I saw the Hurricane Helene response up close. This is how disaster relief actually works.

The storm damage in western North Carolina after Hurricane Helene swept through on September 27 was immense. More than 1,000 bridges, some 5,000 miles of state-owned roads, 160 water and sewage systems, and an estimated 126,000 homes were damaged or destroyed. At least 100 people were killed, and about 20 more were still missing as of mid-October. North Carolina Gov. Roy Cooper estimated it would cost a record-breaking $53 billion to repair damage and cover all recovery needs.

It’s little surprise that in the weeks after the storm, grassroots response efforts inundated the region. Driving south from Bakersville into Asheville, nearly every church, grocery store, gas station, firehouse, and strip mall parking lot had been converted to some sort of supply distribution point or relief hub. Schools, agricultural centers, and abandoned gyms served as American Red Cross shelters housing nearly 1,000 people who lost their homes. Hand-painted signs pointing the way to a hot meal or free supplies dotted the roads. Droves of volunteers descended on downed trees with chainsaws, hacking a path through to isolated mountain communities and houses. With so many roadways damaged or simply washed away, nurses, paramedics, and other volunteers with medical training mounted ATVs to conduct welfare checks. Others loaded up mules and walked supplies into the mountains.

Elsewhere, volunteers packed into neighborhoods to muck out homes — removing water-damaged items, gutting houses down to their studs, and disinfecting remaining surfaces to prevent mold and help the house dry out before it could be rebuilt. Nonprofit organizations such as Operation Airdrop and individuals with military experience flew around in privately owned helicopters conducting rescue operations and airdropping supplies to people cut off from toppled roadways. In the first two weeks after Hurricane Helene, there was a constant whir of helicopters flying overhead.

“It’s been like a war zone,” a Swannanoa resident told Vox.

But amid this deluge of goodwill and generosity pouring into western North Carolina, something sinister was also brewing: misinformation and outright false accusations about federal relief efforts, particularly about the Federal Emergency Management Agency (FEMA).

One Facebook post claimed the Biden administration reallocated some $1 billion in funds from disaster relief to “house illegal immigrants,” leaving FEMA underfunded to help hurricane relief and response efforts. Another rumor was that FEMA was limiting financial assistance for disaster survivors to $750 and that recipients would eventually have to repay those funds or risk losing their homes.

Both claims were false, according to FEMA. The initial payout was meant to allow survivors to cover any urgent needs such as prescription medicine they lost during the storm, said Elizabeth Zimmerman, a former director of disaster operations at FEMA and now a senior executive advisor at IEM, an emergency management company.

“That money is not going to be taken back from anybody,” Zimmerman said. “It is not a loan. And that’s just the beginning.” Even just two weeks after the hurricane blew through, some homeowners told Vox they had already been promised additional assistance, in the realm of $40,000, to help rebuild their homes.

This misinformation has occasionally hindered relief efforts.

During the weekend of October 12, there was a rumor among residents and FEMA staff that “armed militias” were threatening FEMA staff, which led the agency to briefly pause some of its response activities. The Rutherford County Sheriff’s Office later arrested and charged a man who made public comments about harming FEMA employees. Late in October, local police in Tennessee also reported they were investigating reports of armed groups who were “harassing hurricane relief workers.”

Beyond the outright false statements swirling on social media, much of the confusion and criticism comes down to a misunderstanding of how disaster response works, according to Brock Long, a former head of FEMA who now serves as the executive chair at Hagerty Consulting, an emergency management consulting firm.

Many erroneously believe that FEMA is ultimately responsible for all relief and recovery efforts. “People think it’s just FEMA comes in and they take over,” Zimmerman said. “They do not take over. They cannot take over.”

Even in a disaster the scale of Hurricane Helene, FEMA plays only a small role in the much larger recovery and relief effort. “It’s a team sport,” Long said, and there are four major players: local county and state governments, the federal government, the private sector, and most importantly, the bedrock of disaster response — volunteers.

