BATON ROUGE, La. -- "One look and you could tell she was in bad shape," said Kathy Kobus, a captain with the U.S. Public Health Service (USPHS). "She wouldn't have come to us at all, but she heard we were providing free medical care."
Captain Kobus is working from FEMA's Mobile Emergency Medical Unit in Belle Chasse, Louisiana. The semi-trailer unit, which can arrive at a disaster and provide patient care in as little as one-and-a-half hours, is equipped with wireless x-ray and cardio-monitors, a minor-surgery bay, a pharmacy and enough bed space to examine 12 patients at once.
"We got the woman stabilized but her condition was more than we were equipped to handle. Her kidneys and liver were failing," continued Kobus. "We quickly made arrangements to transport her to the nearest hospital, but she wouldn't go. She said she couldn't afford it - the disaster had left the family without money and they had no health insurance. Her husband was pleading with her. She was deteriorating fast but wouldn't get in the ambulance."
A quick thinking staff member got on the phone and found a hospital that would treat her free of charge. Only then did the woman agree to get in the ambulance.
Weeks later she was back at the mobile clinic. Looking much better this time - she just wanted to tell the staff, "Thank you. You saved my life."
The story that Kobus described took place months after Hurricane Katrina hit the vicinity. It illustrates the importance of getting health care into a disaster area and keeping it operational until local medical infrastructure can be restored. Not only had much of the region's health care capability been interrupted by wind and flood waters but so were area businesses. Even if facilities were available, the loss of jobs had crippled many residents' ability to afford treatment.
"This is a critical service to a suddenly cash-strapped populace," said Maria Chansky, a civilian volunteer with the medical unit. She is a family physician from Colorado who put her private practice on hold to come help out in Louisiana. She points out that a disaster strains an area financially and physically. "People are under a great deal of stress and their immune systems are weak. The slightest illness can turn into something much more. There's no such thing as a little cold around here."
The first FEMA Disaster Medical Assistance Team (DMAT) to arrive in the area after Katrina was seeing 60 to 70 patients a day. The DMAT was replaced by the present mobile unit in January and it is still seeing 40 to 50 people daily. That includes 2 or 3 x-rays for fractures. Processing that number of less severe cases also takes a huge workload off medical facilities that did survive the disaster, allowing them to care for more serious injury and illness.
One of the mobile unit's regular visitors is a fireman who frequently drops by for bandage changes on an existing injury. This saves him from long waits at a crowded hospital and keeps him on the job. That's no small consideration in a region where emergency responders are so desperately needed.
As more and more FEMA-provided temporary housing units arrive, evacuated residents are returning to the hardest hit vicinities. These large regions of destruction and debris can present hazards that make the clinics even more essential. As a result a new clinic is being set up 35 miles south of the present site.
The new health center is in Port Sulfur. It's the heart of some of the worst damage the hurricane produced. It sits in a 45 mile stretch with virtually no habitable houses or buildings. The town of Port Sulfur is totally destroyed. Most homes are not even recognizable as houses - just twisted piles of debris. There are so many cars in ruins, the area looks much like an auto salvage yard.
The facility is located be...