Air National Guard Medical Teams Provide Medical Care

This is the first time the EMEDS - Emergency Medical Support - unit, like this one in Hancock County, Miss., has been deployed in a homeland-security disaster, officials here said. Photo by Capt. Steve Alvarez, USA   (Click photo for screen-resolution image);high-resolution image available.

"The needs are great," Tim Keller said. Most of the county leaders were homeless, he noted, adding that they had "zero government buildings" and that the National Guard was repairing many of the destroyed government buildings to help the county "get back up."

The Guard is out in force here, providing security, traffic management and humanitarian-relief goods, and clearing streets But they have now also erected a transportable medical center on the grounds of the county's hospital - a stopgap until county medical organizations can operate again.

"Hancock Medical Center is the only medical facility in this county," Mississippi Air National Guard Col. Janet Sessums, senior officer on the ground, said. "We're filling a huge void right now." Hurricane Katrina devastated the area when it made landfall on Aug. 29.

Sessums and 85 other medical professionals from the Mississippi, Alabama, Kansas and Delaware Air National Guards erected the soft-sided hospital - known as an EMEDS, for Expeditionary Medical Support - in two days and have been taking shifts, working 12-hour days since operations started Sept. 7. They are the only medical support available west of Gulfport in Mississippi. The EMEDS mission is to provide medical care and stabilize critical patients for evacuation to an established medical facility.

EMEDS is ordinarily used to provide expeditionary-force medical care in combat theaters. The medical staff here compared the concept to a "high-tech concept of MASH," or Mobile Army Surgical Hospital, and said that EMEDS was being used overseas in Iraq.

The hospital is modular and can be expanded or reduced in capability as the situation dictates. The EMEDS has an emergency room, a family practice clinic, a flight surgeon, physician's assistants, an intensive-care unit, a dental clinic, respiratory therapist, anesthesiologists, operating room, a pharmacy, supply room, a laboratory, radiology department, bioenvironmental and public health teams, and surgeons that can perform orthopedic and general surgery.

"This is the first time this setup has been used in a disaster," Sessums said. The EMEDS erected here was reserved for homeland-security disasters by the federal government and stored in Kansas, Sessums said. It had never been used, Sessums noting it still "smelled new."

Two C-17 Globemaster IIIs on 22 pallets moved the EMEDS unit here. Prior to the EMEDS concept, Sessums said, a hospital of this size and capability would require an entire squadron for movement.

The hospital is self-contained. It provides its own power and cooling, and the Air National Guard even sent Air Guard security forces to protect the patients, staff and equipment since personnel safety was questionable in the early days of the relief operation.

To date, the hospital has treated civilian and military patients alike for car-crash injuries, lacerated digits and sprains. Its first surgery was a dental procedure. But the staff is expecting an influx of patients with gastrointestinal infections, severe cuts to limbs and muscle and joint strains once people move back into the area and begin to clean up and operate equipment like chainsaws.

"This is just total devastation down here," Air Guard Lt. Col. (Dr.) James Lee Valentine said. "Nobody can anticipate that," he said. "This is a disaster unlike any we've ever seen before. Everyone is in shock."

Hancock's hospital was hit by a tidal surge of nearly 40 feet, some here estimate. Air National Guard engineers at nearby Camp Haywood say that once water floods a hospital in that manner, the electrical infrastructure is destroyed and must be rebuilt.

"We're going to be Hancock Medical Center until they can reopen," Sessums said. "This facility will be here until the hospital reopens."

EMEDS personnel are also working with local doctors to encourage them to use the facility in the event their clinics were damaged by Katrina.

"When we admit their patients, we're allowing them to make rounds on their patients here," flight surgeon Lt. Col. Peter Barrenechea said. "The Air Force here is providing the majority of the health care."

The hospital is also equipped with two landing zones, or "LZs" as they are called, enabling the EMEDS to provide aeromedical evacuation capability to critically injured personnel, a concept that has improved the survivability of soldiers on the battlefield as the EMEDS are positioned closer to combat troops.

"We can take them and stabilize them," Valentine said. "We then work with the evacuation teams to get them to other hospitals, but they can have surgery and get stabilized if needed," he said.

EMEDS was born from the recommendations and ideas of military medical personnel who combined lessons learned and after-action reports to devise the concept. An equipped EMEDS hospital is valued at about $4.5 million. The one here can accommodate 25 in-patient beds, but can treat many outpatients.

As the medical teams waited for the EMEDS to arrive when they first responded to the region on Aug. 31, they teamed up with Army Guard helicopter teams and convoys, and Federal Emergency Management Agency officials and they flew and drove into hard-to-reach areas to provide medical care.

"We'd send medical teams out with relief teams and we found pockets of people that needed medications and assistance," Valentine said.

On one medical mission, as the helicopter departed after medical crews from the 172nd Medical Group had spent a day in a cut-off community, they noticed that the town had gotten together and assembled pieces of their tin roofs on the ground. The residents were expressing their gratitude In a message that read: "Thanks 172nd." "The helicopters have been a lifesaver," Sessums said. "It has truly been a joint adventure here."

Currently EMEDS bioenvironmental and public health teams are checking for signs of cholera and contaminated water. County officials here say that a boil-water notice is in effect and that the recovery of victims continues, the last discovered on Sept. 4. As of Sept. 9, 52 people were missing here.

"More than half of our county was covered by storm surge," Keller said.

The EMEDS is comprised of medical elements from the 117th Air Refueling Wing's Medical Group out of Kansas, the 186th Air Refueling Wing's Medical Squadron, Meridian, Miss., and the 172nd Airlift Wing's Medical Squadron, Jackson, Miss.