The human and economic impacts of disasters are immense. According to a study by the Center for Research on the Epidemiology of Disasters (CRED), between 2000 and 2009 an average of 227.5 million people were affected by disasters each year. Economic damages averaged $98.9 billion annually during that same period. Given the direct toll of such events, and the ripple effect that can be felt globally, finding ways mitigate barriers to the most effective humanitarian relief is necessary to preserve life and quality of life, as well as minimize negative economic impacts.

When a disaster strikes a natural human response is to act. Churches send volunteers to help rebuild. Massive quantities of food, clothing and medical supplies are shipped from countries around the world. Relief agencies set up make-shift hospitals to treat the injured. And millions upon millions of dollars are donated in response.

In the rush to respond multiple agents work independently to provide relief as quickly as possible. Unfortunately, this uncoordinated effort often leads to suboptimal results. Critical questions can be overlooked. Where’s the best location to place a hospital? What’s the most efficient and equitable way to distribute supplies? How can monetary resources best be used? What synergies can be realized through coordinated planning?

The study of humanitarian logistics seeks to proactively improve the response to disasters by focusing on supply chain issues such as the type and quantity of resources available; methods of procurement and storage of supplies; tools of tracking and means of transportation to the stricken area; and cooperation between teams participating in the operation . Now, a Kansas State University assistant professor is taking humanitarian logistics beyond emergency preparedness and response, using both traditional and novel industrial engineering techniques to develop decision support systems for those responsible for responding to disasters.

“Every supply chain faces challenges in delivering the right quantity and type of product to the right place at the right time,” said Jessica Heier Stamm, a faculty member with K-State’s Industrial and Manufacturing Systems Engineering (IMSE) department. “However, designing and managing systems to deliver aid to those affected by natural disasters is especially difficult given additional challenges such as damaged infrastructure and constantly changing conditions.”

One such factor that is frequently overlooked but has a significant impact is the influence of multiple and decentralized decision makers, according to Heier Stamm.

“There are often a wide range of entities involved in these supply chains, including government, military, private, and non-governmental organizations and individuals,” she explained. “While they all share a common goal – to help those affected by the disaster – each party operates based on their own objectives and levels of information, which often leads to duplication of efforts, waste, and in the worst cases aid not reaching those who need it most.”

“Traditional optimization approaches would advocate the adoption of a centralized decision maker to coordinate the entire response,” Heier Stamm continued. “But in disaster scenarios this is frequently impractical or impossible. Through my research I am identifying methods and novel approaches that enable decentralized systems to approximate the performance of centralized systems.”

Optimizing Care Delivery

A current focus of study is the impact of decentralized decision making on the treatment of cholera in Haiti following the January 2010 earthquake. The disease was discovered in October 2010 and it quickly spread across the country with more than 460,000 cases reported a year later. More than 110 different organizations responded to this outbreak by establishing cholera treatment facilities.

“In Port-au-Prince, we found that this decentralized approach resulted in the location of the vast majority of treatment facilities in a densely populated but relatively small geographic area,” said Heier Stamm. “For people living outside this area, opportunities for treatment were very limited, especially given inadequate means of transportation and the urgency with which care is required after the onset of symptoms.”

The goal of the research was to quantify the potential to improve access to care by modeling the desirable components of a centralized system while maintaining the same resources as the decentralized system. Among the centralized components were adequate access to treatment for all populations, equity in access, and efficient use of resources.

“Balancing efficiency with equity is a major issue,” Heier Stamm said. “In addition to the complexity that this introduces into the optimization models, there are social and political issues that must be taken into consideration. It’s important that the tools we use to analyze the system not only help support informed decision making, but that we can also explain the rationale behind the decision.”

Using integer programming models, Heier Stamm and IMSE graduate student Brian Moore were able to identify optimized locations for adequate and more equitable access to cholera care in Port-au-Prince and throughout Haiti. While treatment centers were still concentrated in more populous areas, a greater number were opened in suburban and rural areas.

