Speaker 0 00:00:00 Hey, Daisy. Hi. Well, okay. We've got another one. Um, this is an incredible conversation with Bridget Valasco and Ralph GoTo from Hawaii. Um, both Bridget and Ralph are incredible people. They're so knowledgeable and they have really driven the drowning prevention and water safety, um, uh, effort forward, both in Hawaii and, uh, and in other spaces as well. So tizzy, is there any background that we should know about before we jump into this conversation?
Speaker 1 00:00:35 Just a couple of things they use the term dye pack, and what that stands for is the drowning and aquatic injury prevention advisory committee. They also use a term Kiki water safety. And for those of you who have not spent time in Hawaii, that is children's water safety. And then finally it might be helpful for you to have context, right from the beginning that this group is under the state health department. Right. And with that, let's get going
Speaker 2 00:01:12 Around.
Speaker 1 00:01:13 Hi Bridget.
Speaker 3 00:01:14 Hi.
Speaker 1 00:01:16 Hi. Good to see you both. And I've just been so inspired by what you have done and what you are doing in Hawaii. Thank you very, very much for taking this time. So Ralph and Bridget, can you please introduce yourselves and tell us a little bit about each of you and your connection to water safety?
Speaker 3 00:01:42 Oh, okay. I'll go first because my resume is probably a lot shorter than Ralph's. Um, I am currently facilitating the Johnny and aquatic injury prevention advisory committee, which we have cut down to be called dye pack. Um, so I I'm I'm in that role, I was the Johnny prevention coordinator with the state. I may be going back to that role. That's kind of pending, um, that that role actually got frozen, a lot of background to that, which I won't go into. But, um, so my background is pretty brief. I think we started, you know, to kind of delve into the first question. We started the coalition or the advisory in 2015, and I was hired on as the first state coordinator with the health department in 2014, that was the established position. And the position was established specifically because of work that thumb rough-in. Those guys had done loving for the funds for that.
Speaker 2 00:02:43 I just spent a few years running this city and county ocean safety division, learned a little bit about public health, learned a lot about public health, um, and was really fortunate to have people here in the health department from a injury prevention and public health perspective, talk and work with lifeguards because traditionally lifeguard life bearing, uh, you know, it's full of the stereotypes. It's sitting in a tower, um, surfing when you can talk into, you know, whoever happens to pass by and waiting for stuff to happen. And that's the traditional, uh, image that we have. And, and I think we sh we consciously made a decision to shift, um, you know, more active prevention. So, you know, in doing that, we had to learn about injury prevention. So we, we, um, you know, got familiar with the Haddon matrix and all the wonderful things, um, that are involved with data collection and bringing some science to, to the field, which, you know, in the past, up to that point really hadn't been done. So I think that the connection between, uh, ocean safety and lifeguards in general, in Hawaii and the public health model, um, and the injury prevention model really kind of spurned this whole deal.
Speaker 0 00:04:10 Well, Ralph, you touched on, um, so many important things there, and I, I would just like to recognize your contribution to water safety as a whole, but also as a lifeguard to lifeguarding. I mean, you pioneered, um, so many advancements in the profession and, um, specifically you talk about this shift towards a public health framework, um, which requires, um, I think, uh, the ability to step outside what, you know, and you did that masterfully. So thank you for your contribution to the field in, in so many different ways, but I want to take you both back to before Deepak was started bridging, you had mentioned that there was some advocacy and there is some kind of foundational work, um, that happened. And so, Ralph, I think you were involved in that. Can you describe like the lead up to actually getting a funded department of health drowning coordinator?
Speaker 3 00:05:12 Um, so the, the Hawaii injury prevention plan that I mentioned is a plan that's worked over, they do it in five-year chunks. And the last one, the one that I mentioned had the recommendations specific to developing an advisory committee was one of three recommendations. The other two were, um, getting a health education campaign going, and I forget what the other one was. Um, so when I stepped in to that, that role, the kind of the, the background that I was given was that, um, ad hoc, these, um, you know, content experts had been meeting and they were kind of working up toward that anyway, but it wasn't really facilitated and organized. So it kind of came together. I think the timing was right, and I wouldn't be able to speak to actually the funding behind it. I know it had to do with general thinking that to do a general funds with it, you know, just how the budgeting happened within the health department, the government side of it. I do know that the foundation was at, Hey, all this time, basically Honolulu, Seton county has been carrying the ball and we need to step up as we are with other injury injury areas, such as suicide cart incidents, et cetera. So that's kind of that framework.
