Trust Me: Building Relationships to Weather Our Political Climate  

Generations of Morgans are buried in Black Mountain, North Carolina. We spent summers and school breaks with my grandparents in Banner Elk and Beech Mountain, where we went to Sunday School with the kids from Grandfather Mountain Children’s Home at Mount Calvary Baptist Church. Having moved 10 times before graduating from high school, this is still my home. We have fished every stream in the area and traipsed the campgrounds and trails from Elk Park to Roan Mountain to Erwin, Tennessee. The old stone church where I was married is still standing in Crossnore, but on the last weekend of September, the Watauga River overran our wedding reception site, and when the river was done with the roads, its tributaries ripped the water pipes out of the ground.  

What I have lost is nothing compared to the lost lives, homes, churches, and livelihoods of those who call this region home every day. Yet I share in the collective grief for a personal and national treasure of people and places. My desire to honor these memories drove me to get as close as I could, as quickly as I could. Seventeen days after Hurricane Helene dumped over a trillion gallons of water into the mountain valleys, I made it to Washington County, Tennessee. It was as near as I could get to the mountains I call home, which were still accessible only to emergency vehicles. I signed up to volunteer over a long weekend, not as a physician or representative of any state agency, but as anyone could through the regional United Way.  

People are mobilized by tragedy, and they show up for each other and their communities across the country. By the time I arrived, the owners of a food truck from South Dakota had been giving out free barbecue for over two weeks. A team of construction workers from Mississippi had been there for a week. The small and spontaneously “staffed” Ruritan club, which normally organizes youth baseball, had turned its one room/one kitchen building into a supply depot and welcomed my truckload of supplies along with those from local, state, and federal sources. The members let me figure out which supplies needed to be sorted and how to distribute them to people wandering down from the mountains to look for blankets to prepare for a cold front. People in the region trust this kind of personal response from strangers more than government response, and the context and conversation provided some lessons worth hearing. 

I heard a lot of stories. Everyone had lost something, and most people had lost someone close to them. An older man and his adult son talked about how his boss of 17 years and boss’s wife had been swept away in a nearby campground we’ve often driven by. He was still in shock and unsure of where he would find new work. Others were concerned about looting, and I tried to mask my discomfort as men and women tried on donated clothes, commenting on whether they wanted to conceal their weapons as they prepared for what the night might bring.  

Another woman, who had assumed a role as chief organizer at the Ruritan, described how her young adult son was clearing debris with his locally contracted company. Her son and the other workers would wait for forensic dogs to search through debris before they cleared it. Over the prior week, the dogs had found the bodies of five of the six missing Impact Plastics employees who had been swept away after they were told not to leave the company site. She said that the debris crew offered a moment of silence for each victim and possessed an awareness that they were giving a terrible gift of closure and respect to families — at significant cost to themselves. When I briefly offered a few mental health resources for her son, she quickly said “no thanks.” She has lived through extensive, debilitating loss herself and felt prepared to support her son. And indeed we know from evidence experience that this personal, trusted support will be his best source of strength, something mountain people are particularly proud of — and she’ll have some backup via structures in place from government and health care if she needs it. 

Distrust and, indeed, hatred, of the federal government and specifically FEMA was a popular theme in stories that I heard that weekend. It is not a new sentiment in these mountain communities. One volunteer told me a story she heard of a neighbor who had lost her home and all belongings but had been denied FEMA benefits when she applied that week. Hearing that the neighbor had been denied benefits because another neighbor gave her a camper to stay in, the community was irate. As they sorted and handed out donations, other volunteers proudly told the story of several friends who made a makeshift bridge out of the bed of two semi-trucks to deliver supplies across a river immediately after the storm. FEMA subsequently told them to remove their trucks from the river due to safety concerns, and for a short time the locals “ran them off,” noting they themselves had built bridges with much less than that during Vietnam. They did not want the government meddling or telling them their hard work was not helpful, which was an insult to the help they have been giving their communities for years.  

