Hurricane Katrina

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

2. 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

3. Hill County, MT

4. 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.

5. Disaster Health Services Protocols

6. Personnel Roster

7. Red Cross Report

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

9. Houston to Baton Rouge

10. 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

11. 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

12. Staging: Baton Rouge Aug 31 Baton Rouge – 12:00 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

13. 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

14. First Assignment 3:15 pm Asked for assignment to Denham Springs Jr. High School in Denham Springs. Waited for car and supplies. 5:00 pmLeft Baton Rouge 6:15 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

15. 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

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

17. Ministerial Response Aug 31Revival Temple – Arrived 8:00 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

18. 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

19. 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

20. 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

21. 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

22. Next assignment Sep 4Left Revival Temple 2:00 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

23. Baton Rouge to Monroe

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

25. 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.

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

27. 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

28. 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?

29. 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?

30. 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

31. 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

32. 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

33. 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?

34. 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