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Article Excerpt
Abstract: On September 1, 2005, with only 12 hours notice, various collaborators established a medical facility--the Katrina Clinic--at the Astrodome/Reliant Center Complex in Houston. By the time the facility closed roughly two weeks later, the Katrina Clinic medical staff had seen over 11,000 of the estimated 27,000 Hurricane Katrina evacuees who sought shelter in the Complex. Herein, we describe the scope of this medical response, citing our major challenges, successes, and recommendations for conducting similar efforts in the future.
Key Words: disaster relief, Hurricane Katrina, emergency medical response, surge capacity
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On Monday, August 29, 2005, a category 4 hurricane struck New Orleans and the adjacent Gulf Coast, resulting in the largest natural disaster in US history. Hurricane Katrina displaced hundreds of thousands of people from their homes on the Gulf Coast and severely damaged the historic city of New Orleans. The thousands who could not leave New Orleans found themselves in local shelters of last resort, without food, medicine, or care. Houston, the nearest large city, was a logical destination for those who could be evacuated, and the political and medical leaders of Houston and Harris County immediately agreed to participate in the relief effort. Using the Astrodome/Reliant Center Complex as a home base, they organized housing, food, and medical facilities in preparing for the arrival of an estimated 25,000 people. Disembarking from buses after struggling for days without adequate food, water, or rest, many of the 27,000 who eventually arrived at the Complex were found to be dehydrated, delirious, and suffering from the neglect of chronic medical and psychiatric conditions. Among other local, national, and regional groups and organizations, the medical community of Houston and Harris County scrambled to meet the extraordinary requirements of these displaced people--their neighbors in need.
Medical Response at the Astrodome/Reliant Center Complex
Overview
The medical facility at the Houston Astrodome/Reliant Center Complex, known as the Katrina Clinic, bore the brunt of patient care for the first wave of evacuees and subsequently served the large population housed at the mass shelter within the Complex. More than 11,000 patients were seen by the medical staff over the course of two weeks. Figure 1 and Table 1 provide specific data concerning the evacuees housed at the Complex who were seen by medical staff at the Katrina Clinic.
The majority of patients who required more extensive care, including hospital admission, were referred for further evaluation to publicly funded hospitals within the Harris County Hospital District, specifically, Ben Taub General Hospital and Lyndon B. Johnson Hospital.
Creating an Infrastructure
Leaders from the political, public health, Harris County Hospital District, and Harris County medical community met on August 31, 2005, to plan housing, medical care, and social services (see Table 2 for a partial list of organizations participating in this medical response) for Katrina evacuees, some of whom were already en route to Houston. The initial leadership group established a unified command and control system to direct and coordinate the services they anticipated the evacuees would need, as well as a public health infrastructure comparable to that of a small town. The system followed Federal Emergency Management Agency (FEMA) guidelines for creating a Unified Area Command. The Medical Branch of the Operations Section was authorized to direct all health and medical initiatives for the evacuee population at the Houston Astrodome/Reliant Center Complex. Representatives met several times a day to reassess operations and accommodate the fluid situation. Flexibility, frequency of communication, and adequate medical staff and resources were key to staying abreast of the Complex population's needs. (1)
The Medical Branch of the Katrina Relief Operation at the Houston Astrodome/Reliant Center Complex was led by Harris County Public Health and Environmental Services (HCPHES). The Ambulatory Care Group within the Medical Branch at the Complex was led by faculty from the Harris County Hospital District (HCHD) and Baylor College of Medicine (BCM). The Katrina Clinic eventually included 65 examination rooms, with...
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