Hurricane Dorian has spent the week cutting an unpredictable path through the Caribbean, leaving scientists guessing about both its strength and final destination. Current forecasts predict that the storm will crash into Florida as a Category 4 hurricane, potentially lingering over the state’s eastern coastline.
And across Florida, health centers and clinics are gearing up to meet the storm.
Over the past few years, Florida has been hit by a succession of major hurricanes: Matthew, Irma, and Michael, which struck during the past three hurricane seasons.
“We’d had hurricanes and tropical storms, but not to the extent of Irma and Michael and Matthew,” said Angie Lindsey, a professor who studies disaster response and recovery at the University of Florida. “I think the past three years have made Floridians a little more aware.”
“We’ve Got to Focus on Being Up and Open”
That awareness has helped healthcare organizations shape a hurricane response that’s more and more focused on advanced planning: Setting up makeshift clinics before a storm arrives. Storing temperature-sensitive medication in a refrigerator with a backup power source. Working to avoid damage before it hits.
For Federally Qualified Health Centers, “our mission is to provide services to the community, and to do that, we’ve got to focus on being up and open” as soon as possible after the storm, said Tom Knox, Director of Emergency Preparedness and Education Programs at the Florida Association of Community Health centers.
Knox explained that, in the days after a disaster, medical care can be hard to access. Doctor’s offices frequently close – and sometimes, they never open again. The job of getting medical care to people who are injured or who need medication or supplies often falls to public healthcare organizations, which may have their own damage to contend with.
That’s why Knox urges the centers he works with to focus on personal preparedness steps – having a well-developed emergency plan, putting a backup generator in place – that can help an organization rebound more quickly.
“By preparing, you’re showing your people you care about them and you’re running an effective medical organization,” he said.
Health centers and clinics are rising to the challenge.
“We’re Pretty Calm Here”
Anna Ferguson, the Chief Nursing and Operations Officer at Camillus Health Concern in Miami, was breathless when she answered the phone.
Camillus, she explained, was in the middle of transporting medical supplies, coordinating with a local hospital, and making sure that high-risk patients had plenty of medication.
“We’re pretty calm here. We know the storm is going to be pretty bad, but this is part of our normal process,” she said. “It’s kind of like business as usual with us, with the added layer of ‘Let’s make sure that we take care of those patients for next week.’”
“We’re There for Them”
For Miami Rescue Mission Clinic, which serves a homeless population, taking care of vulnerable patients was also paramount. The clinic had partnered with a shelter to provide a safe place for patients to stay, then gone around the neighborhood to make sure everyone knew where to go.
At the shelter, clinic staff were setting up a makeshift clinic and a dispensing room, with cold storage powered by a generator, explained Gisela Bretones, a medical administrator for the clinic.
Bretones said Miami Rescue Mission Clinic had learned one strong lesson after Irma: Get everything set up in advance.
“With Irma, everything had to come on the fly,” she said. This year, “I feel like that helps patients a lot more, to see that we’re organized and we’re calm, that everything’s in order.”
Bretones is worried about Dorian’s potential impact on her patients’ mental health. “After the hurricane, people have so many problems and so much anxiety,” she said. “We want to show our patients we’re there for them.”
“Everything They Need”
Sorangely Menjivar, COO at Miami Beach Community Health Center, was focusing on preparing high-risk patients for Dorian. That includes patients with chronic diseases like hypertension and diabetes, as well as a large patient population with HIV.
“If they need medications, they can come, or we are delivering medication to patients who can’t come themselves,” she said. “We…make sure they have everything they need before the storm.”
However, Menjivar said, flexibility was important. “After the storm, that’s when we determine the need for our patient population,” she explained.
Menjivar anticipated that Miami Beach Community Medical Center would probably be delivering water and medications after the storm – and transporting patients who need medical attention to the clinic by van.
In the meantime, the health center was carrying out its hurricane preparedness plan, transporting vaccines and other temperature-sensitive medications to a refrigerator with a generator and putting out sandbags.
“We are prepared,” she said. But “you’ll never be prepared for a Category 5 hurricane. Hopefully this will turn out not to be a big storm and we can say we were saved from this one.”
“A Secondary, Unfunded Mandate”
“In Florida, you’re used to this drill, Everyone’s preparing for Dorian from Jacksonville all the way to Pensacola,” Knox said. For Florida’s healthcare organizations, “emergency management is a secondary, unfunded mandate.”
Knox has seen health centers provide pull of remarkable feats in the days after a storm. He recalled receiving an emergency call from a major NGO, asking for epinephrine for a cleanup crew that had come across a bald-faced hornet nest.
Despite the post-disaster chaos, he said, health centers were able to pull together and quickly transport the supplies.
“They saved the day,” he said. “There’s lots of stories like that. People go above and beyond.”
Direct Relief staff are on the ground in Florida, monitoring Dorian’s path, ready to respond as required. Fifteen caches of medicine have been pre-positioned across the state. The supplies were placed in storm-prone communities by Direct Relief at the start of hurricane season, and include the most commonly requested medicines in a disaster. Direct Relief is also making available more than $37 million in emergency medical aid to organizations in the storm’s path.