Misinformation in the wake of a natural disaster is nothing new, but prolonged power and cell service outages have made it worse. The erosion of local media and reliance on unverified information on social media has also exacerbated the misinformation crisis; if unchecked, it will continue to complicate future disaster response efforts. Understanding how disaster response really works and empowering volunteers and communities to be more prepared for these catastrophes will help us be more resilient in the face of threats.

Local county and state governments are ultimately responsible for managing disaster recovery and relief efforts. However, in many cases — and particularly in remote places like rural western North Carolina — there are limited financial and human resources for disaster response, and counties can quickly become overwhelmed.

An affected county government can reach out to neighboring counties for additional resources, be it manpower or equipment. If that influx of additional support is not sufficient, county governments can then ask the state government for assistance.

If the resources available at the state level are still not enough to meet the needs of disaster-affected communities, the governor can then request assistance from FEMA. The FEMA administrator then gets in touch with the National Security Council at the White House to request that the president declare an emergency or major disaster declaration.

This process can all happen within days or even hours. In the case of Hurricane Helene, the Biden administration approved an emergency declaration for North Carolina on September 26, the same day Hurricane Helene made landfall in Florida.

Once an emergency declaration has been approved, it unlocks a huge influx of federal funds. FEMA has doled out more than $200 million to individuals and households for recovery, according to a FEMA spokesperson. The US Department of Transportation has also allocated $100 million to rebuild bridges and roads in the state. Cooper has also proposed to provide an additional $3.9 billion in state funds for recovery efforts.

In addition to federal funds, an emergency authorization also allows FEMA to tap into an entire family of federal agencies, including the National Guard, Army Corps of Engineers, and the Departments of Energy, Education, and Transportation, among others.

All federal agencies involved in disaster response, alongside representatives from major volunteer organizations such as the American Red Cross, convene in the National Response Coordination Center at FEMA’s headquarters in Washington, with additional coordination at regional headquarters and disaster-affected states. At each location, staff and volunteers work to identify community needs, recruit personnel, procure critical equipment and material items, and coordinate the overall response.

What this all means is that FEMA plays more of a high-level management and coordinator role that supports the state. It is not, as it is often believed to be and blamed when it fails to be, the final authority on disaster response. “The way that disaster [response] works is that they’re typically locally executed, state managed, and federally supported,” Long said.

But local, state, and federal governments are still just one of four major groups that help communities recover from disasters. Another key player is the private sector: the power, water, and communications companies, private health care facilities, and other businesses that own and operate local infrastructure that might need to be repaired and reopened following a disaster.

About 1 million people in North Carolina lost power immediately after Hurricane Helene. At the time of writing, nearly 2,000 people in the state were still without power and more than 150,000 people were either without water or remain under boil-water mandates. In some of the hardest to reach areas, volunteer and relief workers told me power may not be restored until January. While FEMA often takes the heat when these services aren’t rapidly restored, the agency does not actually have any jurisdiction over this work, Long said.

For all the importance of local, state, and federal government agencies and private sector companies in disaster response, volunteers, churches, and community-based groups are even more vital.

“The most important tool in the toolbox when it comes to response and recovery are the volunteer organizations active in disaster,” Long said.

In the two weeks following Hurricane Helene, there was such an influx of food, water, and other supplies to western North Carolina that churches and volunteer groups on the ground were running out of storage space and were turning away donations. It demonstrated how, despite all the focus on the federal government, volunteers are the bedrock of disaster relief. They can quickly amass huge amounts of supplies and deploy resources to any area of the country long before state and federal governments have completed their bureaucratic processes to mobilize a response.

“A lot of times, state and local and federal governments have to adhere to big, bulky laws, policies, and concepts, but the volunteer organizations active in disaster do not, Long said. “And so a lot of times the most effective use of the volunteer organizations is pointing them in the right direction of the citizens’ needs that cannot be fulfilled by the federal government.

Most major volunteer groups that help with disaster recovery and response are part of a formal coalition, the Voluntary Organizations Active in Disaster (VOAD). There is a national VOAD as well as associations for each US state and territory. While disaster relief and recovery efforts will always be a bit of organized chaos with well-meaning individuals and groups pouring in from around the country, these coalitions help to coordinate volunteer activities; ensure that funds, equipment, and people are evenly distributed across a disaster area; and reduce the duplication of efforts.