Speaker 2 00:06:27 Yeah. I think, you know, looking back, uh, while it was still working, a lot of it had to do with strategy funding strategies. Okay. Like how can we justify more funds for personnel or for more equipment? And, you know, just to say, there are so many drownings in so many rescues, that's what we did in the past week. We had a pretty basic data collection system, um, and use that and throw, threw those numbers out. But you know, it wasn't until we got really involved with, um, you know, the actual how to do this and, and make that data or shift that data into meaningful information, um, that we could apply that to budget process. So then when we would, um, meet with whoever was handing out the dough, it wasn't just, we had 12 drownings here. Um, I mean, the drownings are important to know, but, you know, as we all know that those aren't just the only indicators of, of success or no success. So I think, you know, we're able to do that. And then we had a, uh, a very, um, supportive bunch of people at the health department. You know what I mean, drowning here is a major issue. I think they recognize it. Um, we had good support from people in the town like Bridget, who did a lot of work and Dan Galanis, his epidemiologist who's really helped us out. Um, you know, making sense of those numbers and putting them into a form where we could use some,
Speaker 1 00:08:07 You speak a little bit more to how you've incorporated, uh, EMS rescue type of data together with hospitalizations and death data. I think many states, uh, Washington included are challenged to bring in that component of the data. And we've recognized how much, how rich the information is like from lifeguard response that doesn't get captured beyond the, the organization where it actually occurred a city or county parks department.
Speaker 2 00:08:44 I think one of the unique things about the operation here, um, I think the city and county life where an organization is the only one that is, uh, in the same department as EMS, the other three county lifeguard operations are part of fire departments. And before that, they were part of parks and recreation. Um, and we were in parks and recreation for the first couple of years of my career. Um, but uniquely, uh, to be partnered with EMS, affords us a lot of access to things that normally lifeguard agencies are not, uh, able to access. Um, and, you know, having medical response or emergency response, people like brothers and sisters in EMS, uh, usually the director of the department was, uh, was a physician or someone, you know, who's whose background really lended itself to that. So it was kind of a, I don't know if it was a natural fit, but it was a very opportune fit. And, you know, the, the data that we collected and the data that, uh, that Dan was involved in, you know, kind of neatly dovetailed, uh, so ocean safety data and EMS data were kind of compatible.
Speaker 1 00:10:07 So to your point, the bringing together from an administrative standpoint where that data comes together may help with, um, challenges others or California may have around HIPAA and sharing. And that's my data set. And so interesting. Thank you.
Speaker 3 00:10:29 So I think we're still evolving because some of the gaps, you know, I would be interested in learning. I think I only got to go to one drowning prevention conference. It was in Arizona, but they spoke to some of the ways that I was interested cause Danville taken link the data, but even with a lifeguard incident, it's not saying it's drowning necessarily. Right. Cause the outcome might not be there so he can link up to a hospital, but then like our death records with the health department, they hold them pretty tight. So it, so yeah, I think there's still gaps. It's, it's better. It gets better. But, um, in terms of like what tizzy saying with application to motivation for policy administrative changes, we do the best we can, but we're, we'd love to learn. Also.
Speaker 0 00:11:14 I think you guys are really a on the forefront of, um, that data linkage at the state level. There's some great examples of this happening locally. Um, and you know, in California or in other places, but, uh, the fact that the state health department is looking at this for your entire region, I think is, um, really good, even though there are still gaps and there's still, you know, uh, things to accomplish. Um, I want to move us on to talk a little bit about how the coalition is organized. Uh, Deepak is organized, so you have some chairs and some co-chairs and subcommittees. And, uh, can you just briefly walk us through what that structure looks like?
Speaker 3 00:11:56 It's actually pretty, pretty basic. I think, uh, we have two co-chair, uh, two chairs. And so Ralph is, I think perpetually one initially would set it up for two years revolving, but COVID et cetera. Right. Um, and so they oversee the dye pack. We had initially called it a task force. We switched that to an advisory committee because we realized we're not necessarily like, like we're more of the advisors. Right. So getting the heads together and then the thought was, okay, we're going to make the subcommittees just kind of organically formed. I don't think it was even in our original plan. And so those subcommittees do have their own chairs, if you will.
Speaker 0 00:12:38 And how are those sub, how, how did you originally come up with those sub committees that was a billion, different models and there's a lot of different groupings for this. How did you come up with your subcommittees?
