Emergency Medical Care Meets the Needs of Wildfire Evacuees

When wildfires ignited across Southern California last fall, Gov. Arnold Schwarzenegger asked me to go to Qualcomm Stadium in San Diego and get a firsthand look at the medical care being provided to evacuees sheltered there.

I arrived on the first day of shelter operations and was immediately impressed with the programs and services already established. A medical clinic was completely staffed, and several large rooms around the stadium were designated for housing nursing home residents and other medically fragile evacuees. Many of the evacuated nursing homes ensured their patients were accompanied by nurses, medicines and other essential supplies.

In addition, a national retailer donated pharmaceutical supplies and a local hospital provided an on-site pharmacist to distribute medication to evacuees who were in need.

The Medical Reserve Corps set up a system to get trained medical professionals to the stadium and it was quite successful. As health-care workers arrived and began to serve the evacuees, an overall command structure developed quickly: A medical director position was established and an incident command center was set up to provide a coordinated approach to meeting the evacuees' needs.

I made rounds of the various medical units. There were clinical stations for a wide range of services, including ophthalmology and dermatology, to meet individuals' ongoing needs. Overall, evacuees received the food, water, shelter and medical care they needed, and were in good spirits. Movies were shown on the stadium scoreboard, TV sets were put near cots, and balloon artists and ventriloquists circulated among the crowd, creating a positive and supportive environment despite the devastation that was less than an hour's drive away. The evacuees were very grateful for the care they received.

Both evacuees and volunteers also appreciated of the visit by Gov. Schwarzenegger and U.S. Department of Homeland Security Secretary Michael Chertoff to check on their condition.

Though things went smoothly, the experience still offered some important lessons for responding to future emergencies.

While accompanying Medical Director Dr. James Dunford, as he toured the stadium, I saw that one of his major struggles was organizing the abundance of volunteers, equipment and supplies. The outpouring of generosity was so great that it became a huge logistical challenge. For example, when some doctors, nurses and other medical professionals arrived at the stadium unannounced offering to help, he had to quickly determine the best way to deploy them. He also had to decide how and where to store the donated supplies - a large task, and a situation some emergency managers don't consider until they are inundated with donations.

I came away from my time at Qualcomm Stadium with a better appreciation of the significant challenge of caring for thousands of individuals displaced during a major disaster. I also have a deeper gratitude for the professionals who stand ready to respond to our next emergency.

Another lesson learned from the wildfires - and perhaps the biggest - is the importance of state and local officials working together in a coordinated fashion. This cannot be overstated: In the aftermath of a disaster, when events are unfolding rapidly, collaboration is key.

Dr. Mark Horton is the director of the California Department of Public Health, and is a pediatrician and public health official with more than 30 years of experience. He also served as the deputy agency director and health officer for the Orange County Health Care Agency.