Hurricane Katrina

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Hurricane Katrina

• A public health official in a Red Cross
  volunteer world
• Cindy Smith, RN
• Director, Hill County Health Department, Havre,
  MT

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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
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Hill County, MT
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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.

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Disaster Health Services Protocols
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Personnel Roster
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Red Cross Report
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Question

• Have you had training as a red cross volunteer?
• A. Yes
• B. No

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Houston to Baton Rouge
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Staging Houston
Aug. 30 Houston assignments into three member
team Aug. 31 Rental Car from Houston to Baton
Rouge

• 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

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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

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Staging Baton Rouge
Aug 31 Baton Rouge 1200 pm Assignment into
the field? Where does the medical staff check in?
(Chaos and uncertainty)

• 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

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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

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First Assignment
315 pm Asked for assignment to Denham Springs
Jr. High School in Denham Springs. Waited for car
and supplies. 500 pm Left Baton Rouge 615
pm Arrived at Jr. High

• Good
• Physician and LPN triaged ill people
• Had lots of food and supplies e.g., clothes,
  toiletries, diapers
• Many Red Cross Volunteers

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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

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Question

• Does your local or state emergency preparedness
  plans include the use of faith institutions for
  shelters?
• A. Yes
• B. No

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Ministerial Response
Aug 31 Revival Temple Arrived 800 pm

• 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

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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

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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

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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

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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

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Next assignment
Sep 4 Left Revival Temple 200 pm. Return to
Baton Rouge for Staff Health 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

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Baton Rouge to Monroe
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Monroe
Sep 6 4 1/2 hour drive. Check in and briefing at
local Red Cross Chapter 800 pm. Sep 7 700 am
to 700 pm at Monroe Civic Center with 2500
displaced people.

• Public Health Chart Reviews
• Where is local Public Health?
• Nursing assessments and referrals to mobile
  clinics

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Monroe (cont.)

• Sep 8 700 am to 700 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.

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State Farm Residential Community

• Good
• Badges made for all volunteers and shelter
  residents
• Lots of space
• Medical wing existed in State Farm organization

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State Farm (cont.)

• 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

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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?

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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?

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Even if your community is not a direct hit of the
incident, you may be affected.
2. Indirect Impact

• 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

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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

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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

• Medical
• Disabled

• Elderly
• Poor

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5. Communication and documentation

• If 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?

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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

• Police chief
• Public Health

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

• Governor
• State Public Health