Speaker 3 00:12:49 It was just by what we would look at as our priorities and what we would keep coming up against at the meetings and knowing we're not having enough time, energy people to deal with this at hand as we are meeting. So we need a separate group for that. So the first one was the cake that child water safety subcommittee that developed. And that was actually pretty big and strong for a while. We lost quite a bit of our leadership of late for that. And the idea is for those subcommittees to take the act, the, you know, the recommendations and really interact with leadership at Deepak, I think it's pretty loose. I I'd like to work on tightening that up a little bit more.
Speaker 2 00:13:30 The other sub committee we have it's this snorkel safety subcommittee, um, which we were fortunate to get some funding from the tourism for, which was pretty unique. Um, you know, where we studied the snorkels and the equipment and the full face mass and, uh, uh, lack of swimming ability, et cetera, et cetera. Well, that study has pretty much run its course we're out of money. Uh, we did not come up with any definitive conclusions or our conclusion was we need to, we need more funding to study this so someone can apply for grants, but you know, the subcommittees, I think there were formed just because those were the issues going on at the time. And so how are you going to, how are you going to, uh, you know, really address those? So the people in the KCI water safety committee, uh, you know, historically are the people that do the learn to swim or tried for years to do a swimming program. Um, and you know, the snorkeling thing was because of the number of drownings and the incidence and, you know, it was with visitors. So that's how we got to visit her industry, uh, involved with it.
Speaker 0 00:14:49 Yeah. I was going to ask you a follow up on that. So, um, you have, I know that you have worked with, uh, tourism and both, probably in a state at a government level and, um, you know, with industry, can you describe a little bit of what that relationship has looked like and, um, maybe some of the, the good things or the challenges about working in and around tourism in Hawaii?
Speaker 2 00:15:13 Yeah, my, during my whole career, when I was working as a government employee, uh, there were certain constraints that we all have as, as in place. Um, we tried to meet with the visitor industry folks for years and, you know, the message would say, you guys are marketing this place, you're using the beach to bring people here. So you have some kind of responsibility to deal with them when you get here for years, that was just never addressed. And finally, we were able to make some progress in meeting with people. And, you know, I think what happened and what happens in a lot of cases is the stars align and the right people are in the right place. So we're fortunate to be able to talk to some people because we knew them. And we knew some people on the board of the tourism authority that were sympathetic that were ocean people that knew what was going on. And so they were, they were very instrumental in helping us make that progress. So we went from, you know, them really not wanting to talk about it to okay. They recognize that, uh, drowning with visitors was an issue. And then to the point where they actually actively got involved with us in terms of funding
Speaker 3 00:16:36 And social media timing and just regular media timing helped that I'm sure. Right. So that, that, like Ralph said, I think it was in his back days. It was, you know, them, you're, you're scaring people, don't talk and now it's like, oh, when's your guys' next meeting. We want to do a photo with you guys. Right. So it has changed a lot. And so one of the outcomes, like really concrete was they paid for one of our, um, public service RPSA videos to be played at all the county airport, the state airport in each county. Um, and they paid for that real estate. And then that got cut that got pulled with COVID. So that's like next on our list to go say, okay, people know how to wash their hands, go put the video back on. We're covered. Right.
Speaker 1 00:17:23 Um, can you talk a little bit more about how people become members of whether it be subcommittees or the advisory committee? I have people or organizations.
Speaker 3 00:17:35 Yeah. So I, I put in the notes that I sent you guys that I don't know if somebody said like up and starting, I would probably do it, how we did it, which is pretty formal. We sent like a letter from the director, the health director had signed it, that you are formally invited and you need your, your supervisor's permission and all this stuff. And that was chosen basically based on who people knew, where the guys to get at the table. And then from there, it was, you know, spread from there where if somebody leaves and they make sure they recommend someone to them. And, and then, you know, we take it to a vote, but there's no list of requirements beyond having somewhere in your organization's mission that you, I think it's just, I don't even know how I word it. I have to look at our structure and guidelines, but that there's some water safety, um, responsibility in your mission as well as ability to attend the meetings. Sure.
Speaker 0 00:18:27 So I, and I want to ask a quick follow-up on that because governance structure is so important, important for getting this rolling. Um, as far as I know, you are the only coalition that's actually housed inside of a government agency. Um, a lot of these other groups in the states are housed either as independent nonprofits or they live under a, you know, like an, a lead organization type of model. Um, what are some of the challenges and benefits of doing this work from inside a state agency?
