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State disease chief
Two weeks of treating Hurricane Katrina victims in a Louisiana emergency shelter convinced state Department of Health epidemiologist Paul Effler that "we need to look at all the vulnerabilities that exist here."
Effler, chief of the state Disease Outbreak and Control Division, joined one of 50 Disaster Medical Assistance Teams from several states called to the disaster area. He returned Saturday after serving with an Ohio team at a suburban shelter about 40 miles north of New Orleans.
The Covington High School shelter was set up to house patients evacuated from nursing homes and a hospice. But, Effler said, "we saw all comers," as other evacuees from the flooded city were brought for help. After the first days of 24-hour shifts, the team members worked 12 hours at a time.
"At 2:30 one morning, a busload of seriously ill people was transported in," Effler said yesterday at a news conference. The team treated people with infections, lacerations, animal bites and existing health problems, such as breathing and nervous disorders that worsened because of the disaster conditions.
"People who had lost everything broke down crying; we provided an ear to listen to them," he said. "My impression was that they were poor. Chronically ill people tend to be poor, receiving inadequate treatment. They came in with no ID, no money. We had to refer them to other agencies for help, which made it difficult."
"There were medically fragile people who are used to being in their homes or in nursing care, now transferred into sleeping on cots in a crowded gymnasium," he said.
Patient No. 1,003 was treated on Effler's last watch at the shelter Friday.
Effler said he expects that he and the nine-member Hawaii medical "strike force" that will return Thursday from a two-week deployment in Louisiana will use their experiences to bolster local plans for response to disasters.
"It had not been on my radar that there are homebound ill and fragile people we need to plan for," Effler said.
Another lesson for local planners comes from the flooding that stranded New Orleans residents. "Do we have areas we would not be able to reach for days?" he asked.
He said Hawaii's Disaster Medical Assistance Team was "just reconstituted a month before Katrina," and it is far short of participating medical professionals to qualify as a Level 1 team in the DMAT system funded by the Federal Emergency Management Administration. Usually a 35-person team is deployed. "We need volunteers to be three deep so we can fill the positions," he said. Prospective volunteers can find information online: www.dmat-hawaii.org.
"We want to have a fully operational DMAT," Effler said. "We need to recruit more physicians, nurses and medical technicians. Ideally the Hawaii team would be deployed to serve if disaster strikes another U.S. position in the Pacific."
Effler declined to analyze the overall federal response to the disaster. "We didn't get any more information than the public was getting. There will be a lot to analyze when all the pieces of information are put together. As to whether there was sub-optimal response, most have concluded there was not," he said.