CDC's Hurricane Help: Stories From Staff

November 3, 2005

NOTE: This article is reprinted from CDC Connects, a CDC internal publication. It first appeared on November 3, 2005, while CDC was engaged in the initial response to Hurricane Katrina. CDC staff who were deployed to the field shared their experiences, and the agency honors them for the work they did and continue to do on behalf of those affected by Hurricane Katrina.

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This photo was taken in Bay St. Louis, Mississippi, at the crossing of the Gulf along US route 90 which was destroyed. From left to right: Ron Burger (NCEH); Kristin Uhde (NCID); Lori Newman (NCHSTP); Hannah Jordan (NCID). Burger says, "I have been responding to hurricanes since Hugo in 1989 and this has not only been the most destructive, but has also caused the biggest disruption by far of the public health and medical infrastructure."

Katrina. Rita. Wilma. In the past few months, hurricanes have hammered the Southeast and Gulf Coast and thrust CDC into major relief efforts. Hundreds of staff are helping in the field, others are helping at headquarters and around CDC, and still others are volunteering their own time after hours. We share some of their stories with you, to highlight the depth and breadth of CDC's public health mission and the dedication of its workers.

Grateful in the Face of Great Suffering

"Seeing human suffering firsthand is life-changing and more than humbling. Even more is seeing the people who suffer do so with a grateful and happy heart. That's what folks are like in Mississippi," says Kristin Uhde, EIS Officer in Meningitis and Special Pathogens Branch, DBMD, NCID. She and her team carried out syndromic/ injury surveillance among healthcare facilities around coastal Mississippi. She says the major challenges included limited access to technology. She shares some amazing stories of survival and the human spirit.

"While we were in a clinic collecting data, we met a lady who survived the storm by floating on a soccer ball while her friend hung from the rafters in a gymnasium," Uhde recalls. "A physician shared with us a story about a 90-year-old lady in Pearlington, Miss., who had end-stage pancreatic cancer. This can be a very painful type of cancer. This woman had no access to pain medication, living in a tent with no generator while the heat index was reported to be around 113. To see the suffering of these people in Pearlington was humbling. Although these people were suffering so much, they were so grateful for any help anyone could provide and had such positive attitudes. While we were driving in an air-conditioned SUV, we passed a family that was sitting outside where their home used to be. We stopped to say hello and they offered us water from their cooler."

During a visit to Louisiana to check on hurricane relief efforts, CDC Director Julie Gerberding, MD, MPH, pats "Lucky," a dog found wandering on a highway in New Orleans. A CDC team there rescued and adopted the animal.

For Many, Most Destructive Disaster Ever Seen

The situations in the field were staggering even for long-time relief workers. Ronald C. Burger, Senior Emergency Coordinator with NCEH's Office of Terrorism Preparedness and Emergency Response, has been with CDC for 33 years. He says, "I have been responding to hurricanes since Hugo in 1989, and this has not only been the most destructive, but has also caused the biggest disruption by far of the public health and medical infrastructure. Public health workers at all levels were ready for the challenge to either actually deliver or connect the public to their essential services. Prevention, assessment and surveillance were the keys throughout the response and public health staff planned, prepared, and implemented all of the activities necessary for a successful recovery."

From Tent Cities to the USS Iwo Jima

Robert Bossarte (LT, USPHS) rides in a Humvee. He was working in New Orleans with state and local health officials to collect data on the ability of the local healthcare facilities to care for the injured and ill and monitor for outbreaks of disease. He spent one night in a tent city outside of Baton Rouge, and a week on the USS Iwo Jima. President Bush paid a visit to the ship while Bossarte was there.

Robert Bossarte, PhD, EIS Officer (LT USPHS), Division of Violence Prevention, was assigned to the hospital-based surveillance team in New Orleans. "We were responsible for collecting data from all open hospital facilities in and around New Orleans. Many of the challenges faced by the surveillance team were probably common to most relief agencies/workers in the New Orleans area. Because our task involved collecting data from participating facilities, one obstacle was safe and timely movement through the area. In the early days of the effort this was often made difficult by downed power lines, flooded streets, missing or misdirected street signs, etc. During Hurricane Rita we were also evacuated to nearby Gonzales, La. This meant the team had to continue surveillance activities from a distance and (for a couple of days) commute into New Orleans during the day to make contact with open facilities and pick up data."

