Bed Bugs: A Municipal Case Study and Beyond Phil Alexakos, MPH, REHS Chief of Environmental Health & Emergency Response Manchester Health Department

Bed Bug History in Manchester First Calls 2002 Langdon Mill Building 20 Units Multiple Languages Older Construction Multiple Complaints

Health Department Role Not in the business of housing code enforcement Some in the audience may be wearing both “hats” Educational role Connections and access to resources in the Community

More History Collaborative Efforts 2005 Mailings to all Laundromats, used furniture providers (that we knew of), furniture rental businesses Development of educational materials for the public Awareness and Treatment Guidelines English, Spanish, Russian, Bosnian Posted on Web

Langdon Mill 2005 October 2005 Identification of a major bedbug and cockroach infestation Coordination with Housing Code to ensure proper enforcement Coordination with Pest Control Company to assure that residents were instructed on treatment preparation

Langdon Mill 2005 Major issues encountered Language Barriers Functional Needs Barriers Cooperation Barriers Laundering Site Prep Financial Barriers (for tenants and owner) Where it all fell short…..LONG TERM SUSTAINABILITY

Landon Mill 2009 March 2009 Reports of children and infants were being “eaten alive” by bed bugs in this building Community advocacy groups began to act on behalf of these residents on their behalf Meetings of stakeholders were organized

Langdon Mill 2009 Organizers Granite State Organizing Project (GSOP) American Friends Service Committee Utilized their resources to bring all parties to the table Ensured that meetings were well organized and people/ agencies were accountable to effort

Langdon Mill 2009 Property Ownership Engaged from DAY 1!! Committed to a solution Ensures that resources invested are effective Integral in the success of any effort

Langdon Mill Part 2009 City Government Health Department Public Works Hosted meetings Provided access to educational materials Functioned as the primary linkage to all City services Provided technical expertise and training to volunteers and participants Public Works Provided free access to the City Transfer Station for disposal

Langdon Mill 2009- Community Organizations Multiple Faith-Based groups and most importantly volunteers were energized and trained to continue engaging the residents Remember, one of the shortcomings of the previous initiatives was sustainability! Social Service Agencies These groups are likely to encounter people affected by bedbug issues Training these workers also protects them from unknowingly putting themselves at risk

Langdon Mill 2009- Community Organizations Cultural Organizations Assist with translation and training efforts Increased “buy-in” Enhanced understanding of issues and challenges for planners and volunteers Allowed effort to penetrate deeper into the community

Langdon Mill 2009 School Department Social workers, nurses and teachers are likely to encounter the issue They can help identify problems before they become severe Provided two great “Case Workers” during the effort which increased trust and continuity during the relocation

Langdon Mill 2009 Colleges Provided an opportunity for “service learning” in the community. Provide an unlimited supply of volunteers over time. Access to grants and research opportunities

Langdon Mill 2009 Businesses Provided needed monetary support and resources needed to properly enact the effort Increase awareness and reduce the stigma associated with bed bugs Local Pest Control Company lent its expert to the effort

Langdon Mill 2009- Timeline April/May Community Planning May/June Tenant Education June Media and Community Awareness June/ July Furniture and Household Items July/August Tenant Relocation August Treatment of Building and Maintenance August Re-Housing ONGOING Education and Prevention

Langdon Mill 2009- Logistics Housing Transportation Volunteer Coordination Donation Coordination Food Case Workers $$$$ ????

Everyone is Back…Now What? Ongoing involvement Owner has designated an apartment as a “volunteer office” Local college remains a strong presence in the building with student volunteers Tenants are engaged to ensure safe practices New tenants are educated upon arrival Units are surveyed for any signs of activity Action is taken immediately at the first sign of an issue

Keeping the Momentum Going Next Steps Keeping the Momentum Going

This Isn’t the Only Problem in Town, Let Alone the State Bed Bug “Task Force”, “Policy Group”, “Coalition” was formed Knowing this continues to be an issue the members of the Langdon Mill Project were determined to energize others to advocate for bed bug awareness and infestation prevention

New Partners NH Department of Agriculture, Pesticides New Hampshire Legal Assistance The Way Home NH Cooperative Extension and UNH Manchester Medical Providers Many Community-Based Agencies

Subcommittees Public Education Policy Funding

Public Education Who needs information Where to go for information Tenants Property owners Policy makers Businesses Where to go for information UNH Cooperative Extension NH 211 Websites

Public Information Needs Considerations Pamphlets Magnets Stickers Ease of reading and understanding Culturally appropriate Consistency Funding $$$ Grants and Partnerships

Policy Assessment and Ownership of the Problem Data collection Target areas for interventions Municipal Policy Maker Resolution Evidence Based Best Practices What are other places doing? Minimizing Risk Enforcement, trash collection, regulation of used furniture place Consistency Linkage to Resources

Funding Increase public and civic awareness The more people and businesses know… This is a REAL problem Less stigma More apt to want to commit resources to prevention and treatment Opportunities to collaborate Healthy Homes

Future Bed Bug Task Force will continue to expand and meet Hope to organize a statewide conference Formalize a centralized location for bed bug information Engage state policy makers