After Helene, clinician teams brought critical care to isolated WNC communities
By Jaymie Baxley
After the remnants of Hurricane Helene wreaked havoc on western North Carolina’s health care infrastructure, the N.C. Office of Emergency Medical Services deployed nine multidisciplinary teams of clinicians to waterlogged communities where residents were cut off from providers.
It was a complex undertaking that required the state to set up mobile treatment centers, medical support shelters and pop-up emergency departments in places with limited — or no — access to clean water and electricity. One team was forced to take a long detour through Tennessee just to reach the flooded county it had been assigned to.
Kimberly Clement, manager of NCEMS’ Healthcare Preparedness Program, said more than 1,000 patients were treated across the federally declared disaster area for issues ranging from respiratory illness to injuries suffered while clearing debris from their storm-battered homes. Some of the visiting clinicians stayed for nearly two months, leaving only after the situation had improved enough for local emergency agencies to resume regular operations.
The state recently deactivated its last medical unit in western North Carolina, a mobile clinic in McDowell County that stayed open for seven weeks after Helene blew through. Clement described the site’s closure as a milestone in the region’s long road to recovery.
“We want local health care providers to get back up on their feet so they’re able to do what they do normally, because they do a great job,” she said in an interview earlier this month with NC Health News. “But when their services are interrupted because of emergencies or disasters, that’s when our team steps in and says, ‘Hey, let us help out.’”
‘Rewarding’ work
NCEMS has responded to multiple hurricanes through the years, but Clement said Helene was “very different and very extreme.”
It was the first time in modern history that the mountainous western region of the state had experienced a catastrophic flooding event. The storm caused at least 103 fatalities and a record $54 billion in damages, according to an estimate from Gov. Roy Cooper.
“We had to adjust and change how we normally do things,” Clement said. “It’s not like when a natural disaster hits a large island off the coast where you can fly a helicopter in and drop the resources. This was very, very different, and it really involved our teams adapting and adjusting, and being willing to be super flexible.”
The site in Yancey County, a community of about 18,000 people in the heart of the Blue Ridge Mountains, was especially difficult to set up. Flooding from the Cane and South Toe rivers rendered several of the county’s roads and critical access routes impassable.
“A portion of the county was completely cut off — not only to the rest of the county, but to the entire state,” Clement said. “You had to drive about an hour and a half around into Tennessee to get back into that part of Yancey County. The road was completely washed out, so you were driving through people’s front yards to get to where the site was.”
The clinicians’ living conditions weren’t all that different from the conditions faced by many of the storm-displaced residents they went there to serve.
At night, they slept under a large tent next to the mobile medical unit, which Clement said was similar in size to a bloodmobile. Their meal options were limited to the contents of a mini-fridge powered by the unit’s electric generator.
“I think they were pretty tired of turkey sandwiches by the time they left,” Clement said. “It was true camping-style work for our clinicians who were out there, but it was very rewarding for them. Many of them really adopted that community and didn’t want to leave.”
While the clinicians were roughing it in the field, NCEMS was working to ensure that the site had enough supplies to stay online. Helene knocked most of the county’s utilities and businesses out of commission, forcing the agency to bring in water and fuel from other areas.
The Yancey County site was open for little over a month before the state deactivated it on Nov. 10. Clement said the community is “now connected back to North Carolina,” allowing EMS units to safely transport residents to Blue Ridge Regional Hospital in nearby Mitchell County.
Filling gaps
In addition to Yancey and McDowell, NCEMS deployed mobile units to Avery, Buncombe, Haywood, Jackson, Madison, Mitchell and Watauga counties.
The sites were open to anyone in need of medical assistance. Clement said patients ran the gamut from people experiencing typical “911-type things” like chest pain to residents who had suffered “fairly significant trauma.”
“There was a fair bit of wound care that was needed for people who were cleaning up from the storm and got injured,” she said. “One patient was trying to get a tree loose and off of a house, and the tree took that individual with them.”
People also visited the sites to replace medications that were lost or destroyed during the storm.
“We had a lot of diabetic patients who lost access to their insulin, and we were able to provide that insulin to them and make sure it was temperature-controlled,” Clement said.
If a patient was unable to travel to one of the sites for care, a clinician would pick their way over hazard-strewn roads to see them in their home.
“We had some people who were chronically ill or in hospice, or living with end-stage chronic obstructive pulmonary disease,” Clement said, referring to a condition in which people are at high risk of developing severe lung infections. “Our teams would actually set up and go into the community and care for them in their home to help support them because they had been disconnected from their normal health care system.”
The decision to deactivate the units, Clement said, was made after local emergency services providers told NCEMS that they had enough “stuff, staff and space” to respond to their communities’ needs.
“We’ve done this in many different disasters across North Carolina,” she said. “Sometimes, the local emergency staff can still work and they still have supplies, but they need a space to do it in. Sometimes they have the space but they need staff. Our role is to help support them so they can get back on their feet.”
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