Hurricane KatrinaA public health official in a Red Cross volunteer worldCindy Smith, RNDirector, Hill County Health Department, Havre, MT
Red Cross ResponseTraining 3 months prior with certification for Disaster Health Services. Why? To understand Red Cross role and how Public Health would work with Red Cross in any disaster.Aug 28 Call out Aug 30 Flight
Hill County, MT
Red Cross ProtocolsRed Cross disaster Health Services provides emergency and preventive health services to people affected by disaster and to Red Cross staff assigned to a disaster relief operation. The primary responsibility for the general health of a community in a disaster rests with the local public health authorities and local medical, nursing, and health resources.
Disaster Health Services Protocols
Red Cross Report
Question Have you had training as a red cross volunteer?
A. YesB. No
Houston to Baton Rouge
Staging: HoustonGoodEasy to find check-in site at airportMet and talked to many well qualified volunteers from all over the US and the worldLots of H2OAug. 30 Houston: assignments into three member teamAug. 31 Rental Car from Houston to Baton Rouge
Staging: Houston (cont.)Needs improvement Organization of volunteers to travel to Baton RougeNo clear time for the announcement of assignmentsTracking volunteers once sent to Baton Rouge
Staging: Baton RougeGoodLots of computersBreak down into command structure e.g., logistics, operationsVolunteers eager to be deployed Some sections appeared to be organizedGreat city, very friendly people, many volunteering their time and their homesAug 31 Baton Rouge 12:00 pm Assignment into the field? Where does the medical staff check in? (Chaos and uncertainty)
Staging: Baton Rouge (cont.)Needs improvementNo one knew where to check in the health service volunteersSomeone from DC assigned me to staff health without prior trainingLong waiting times for assignments while news reports showed Mayors etc., calling for help from Red Cross and FEMAUnorganized tracking of where they sent the Health Service volunteersNo one used computers to make a central data base of shelters, volunteers assigned to the shelters, who needed help at existing shelters, identifying areas of need, etc.No forms made to take with us into the field
First AssignmentGood Physician and LPN triaged ill peopleHad lots of food and supplies e.g., clothes, toiletries, diapersMany Red Cross Volunteers3:15 pm Asked for assignment to Denham Springs Jr. High School in Denham Springs. Waited for car and supplies. 5:00 pm Left Baton Rouge 6:15 pmArrived at Jr. High
First Assignment (cont.)Needs improvementLittle medical suppliesNo forms to fill out medical records on100 degrees in gym and medical roomSmall area designated for ill Long distance to BR for elderly and disabledSchool to start in one week
QuestionDoes your local or state emergency preparedness plans include the use of faith institutions for shelters? A. YesB. No
Ministerial ResponseGoodGreat response from parishionersVans for transportationKitchens with prior sanitarian inspectionsPolice protection supportShowers and washer and dryersMinisterial association helped to provide mental healthAug 31 Revival Temple Arrived 8:00 pm
Ministerial Response (cont.)Needs improvementNo medical supplies at the startNo O2No local Public Health presenceNo Red Cross support from Baton RougeEmergency numbers given were not helpful
First ResponseSet up beds on church pewsBegin to interview, assess and care for the displaced Volunteer parishioners and area churches come to the rescueVolunteer professionals Donations
Emotions begin to swirl LockdownThankfulnessAnxietyFear and worry about displaced family membersFear and worry about the futurePainSorrowLaughterHappiness JealousyFrustration
Settling InMedical needs Physician visitsPharmacySearching web sitesRegistering names into data baseFEMA arrives with family membersDisbursed all over the United States and some back home to face the next challengeChurch service
Next assignmentSent to staff shelter Great people in Baton Rouge2 days with Staff Health (Just what is staff health?)Request for Health Services transfer Public Health Team assigned by National Red Cross to Baton Rouge met with resistance by existing Health Services staffSep 4 Left Revival Temple 2:00 pm. Return to Baton Rouge for Staff Health Assignment.
Baton Rouge to Monroe
MonroePublic Health Chart ReviewsWhere is local Public Health?Nursing assessments and referrals to mobile clinicsSep 6 4 1/2 hour drive. Check in and briefing at local Red Cross Chapter 8:00 pm.Sep 7 7:00 am to 7:00 pm at Monroe Civic Center with 2500 displaced people.
Monroe (cont.)Sep 8 7:00 am to 7:00 pmMore chart reviewsWhere to find the people with identified symptoms and or risk factors?Sep 9 Plan to move all 2500 to old State Farm headquarter 300,000 square foot building because of wrestling match scheduled in civic center.
State Farm Residential CommunityGoodBadges made for all volunteers and shelter residentsLots of space Medical wing existed in State Farm organization
State Farm (cont.)Needs Improvement600-700 made the moveNo tracking of names of those who movedNo on site cooking or meal preparationNo showersNo place for the petsSo big with lights out at 10 pm
State Farm (cont.)Needs ImprovementCommunication about events, plans, location of services, etc did not filter from charge staff to volunteers assigned to specific dutiesNeed for cultural diversity training to volunteers and local chapterAll forms still not availableCommissioned Public Health Officers made a 30 minute assessmentWhere do people put all their new belongings?How do they get all the things people send?
Lessons Learned: 1. Cross TrainingCross Training and continued discussions with local, state and national volunteer organizationsDo they exist in our communities and are they at our table or will we need to seek them out?What can we learn from them?What can they learn from us?
Even if your community is not a direct hit of the incident, you may be affected.Think about having a city population that is twice your size all of a sudden moving to your area. In addition there may be volunteers in hundred counts coming right with them. Banks Food Service Traffic Security Grocery Stores Hardware and appliance Realty Churches2. Indirect Impact
3. Mental HealthAn overwhelming need to increase the training to all responders. People needed to talk and they needed to be acknowledged and heard. Sure they were safe and in a shelter, but their previous troubles along with new added trauma became explosive. Pain managementAlcohol and drug useFamily dynamicsGrieving
4. Local CapacityIn your local emergency plans do you haveMinisterial Response PlansOxygen supply companiesSpecial needs children and adults identified with written evacuation or notification protocols in place and understood by those populationsWho are the special needs populations Elderly Poor Medical Disabled
5. Communication and documentationIf you dont know anything what good are you?What happened to all the forms? How many forms do you have in your plan and how will you get them to those who need to use them. Just whose forms will we use?
6. More communicationHow well will your local government work together in an emergency? Do they know what is in your plan? Are they trained? Do they have the training as a priority on their list?MayorCommissionersHow well will you work with your state government in an emergency? Police chief Public Health Governor State Public Health