When Hurricane Katrina demolished the medical infrastructure throughout the Gulf Coast, it left a yawning gap in America's health care system. Without functional physician clinics or hospitals, disaster survivors were left with virtually no medical care.
Enter family physicians. Without reliance on institution-based technology, structure or procedures, family physicians brought with them the community-based experience to organize a postdisaster health system, the medical expertise to triage patients to hospitals and the primary care focus to meet most hurricane evacuees' immediate needs.
Medical Clinic Augments Red Cross Response
By Leslie Champlin
11/15/2005
An umbrella bag stand serves as an IV stand and cots serve as examination tables in a makeshift Baton Rouge, La., medical clinic where family physician Joseph Stallings, M.D., and others care for evacuees of Hurricane Katrina.
"We offered an aspect of care that not even emergency physicians are comfortable with," said Joseph Stallings, M.D., director of the Area Health Education Center Northeast Family Practice Residency Program, Jonesboro, Ark.
He should know. Joined by family medicine residents Brad Bibb, M.D., and Shane Speights, M.D.; Rhonda Irving, R.N.; Angie Riggs, L.P.N.; and third-year medical students Vernon Brewer and Sarah Woodruff, Stallings traveled from Jonesboro to Baton Rouge, La. There, the group helped oversee medical care for some 5,000 evacuees at a shelter established by fellow family physicians Tommy Wagner, M.D., of Manila, Ark.; Drew Dawson, M.D., of Pocahontas, Ark.; and Chris Montgomery, M.D., of Poplar Bluff, Mo., in the local convention hall, River Center.
"I didn't realize that (the American) Red Cross provides only shelter and food," said Stallings. "They don't provide medical care or clothing. It's not their policy to have a medical clinic attached to Red Cross shelters."
During the following three weeks, the group helped fill that medical care gap, refilling prescriptions for chronic conditions, treating hurricane-related and post-hurricane injuries and illness, and triaging patients with serious medical needs to hospitals sometimes hundreds of miles away.
The clinic established an isolation unit in a large janitor's closet, "which was perfect because it had a sink with running water and a concrete floor" that could be easily sterilized, said Speights . The staff reserved a "hospital" area for patients who needed more intensive nursing and a "long-term" area for elderly patients who would have trouble living in the main convention center arena.
He should know. Joined by family medicine residents Brad Bibb, M.D., and Shane Speights, M.D.; Rhonda Irving, R.N.; Angie Riggs, L.P.N.; and third-year medical students Vernon Brewer and Sarah Woodruff, Stallings traveled from Jonesboro to Baton Rouge, La. There, the group helped oversee medical care for some 5,000 evacuees at a shelter established by fellow family physicians Tommy Wagner, M.D., of Manila, Ark.; Drew Dawson, M.D., of Pocahontas, Ark.; and Chris Montgomery, M.D., of Poplar Bluff, Mo., in the local convention hall, River Center.
"I didn't realize that (the American) Red Cross provides only shelter and food," said Stallings. "They don't provide medical care or clothing. It's not their policy to have a medical clinic attached to Red Cross shelters."
During the following three weeks, the group helped fill that medical care gap, refilling prescriptions for chronic conditions, treating hurricane-related and post-hurricane injuries and illness, and triaging patients with serious medical needs to hospitals sometimes hundreds of miles away.
The clinic established an isolation unit in a large janitor's closet, "which was perfect because it had a sink with running water and a concrete floor" that could be easily sterilized, said Speights . The staff reserved a "hospital" area for patients who needed more intensive nursing and a "long-term" area for elderly patients who would have trouble living in the main convention center arena.
Brad Bibb, M.D., a resident in the Area Health Education Center Northeast Family Practice Residency Program, Jonesboro, Ark., gathers patient care supplies at the makeshift clinic.
Being family physicians, we treated everything," said Bibb. "We had gastroenteritis in three kids who had to be isolated. We could just see 5,000 people with gastroenteritis."
About 15 women required prenatal care. One developed serious hypertension and abdominal pain.
"We were working to get her stabilized, and we decided she needed to get to the hospital," said Bibb. "The paramedics said it would be five to six hours before they could get an ambulance. We pointed out that if she developed a ruptured placenta and bled to death and the baby died, that would be very bad. The paramedic said an ambulance would be there in five minutes."
Unlike a stable community's patient census, the population at the River Center shelter turned over dramatically every few days as families moved to temporary housing and new evacuees replaced them.
"Every day, a certain percentage of the population we saw were new" to the shelter, said Bibb. "We would see several hundred people every day."
And when they weren't in the clinic, the doctors cruised through the convention center, serving as public health officers on the lookout for sick evacuees who might not otherwise seek medical care.
"Dr. Stallings loved taking medical students and roaming around the center," recalled Bibb. "It provided a calming effect on the people, knowing a physician was walking around, checking everything out."
And, the physicians agreed, the evacuees appreciated the effort.
"You could see the thank-yous in their eyes," said Stallings.
About 15 women required prenatal care. One developed serious hypertension and abdominal pain.
"We were working to get her stabilized, and we decided she needed to get to the hospital," said Bibb. "The paramedics said it would be five to six hours before they could get an ambulance. We pointed out that if she developed a ruptured placenta and bled to death and the baby died, that would be very bad. The paramedic said an ambulance would be there in five minutes."
Unlike a stable community's patient census, the population at the River Center shelter turned over dramatically every few days as families moved to temporary housing and new evacuees replaced them.
"Every day, a certain percentage of the population we saw were new" to the shelter, said Bibb. "We would see several hundred people every day."
And when they weren't in the clinic, the doctors cruised through the convention center, serving as public health officers on the lookout for sick evacuees who might not otherwise seek medical care.
"Dr. Stallings loved taking medical students and roaming around the center," recalled Bibb. "It provided a calming effect on the people, knowing a physician was walking around, checking everything out."
And, the physicians agreed, the evacuees appreciated the effort.
"You could see the thank-yous in their eyes," said Stallings.
