Hurricane Gustav took its toll on St. Charles Community Health Center, just outside New Orleans, which we visited on our last day. The main clinic was spared, but the Behavioral Health/Podiatry/Administration building across the street sustained severe structural damage. The roof was picked up, causing leaks and water damage and the fire escape was torn from the building and destroyed. The building is uninhabitable, so the departments housed in that building had to move into the main facility. Behavioral Health now occupies the kitchen and psychiatry appointments take place in IT offices or empty treatment rooms. Repairs will take four to six weeks. Julia Bodden, Community Outreach Coordinator, told us that St. Charles closed for a week after Gustav because of a power outage. When they reopened, the clinic saw about 45 additional patients a day from surrounding parishes. Its mobile unit was sent to the food-stamp line to treat people waiting in line in extreme heat and humidity.

We also met Maria Rivas and her young daughter. Ms. Rivas was one of the first patients to go through St. Charles’ Pregnancy Program, started nearly two years ago with Direct Relief grant funds. She has served as an advocate for St. Charles among the area’s growing Hispanic community.

This morning we met with Emma Tanner at Capitol City Family Health Center in Baton Rouge. Capitol City moved into a beautiful new facility last December, where it offers primary care, dental services, HIV counseling/testing, immunization, mental health, lab testing, and nutrition education services. If a patient comes in for something like stitches, he can meet with a dentist, complete lab work, or talk with a social worker all in one visit. The clinic closed for a few days after Gustav and sustained minor roof leaks; most patients following the hurricane needed medication for chronic illnesses. Ms. Tanner said that Capitol City patients are often late to or miss appointments because they can’t afford transportation to the clinic.

Back in New Orleans, we met with Mary Crooks at the Community Outreach Center at EXCELth, Inc, at its corporate office downtown. EXCELlth operates four clinic sites and four mobile units throughout New Orleans. Adequate facilities are the biggest challenge facing EXCELth’s clinics, which all experienced power outages after Gustav, though only the Algiers Clinic had roof leaks. With Ms. Crooks, we toured one of the mobile sites, a bus with one treatment room and a triage area. EXCELth sees many patients through its mobile clinics, which allow them to reach new patients. When a patient can’t make it to a clinic, EXCELth brings the clinic to the patient.

At the end of the day, we visited St. Thomas Community Health Center, housed in a two-story brick building from the early 1900s. In a predominately poor, African American community, the clinic serves about 150 patients a day. This number grew significantly after Katrina. Dr. Donald T. Erwin, president and CEO, requires that all his staff attend a seminar titled “Undoing Racism,” because he feels that the only way to truly help the community is to understand its background.

St. Thomas offers a variety of programs. It partners with the Isaac Stauffer Memorial Eye Clinic to offer free eye exams and glasses for the uninsured. It also owns a mammography machine and provides comprehensive exams for women. The only area clinic to offer cardiology testing, St. Thomas conducts testing on-site and refers patients who need advanced treatment to a hospital. Dr. Erwin, like most of the people we met in Louisiana, believes that the catastrophe of Katrina revitalized altruism in a lot of people. Before the hurricane, the healthcare system throughout Louisiana was in dire straits and Katrina wiped the slate clean so the system could be rebuilt.

Ms. Hunt says that RKM prides itself on its quick and friendly service. In the waiting room, we spoke with a mother and daughter in to see a doctor about a foot injury. Both mentioned that the staff was much nicer at RKM than at the private practice and that the service is always faster. Of the more than 20,000 patients RKM sees each year, 26 percent live below the federal poverty line, 7.4 percent are unemployed, and 32.9 percent don’t have a high school education.

We moved on to St. Helena Community Health Center in Greensburg, another very rural, poor area. We spoke with Henrietta Spears, interim executive director of St. Helena, which serves more than 40,000 patients annually, 75 percent of whom are under- or uninsured. While the clinics weren’t damaged in the hurricane, they were closed for two days due to lack of power, water, and gas. A major obstacle for St. Helena is getting patients to come in to the office. Homes are sometimes more than 20 miles apart and residents are unable to afford transportation to the clinic. Many of St. Helena’s staff have lived in the area their whole lives and know the people they treat. Staff members often stop by patients’ homes after hours to make sure they have their medications or to bring food that patients wouldn’t be able to buy.

