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Editor's note: More than 60 volunteers from the School of Nursing have headed east to help with Hurricane Floyd relief efforts, doing everything from mopping up to giving tetanus shots. The following account -- which will appear in Carrington Quarterly -- relates the experiences of one of those volunteers.
By Susan Labyak, registered nurse and assistant professor, Department of Adult and Geriatric Health, School of Nursing
I signed on to my e-mail on a Tuesday morning, Sept. 21, just four days
after massive flooding had occurred in eastern North Carolina. This
announcement caught my eye:
EMERGENCY -- RNs NEEDED NOW!!
Before I knew what was happening, I found myself signing on for a
three-day tour of duty in the east. Shortly after I responded, Joy Reed,
director of Public Health Nursing, called to request that I join a group of
nurses leaving Raleigh at 7:30 the following morning.
After touching base with the powers that be at the School of Nursing, I
cleared my calendar and readied myself for the trip. We were instructed to
bring essential items, such as a rain jacket (preferably a poncho), heavy-duty
rubber boots, sleeping bag and change of clothes. I also packed my nursing drug
manual, Kleenex packets to distribute, antibacterial soap and several bottles
of water.
It was an incredible experience! Twenty of us (mostly public health
nurses) met in Raleigh at the N.C. Health and Human Services Building. Three of
the nurses had driven five hours from Hendersonville, staying overnight in a
local hotel so that they could help with the nursing effort.
Getting briefed
After signing in, we were given a quick breakfast and briefed by
the director of the medical staff. Speaking at length about the situation in
the east, he described the conditions that we would be seeing and living in.
Information sheets were handed out, alerting us to potential issues.
Quickly perusing the list, I hoped that I would not be confronted by the
first item -- the sight of caskets unearthed by the floodwaters. The medical
director encouraged us to focus on public health education by implementing
"good old-fashioned public health techniques." We were then transported by van
to the disaster headquarters for Pitt County, located in Greenville. Vans and
personnel were provided by Dorothea Dix Hospital for shuttling the assistance
teams to eastern North Carolina.
Before arriving in Greenville, we stopped at Wal-Mart, where we were
instructed to buy anything we thought necessary (e.g., bottled water and
snacks). Many of the nurses purchased games and items for the children living
in the shelters. The manager of Wal-Mart very graciously donated cases of
bottled water for us to take to Greenville, since the water supply was
contaminated there. It took us 15 minutes to load all the water into the
already crowded vans, and seating arrangements were altered to accommodate the
numerous boxes.
On arriving in Greenville, our team of nurses went through the usual
government bureaucracy. It took approximately four hours to decide where we
would all be going, and then it took another two or three hours to obtain
transportation and actually get to the site.
Water welcomed
Given the contaminated water in Greenville, one of our first
confrontations with the disaster was in the public restroom facilities.
Prominently posted in the restrooms were signs that read "FLUSH ONLY IF #2."
Drinking fountains were covered in large black trash bags, and above one
fountain was the warning "WATER NOT POTABLE -- DO NOT DRINK!"
Wal-Mart's donation of bottled water was put to good use. The public
health nurse in charge of the Women and Infants Program stopped to speak with
her sister, one of the nurses on our team. She was overwhelmed when we informed
her that we had this huge provision of safe water. With 900 children in her
Well Infant Care program, she had no water for mothers to use in preparing
formula. She loaded up her Jeep Grand Cherokee with boxes of water and headed
out, thanking us profusely.
I was one of the nurses selected to be airlifted across the Tar River for
relief work in a shelter. The area north of the river was flooded, and roads
were impassable. Everything from food and supplies to volunteers had to be
airlifted in. Seven of us flew by military helicopter, giving us an opportunity
to get a real bird's-eye view of the flooded region. The view was devastating,
preparing us for what we were about to see in the shelters.
I was paired with Marilyn, a Red Cross nurse who had been flown in from
California. She was a bit anxious, as it was her first assignment to assist in
a national disaster. I tried to reassure her, but it was also my first disaster
and I wasn't completely convincing. We were airlifted to the Welcome School
shelter, housing about 250 flood victims. However, our final destination was
the Stokes Elementary School, a shelter in the little town of Stokes.
At the shelter
After arriving by helicopter, we waited another hour for a ride to
the shelter. On the way there, our driver pointed out an abandoned car in a
nearby ditch. Two days before, an elderly couple had been trapped in the car
surrounded by floodwaters. Local residents rescued them by smashing car windows
to free them. Fortunately, the couple was brought to safety with only a few
cuts and bruises.
Organized by local citizens, the Stokes school shelter had been set up the
preceding weekend to accommodate victims from the flood that started late
Friday. By the time we arrived, everything was beautifully organized and
running very efficiently: the auditorium for sleeping quarters, one room for
clothing, one room for medical treatment/triage/first aid, another room for
toiletries, a large hallway for baby supplies and the cafeteria for food
brought in by airlift.
Locals were volunteering their time and energy to support and staff each
of these areas. In the cafeteria, a television was continuously tuned to
Channel 9, a local station providing updates on the flood situation and relief
effort in the east.
When we arrived, there were about 130 people living at the school,
representing a diverse group of African Americans, Hispanics and Caucasians.
