They were off before the storm even hit, gathering in Anniston, Ala., as Hurricane Katrina moved toward the Gulf Coast on Aug. 28, then came through with devastating fury: 33 doctors, nurses, paramedics and other health care professionals ready to help the victims.
This is what the Rhode Island Disaster Medical Assistance Team (DMAT) does. It heads out into uncertainty with just enough supplies to be self-sufficient for 72 hours, and enough materials to handle any medical mission, whether it’s treating heart attacks, or giving tetanus shots.
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They never know exactly what they’ll be asked to do, or where. Like DMAT teams from across the nation, they mobilize, then wait for their orders. In this case, they moved to Camp Shelby, Miss., then to Baton Rouge, La., before heading into New Orleans.
A California team had been forced to clear out of the Superdome due to violence and turmoil, but that Thursday morning, the Rhode Island team was asked to set up a new clinic. Deputy Commander Tom Lawrence, a paramedic who heads the Rhode Island Emergency Medical Services for Children Program at Hasbro Children’s Hospital, was the first one in.
“Three of us went with federal police,” he said. “We had to trudge through four feet of water.”
Things had calmed down, and still accompanied by armed federal police and National Guard officers, the team – which by then had grown to 35 volunteers – set up shop about 20 yards outside the Superdome. Every patient was searched for weapons before entering; even New Orleans police officers were disarmed, much to their dismay, Lawrence said.
But all the precautions paid off: The team worked safely in the heart of the disaster for three days, Lawrence said, until the last hurricane victims were evacuated.
“I never felt I was in danger,” Lawrence said. “The federal police and the military ensured our safety all the time. … There was one occasion with some gunfire just outside our clinic, and the police formed a perimeter and had us back up into a hallway,” but then they returned to work.
But safety from gunfire doesn’t mean they were sheltered. The filthy conditions that plagued the hurricane victims were no better for the DMAT members – they too had no running water, no electricity; they too were surrounded by the stench of human waste and foul water.
Many DMAT members were at the World Trade Center after the Sept. 11 attacks, and they’ve served at the scene of a major ice storm. Still, the Gulf Coast “was as bad as we’ve ever seen or even imagined,” Lawrence said. “We think about this happening in other countries. We never think of it happening here.”
Two DMAT members had to be hospitalized with gastrointestinal illness, Lawrence said. And the stress of the situation took a toll on all of them, even with a counselor traveling with them.
It was the patients, however, who shocked and saddened them most. They treated “a couple” of gunshot wounds, and some trauma from fights, Lawrence said, but mostly they treated people with diabetes, heart problems and other chronic illnesses that had gotten much worse from lack of medicine, from the heat and the foul conditions.
“A lot of these people were at risk anyway, because they hadn’t had opportunity to have very good medical care in their lives, and as a result they were much more fragile,” he said. The team also treated “a lot of people who had been in the water for days and days,” Lawrence said, and who were developing severe foot problems, skin infections and worse.
“There’s some unique diseases here,” Lawrence said. “Some people won’t survive. Some will get diseases from the water and the environment, and they won’t be able to survive.”
The DMAT left the Superdome that Saturday night, after the last victims had been evacuated. They regrouped in Baton Rouge for one night, then headed to Metarie, La., a small town about halfway between the French Quarter and the New Orleans Airport.
No hospital in Orleans Parish was open and accepting patients, Lawrence said, but Jefferson General Hospital, which hadn’t been flooded, had done “a remarkable job” of maintaining its own infrastructure, restoring power and running water – though not potable water.
The DMAT stepped in to help the hospital staff, who were exhausted from working nonstop, this being one of the few operational hospitals around. Some of the Rhode Island nurses went to work on the floor, and two pharmacists began filling out prescriptions and mixing medications. Paramedics and emergency medical technicians helped the local EMT service, enabling them to provide advanced life support, not just basic.
Then, after the initial crunch was over, the DMAT set up tents outside the building and began immunizing people – first the hospital staff, then the general public – against tetanus and hepatitis A and B. Over two days, they immunized about 1,500 people, Lawrence said.
When they were finished, they headed to Baton Rouge again, where they were demobilized. They’d served two weeks, the standard DMAT mission, Lawrence said. Other DMATs would take their place. They drove to Houston and came home – though several, including Lawrence, soon joined their colleagues providing medical services to evacuees now in Rhode Island.
But they’re still shaky. It was a deeply emotional time; Lawrence, whose wife, Cheryl, is part of the team, said her company “made a world of difference” to him, and yet he too lost his composure and cried when a grateful patient hugged him.
“I think the team felt, justifiably, very satisfied with the help we’ve been able to render to people who really needed it and who really appreciated it,” he said. “But emotionally, there may be some issues. We’ll probably do a critical incident stress meeting – just to talk about things informally – sometime over the weekend.”