Bossarte was originally scheduled for a two-week deployment, but ended up extending his stay for slightly more than one month. "Because I was in the New Orleans area for several weeks I was able to see an amazing change. Streets that were initially deserted and covered with debris were becoming busy again, and residents could be seen cleaning their yards and sidewalks of debris by the time I left."

"Being in Louisiana for that period of time also meant that I was housed in several interesting sleeping quarters," he continues. "Our first night in Louisiana was spent in a tent city outside of Baton Rouge. From there we moved to the USS Iwo Jima, where we spent just over a week sleeping in the berthing quarters normally reserved for the crew. President Bush visited the New Orleans area twice and both times stayed on the Iwo Jima during our time there. When Hurricane Rita came through we were evacuated to a gym in a Baptist church while longer term arrangements could be made."

Bossarte says that for an EIS officer this was an amazing opportunity to learn about surveillance following a disaster and to play a role in a massive public health response. "As a public health professional it was a unique opportunity to assist local and state public health officials rebuild the infrastructure of their public health system. As an individual, it was an honor to work with those who had been so severely impacted by the storm. I will never forget the kindness and hospitality shown to us by those who may have lost their homes and possessions in these storms. Several of the nurses and physicians in local hospitals had not been able to return to their homes or had been separated from their families. Yet, they were eager partners in our surveillance effort and even managed to show concern for our well-being."

Water, Water Everywhere, and Finally, Safe Water to Drink

Mike McCain (left), the developer of the technology being employed, and Mathew Martinson (LCDR, USPHS) observe the deployment and employment of a Expeditionary Unit Water Purifier that provided safe water to a hospital for approximately 7 weeks. Martinson says, "The impact of this intergovernmental collaboration was that a major hospital was able to become 100 percent operational in the midst of a neighborhood with few homes still standing... a source of hope to residents of the area."

Mathew J Martinson, PE (LCDR USPHS), Civil Engineer/ Construction Manager, OCOO-CDC Facilities Planning and Project Management Office, was deployed through the Office of Surgeon General, under the Secretary's Emergency Response Team (SERT), as Civil Engineer for the Mississippi Hospital Engineering Assessment Team. He was there to assess the condition of Mississippi Gulf Coast hospitals following Katrina.

"My team was deployed immediately following Katrina. With little communications with the storm-affected area, my team was not sure what to expect. After our first hospital visit, we realized how little information state and federal officials had regarding the hospitals and their operability."

From that first hospital assessment, they adjusted their strategy and the information they communicated back to match the circumstances. Martinson filed reports with the Secretary's Command Center, the SERT, CDC DEOC, and the State Incident Command. It became valuable public health information beyond the physical condition of the hospitals, including actual bed capacity, licensed bed capacity, scope of services and facility condition, and a "bottom line" on each facility.

"One of the most interesting successes we had as a team was a great example of how the Commissioned Corps can help bridge the divides between agencies for the benefit of the public," says Martinson. "One large hospital sustained very little damage, but the surrounding community was destroyed and the two neighboring hospitals were shut down. A lack of a functioning (or safe) public water system prevented the hospital from becoming fully operational. An engineer Commissioned Officer from EPA called our team to touch base, knowing we were in the area. In the process of comparing notes, a potential solution to the hospital's water situation was developed."

John Brooks, Andrew Dannenberg, and Shahul Ebrahim help out at Red Cross Headquarters in Baton Rouge, assisting with disease surveillance at shelters for 42,000 people in Louisiana who were displaced by Hurricanes Katrina and Rita. Photo by Steve Coughlin

Technology and collaboration soon brought help and hope, he explains. "The EPA Officer and our team facilitated communication between the hospital CEO, the MS Dept. of Health, the EPA and the supplier of a water purifier (US Army R&D program), and appropriate agreements were made. The system was set up to pull water out of Mississippi Sound. It produced safe water (tested by several labs). It remained in place, supplying the hospital's water for about 7 weeks, until city water became safe and reliable. The impact of this intergovernmental collaboration was that a major hospital was able to become 100 percent operational in the midst of a neighborhood with few homes still standing. Consequently, not only did the facility provide needed health care, but it provided an element of normalcy and a source of hope for the residents of the area."

Martinson says the team had several experiences like this. "I believe the key to our positive contributions was that we focused on mission and service, and we assumed that we had to adapt and overcome poor conditions. That is, we had a sense that the austere conditionsn and logistical misfires were to be expected, and needed to be overcome quickly if we were to make a positive impact."

