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Unity, Hope, and Healing
in the hour of need

By Darla Brown

Hurricane Katrina and its devastating aftermath brought thousands of survivors to the Houston area in need of shelter, food, and medical care. They flowed into the fourth-largest U.S. city by bus, car, and even helicopter. The first “super shelter” to care for this growing population was set up at the Astrodome, with medical facilities run by the Harris County Hospital District. The University of Texas Health Science Center at Houston was soon charged with opening the medical portion of a second “super shelter” at the George R. Brown Convention Center (GRB) Friday, Sept. 1, to accommodate the increasing influx of hurricane survivors.

Heeding the call
Phones and e-mails were buzzing the week of Katrina with pleas asking volunteers to donate their time, resources, and expertise to the cause. Mike McKinney, M.D., senior executive vice president and chief operating officer of the health science center, was the first one to receive the call to set up a UT medical clinic for evacuees.

“We got the call at 9 a.m. Friday, and by 5 p.m., it was all set up,” he explains.

Carlos Moreno, M.D., chair of the Department of Family and Community Medicine, was planning to volunteer at the Astrodome Friday afternoon with Joe Bedford, M.D., associate professor of family and community medicine, when his plans changed.

“We were supposed to have a meeting together and decided to volunteer for the Katrina effort instead,” Dr. Moreno recalls. “Well, I got a call before then that Dr. McKinney wanted me at a meeting at the George R. Brown and told Dr. Bedford, let’s forget the Dome and go to the convention center.”

A planning meeting with city health officials, the mayor’s office, fire and police officials, and Memorial Hermann Hospital ensued to plan the city’s second super shelter.

“We all left the meeting at 3:30 p.m. with plans to return at 5 p.m. When I left, the convention center was empty except for some people inflating mattresses,” Dr. Moreno recalls.

Larry Gilstrap III, M.D., chair of the Department of Obstetrics, Gynecology, and Reproductive Sciences, also got the call to show up at the GRB.

“I came back early to the convention center Friday to see patients and got put into service by city health officials and EMS people who started asking me where we wanted to set up the clinics for adults, pediatrics, and mental health,” he says.

Relying upon his former military experience of setting up field hospitals, Dr. Gilstrap, a retired Air Force colonel, took command of the situation and started setting up the various clinics with the help of one of his former military nurses.

“Initially we set up a trauma/acute care section next to the adult medical section and set up an equipment and supply section – all of this was under Dr. McKinney’s planning. We got a lot of help from Memorial Hermann Hospital and Walgreens and Walmart, which set up a pharmacy,” he explains.

Volunteers were on hand ready to assist, even though no patients had yet arrived.

“There was a nurse who I had worked with in the military who was volunteering, in spite of receiving chemo, and she was extremely helpful to me in deciding where the clinics would go and in actually setting them up,” Dr. Gilstrap adds.

Taking cues from the Astrodome clinic set up days earlier proved beneficial for the UT effort.

“The lessons from the Dome were valuable – hit fast and hard. We coordinated as many people as we could, and we had 24-hour service and participating from all of our health science center schools,” explains Michael Bungo, M.D., associate dean for Harris County programs. “The facility at the George R. Brown anticipated large numbers of patients and tried to overprovide.”

Two separate waiting areas for patients, before triage and before their exam, were set up, as was a physical separation between intake and exam areas. An online credentialing center allowed for clinical volunteers to be checked in to the system. Ancillary services and a pharmacy were set up from the start of the operation.

“It was amazing – in five hours, we took a bare floor and turned it into a good clinical enterprise that let us take care of the needs of the people,” says Margaret McNeese, M.D., associate dean for student affairs.

Committed to care
By that evening, the troops were rallied.

“A privately owned mobile health van showed up, two truckloads of supplies drove up, St. Luke’s Kelsey brought exam tables, and 20-30 nurses and physicians were there,” Dr. Moreno says. “Elda Ramirez, a nursing faculty member, designed the triage area and some of her graduate students were always there.”

The volunteers organized the supplies all evening and were prepared when the first bus load showed up – a group of evacuees from a shelter in Baytown that was closing. At 11 p.m., 250 people got off of the first bus.

“We only had 25 patients from 11 p.m. to 3 a.m., then people went to sleep, so we sent volunteers home to get some rest,” Dr. Moreno explains.

By the next day, more patients made their way to the newly commissioned UT clinic.

“We saw the sickest patients in the first 48-72 hours,” Dr. Gilstrap says. “Then the chronic care operation began. People came in for insulin, which they had gone without for several days. Some had asthma, diabetes, a huge number of patients were at the pediatric clinic with fever and rashes.”