RKM and St. Helena serve similar populations and see the same problems. At both, many patients post-Gustav came in seeking mental health treatment. Depression and anxiety are common but spike after hurricanes. Fortunately, both health centers employ psychologists and social workers to provide treatment.

We toured New Orleans’ Lower Ninth Ward in the morning, where much of the devastation from Katrina is still apparent. Crossing the Industrial Canal, we could see the newly constructed levees. It wasn’t hard to imagine how, with enough water, the canal could overflow into the nearby neighborhoods. We passed row after row of destroyed city blocks. Windows and doors were boarded up and spray painted with Xs, used as a marker during Katrina to identify the number of survivors and the number of deceased. Roofs were caved in, and walls were completely missing as many of these homes have remained untouched since 2005. Now and then we came across a home that had been rebuilt. Despite all the demolition, people remain in the Lower Ninth Ward as homes are renovated one by one.

Our next stop was the St. Gabriel Eastside Community Health Center, in St. Gabriel, outside Baton Rouge, where we met with Phyllis Adams, chief executive officer. St. Gabriel sustained minor wind damage from Hurricane Gustav; part of the roof was blown off, destroying some of their immunization stock. Luckily, insurance will cover the roof damage, and the State of Louisiana will replace the spoiled medication. St. Gabriel closed for four days after Gustav due to lack of power. The center received a generator from a local church and ran the clinic with minimal lights and no air conditioning. Most of the patients the clinic saw in those early days suffered from depression, hypertension, and asthma, and many needed medications for chronic conditions. A social worker and a psychologist on-site worked with the medical director and nurses to care for these patients.

The $150,000 Direct Relief pledged earlier this week to the National Association of Community Health Centers (NACHC) will be used first to help health centers buy the essential medicines they need to treat the influx of patients, and second, to help clinics rebuild and recover. With at least one health center completely flooded, funds for rebuilding are critically needed.

Gwen Laury, managing the disaster response efforts for the Louisiana Primary Care Association, is in Baton Rouge, where emergency shelters are “filled to capacity,” caring for a large influx of special needs patients evacuated from regional hospitals without power. Reports indicate that in some parts of the state, it may take two weeks for power to be restored.

The LPCA runs 22 health centers with 44 clinical sites in Louisiana. Tomorrow, Direct Relief is sending medical aid shipments, including first aid materials, antibiotics, medicines for chronic conditions, and personal care products to help treat evacuees. Health centers are operating around the clock, which requires additional funding for staff—a challenge for cash-strapped centers treating large populations of uninsured patients.

RKM Primary Care in Clinton, Louisiana, is the only clinic open in Feliciana Parish, reports Leslie Matte, RKM’s director. “We are also providing 24-hour care due to power outages at area hospitals,” Matte reported Tuesday. “Lane Regional Medical Center was evacuated today due to generator problems; Oschner Medical Center was evacuated due to damage. West Feliciana Hospital and Field Memorial Hospital in Centreville, Mississippi are running on minimum generator power.”

“RKM is housing Acadian Ambulance Service and we are triaging and stabilizing all patients brought in until they can be transported to a surrounding hospital when available,” Matte said. “East Feliciana Parish is also evacuating families due to flooding. We are working hard on minimum supplies and equipment to help whoever walks through the door.”

Direct Relief domestic programs staff remains in constant contact with partners in Louisiana and Mississippi to identify needs as they emerge.

“We think it’s important to make these funds available so that safety-net clinics and community health centers can ramp up their operations,” said President and CEO Thomas Tighe. “These nonprofit facilities have no financial cushion to absorb an influx of patients or financial losses caused by emergencies like this; they may need to procure items locally that are needed immediately, pay for extra staff, or finance other short-term concerns.”

Direct Relief is coordinating with the National Association of Community Health Centers and State Primary Care Associations in the Gulf, as well as with individual clinics – all of which Direct Relief has worked with on an ongoing basis since Hurricane Katrina struck three years ago.