Lending a Helping Hand and Heart

Steve Coughlin spent two weeks in Louisiana following Hurricane Katrina. "I appreciate the support I received from our team leader John Brooks (see photo below)," he says, "and from the team members, public health professionals and Red Cross volunteers in Louisiana, DEOC staff in Baton Rouge and Atlanta and colleagues here in DCPC."

"I had the pleasure of working with a really great team from CDC and the Louisiana Department of Health and Hospitals, helping with disease surveillance at shelters for people in Louisiana who were displaced by Hurricanes Katrina and Rita," says Steven S. Coughlin, PhD, epidemiologist, Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, NCCDPHP. "I was assigned to Public Health Region III (Thibodeaux in Lafourche Parish and Houma in Terrebone Parish) and Region V (Lake Charles) and was also at the Red Cross Headquarters in Baton Rouge. In my two-week detail, I met lots of people in Louisiana who were affected by the hurricanes and I was happy to be there to lend a hand with public health activities. My heart goes out to the people in the Gulf Coast area and Florida who are recovering from the hurricane disasters. I appreciate the support I received from our team leader John Brooks, and from the team members, public health professionals and Red Cross volunteers in Louisiana, DEOC staff in Baton Rouge and Atlanta, and colleagues here in DCPC. The support we received from DEOC was extremely helpful."

DEOC Met Heavy Demands

Hard at work in DEOC covering hurricane relief efforts are (right) Michaela Santen, with the Strategic National Stockpile, and Toby Crafton, Logistics Lead, DEO, COTPER. Photo by Kathy Nellis

The Director's Emergency Operations Center was ready, even before the storms made landfall, says Toby Crafton, Logistics Lead, COTPER. "CDC deployed over 500 people to support Hurricanes Katrina and Rita."

The Logistics Support Area (LSA), is the place where all travel is coordinated and all equipment and supplies are received, stored, inventoried, issued, and maintained. It's a well organized site packed with supplies critical to CDC's mission in the field. From the LSA, deployed staff were issued field survival gear, vehicles, laptops, cell phones, GPS units, meals ready-to-eat, CDC shirts and duffle bags, and Blackberries. It is also the place where they received their travel orders, and where they filed their voucher paperwork once they returned.

Working to cut travel orders for staff being deployed are Myles Holly, with traveler Joshua Mott; Wanda Fickens (standing), Deborah McElroy and Ricky Garrett. The Logistics Support Area was staffed 24/7 for the first 3-4 weeks of the response. "We were only able to process the amount of orders and vouchers we have because of the dedicated and selfless support we received from the travel volunteers," says Toby Crafton. Photo by Kathy Nellis

"The LSA was staffed 24/7 for the first 3-4 weeks of the response," says Crafton. "We were getting deliveries of supplies and equipment at all hours of the day and night. We were also producing travel orders and addressing travel issues 24/7 from this facility. We realized that the two LST travel preparers who had up to that point supported all other DEOC events were going to be overwhelmed. A call immediately went out to the agency for volunteers to support the event. The response was unbelievable. We were only able to process the amount of orders and vouchers we have because of the dedicated and selfless support we received from the travel volunteers."

Procurement and Grants Office (PGO) Facilitates Needed Purchases

PGO was a significant partner as well, Crafton adds. "PGO supported the teams by procuring vaccines, medical supplies, survival equipment, vehicles, hotel rooms, meeting space, document reproduction, etc. Their ability to turn requests around was amazing."

The LSA will be a permanent part of the DEO structure from now on, he explains. "Now that we have built it, it will stand ready for all other events the CDC will respond to in the future."

Crafton has high praise for the people who worked long hours to provide this critical support. "The dedication and selfless service of the team that staffed and supported the LSA was amazing. It is a testament to the kind of people that work at CDC.

The Sky Is the Limit: Angel Flight

Steve Hurst volunteered to fly missions with Angel Flight of Georgia. He delivered supplies to shelters in Mobile, Alabama.

Steve Hurst, Microbiologist, NCID/DBMD, provided help and support on his own time. "I was not called to help with the Katrina work at CDC; so I was left with donating to relief organizations and giving food at the grocery store. I was flying at Peachtree airport and we walked by a hangar where huge piles of supplies were being loaded into planes. Angel Flight of Georgia was running an airlift to get critical supplies into small airports near shelters and hospitals. A volunteer group, they were sending over 150 flights a week into the hurricane zone. This was like running a small airline. I asked if they needed pilots, and had to fight to get away. So I took annual leave and my wife Terry did too and we volunteered."