The patients and volunteers began to flow through the newly established system.
“It was a very efficient place, and the patients were amazingly calm,” Dr. Moreno says. “They didn’t get agitated – people were very thankful and pleased we were there. It was world-class faculty taking care of people.”

Besides examinations and routine medical care, Lenscrafters was on site, making 150 glasses a day; Reach Out and Read came to distribute books to children in the shelter; and the UT Dental Branch showed up with its mobile clinic and immediately had a line.

“Everyone thanked us; they were so grateful. One woman said she had been to five different shelters, and that we were the best,” Dr. McNeese recalls.

Overall, the clinic had 11,000 patient visits and a peak population of 3,500. By comparison, the Astrodome had 15,000 patient visits with a peak population of 27,000 residents.

“The reason for the similar number of patients despite the disparity in patient population was that the Dome clinic was for Dome residents only. The George R. Brown saw patients from shelters around town. One day, a bus of Hondurans with no English skills from a local hotel drove up for treatment,” Dr. Bungo recalls.

Toward the end of the operation, the convention center clinic saw 50-60 visits a day and functioned smoothly.

“From sheer will, this blossomed into a happy place. It touched my soul to see what my colleagues were able to accomplish, how we came together and sustained it,” Dr. McNeese says.

Medicine unencumbered
During its operation, patients received the care they needed no matter what.

“One little boy I remember had a complex seizure disorder and had no glasses, helmet, or seizure medications. I put a call into Memorial Hermann Hospital, and a woman appeared with four or five different helmets for him to try on,” Dr. McNeese recalls.

The clinic and residents had what they needed, from food and clothing to a playground for children and portable X-ray machines and free medication.

“The central supply was like a candy store, it had so many items,” McNeese recalls. “There was no paperwork, no calls for permissions to do tests – you could just do what you were trained to do.”

Volunteer effort
Things and people kept appearing to refuel the effort.

“There was an overabundance of volunteers the first couple of days, especially from UT – doctors, nurses, non-medical personnel,” says Dr. Gilstrap. “I was proud to be UT and to see how my colleagues responded.”

Then volunteers from all over the United States started arriving.

“One guy worked all Labor Day weekend on the computers, then he came by to shake my hand to tell me he had to go because he had to go back to work. I asked him where he worked – he said Minnesota,” Dr. Moreno recalls.

“People just showed up – there was a doctor and his wife from California, nurses from Hawaii, a mobile clinic drove in from California. It restored my faith in humankind,” Dr. McNeese says.

“We had a doctor from the Indian Health Service in Arizona, doctors from New York and California, some from New Orleans. What was really encouraging to me as a teacher was the number of medical students and residents who volunteered,” Dr. Gilstrap says.

Those volunteers knew they were there to do a job and to make life of the evacuees easier.

“People would do whatever you asked them to do – minimum conflict, great cooperation,” Dr. Moreno notes.

“If there was a thought that was worthwhile, it got done,” Dr. McNeese adds.

It was the quick thinking of three volunteers, a nurse and her daughter, a UT School of Public Health student, and a physician from New Orleans who supplied the clinic with antibiotics and clinical supplies driven down in two vans on its opening night.

“Without that nucleus of drugs, we wouldn’t have gotten started that night,” Dr. McNeese recalls.

“It was comparable to a military operation in a civilian emergency with one exception – we had everything we needed and everyone responded to our needs. You needed wheelchairs, and they appeared. People sent equipment from all over the United States,” Dr. Gilstrap says. “The community response was incredible.”

‘Found our mission again’
UT’s George R. Brown clinic was open 18 days – a timeframe that has changed lives.

“It was an amazing experience out of a terrible circumstance,” Dr. McKinney says. “We were able to render care that we had failed to render on our own citizens for a long time. We found our mission again.”

The feeling of family and coming together as a health science center touched the volunteers and those who witnessed the efforts.

“Everyone pitched in and made it really special. It benefited me as much as the survivors,” Dr. McNeese says. “It made me very proud of this institution.”

“I don’t think I’ve ever had an experience in which I felt more like a physician. It was one of the most satisfying things I’ve participated in. It renewed my faith in Texas, the Medical School, and Houston to see our commitment to care in this type of emergency,” Dr. Gilstrap says.

The experience helped to prepare the Medical School and UT Health Science Center for future emergencies – in fact, many were prepared in case Hurricane Rita would have set her sights on Houston.

“The spontaneity of the situation worked very well,” Dr. Moreno says. “The next time there is a crisis, just give us four hours to plan and implement a solution, and we’ll get the job done.”