In addition to cash resources, Direct Relief has already placed medical material aid into the region. In July, the organization delivered 18 hurricane preparedness packs to locations along the Gulf Coast in advance of possible hurricanes in the late summer and early fall months, and Friday sent three additional shipments of medical supplies to alternate care sites in Louisiana operating at evacuation sites. Long-time corporate donors including Abbott, BD, CVS, Johnson & Johnson, Matrixx, and Miltex have given their product for use at these sites, and FedEx has generously donated transportation services.

Additional infusions of medical essentials will be provided as necessary to help meet demand. Direct Relief possesses about $60 million (wholesale) in standing medical material inventory at any given time at its headquarters in Santa Barbara, California that can be focused on helping the people of the Gulf Coast.

Members of the public wishing to support Direct Relief’s activities for Hurricane Gustav may donate to the Hurricane Preparedness & Response fund online at DirectRelief.org, by phone at 805-964-4767, or by mail at the address on the website. Every dollar donated to this fund is used exclusively for programs assisting healthcare for people affected by hurricanes, not for fundraising or administration.

Today, shipments of specifically requested emergency medical materials were sent to:

• David Raines Community Health Center of Shreveport, Louisiana;
• Morehouse Community Medical Center of Bastrop, Louisiana; and
• Primary Health Care Services of Monroe, Louisiana.

Their contents included basic first-aid materials, antibiotics, personal care products, and supplies for diabetics valued at a total of $13,000 for all three shipments. All three clinics are operating alternate care sites at shelters in their respective areas. More shipments will be planned as necessary to help meet clinic demand.

These materials were generously donated by Abbott, BD, CVS, Johnson & Johnson, Matrixx, and Miltex. FedEx is transporting the materials to the recipients overnight free of charge. With the Labor Day holiday weekend fast approaching in the U.S., swift response was key in determining partner needs today.

To supply partners for the hurricane season, Direct Relief delivered Hurricane Preparedness Packs in July to the Dominican Republic and Jamaica, as well as domestically in the states of Alabama, Louisiana, Mississippi, and Texas. The packs, which contain enough materials to treat 100 patients for a range of conditions for a 72-hour period, were developed after careful analysis of the healthcare conditions following Hurricanes Katrina and Rita, which struck the Gulf three years ago today.

In the three years since Katrina and Rita, Direct Relief has supported safety-net clinics and community health centers along the Gulf Coast with $47 million in medical material aid and $4.6 million in cash assistance.

Direct Relief has also contacted five of its partner groups working in the Dominican Republic and Haiti to offer assistance. Before reaching hurricane strength, Gustav flooded Haiti and caused landslides in the Dominican Republic, killing at least 59 people in its wake. Standing water, combined with a displaced population, could lead to significant public health issues.

“Standing water creates a breeding ground for a range of diseases, including those that cause severe diarrhea, which can be deadly if untreated,” said Emergency Response Coordinator Brett Williams. “We saw a similar situation arise after Cyclone Nargis struck Myanmar in May.”

As with all its emergency response efforts, Direct Relief is communicating frequently with healthcare partners treating people affected by Gustav to deliver the most effective aid possible, both in the U.S. and in the Caribbean.

As needs are identified with local partner organizations in country, Direct Relief will deliver requested medical aid to Haiti, where Gustav has caused extensive flooding and 51 deaths. Landslides in neighboring Dominican Republic, which shares the island of Hispaniola, have killed eight people. Packing winds of 70 mph and building toward hurricane strength, Gustav is winding its way over Jamaica and is scheduled to make landfall along the U.S. Gulf Coast by Tuesday.

In July, Direct Relief delivered Hurricane Preparedness Packs to its partners in the Dominican Republic, Jamaica, and the U.S. Gulf States of Texas, Louisiana, Mississippi and Alabama. The packs, which contain medical materials to treat 100 patients for a range of traumas and conditions for a 72-hour period, were developed after careful analysis of the health conditions and lack of available medications to treat them following 2005’s Hurricanes Katrina and Rita.

Direct Relief provides humanitarian assistance on an ongoing basis to charitable health facilities in Haiti, Jamaica, and other Caribbean nations. Personal care supplies, antibiotics, analgesics, and first-aid materials are among the most commonly supplied items. Direct Relief has been providing assistance in Haiti since 1964; since 1989, it has delivered $77.5 million (wholesale) in medical material aid.