Speaker 3 00:18:57 Um, I don't know, because I haven't been able to do anything different. I mean, I did speak with the Arizona nonprofit, um, and they kind of like, you know, we were just starting and they kind of like warned me. You guys need to switch to a nonprofit. You're going to have hard time with, you know, getting just people to like, I guess, believe in you kind of thing. I feel like because we have everybody, we have the nonprofits, the business side, we have, you know, like you mentioned the tourism side, we have military side representation. So even though you look at like me, I work for the health department and we do get a little bit of funding from my program. And technically right now the website is owned by the health department. That's the only fall men. And we do, we do have in our, in our, um, one of the roles of the advisory is to report to, I don't know if it's my director or the health director herself on our recommendations, which we have, you know, had the, um, I think when the full face mask thing came up, we got called in to speak to that, you know, the advisory.
Speaker 3 00:20:07 Yeah. But other than that, I don't, I don't, I can't really think of any, I don't know, Ralph might have any opinions on that.
Speaker 2 00:20:15 I think it was, um, you know, just looking around and saying, okay, who would be, you know, who would be good to have on this, in this group? And for instance, the lifeguard, you know, we have representation from every lifeguard agencies, but we also wanted to get, you know, who was above them because lifeguard, chief could say all they wanted, but unless you had the support, you know, big boss, you know, it was kind of a feudal, um, health department lens, a lot of credence to the effort. And when you say, well type X part of health, health department, um, you know, that, that gives it some juice. And I think that that's important to identify, um, who you want to get involved in what they're going to be able to bring to the table.
Speaker 0 00:21:08 Okay. I just have, um, a couple more questions as we wrap up. I, and here's where I want to go. I want to talk about some successes that you guys have had. I want to talk about some challenges that you guys have had, and I want to get your advice or recommendations for people who are just starting out and embarking on this work. So let's start with successes. Um, what are a couple of the things that, um, Deepak has accomplished that you would feel really proud about? Um, and colleagues' success.
Speaker 3 00:21:43 I would say, just getting ourselves together and organized and, you know, meeting in the same room more virtually continuously for however, ever since 2015, I think we've maybe missed one meeting. I think that was at the very start of COVID maybe. So, just that in and of itself, like I said, I feel like there's a lot of potential we've laid the groundwork, but we did our first two years really was just to have guest speaker. I mean, we, you know, laid out this plans and, you know, what are we doing? But we really just had a lot of guest speakers and different from, you know, pediatricians, neurologists. We had, um, you know, folks from the tourism authority and, uh, really just try to lay down a common foundation of knowledge for the group. So just that in itself, I think we did pretty good with that and that we're still around. And then I think that the other one I listed in, in, you know, your questionnaire was that we did, um, group together and make decisions around things that, you know, maybe I was doing as part of my job, but really it was the advisory that I look to to give that direction to our visitor campaign or John prevented. And that campaign took about two years just to, you know, from inception of data to product. So I would definitely give that, um, kudos to the, the advisory. Um,
Speaker 2 00:23:04 Uh, one of the things that has happened is that the, uh, advisory committee has pretty much established itself as, um, what would you say? You know, they're not, we're not the experts, but you know, if diabetics is okay, well, we support this because of this. I think there's credibility. Um, and I think that, you know, bringing everybody to the table to discuss stuff like that, uh, helped the credibility, like, um, we go to the legislature or we go to city council and talk about stuff. It's not just individuals speaking or the lifeguard association. Yeah. It's didactic and it's supportive, uh, supported by everyone and your list, everyone that's involved. And that does lend credibility to, to, you know, what we're trying to do. And it may help with the funding. I think that it certainly did with, uh, with the snorkel study, you know, we just came out of the blue and said, we need money to do this study. Uh, I don't think we would have gotten the funding that we do.
