Hurricane Katrina

A public health official in a Red Cross volunteer world

Cindy Smith, RN

Director, Hill County Health Department, Havre, MT

Red Cross Response

Training 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 Protocols

Red 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

Personnel Roster

Red Cross Report

Question

Have you had training as a red cross volunteer?

A. Yes

B. No

Houston to Baton Rouge

Staging: Houston

Good• Easy to find check-in site at airport

• Met and talked to many well qualified volunteers from all over the US and the world

• Lots of H2O

Aug. 30 Houston: assignments into three member team

Aug. 31 Rental Car from Houston to Baton Rouge

Staging: Houston (cont.)

Needs improvement

• Organization of volunteers to travel to Baton Rouge

• No clear time for the announcement of assignments

• Tracking volunteers once sent to Baton Rouge

Staging: Baton Rouge

Good

• Lots of computers

• Break down into command structure e.g., logistics, operations

• Volunteers eager to be deployed

• Some sections appeared to be organized

• Great city, very friendly people, many volunteering their time and their homes

Aug 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 improvement• No one knew where to check in the health service

volunteers

• Someone from DC assigned me to staff health without prior training

• Long waiting times for assignments while news reports showed Mayors etc., calling for help from Red Cross and FEMA

• Unorganized tracking of where they sent the Health Service volunteers

• No 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 Assignment

Good

• Physician and LPN triaged ill people

• Had lots of food and supplies e.g., clothes, toiletries, diapers

• Many Red Cross Volunteers

3:15 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 pm Arrived at Jr. High

First Assignment (cont.)

Needs improvement

• Little medical supplies

• No forms to fill out medical records on

• 100 degrees in gym and medical room

• Small area designated for ill

• Long distance to BR for elderly and disabled

• School to start in one week

Question

Does your local or state emergency preparedness plans include the use of faith institutions for shelters?

A. Yes

B. No

Ministerial Response

Good

• Great response from parishioners

• Vans for transportation

• Kitchens with prior sanitarian inspections

• Police protection support

• Showers and washer and dryers

• Ministerial association helped to provide mental health

Aug 31 Revival Temple – Arrived 8:00 pm

Ministerial Response (cont.)

Needs improvement

• No medical supplies at the start

• No O2

• No local Public Health presence

• No Red Cross support from Baton Rouge

• Emergency numbers given were not helpful

First Response

Set up beds on church pews

Begin to interview, assess and care for the displaced

Volunteer parishioners and area churches come to the rescue

Volunteer professionals

Donations

Emotions begin to swirl

Lockdown

Thankfulness

Anxiety

Fear and worry about displaced family members

Fear and worry about the future

Pain

Sorrow

Laughter

Happiness

Jealousy

Frustration

Settling In

Medical needs

• Physician visits

• Pharmacy

Searching web sites

Registering names into data base

FEMA arrives with family members

Disbursed all over the United States and some back home to face the next challenge

Church service

Next assignment

• Sent to staff shelter

• Great people in Baton Rouge

• 2 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 staff

Sep 4 Left Revival Temple 2:00 pm. Return to Baton Rouge for Staff Health Assignment.

Baton Rouge to Monroe

Monroe

• Public Health Chart Reviews

• Where is local Public Health?

• Nursing assessments and referrals to mobile clinics

Sep 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 pm• More chart reviews

• Where 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 Community

Good• Badges made for all volunteers and

shelter residents

• Lots of space

• Medical wing existed in State Farm organization

Needs Improvement

• 600-700 made the move

• No tracking of names of those who moved

• No on site cooking or meal preparation

• No showers

• No place for the pets

• So big with lights out at 10 pm

State Farm (cont.)

Needs Improvement

• Communication about events, plans, location of services, etc did not filter from charge staff to volunteers assigned to specific duties

• Need for cultural diversity training to volunteers and local chapter

• All forms still not available

• Commissioned Public Health Officers made a 30 minute assessment

• Where do people put all their new belongings?

• How do they get all the things people send?

State Farm (cont.)

Lessons Learned: 1. Cross Training

Cross Training and continued discussions with local, state and national volunteer organizations

• Do 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

• Churches

2. Indirect Impact

3. Mental Health

An 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 management

• Alcohol and drug use

• Family dynamics

• Grieving

4. Local Capacity

In your local emergency plans do you have

• Ministerial Response Plans

• Oxygen supply companies

• Special needs children and adults identified with written evacuation or notification protocols in place and understood by those populations

Who are the special needs populations

• Elderly

• Poor

• Medical

• Disabled

5. Communication and documentation

If you don’t 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 communication

How 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?

• Mayor

• Commissioners

How well will you work with your state government in an emergency?

• Police chief

• Public Health

• Governor

• State Public Health