By Annette M. Boyle
HOUSTON—As Hurricane Harvey bore down on the Texas coast, the VA geared up to support veterans and staff through the storm and its aftermath. As a result, critical staff stayed in place, emergency services continued and call lines remained open, even as the region experienced unprecedented flooding.
And, as the water flowed back to the sea, mobile units and relief staff rolled in.
More than 510,000 veterans live in the area affected by Harvey, and 175,000 of them receive medical care through the VA’s 115 facilities in the region, according to the agency.
As the storm loomed, “the VA Integrated Operations Center was activated to coordinate efforts from VA’s central office in Washington. Local and regional assets in Texas, Arkansas and Louisiana [were] also mobilized to respond and assist those VA facilities most impacted by the storm,” the VA said in an update.
The Michael E. DeBakey VAMC in Houston stayed open, which was fortunate for Matt Meloni, a former Army Ranger. Meloni had come into town from Oklahoma for prostate surgery on Aug. 28. With the hurricane’s arrival, he expected to wait for a few days in his hotel. The night the storm came ashore, the sudden onset of significant abdominal pain made him realize he had to get to the hospital quickly. He waded 2 miles through chest-high water to have an appendectomy, according to a VA blog post.
“I came here in the middle of a weather event where it would not be reasonable to get the level of service I was provided,” Meloni said. “I came here in the middle of a hurricane, got laparoscopic surgery in the middle of the night from an amazing surgeon here. … There’s no private entity that could have done this better.”
The surgeon who cared for Meloni, Christy Chai, MD, chief of general surgery and surgical oncology, explained that some staff had prepared to stay through the hurricane. “As a hospital, we were well prepared in anticipation of these emergencies.”
The DeBakey VAMC cardiology team all stayed on-site from the storm’s arrival on Friday through at least Tuesday. “We performed cardiac caths, stents, pericardiocentesis, pacemaker placement, transesophagel echocardiograms as if nothing along the lines of a major hurricane and flooding was taking place right outside our doors,” explained Anita Deswal, MD, the center’s chief of cardiology.
The Houston VAMC not only had 700 staff in-house in preparation for the storm, it also brought in some of its most vulnerable veterans. The spinal cord injury (SCI) unit typically makes house calls to check on veterans with spinal injuries, but, knowing that the hurricane would make those visits impossible and put some of their patients at risk, they created emergency safety plans for some and brought others into the SCI unit. That brought the unit up to 35 occupied beds, with most of the patients on life-assisting equipment.
‘Most Stressful Week’
“It has been the most stressful week of my life as a physician and a person,” said Carol Bodenheimer, MD, a physician in the SCI unit whose family remained in their home with rising water and no power.
The Houston VAMC also sheltered homeless veterans during the hurricane, wrote SreyRam Kuy, MD, the medical center’s associate chief of staff in a VAntage blog post, “in addition to caring for the medical needs of veterans and anyone else who walks in the doors.”
Staff worked around the clock from Friday until relief staff arrived on Wednesday. “VA is such a huge family,” said Sally Holmes, MD, Houston SCI unit chief. “When we are in need, we look to the mission and what it means.”
For many staff members, that meant continuing to work with no idea whether their homes had sustained damage—or despite certainty that they had, Kuy wrote.
About 20 nurses from Dallas joined more than 50 from San Antonio and Austin in Houston midweek to give the DeBakey staff time to rest and reunite with their loved ones. “When we called for volunteers to relieve the Houston staff, our nurses stepped up immediately to help,” said VA North Texas interim director Kendrick Brown.
Other VA staff gave the DeBakey VAMC staff support from afar. As Hurricane Harvey approached the Texas coast, the Central Arkansas Veterans Healthcare System in Little Rock started taking calls that are normally routed to Houston from veterans from Texas, Louisiana, Mississippi, Arkansas and Oklahoma. The Arkansas VAMC provided 24/7 coverage to answer nervous veterans’ questions about clinic operations in their area and to get ill veterans the care they need—even calling on fire departments to extract a veteran who ambulances could not reach.
“We have nurses, administrative staff and management all taking calls,” said Pat Kloske, RN, the nurse manager for Little Rock’s two specialty clinics, who has been directing the call center. “We’re extremely proud to be helping out during this disaster, and we’re keeping the Houston VA and our veterans in our thoughts and prayers.”
The VA also provided direct assistance to the staff and patients at the Houston VAMC. With local food supplies low, the department sent seven tractor-trailers of perishable and nonperishable food to resupply the hospital on Tuesday, as the facility continued to care for more than 400 patients.
With so many veterans and clinics affected by the hurricane and subsequent flooding, the VA has implemented plans to provide service when and where it is needed. Veterans are urged to seek care at the closest open VA medical center or outpatient clinic.
Those who are stranded, relocated or otherwise unable to get to a VA facility and need urgent care can receive care from the nearest provider through the Veterans Choice program under the Unusual and Excessive Burden category, explained Annapurni Teague, associate chief of staff for outpatient care at the Houston VAMC. Patients should contact the Houston VA and tell them where they are going for care and “we will put the wheels in motion immediately,” she said.
The Pharmacy Disaster Relief Plan also was activated, allowing affected veterans with a VA ID card to receive a 14-day supply of medications from any CVS or H-E-B online pharmacy with a written prescription or active VA prescription bottle.
A Mobile Vet Center from McAllen, TX, rolled into Corpus Christi to offer counseling services for veterans affected by the hurricane early in the week, while a Mobile Vet Center from San Antonio arrived in Houston a few days later. Veterans relocated to Dallas or staying in the Kay Bailey Hutchison Convention Center shelter had access to counseling services through a Mobile Vet Center from Lawton, TX.
The Emergency Management Mobile Clinic from Big Spring, TX, meanwhile, headed to Dallas as the hurricane passed. Staff from Big Springs, Amarillo and El Paso will operate the mobile care unit, which has a registered nurse and medical assistant who consult with a provider via video conferencing. The unit is expected to move to Houston as the city begins its recovery.
As of September 11, “the primary care community based outpatient clinics (CBOCs) in Beaumont and Corpus Christi, TX, are closed due to storm damage,” VA spokesperson Ndidi Mojay told U.S. Medicine. “All other VA facilities have resumed some level of operations and are providing service to veterans.”
“Corpus Christi is providing service to Veterans through a Mobile Medical Unit and Mobile Vet Center, providing both healthcare and counseling services. Beaumont also has a Mobile Vet Center on site along with two Mobile Medical Units,” Mojay said. A veterans’ canteen service emergency unit provides free meals to employees and veterans in Corpus Christi.
Despite the flooding, the Houston VAMC was able to help out other facilities shortly after the hurricane. Patients who usually received dialysis in Beaumont were unable to get to their usual clinic and were airlifted to the DeBakey VAMC. A nonveteran who needed emergency stabilization also arrived at the medical center via the helipad in the week following Hurricane Harvey.
“In this situation, veteran or not, our job was to provide immediate medical attention to the patient,” said Sherri Almeida, the head nurse on duty.
Throughout the storm and its aftermath, the VA kept that job in mind. “As of September 7, all deployed VA resources in Texas have treated or assisted 824 veterans, 202 veteran family members and 1, 518 non-veterans,” Mojay said.
Prioritizing care for all patients guided the response of VA employees throughout the hurricane and subsequent flooding, from the local staff that stayed for six days to ensure care to the VA volunteers throughout the region that came to their assistance. “Our nurses and medical providers have given of themselves in so many seemingly insurmountable ways,” said Kelly Irving, chief nurse, DeBakey VAMC. “As a nurse and leader, I don’t think I have ever felt more proud to be in this profession and part of this organization.”