Perhaps more importantly, many volunteers and organizations that are leading relief efforts are from affected areas, which is crucial for the kind of long-term recovery and rebuilding needed after a catastrophe of this magnitude. Immediately after a major disaster like Helene, there is a huge influx of donations and volunteers, but after a few months, the disaster fades from news headlines. Donations dwindle, while volunteers from the opposite side of the country stop coming or divert to another disaster. But local volunteers stay for the months or even years that it takes to rebuild their communities.

In the parking lot of First Baptist Church in Swannanoa, on the eastern outskirts of Asheville, Dana Williams, 44, a neonatal ICU nurse from nearby Henderson County, has been volunteering at a makeshift medical clinic providing care to locals. She arrived four days after the hurricane hit, after being trapped in her home by downed trees.

“I’m a nurse at heart. I’m a fixer. I want to help always. And so the first couple of days after the storm, we were stuck at the house. I felt so useless,” Williams said. “For years, whenever there would be a major disaster somewhere, I would wish I could go and help those people. Never in a million years did I think it would happen in my own backyard.”

When Williams arrived at the makeshift clinic, other nurses had set out a folding table; with little more than a box full of blood pressure cuffs and ibuprofen, they started providing any kind of care they could.

“Initially, it was just very grassroots,” Williams said. “I mean, we started here and we were like, ‘We’re just going to see what people need and what we can do.‘ We’re hands; we’re bodies. We have medical training.”

At first, the nurses mostly provided first aid and trauma care, treating wounds and respiratory infections and rashes from the dirt and mud that pervaded the entire town after the storm. The volunteers worked to replace prescription medications that had been lost during the storm and to make sure that people who depended on oxygen had fresh tanks. The nurses also provided some basic medical education, making sure that everyone in the area, long accustomed to being able to drink from their local creek, knew that the water was now contaminated because of the flooding.

Over time, the group of volunteers also started focusing on treating people with chronic diseases, while working toward ensuring that people had access to specialty health care services disrupted by the storm, such as chemotherapy. The nurses also connected with the American Red Cross and other larger organizations and started procuring and distributing medical supplies across the region. Donations poured in, and Williams has been able to procure even the most niche medical devices.

Williams is committed to volunteering until all needs are met. She is storing extra medical supplies in her home garage. Recently, she started working toward building a similar volunteer clinic in Bat Cave, a rural area hard hit by the hurricane that has been almost completely cut off from aid. And while Williams is committed, she recognizes that churches and businesses that have loaned out their buildings and parking lots for relief efforts will at some point want to return to business as usual.

“They have to get back to being the businesses that they are to survive now,” Williams said. “But I think if it becomes necessary, as time goes on, I think people are gonna be like, ‘Okay, we need to do this for this community’ … Mountain people are a different breed, and when the call goes out in two months, they will all show up again, just like this. So I don’t have any concerns that anybody’s going to be left behind. I think that everybody who has been involved to this point, we know that this is not a days or weeks endeavor.”

Even before the storm, there was a lack of medical care and a shortage of health care workers across western North Carolina. All 16 counties that make up the region had a shortage of primary care health workers, eight had no practicing psychiatrist, and seven had no OB-GYNs, according to the Mountain Area Health Education Center, a nonprofit regional medical provider. Lenore Ellis, program director at the Center for Rural Health Innovation, told me almost everyone in need of specialized services had to travel to Asheville or into Tennessee. Many schools relied on telehealth services to help kids see a provider.

Williams hopes that hurricane relief efforts will eventually lead to long-term improvements in local health care. “I didn’t realize what the community needs really were because it’s just a whole different perspective when you spend your career inside the walls of the hospital,” she said. Swannanoa and other small towns nestled in the Appalachian Mountains need more primary care and general practitioners but also affordable access to specialists such as oncologists.

“Free care would be wonderful because a lot of these people are going to need free care for a long time, and that wasn’t really accessible here before,” she said.

