Photo: Living Hope Wheelchair Association. 

A new report from the Living Hope Wheelchair Association highlights the challenges and opportunities of communities contending with "pre-existing conditions" in disaster relief and recovery.

Like many in the Houston area, Leticia was directly affected by Hurricane Harvey. Ten months after the storm, she was still battling mold inside the trailer where she, her husband and their six children lived. In a recent interview with the Living Hope Wheelchair Association, she wondered what to do: should she use a couple grants that had finally materialized months after the storm to do mold remediation or should she try to hire a lawyer to help get her husband out of ICE's custody. 

One of 63 people interviewed for the advocacy organization's latest report documenting the ongoing recovery process, Leticia, whose name was changed along with the other individuals included in the report, represents a particularly vulnerable segment of Houston's residents. In its more than decade-long role advocating for "disability rights, healthcare justice and immigrant and worker rights," the Living Hope interviewed Harvey-affected residents who live at the intersection of these issues, exposing what the report calls "pre-existing conditions" that alter the course of disaster recovery. 

Though the report draws on 63 individual interviews, they represent some 259 people in the affected households, with 112 of those saying they were undocumented. All of the people interviewed reported health issues related to the storm in their households, including stress, trauma, coughing, breathing and skin problems. Seventeen reported losing their jobs, 14 said they experienced unsafe working conditions as a result of the storm and four reported not getting paid. 

"These communities suffer from discriminatory public policies, marginalization, poverty, criminalization and racism," reads the report, co-authored by Tomás Aguilar and Francisco Argüelles, executive director of the association. An earlier report from the Episcopal Health Foundation and Kaiser Family Foundation following up on the recovery found, for example, that immigrants in the Texas Gulf Coast were significantly "more likely than their U.S.-born neighbors to suffer employment and income losses" due to the storm: 64 percent compared to 39 percent.

The association's findings underscore the impacts on marginalized communities, the role of small, community-based organizations in responding to otherwise unaddressed needs on the ground and the need for systemic changes that incorporate these voices into decisionmaking processes, particularly as they work to fill gaps in their own communities.

"There's amazing work happening," said Aguilar at the release of the report on Tuesday. "It isn’t just about things happening to us, there are also stories about survival."

Alycia Miles, director of operations at West Street Recovery, shared similar sentiments at Tuesday's panel conversation. "For those of us that are a part of those communities," she said, "this report has highlighted for me how well of a job we do as community individuals to work together with one another to bring together what little resources we have." West Street has worked to help a number of Harvey-affected residents collaboratively with Living Hope, which started in 2005 to fill a gap when the "Harris County Hospital District decided to stop providing necessary medical supplies to people with spinal cord injury that were non-Medicaid eligible." In November, West Street Recovery was one of 17 nonprofits that received funding in the final round of grants from the Greater Houston Community Foundation-administered Hurricane Harvey Relief Fund for case management, according to the GHCF. 

"It echoes what we already know about disaster recovery, which is that it works for some but it doesn't work for the people that need it most," added Zoe Middleton, the Houston and Southeast Texas co-director for Texas Housers. "We see how much disaster recovery needs to improve and how it needs to actually be informed by people's experiences."

Featured in the report are a number of testimonies that speak to the challenges many residents faced and continue to face in getting help. There's Alicia, whose East Houston apartment was still riddled with mold nine months after the storm while her children coughed and suffered. "When Alicia spoke the landlord about moving to a cleaner, safer apartment, he threatened to take her to court because she'd be breaking the lease," according to the report. "Since she was undocumented, she was afraid to do anything." 

Or Ricardo, who lived with his aunt in a home that had to be gutted and elevated. Without the title to the house, which belonged to his grandfather, who lived in Mexico, they had a hard time applying for assistance.

Or Rose, who takes care of her daughter, Ruby, who is in a wheelchair. When their home flooded, she moved them into a motel room, shared with five other people while she tried to work with her insurance company to cover the repair costs. Meanwhile, the state agency "that oversaw Ruby's care was concerned about their living situation" and threatened to take her away if Rose did not secure better living conditions. Under pressure, she accepted the insurance settlements, according to the report and moved back into her house, which was repaired thanks to friends who helped her finish the job.

Or Maria and Jose, who fled floodwaters with the help of inflatable swimming pool for him and his electric wheelchair, along with their children. When they got to the shelter, it wasn't set up for someone in a wheelchair and the bathroom "lacked a private area where Jose could use the bathroom," according to the report.

"The existence of the report itself is progress," said Maria Town, director of the Mayor's Office for People with Disabilities at the panel discussion. In addition to documenting stories that often don't make it into the official narrative, she said it pointed to important policy conversations. "One of the things that the city is looking at right now is how we rebuild to be more resilient and what that often means is elevating homes," she said. "Well, if you elevate homes, how does that work for people who use wheelchairs? What does that mean for all of us who have a hard time finding housing to begin with?" She said the report also called attention to the need for easier to access and understand application processes and better preparedness for shelters, including "looking at things like training churches or furniture stores so they know how to accommodate people with disabilities and provide language access, adding, "at our office we dealt with so many people who couldn't get to safety because they couldn't access a shelter." 

To aid with ongoing recovery and distribute the more than $1 billion in federal recovery funding making its way to Houston, the city opened four Housing Resource Centers earlier in January to help affected Houstonians get assistance. "Our goal is to reach and serve as many of the affected homeowners as possible, especially those who are hardest to reach – our disadvantaged, senior citizens, those with limited English proficiency and those with special needs," said Mayor Sylvester Turner in a statement. "We will not leave anyone behind."

But the recovery process is still fraught with barriers and challenges.

"There is an interest in but very little knowledge about the ways in which immigration statuses, in particular, are a barrier to recovery," explained Kate Vickery, director of the Houston Immigration Legal Services Collaborative. So while analysis will often rely on FEMA data, for example, officials and researchers know that leaves out individuals without documentation. "That's not sufficient, it's not enough," said Vickery. "The stories being told by Living Hope...are helping to combat that."

To further combat the gap, Vickery echoed the report's calls for more integrated decisionmaking processes that fund and include small, grassroots organizations representing immigrants and people with disabilities in particular; "really inviting groups to the table where decisions are being made and where the power is held."