This past September, doctors, nurses, and other health professionals from all over the United States went to New Orleans to assist in the aftermath of the greatest natural disaster to ever hit the United States, Hurricane Katrina. Representing The Brooklyn Hospital Center (TBHC) were Dr. Irizarry, Chairman of Emergency Medicine Department, and Dr. Raymond Harvey, from the Department of Family Practice.
Dr. Irizarry is currently on deployment for Hurricane Rita DMAT NY-2 (Disaster Medical Assistance Team) as its Chief Medical Officer. He was dispatched by Federal Emergency Management Agency (FEMA) in response to Hurricane Katrina, and is currently assigned to West Jefferson Medical Center . According to Dr. Irizarry, "The function of DMAT is to provide acute medical care for the vaccination/innoculation process (primarily for Tetanus and Hepatitis A & B) to treat the citizens of New Orleans . We are one of the many teams that have been dispatched to New Orleans , where we see on average approximately 1,200 - 1,500 patients per day. We are one of six "level-one" DMAT teams in the country, and one of the largest DMAT teams. A "level one" team means that we are fully self-sustainable - we have our own medical supplies, operative supplies, food and water. Our team has a very rapid response rate; we responded in 4 ½ hours to Hurricane Katrina."
The National Disaster Medical System (NDMS), under the direction of the U.S. Department of Homeland Security and FEMA, fosters the development of volunteer teams, called Disaster Medical Assistance Teams (DMATs). A DMAT is a group of professional and paraprofessional medical personnel (supported by a cadre of logistical and administrative staff) designed to provide emergency medical care during a disaster or other event. DMATs are principally a community resource available to support local, regional, and State requirements. However, as a National resource they can be federalized to provide interstate aid. Dr. Irizarry has been a member of the DMAT team for approximately two years. To date, DMAT teams have treated over 115,000 patients in various field hospitals, clinics and other medical sites in response to the aftermath of Hurricane Katrina.
As is the case with any catastrophic situation, there have been many obstacles for the medical teams during their trips to the disaster areas. According to Dr. Irizarry, "We have faced major obstacles in New Orleans regarding our day-to-day living environment. Because the water supply was contaminated, we brought down a water filtration system along with bottled water. Our sleeping accommodations were compromised also, so we slept wherever we could set up our cots. It is certainly exhausting work - our clinics are functioning twenty-four hours a day, providing fully functioning pharmaceutical care, acute medication and chronic care for patients. Because the environment can become very stressful for the medical staff, we are grateful to have a member of our team who is trained in Critical Incident Management and mental health issues to assist our team. They are able to provide us with counseling to work with us through our day-to-day concerns, and help our team to cope on an emotional level".
Looking ahead, Dr. Irizarry said that the DMAT groups would continue to be called upon throughout the nation for help. "We will have to be intermittently deployed on a rotating basis so that we can continue to aid in the recovery efforts. There are still parts of western Louisiana and Texas where 40%-50% of the communities are still without power".
However, when asked to describe the positive experiences he has had, Dr. Irizarry explained (with regard to DMAT), "There is an exceptional quality of function and training on this team, with members from NY, NJ and Connecticut . We have the capability to provide immediate medical care once we are dropped off at a site - this allow us to assist the population to the best of our abilities, and that, in turn, has been a very positive experience for us as a team."
Dr. Harvey reported to the Emergency Operations Command Center in Baton Rouge , Louisiana , at the Jimmy Swaggart Center on September 4, 2005 . His first assignment was a 12-hour shift at PMAC ( Pete Maravich Assembly Center ), a sports arena located on the campus of Louisiana State University and operated by the Illinois Medical Emergency Response Team in cooperation with local officials. The facility included x-ray machines, laboratory access, a fully functioning ICU, a full range of specialists, from nephrologists to orthopedic surgeons, and a fully stocked pharmacy and pharmacists to run it. "The Illinois team did a tremendous job in a very short time. This should be looked at as a model for future disasters," explained Dr. Harvey.
Dr. Harvey described the group's experience, explaining, "The staff we had was perfect for a family practice-style clinic, and it was a very similar arrangement to what we have here at The Brooklyn Hospital Center. We were able to establish and maintain record keeping, write prescriptions, dispense medication, and give immunizations. We saw patients 24 hours a day who were suffering from skin rashes, dehydration, heat exhaustion, athlete's foot, severe diarrhea, and other ailments associated with a disaster of this kind. This was a simple clinic, and at times very stressful. However, we were glad to provide comfort to the people we saw, and maybe even make them laugh a little bit."
Ten days after the hurricane, Dr. Harvey and Gail Ciesielski, RN from Lawrence , Kansas had an opportunity to assist in a boat evacuation. Said Dr. Harvey, "Some of the survivors didn't need our help, but others were in a badly weakened state, especially the elderly. One of the victims - a cardiac patient who was completely dehydrated - required immediate attention, so we administered IV fluids right in the boat. The water engulfing New Orleans is full of sewage and debris, making it very dangerous for people who are still stranded in their homes."
In retrospect, Dr. Harvey said, "I was fortunate that I had the opportunity to help, because I know a lot of people wanted to take part in the recovery efforts. This is only the beginning - many people are going to need assistance for a long time. Now comes the hard part."