Ariel Morris, 26, had only lived in Beacon Village, a Swannanoa neighborhood, for about three months before the hurricane blew in. Morris recalled that in the early morning hours of September 27, as Helene descended on the area, there was at first just a lot of rain and wind, like any other bad storm coming through.

“But then, we got a little bit too much, and then the Montreat Dam and the Bee Tree Dam both let out at the exact same time — at the height of the storm,” Morris recalled.

There are about 20 homes in the Beacon Village neighborhood. Half of them, including the house where Morris was staying with her mom, sat on a slight elevation. When the dams overflowed, the other half of the neighborhood flooded within minutes. Around 7 am that day, Morris and some of her neighbors heard people screaming for help. When they looked down toward the yelling, they saw their neighbors standing on their roofs or clutching their chimneys as their cars and sheds rushed by them.

Morris’s neighbor, John Arndt, a recreational kayaker from Oregon, grabbed some rope and jumped in one of the kayaks stored outside his house and paddled out to people and pulled them toward an island of higher ground where Morris and other neighbors had gathered. Morris told her mom to keep calling 911 until someone answered but she couldn’t get through or the operator hung up on her. Finally, someone answered only to say, “We’re flooded with calls. Please stop calling.”

Another neighbor pulled off his insulin pump, jumped barefoot into one of Arndt’s other kayaks without even a lifejacket, and also started rescuing people, sometimes hacking through roofs to free people trapped in their attic. In all, Arndt and his neighbor rescued 15 people, 10 pets, and a bearded dragon, Morris said. One elderly neighbor couldn’t hang on to the kayak long enough to be pulled out of the floodwaters so Arndt and his neighbor wrapped her in a tarp and blankets and waited for help to arrive, but it wasn’t until around 6 pm that firefighters from Wilmington, on the eastern coast of North Carolina, arrived and took over the rescue operations.

As a kayaker, Arndt had some training to rescue people from whitewater rivers, not necessarily from massive flooding. “I’ve been involved in rescues kayaking, but you don’t have cars and tires floating past you and power lines and alarms going off and a bunch of different people yelling,” Arndt said.

Locals and communities are the last major players in disaster response, according to Long, but not all communities are well-equipped to respond when disaster strikes. National surveys have revealed that about 50 percent of Americans know how to do CPR, but only around 20 percent are up to date with the training. A FEMA survey reported that only 51 percent of Americans feel prepared for a disaster.

“Why do we allow people to graduate from some of the most prestigious universities in the state of North Carolina and still not know how to do CPR or invest $1 toward retirement or become financially resilient?” Long asked.

“We’ve got to get citizens to realize that in any situation, you are the true first responder, until the official first responder arrives, and there’s always a time gap. Are you trained for the first five to six minutes of any emergency situation in your household or out in public?” he added.

There is also a nationwide shortage of emergency medical technicians, an ongoing problem that needs to be addressed. But poorly prepared civilians and a lack of first responders are only two challenges. All the key players involved in disaster response need to reform and improve.

“I think down the road, we really need to have a conversation around what are the core capabilities that should exist at the local, state, and federal levels,” Long said. “How do we better utilize the resources of nonprofits? How do we increase tangible skills within our citizenry? It starts with neighbor helping neighbor all the way to the Federal Emergency Management Agency.”

According to Long, one way to strengthen community-level disaster response is for Congress to start incentivizing local jurisdictions and states for prioritizing preparedness, for instance by passing and enforcing strong building codes, having disaster-cognizant land-use plans, and not building infrastructure on vulnerable land. The North Carolina government has not fully implemented updated building codes — which require better flood and wind protection in homes — and that has caused the state to lose out on some $70 million in disaster preparedness funds from FEMA.

Some nonprofit disaster response organizations offer various types of training for civilians, but there is no formal state or federal programming or earmarked funding for these efforts.

Until individuals, communities, local and state governments, federal agencies, and private companies come together to strengthen disaster preparedness, then response efforts will be lacking, and that will cost lives. Storms are not the only disasters we face. “We have to be able to build dynamic capability at all levels to be able to handle different disasters, from cyberattacks to hurricanes,” Long said.