While I know very well the best motivations and skill held by people serving in government, arguing that point would not have changed anyone’s minds in that supply center. Nor did I leave with a lot of hope of bridging together Appalachia and Nashville, much less Nashville and New York. I don’t have much hope as long as we live in different worlds, fueled by media that is driven by political and financial interest. On the other hand, it’s everyday people who have to do the hard work of relationship and trust building. The same people in the donation center who accused immigrants of looting quickly gave a non-English-speaking mother the clothing off their backs, while trying to draw a laugh out of the son who was translating for her. Perhaps the kindness of strangers in every community will weave us together. Perhaps the rebuilding efforts will help forge familiarity and a few trusted relationships among the members of two local church congregations that speak different languages.  

The people I talked with that weekend left me with a few lessons for those in government who struggle to build trust to do the day-to-day work of building effective government that will weather stress tests from pandemics to weather-related emergences:  

1. Let the locals do the work… and don’t take their trust for granted. Confidence in local government is more common than belief in state or federal government, at least initially. The community I volunteered with personally knew people in the health department and those running testing at the water plant, so they believed the water boil advisories and that these workers were working around the clock to restore safe access to water. When the local sheriff delivers a thank you for a temporary bridge and introduces FEMA representatives, local responders leave feeling like valued heroes. This local trust takes effort to maintain and can tip quickly in an emergency response, creating tension with state and federal arms of the response that the latter do not always recognize. 

2. Show up quickly and commit to the long haul. A strong and well-distributed presence is needed immediately, and its presence needs to be publicized repeatedly. The rapid appearance of emergency helicopters in the region made a substantial impression, as did the lack of them in some areas. The impact of seeing public officials on the ground and hearing about the amount of money and personnel deployed waned with each day of the response, as people grew more desperate, and rumors fed discontent. Still, I applaud the state officials on both sides of our mountain border for engaging in regular news conferences, website posts, tweets, and other media to let the public know the response was substantial and ongoing. 

3. Don’t wait for the battlefield to exchange business cards. Preparing for emergency scenarios takes dedicated and ongoing federal, state, and local funding, as well as attention to building trusted relationships between agencies, levels of government, and non-government sectors that will be put to the test during a pandemic or in a flood recovery. A more rapid response was possible due to positioning of emergency response equipment bought with pandemic response funds throughout the state and used in drills. Teams from emergency services, the National Guard, health care systems, and public health departments need to know each other and have an established emergency chain of command and communication to accomplish hospital roof rescues and rebuild infrastructure. Tempers hold a little longer in stressful situations when you know the people you’re working with. And if those in government don’t trust each other, the public won’t trust government. 

4. Vocalize your respect for every responder, in or out of government. Members of local, state or federal government can easily become frustrated with those operating in other levels, sectors or agencies, but peacemaking is often the skill that the public needs to see regardless of what is happening behind closed doors. We are often brokers of trust for each other, sometimes without even knowing it. It was local nonprofits that converted threatening militias to donators in some situations over the last few weeks.   

5. Crisis communication skills really matter. Whether it’s the 5 Cs of crisis communication (Concern, Commitment, Competency, Clarity, and Confidence) or the toolkits available from federal agencies, leverage evidence-based resources to get accurate information out quickly. Reliable and regularly updated sources of information are essential to maintain trust. In what seemed to be a new and successful approach, FEMA debunked rumors head on via a central website and ongoing communications effort. 

6. Build a trustworthy brand between crises. Building ongoing trust by serving as a go-to resource is the everyday work of government agencies, nonprofit entities like The Frameworks Institute and The Public Health Communications Collaborative (funded by CDC Foundation, de Beaumont Foundation and Trust for America’s Health), and medical professional associations like the American Association of Pediatrics.  

As with every crisis, we will mourn; and we will rebuild. What I am mourning now is the reminder of a society that is seething with distrust. Trust is the vaccine that we all need to manufacture to counter this destructive force. And just like vaccine development, getting it into the community will take significant time and investment from all of us.