Speaker 0 00:24:16 Sure. Okay. Moving on to some challenges, what has been difficult in keeping this thing running and, and, um, moving the needle
Speaker 3 00:24:27 Meeting has been not too hard, getting people together has been okay. Um, even if we sometimes we'll have five or six, like one meeting where like five or six people, but I think just, you know, we have a lot of great ideas. We have, uh, you know, such a huge, robust knowledge base and experience base. And then the actual, not like making things actionable. I think we're a little bit still struggling with, if this is what is like our role. And so we'll get excited about getting stuff done, but then everybody has like their full-time job or their full-time retirement. I mean, you know, otherwise, cause it does like, it isn't fair. Like a lot of things do get pushed to Ralph and, and our other chair. And um, so just really trying to spread the load a little bit more or figure out how to delegate those to the, so I think part of that though is on me where, you know, we have people from like one person from one city in Caltech county, ocean safety entity come, and then do they really communicate that information back to their entity? Like how much is that sharing really going on? And so then that would affect participation, right. Because if they're invested in outcome, so that I think is one of the bigger challenges,
Speaker 2 00:25:47 You know, now that you mentioned that I think one of the, uh, the challenges for me especially was okay, it's great to sit around in this wonderful little group of experts. Okay. But you know, how does that affect the guy on the beach? Okay. And what's in it for him, you know, why, why should he take the he, or she take the time to get the person's snorkel and take a picture of it and save it, uh, so that we can, you know, do this study. They have no interest in doing that. You know, that,
Speaker 0 00:26:21 And you're talking, you're talking about lifeguards on the beach, it would be following up
Speaker 2 00:26:25 Or just, you know, just, just the practitioners what's in it for them. Now the guy at the pool, the people at the pool, you know, how's that going to help them with their, with their programming. And I think that that's really important. And I don't know if it's a challenge, but I think it's really important to in your mind as you're going through, you know, these wonderful planning ideas
Speaker 0 00:26:47 And that's yeah. I think that, um, creating shared value right. Where they, they see the value in participating and following through some of these,
Speaker 1 00:26:57 Thank you, Bridget, and Ralph so much for this incredibly helpful advice. And speaking of advice, as different water, safety advocates and stakeholders across the country, begin to think about what a coalition might look like in their own region. What advice or guidance would you offer for people who are thinking about, or just starting off on this journey or one that someone's now been on for the last six or seven years,
Speaker 3 00:27:24 They got to know the L like if they know the lay of their land already, and that's, what's the impetus to get the coalition. That's one thing like for me, it was kind of already a lot of the work that legwork had been done. So I came in kind of, this is what needs to get done because that part had already been done. And that being said, though, we still took a year to really lay out what we wanted from this group and the shell. We kept it loose. I would advise having a shell, you know, something kind of standardized, but also being really open to making sure that discussion happens to be open, to changing that rather than we need to get going in first meeting. Okay. In three years we want to get 5% less drowning or whatever. Right. You know, that's, you definitely want to have all that conversation hashed out there is, there is time to it. Yeah. I think our first couple meetings, we went three, four hours and now we've kind of cut it down to an hour, hour and a half, you know, but we could, and that's partially the zoom thing. Well, probably mostly the zoom team thing, but that would be one of my bigger pieces of advice
Speaker 0 00:28:28 Going into the process. Um, flexible being ready to be flexible and, um, change your ideas and kind of evolve with the need.
Speaker 3 00:28:39 Yeah. Making sure that, you know, if you're talking about kind of what Ralph was saying, if you're talking about making an effect on somebody, make sure you get their voice into what that really means. Yeah. And that kind of public health 1 0 1, right. Just getting the, the input before doing, working toward the output.
Speaker 0 00:28:57 Ralph, what advice would you offer to people who are starting out?
Speaker 2 00:29:02 If there's start, the guys that are starting out one is what were they trying to accomplish, you know, and, and set some goals and, you know, be realistic about it. I mean, whether they do they say, uh, what do you do you think globally? And you act locally, you know, so you have these wonderful missions and, and that's what it is. It's drowning prevention and injury prevention, but then break it down to okay, where what's happening here because what's happening in Arizona is different from what's happening, you know, in, in LA. So I think taking into account all the differences, trying to find a common denominator is going to be really important to be clear from the beginning about what you're trying to do, you know, because you can't, or you're not going to solve all the problems with the universe.
Speaker 0 00:29:55 Ralph Bridget, thank you so much for this really incredible conversation, a tizzy and I, and anyone else who, um, gets to listen to this, uh, has a lot to learn from you and the other Hawaiians who've been involved with Deepak and your experience. And again, just thank you so much for spending some time with us today. No problem
Speaker 2 00:30:20 Anytime. Well,
Speaker 0 00:30:23 All right. Thanks. Both. Talk to you soon.
Speaker 2 00:30:29 Alright,
Speaker 0 00:30:30 Bye.