Hurst's wife Terry ran the checklists and organized the maps for their trip.

They helped at the airport loading supplies and cargo for other planes, waiting for their mission to get under way. Three planes were headed to shelters in Mobile, Ala. "After loading the essential cargo in the baggage compartment, onto the floor and back seats, we packed every nook and cranny with blankets, pillows and toys. I filed the flight plan, and started the engine, Terry ran the checklists and organized the maps, and we were finally under way."

At maximum weight, they were heavy and slow and they headed for the clouds, says Hurst. "It was late in the day, and the good flying weather was gone. The summer afternoon storms washed off the plane. Air Traffic Control helped make our work as easy as possible. I asked for deviation around the storms and we avoided most of the weather. Going into Mobile, we could see the low-lying areas that had been smashed by Katrina."

They landed, and cars and vans from relief centers pulled up. "We unloaded the plane; the words of thanks and looks of gratitude paid for the flight in full. No passengers were waiting to go to Atlanta; we refueled, and ran for the bathroom. I activated the return flight plan and we climbed out of Mobile. We were again slogging along low when Air Traffic Control asked if we could climb to 9000 ft. Could we? You bet! Without a quarter ton of cargo, the plane leaped for joy and quickly put us up on top of the weather. The engine purred happily and the miles disappeared behind us."

Hurst adds, "I hope this will let others see the tremendous efforts that were going on to help the disaster victims. My wife and I were only a small part. Angel Fight organized over 400 relief flights. There are more pictures posted on the Angel Flight of Georgia web site."

Initiative for Affordable Housing

Some members of APRHB after an afternoon of unloading supplies (left to right): Rose Anne Rudd, Marcia Griffith, Gregory Crawford, Marissa Scalia, Jeanne Moorman, Michael King, and Carol Johnson. The group sponsored two families through the Initiative for Affordable Housing.

Irene White, Laura Jackson-Usher, and McDonald (Mac) Williams get gear together in the new Logistics Support Area, which will be a permanent part of the DEO structure from now on. They assemble packs for deployees which include ponchos, sleeping bags, water purification kits, tents, first aid kits, flashlights, sunscreen, rope, insect repellent, and cell phones, to name just a few of the basic necessities provided. Photo by Kathy Nellis

On the ground, the Air Pollution and Respiratory Health Branch (APRHB), was involved in yet another volunteer effort. Early in September, members of the APHRB learned of an opportunity to house people displaced by Katrina through the Initiative for Affordable Housing. After passing a background check, a family would sign a year-long lease, and for the first three months, the rent would be paid for by the Initiative. Sponsors volunteer to pay the utilities for the first three months, furnish the apartment, and help with anything else they can offer-such as clothing, rides, or job-hunting.

"After contacting the organization for details, polling APRHB members about interest in volunteering, and circulating a list of needed items, the members of the branch concluded that there was enough support and furnishings to not only sustain one apartment, but to provide for two," Marissa Scalia, MPH, explains. "Branch members began bringing in small appliances, kitchenware, and other items. On Friday, September 23, staff at the Initiative for Affordable Housing notified APRHB that we'd be getting two families: two sisters, one of whom was married and had a 16-year-old daughter. On Saturday, we began moving things in; most of the furnishings were in place by Sunday evening."

The families came to Atlanta by way of San Antonio, which had been their first stop after leaving New Orleans. "They are hoping to rebuild their lives here and are currently hunting for jobs," says Scalia. "Amanda, who had been in honors classes in New Orleans, is now enrolled at one of the Atlanta-area high schools, trying to pick up in the advanced classes where she left off."

Bridget, her mother, said "I just want to say thank you so much for all your generosity. You don't know us from Adam and Eve. It's good to know that there are good people out there who are willing to help."

If you'd like more information about the Initiative for Affordable Housing (which also offers housing solutions to people other than those displaced by Katrina and which provides an ongoing opportunity for people, groups, and organizations to volunteer), please visit the Initiative for Affordable Housing website or contact them at 404-299-9979 or via email at iahd@mindspring.com.

These are just a few of the stories of CDC's help and involvement in hurricane relief efforts. This article compiled by CDC Connects reporter Kathy Nellis.