Monday, September 12, 2005

For those who think it's not that bad...

From here:

A letter from a physician on the front lines at New Orleans airport:

Hemant H. Vankawala, M.D. greetings from the new orleans airport.

for those of you who dont know i am a member of the texas-4 disaster
medical assistence team (DMAT). we are a part of FEMA. i joined a
couple of months ago and my team was activated 11 days ago. for the
past 8 days i have been living and working at the new orleans airport
delivering medical care to the katrina hurricane survirors.

let me start by saying that i am safe and after a very rough first
week am now better rested and fed.

out team was the first to arrive at the airport and set up our field hospital. we watched our population grow from 30 dmat personal taking care of 6 patients and 2 security guards well to around 10,000 people in the first 15 hours. these people had had no food or water or security for several days and were tired, furstrated, sick, wet,and heart broken. people were brought in by trucks, busses, ambulances, school busses, cars, and helicopters.

we recieved patients from hospitals, schools, homes, the entire remaining population of new orleans funneled through our doors. our little civilian team along with a couple of other dmat teams set up and ran THE biggest evacuation this country has ever seen.

the numbers are absolutely staggering.

in hind site its seems silly that a bunch of civilian yahoo's came in and took over the airport and had it up and running exceeding its normal operating load of passengers with an untrained skeleton crew and generator partial power. but we did what we had to do and i think we did it well.

Our team has been working the flight line off loading helo's. overnight we turned new orleans airport into the busiest helicopter base in the entire world. at any given time there were at least 8-10 helo's off loading on the tarmac, filled with 10-40 survivors at a time, with 10 circling to land, it was a non-stop never ending process 24 hour a day operation. the cnn footage does not even begin to do it justice. the roar of rotar blades, the smell of jet A and the thousands of eyes looking at us for answers, for hope. our busiest day we off loaded just under 15,000 patients by air and ground. at that time we had about 30 medical providers and 100 ancillary staff. ALL we could do was provide the barest ammount of comfort care. we watched many, many people die. we practiced medical traige at its most basic, black tagging the sickest people and culling them from the masses so that they could die in a separate area. i can not even begin to describe to transformation in my own sensibilities from my normal practice of medicine to the reality of the operation here. we were SO short on wheel chairs and litters we had to stack patients in airport chairs and lay them on the floor. they reamined there for hours too tired to be frigthened, too weak to be care about their urine and stool soaked clothing, to desperate to even ask what was going to happend next. imaging trading your single patient use latex gloves for a pair of thick leather work gloves that never came off your hands and you can begin to imagin what it was like.

we did not practice medicine.

there was nothing sexy or glamerous or routine about what we did we moved hundreds of patients an hour, thousands of patients a day off the flight line and into the terminal and baggage area patients were loaded onto baggage carts and trucked to the baggage area, like, well, baggage. and there was no time to talk, no time to cry, no time to think, because they kept on comming. our only salvation was when the beurocratic washington machine was able to ramp up and stream line the exodus of patients out of here.

our team work a couple of shifts in the medcal tent as well. imagine people so despeate, so sick, so like the 5-10 "true" emergencies you may get on a shift comming through the door non stop that is all that you take care of. no imagine having not beds, no O2, no nothing except some nitro, aspirin and all the good intentions in the world. we did everything from delivering babies to simply providing morphine
and a blanket to septic and critical patients and allowing them to die.

during the days that it took for that exodue to occur, we filled the airport to its bursting point. there was a time when there were 16,000 angry, tired, frustrated people here, there were stabbings, rapes, and people on the verge of mobbing. the flight line, lined with 2 parallel rows of dauphins, sea kings, hueys, chinooks and
every other kind of helocopter imanigable, was a dangerous place. but we were much more frightened when ever we entered the sea of displaced humanity that had filled every nook and cranny of the airport. only now that the thousands of survivors had been evacuated, and the floors soaked in bleach, the putrid air allowed to exchange for fresh, the number or soldiers allowed to outnumber the patients, that we feel safe; i have meet so many people while down here. people who were at ground zero at 9-11, people who have done tusanmi relief, tours in iraq and every one of them has said this is the worst thing they have ever seen. its unaminous and these are some battle worn veterans of every kind of disaster you can imagine.

watching the new reports trickle back to us has been frustrating and heart braking. there is NOTHING anyone could have done to prepare for this. it was TOO huge, even now its so big its almost impossible to comprehend. the leaders needed to see first hand the damage but did not because their safety could be guarenteed. its a war zone in new orleans. it is covered in raw sewage with no infrastructure. every engineer i have spoken with believes that most of the city will have to be plowed into fields and that rebuilding what is left will take decades. it will NEVER be the same. never. ever.

for those of you who want to help the next step is to help those who arrive in your local area. the only real medcial care these survivors will recieve is once they land in safe, clean area far from here. for the 50,000 people we ran through this airport over the last couple of days, if they were able to survive and make it somewhere else, their care will begin only when providers in dallas and houston and chicago and baton rouge (etc) volunteer at the shelters and provide care. and yes there are many, many more on their way

many of the sickest simply died while here at the airport, many have been stressed beyond measure and will die shortly even though they were evacuated. if you are not medcial then go the shelters, hold hands, give hugs and prayers. if nothing else it will remind you how much you have and how grateful we all should be. these people have nothing. not only have they lost their material posessions and homes, many
have lost their children, spouses, parents, arms, legs, vision, everything that is important.

talk to these survivors, hear their stories and what they have been through, look into their eyes you will never think of america the same way you will never look at your family the same way you will never look at your home the same way and i promise it will forever change the way you practice medicine

many, many stories to tell when i get back looking forward to seeing you all again. we are VERY safe down here (now thank god) and we shall be home soon

hemant vankawala
Hemant H. Vankawala, M.D.
and do not deem anything unworthy of consideration,
for there is no man that does not have his hour
and no thing that does not have its place."
--Pirkei Avot, chapter 4, section 3

(h/t to COG from Unto the Breach.