Q&A with W. Craig Vanderwagen, MD

In July 2024, the National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a public workshop to discuss opportunities to support the capacity of indigenous and tribal nations and communities to prepare for, respond to, and recover from natural disasters and/or public health emergencies. The event gathered Indigenous leaders, those with lived experience, and experts in public health and public health emergency preparedness.  

In the Q&A below, forum co-chair and workshop co-chair, Dr. W. Craig Vanderwagen, former Assistant Secretary for Preparedness and Response in the U.S. Department of Health and Human Services and multigenerational family medicine physician for the Indian Health Service, shares insights from the experience.

What was the motivation for this workshop and how did it come together?

At a recent meeting of the forum, members of diverse communities, including tribal and rural communities spoke about serious issues they were facing around disaster preparedness. Tribes are unique in that they are sovereign entities. They have complex relationships with different levels of government that members of the forum wanted to better understand. The forum also wanted to understand how current tribal efforts could potentially serve as models for addressing climate change and emergency response elsewhere.

In terms of organizing, personal and professional contacts were key. I grew up on a reservation and the other co-chair of the workshop, Henry Cagey, from Lummi Nation, is a tribal elected official. Between the two of us, we were able to reach the right people. The planning committee ultimately included five indigenous people who had powerful insights about disaster recovery, mitigation, and cultural concerns from recent experiences. The rest of the committee was composed of public health professionals who work closely with tribal governments and community organizations.   

What made this workshop unique?

We wanted to encourage an information exchange that would ultimately give back to tribal communities: here are some things you can use and here are some gaps where we could potentially marshal training programs. One of the speakers shared helpful insights about treating burn victims, for example. Another explained how data exchange often presents a real challenge for tribal communities, because most elders want and need proof before planning. This was an issue during the COVID-19 pandemic when there just weren’t great numbers available early on. How do we communicate that reality to elected officials?

The impact of the speakers was felt in a very different way because people were sitting 10 feet away. The vitality behind something often gets lost on a screen. When you open discussions like this, you want to make sure everyone’s hearts and minds are in the same place, so holding a shared physical space for these discussions helped achieve that.

Can you tell us a little about the keynote speakers?

Fawn Sharp from the Quinault Indian Nation, immediate past President of the National Congress of American Indians, and Oren R. Lyons, a 94-year-old faith keeper from the Turtle Clan of Onondaga Nation, delivered the opening and closing keynote remarks, respectively.

Fawn was the first Native person from the U.S. State Department at the Conference of the Parties. She pointed out that indigenous peoples of the world govern and oversee 80% of Earth’s remaining biodiversity. Because of this, Native communities are often better equipped to be models of how to address climate change and manage isolated, rural community response to natural disasters and trauma care. There are now training tools in production designed to illuminate this knowledge for others. This is how information spreads!  

Oren, a Korean War veteran, remarked on youth’s current disconnect from the land, the food it grows, and the importance of water preservation. He emphasized the need to de-prioritize profit and global conflict over environmental health, biodiversity, peace, and a spiritual connection to Earth—critical messages for people from all walks of life.  

Can you share a powerful moment from the event?

One Native speaker from Hawaii talked about the cultural aspects of dealing with a traumatic event like the recent wildfires. He explained how it was very important for their leaders to “settle the soul” before taking any action. After that, another speaker discussed the details of the actual emergency management plan. These two things presented back-to-back were very powerful. It was definitely an “a-ha” moment. Non-natives didn’t fully understand why tribal leaders wanted to keep people out as the tragedy unfolded. But the Native leaders, who very much felt like they had failed, needed to get their spirits back in place. Non-natives were only thinking “we have to get people out of here.” There was a big disconnect between the Native leaders and government officials. And it’s helpful for people to hear this.

What’s on the horizon for this forum?  

The forum will continue its efforts to spotlight Indigenous perspectives on present and future public health threats. There’s so much work to do in this space. We also recognize how critical these insights will be when it comes to climate change mitigation and response strategies. Hopefully one day we’ll even see an official Indigenous Preparedness Month.

The forum would also like to spotlight other communities that have high vulnerabilities because of social inequities. This workshop was definitely an eye opener in terms of how to do that effectively. Often, our content is very tactical and operational, but this was more strategic, more human-focused. I think everyone learned a lot from this approach and we’re excited to see where it takes us in the future.

Watch a video of the workshop, “Strengthening Indigenous America: Building Resilience through Disaster Preparedness, Response, and Recovery,” and learn more here.”

Dr. W. Craig Vanderwagen, former Assistant Secretary for Preparedness and Response in the U.S. Department of Health and Human Services, is co-chair of the Forum on Medical and Public Health Preparedness for Disasters and Emergencies. He served 28 years as a uniformed officer in the U.S. Public Health Service and 25 years in the Indian Health Service, the U.S. federally-funded program of public health and clinical health care services provided to 2.5 million members of federally recognized American Indian and Alaska Native nations, tribes, and bands. During his career, he deployed multiple times to disaster environments, including Louisiana after Hurricane Katrina in 2005, Indonesia after the tsunami of 2005; Honduras after Hurricane Mitch in 1999, Iraq, and Afghanistan. He is currently an instructor at the Harvard T.H. Chan School of Public Health. Dr. Craig grew up on the Zuni Indian Reservation.