“The goal of this research is not to mandate where organizations should place their treatment centers,” Heier Stamm said, “but rather to quantify the differences between the actual decentralized response and the potential for improved accessibility, to identify coordination structures between organizations that can mitigate the impact of decentralization, and to create dynamic models to support facility planning for areas that encounter disease outbreaks like that experienced in Haiti.”

“We find that more equitable access can be achieved using the same resources that were available in the actual response. Furthermore, we have embedded our optimization models into a rolling horizon framework that is capable of supporting decisions about where to locate new treatment facilities over time as resource availability or disease patterns change. The next step will be to identify incentives or other coordination mechanisms that will encourage independent organizations to locate facilities in a way that improves access. The approach that we are developing is applicable not only to Haiti, but to other scenarios in which multiple agencies respond to infectious disease outbreaks or disasters.”

Coordinating Public Health Efforts

Public health efforts are another area in which Heier Stamm and others in the IMSE department are applying industrial engineering and operations research techniques.

Heier Stamm’s efforts in this area are directed at supply chain modeling to address challenges at the interface of human and animal health. According to the Centers for Disease Control and Prevention (CDC), nearly 75 percent of recently emerging infectious diseases affecting humans are diseases of animal origin and approximately 60 percent of all human pathogens are zoonotic (meaning that they are transmissible between humans and animals). Examples include E. coli, West Nile virus, malaria, and Lyme disease. In addition to life and quality of life considerations, the spread of zoonotic diseases can have considerable economic effects ranging from international trade restrictions to actual or perceived reductions in food quality and safety and loss of a rural livelihood among individual producers or groups.

“There is a growing realization of the need to coordinate activities that protect and promote human, animal, and environmental health, also known as One Health,” said Heier Stamm. “Supply chain engineering can play an important role in prevention, response, and mitigation. Additionally, coordination can lead to better decision making and use of scarce resources.”

“Much like in a disaster situation, response to a zoonotic disease outbreak is decentralized. Not only are there multiple levels of decision makers – for instance local and state governments and various non-governmental organizations – but the focus of the response is directed at two different populations, human and animal.”

Through her research Heier Stamm hopes not only to demonstrate the value of a coordinated One Health approach, but also to determine what mechanisms can be used to coordinate the two systems and how costs and benefits can be allocated among organizations to encourage collaboration.

About Dr. Heier Stamm

An Industrial and Manufacturing Systems Engineering department alumnus, Jessica Heier Stamm (2004) joined the IMSE faculty in December 2010 after receiving her Ph.D. from the Georgia Institute of Technology. A native of Quinter, Kansas, Heier Stamm teaches operations research and logistics engineering courses at both the undergraduate and graduate levels. She was recognized by the Engineers Week Foundation as a 2008 New Face of Engineering honoree, was the recipient of the Institute of Industrial Engineers IIE Gilbreth Memorial Fellowship and NSF Graduate Research Fellowship, and was honored with the INFORMS Transportation Science and Logistics Society Dissertation Award.

Dr. Heier Stamm grew interested in humanitarian applications of industrial engineering and operations research during her undergraduate IE studies. Although she was drawn to the idea of making any system more efficient and effective, Heier Stamm became particularly excited when she realized that the tools she was learning to manage inventory, transportation, and resource allocation decisions in the commercial sector could also be applied to make a difference in the humanitarian sector. She also enjoys sharing her enthusiasm for these applications with students, noting that there are still many challenges and opportunities in this area that IEs are well-prepared to address.

“As we see increases in the number and impact of humanitarian crises, there also seems to be a greater understanding of the importance of improved supply chain systems to coordinate the efforts of many decentralized organizations,” said Heier Stamm. “Success in humanitarian relief efforts is measured not only in lives saved but also in quality of life for survivors. As a result of my research, I hope approaches are developed and adopted within the international relief community which improve response efforts and minimize the short- and long-term human toll of disasters and public health threats.”