned her doctorate in applied mechanics at Caltech, friends say, Mitrani-Reiser was accustomed to asking the kinds of questions that "expand the envelope" in civil engineering, in Comerio's words.

Kirsch said being a woman in a male-dominated field never seems to rattle Mitrani-Reiser, who projects vision, competence and "absolute self-sufficiency" no matter how austere the job conditions.

"Everyone recognizes she can stand toe-to-toe with anyone, intellectually or physically," Kirsch said.

Earlier this month, Mitrani-Reiser was one of a select number of academics invited to a White House summit on earthquake resilience.

Officials announced that President Barack Obama had signed an executive order that, among other things, offers federal support to the creation of an earthquake early-warning system on the West Coast.

Mitrani-Reiser said she was thrilled by the news. A paper she'd written on the subject months earlier was just hitting the presses.


The article describes another of her creations — a tool she calls the "virtual building inspector," which quickly assesses a structure's safety using the same guidelines a building instructor would use — and how it can be employed as part of an early-warning system.

The timing didn't surprise Comerio, who calls Mitrani-Reiser an engineer ahead of her time.

"In 10 to 15 years, the way Judy looks at this field will be considered normal at every engineering department in the country," Comerio predicted. "She's at the front end of the curve."