As wildfires ravaged southern California’s San Diego and San Bernadino counties from October 20 to November 9, 2007—scorching more than 775 square miles, destroying more than 2,000 homes, and forcing the evacuation of more than 200,000 people—the American Red Cross (ARC) asked the Johns Hopkins Center for Refugee and Disaster Response, an arm of PACER, to provide a team of physicians and nurses to assess and enhance the effectiveness of public and private agency reaction to the calamity.
Thomas Kirsch, M.D., M.P.H., who is the center’s co-director, as well as deputy director of Johns Hopkins’ Office of Critical Event Preparedness and Response (CEPAR), another PACER member, and medical director of ARC’s disaster health services, assembled a team of five physicians and one nurse, all trained in epidemiology and emergency medicine. They flew to California to provide support to the devastated region’s shelters and Local Assistance Centers (LAC). The county-administered LACs served as efficient, one-stop sources for disaster relief services, as well as provided access to leading federal, state and county respresentatives and such voluntary organizations as the ARC and the Salvation Army.
In addition to Kirsch, other members of the team were Daksha Brahmbahtt, R.N., M.S.N., from the Center for Refugee and Disaster Response (CRDR), the Hopkins’ Bloomberg School of Public Health, and the Hopkins’ School of Nursing; Lauren Cooper, M.D., M.P.H., a senior international emergency fellow at CRDR, the Bloomberg School and Hopkins’ Department of Emergency Medicine; Emilie Calvello, M.D., M.P.H., a senior emergency medicine resident in Hopkins’ Department of Emergency Medicine; Edbert Hsu, M.D., M.P.H., director of training for CEPAR; and Jennifer Lee Jenkins, M.D., M.P.H., assistant chief of service and senior disaster fellow at CEPAR.
During the thick of the disaster, from October 27 to November 3, the six-member team conducted surveys of 158 affected households—questioning more than 500 people—to determine their healthcare, shelter and other needs. Team members also provided public health and healthcare advice to the management of the local shelters and the ARC headquarters in the area.
The team assessed if the immediate needs of the disaster-affected population were being met. Although it found some difficulties in obtaining healthcare, with about 30 percent of the families requiring the attention of a healthcare provider within the first seven days of the disaster, for the most part the affected population’s needs were being addressed, according to the surveys.
An interesting, preliminary finding of the team was that most of the evacuated families appeared to stay with relatives or friends, rather than in public shelters. That finding—plus the fact that many people moved frequently between shelters, friends or relatives, and hotels—may mean that the placement of shelter services might need re-evaluation and improvement.