Many flood victims had been living in mobile homes that were flooded out
entirely, so that most had no home to return to. Since the flood also
destroyed local crops and livestock, many residents were without work.
The Red Cross had shipped in cots for sleeping, and for several days there
was only one community shower in the custodian's room. By the time I left, two
more showers (plywood contraptions using water from a local fire truck) had
been rigged outdoors to handle the demand.
One of the volunteers extended some Southern hospitality and invited me to
her home to take a shower. The water supply in Stokes was fortunately on high
ground and had not been contaminated, unlike what we had seen in Greenville. We
knew we were also fortunate to have electricity, despite the constant fear that
the power would go out at any time as well as an ongoing effort by locals to
secure a back-up generator.
Strain begins to show
By the time the official Red Cross team arrived at Stokes, about an
hour before we did, citizens from the community had succeeded in setting up a
well-organized shelter. We arrived just in time to catch the "changing of the
guard" -- the official meeting between Red Cross and the locals. Community
volunteers were expressing concern that the Red Cross would come in and take
over their operation. The Red Cross, of course, tried to reassure them that
they would not "take over," but were there to assist.
By noon the next day, friction was quite high between the two groups, with
at least one-third of the community volunteers leaving the site and refusing to
work with Red Cross. Ultimately, the differences were resolved and the
volunteers returned, but it was pretty touch-and-go for a couple of hours!
While local volunteers expressed genuine and legitimate concerns, tensions
emerging from their long hours of maintaining and staffing the shelter and the
common desire to be there for friends and neighbors contributed to the
high-pitched emotional climate. Conflict would have been hard to avoid in even
the best of situations. A nursing professor from East Carolina, Gene Eakes, is
to be commended for her quick thinking and mediating skills. Thanks to Gene,
the locals and the Red Cross team met and were able to work through their
differences.
Largely, we gave first-aid treatment to individuals living in the shelter
and those coming in from the community in need of assistance: dressing cuts and
wounds, dispensing over-the-counter medications for colds and headaches, or
treating sick infants who weren't retaining their feeding.
Supplies, ingenuity enough
Medical staff was plentiful in our shelter at Stokes. Our full-time
resident physician was a local infertility specialist, who lived five minutes
from the shelter and spent about 13 hours a day in the clinic assisting with
triage and treatment. Other teams of physicians and nurses were airlifted in
for shorter stints. A number of nurses living in the community came to offer
relief. Many of them worked in hospitals and clinics across the river and
couldn't get to work, so they graciously donated their time to help serve their
neighbors.
Gene Eakes and her colleague Belinda Lee were airlifted in to assist for
24 hours. In addition to over-the-counter medication, medical supplies were
shipped in at periodic intervals, particularly since only one pharmacy was open
on the north side of the Tar River. We received a defibrillator with emergency
drugs for cardiac/respiratory arrest.
We also had a growing supply of pharmaceutical agents, including insulin
and an array of prescription hypertensive medications. Snake venom was flown
in for potential snakebite victims, and thankfully we did not have occasion to
use it. Snake venom was needed at the Bethel shelter, just several miles up the
road, for a young boy bitten by a water moccasin.
We ran out of tetanus serum the first night that I was at the shelter.
Although the public health service sent in a team of nurses to give injections
for a couple of hours during the day, government regulations prevented them
from leaving us any of the serum.
Thus, people who had been working in the murky water during the day and
coming to us for a tetanus injection in the evening were told that they had to
wait or go to another shelter for the serum. Overall, an adequate supply of
medications, in combination with nursing ingenuity, enabled us to manage with
what we had and cover most needs.
A comforting word
There weren't very many true emergencies. An elderly woman with
severe asthma came in one evening. We put her in our "recliner," a lawn chair
with an adjustable back, and gave her oxygen and a breathing treatment that
seemed to get her through the worst of it. Two local respiratory therapists
were called in to administer the treatment, avoiding a critical
situation.
Our biggest and most important task was to talk with the flood victims,
letting them tell their story and describe their doubts, losses, fears and
reality as they knew it. A common theme in these stories was that the flood
caught most people off-guard. Flooding didn't really become an issue until
Friday night, long after the hurricane had passed through the area. No one was
expecting what happened. Many didn't respond to the warnings, didn't evacuate
and were caught in the flood. A homeless dog found our shelter and was
faithfully guarding the entrance to the school. Very friendly, mild-mannered
and slightly overweight, this dog had obviously been well cared for before the
flood!
When I flew out on Friday, Sept. 24, I rode in a helicopter that had
several stops to make. The flight lasted about 40 minutes, and our route passed
over many of the stricken areas surrounding the Tar River. Words cannot convey
the emotional impact of viewing that scene. As it turned out, I never needed my
high waders or rain poncho. Waiting in Greenville for our transportation home,
a new team of nurses arrived -- many wearing boots, ready for the high waters
-- which made me laugh a bit.
As one of the public health nurses so aptly put it: "We came, we saw, we
went." The sad part was knowing that we were returning to the usual comforts of
home, while many of the folks whom we had gotten to know over those three days
would be in shelters for an indefinite period of time. It was an experience
that I will never forget, and hopefully things were a little bit better because
we were there.
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