Have Hope — Help Is on the Way

The human suffering caused by the devastation of Hurricane Katrina touched the entire nation. Like so many other hospitals and physicians, Scripps was moved to help.

Driven by the events of September 11, 2001, Scripps has dedicated significant resources to make our hospitals more prepared for all types of disasters. As part of that process, we’ve been privileged to establish a strong relationship with U.S. Surgeon General Richard Carmona. Immediately after Katrina hit, Scripps Chief Medical Officer Dr. Eastman contacted Dr. Carmona and offered Scripps’ support. After a series of discussions with the U.S. Department of Health and Human Services (HHS) and Dr. Carmona about how we might be of assistance, HHS made a formal request to send a medical unit. We promptly accepted.

Scripps was asked to relieve an exhausted physician and nurse team from the University of Texas Medical Center (UT) by staffing a temporary clinic UT had established for Hurricane Katrina victims in the Houston convention center. More than 200 physicians and employees volunteered for the response team in the first 24 hours. By the end of our two-week assignment, we had received more than 400 applicants — a number that makes me very proud of our organization.

During the first week, our team consisted of 13 physicians, two physician assistants, one nurse practitioner, 14 RNs, two LVNs, one lab tech, and three administrative personnel. Most of the physicians were pediatricians, internal medicine, primary care, and emergency medicine doctors, along with some specialists. Staffing for the second week was modified slightly, but we still had the same mix of physicians, nurses, and administrative support — about 40. Dr. Eastman and I led the first deployment of the Scripps Medical Response Team (SMRT).

We spent the first week staffing a clinic in the George R. Brown Convention Center in downtown Houston where more than 1,000 evacuees were living when we arrived. However, by the second week the number of survivors in the convention center was starting to drop as the city and county began to find housing in the Houston area. We were informed that the medical facility at the Convention Center would close the following Tuesday. We were also informed that the medical facility operated by Harris County at the Reliant Arena would close even earlier. The facilities were being closed to encourage survivors to seek care in community clinics and other facilities. Given that shift of patient care, we were asked to remain and start supporting about six Disaster Relief Centers and community clinics. While we had planned on operating in a unified, 24-hour, single location structure, we quickly designed a series of small deployment teams and a transportation system for staff to cover these centers. It was our intent to continue staffing those centers until the end of our second week in Houston.

However, Hurricane Rita changed those plans.  Once Houston was identified as a possible “target” of Rita, plans were made to move all remaining Katrina survivors in shelters out of the region or state completely. Since the sheltered survivors were no longer present (even though there were tens of thousands living in private housing or hotels), a mutual decision was made to bring our medical team home on Friday — two days early.

We faced some challenges getting all of our people out in advance of the storm — some of us spent more than 20 hours on clogged Texas freeways in an effort to catch a flight home to San Diego from Dallas when it became impossible to fly out of Houston in time. Thankfully, we had everyone back in San Diego on Friday, September 23, before Hurricane Rita hit the Texas and Louisiana coast the next day.

Scripps’ involvement in this massive humanitarian effort was possible largely through a change in how the federal government works with private healthcare organizations during a disaster. Each member of the Scripps team was sworn in and federalized as non-paid federal employees in the presence of Houston Mayor Bill White. In doing so, the team in its unified structure reported to the U.S. Public Health Service. As federal employees we received insurance and liability coverage, housing and travel costs provided by the federal government. All other expenses were paid by Scripps or by the volunteers themselves.

It was a huge honor to be one of two healthcare providers (Kaiser Oakland provided physicians to staff community clinics) asked to provide medical care in Houston to hurricane victims, and it was even more of an honor to be able to help so many people who desperately needed our assistance.

The duties of SMRT changed as the trip progressed, going from a standing clinic to more of a mobile operation with medical staff traveling throughout the Houston area providing assistance where needed, but the underlying mission never changed. Our team provided expert and compassionate care for thousands of hurricane victims, and they did so in such a professional manner.

While only 60 members of SMRT were sent to Houston, the success of our mission was the result of the support we received from every member of the Scripps family. Whether it was sending us words of encouragement, covering a shift for one of their coworkers on SMRT, or helping us continue to carry out our work in San Diego, this was truly an organizational effort.

It is too early to know what the future of this disaster relief model will be, but we already have been asked to provide formal feedback for the California Hospital Association and the U.S. Surgeon General. In the coming weeks and months, we will analyze the process, evaluate our performance, and make recommendations that could become the foundation for a new method of tapping into the private healthcare sector in response to local and national disasters. Healthcare providers — hospitals and physicians — are among the first responders in any disaster. Having a more clearly defined role and structure for how we respond could improve response times and effectiveness, which ultimately will save lives.

A card one of our team members found on the floor of the Houston convention center after the last families were evacuated from that shelter summed up why Scripps was there. On the front the card read, “Have hope” and inside were the words, “Help is on the way.”