LOUISIANA: Assessing Gustav's Impact on Partners
Direct Relief USA Program staff members Katie Lewis and Amy Fox visited Louisiana health centers and clinics following Hurricane Gustav to assess damage and existing needs. Below is there report from September 2008.
September 15
We spent our first day in New Orleans at the National Association of Community Health Centers (NACHC) annual conference. In addition to attending seminars, we met with our partners at NACHC and Cardinal Health. Thanks to John Lamb from NACHC, Lance Hengst from Cardinal, the technology of Blackberry and the Internet, and our headquarters staff we were able to send eight shipments of hurricane emergency aid to Texas and Louisiana.
September 16
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. Every 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 provide the care these patients needed.
September 17
We traveled about 60 miles northeast of Baton Rouge to visit Ginger Hunt, CEO at the RKM Primary Care Clinic in Clinton, a very rural part of the state. RKM, which opened in March 1999, is one of the newer buildings in the area. It operates six clinics throughout four parishes and treats about 75 patients a day. With some minor roof leaks at two of their sites, RKM escaped major damage from Hurricane Gustav. Running on a generator, the clinics were able to stay open 24/7 following the hurricane.
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.
September 18
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.
September 19
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.
Posted by Allison Joyce at 09/23/2008 09:42:38 AM