Pamela and Peter Foreman
Pamela Foreman, who spent 10 days assisting victims of Hurricane Katrina, is back at home now grateful for all that she has.
The fourth-year doctoral student in the UCSF School of Nursing and her husband, Peter, were dispatched by the American Red Cross on Sept. 5 to Baton Rouge, Louisiana, days after the level-5 hurricane ravaged the Gulf Coast. The storm devastated Mississippi coastal towns on Aug. 29 and left most of New Orleans flooded when the city's protective levees failed at several points.
The disaster has led to more than 1,000 deaths, political finger-pointing, a Senate investigation on what went wrong and the resignation of the director of the Federal Emergency Management Agency (FEMA).
"On a national level, I don't think we are the least bit prepared for mega catastrophes," Foreman said. "On a personal level, it just goes to show that natural disasters can happen to everybody, and if you don't have your emergency supplies together, you're in denial."
When Foreman, an occupational health nurse, arrived on the scene in Baton Rouge, state health services officials were preparing to open a long-term shelter in a huge warehouse formerly occupied by State Farm Insurance in Monroe, Louisiana.
"We made history for the Red Cross," Foreman said. "Never before had the Red Cross opened a long-term residential shelter. We opened it with anticipation that it would be open for a year."
Today, the facility houses some 2,300 evacuees, including some displaced by Hurricane Rita, a weaker storm. The facility, which is self-governed with a grievance council, houses a Head Start program to help children and a post office. Wal-Mart personnel dispense medication orders and the volunteers from the American Red Cross deliver food daily.
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| Pamela Foreman, center, stands with two other volunteers, Kathy a nurse from Irvine and Steve, an EMT from Juno, Alaska. |
Although Foreman had responded to four incidents of flooding around the Russian River as part of the American Red Cross, her experience in Louisiana was a real eye-opener for several reasons.
First, she had never before seen hundreds of victims, mostly uneducated, poor African American men, women and children, virtually abandoned and left homeless after a single disaster.
Second, she was dismayed at the disorganization displayed by so many levels of the government in both preparing and responding to a major catastrophe -- despite the lessons learned four years after 9/11.
Third, she was quite shocked to witness racial discrimination among whites and blacks in the South, even in 2005.
Put in Charge
Based on her previous experience, Foreman was quickly put in charge of what would become and what remains a makeshift home for evacuees. She headed a team of 14 nurses and emergency medical technicians (EMTs), who came from all over the US to volunteer their services. After brief introductions and instructions, the group headed from Baton Rouge to Monroe, a four-hour journey on rural roads. The route was selected specifically because the remote areas, unlike the cities located off the main highways, had not depleted their supplies of gasoline during the mass exodus.
Once arriving at the former State Farm building, a 275,000-square-foot building the size of four football fields in length, Foreman and her team sprang into action, preparing to receive residents, setting up a clinic and mini-hospital, dividing living quarters into sections with cots for families, single men, and women and couples. They were assisted by some 200 volunteers and members of the National Guard every day.
"There was so much chaos at first, but eventually it became organized. Nurses are so great. They are accustomed to going in and getting things done," Foreman said of the 14 nurses from states as far away as Alaska.
"We literally moved a city of men, women, children and the elderly from the civic center in Monroe to the long-term shelter in the State Farm building. Many, who came from the New Orleans Superdome, were very tired and frustrated. It didn't take much to set them off. For some, it was their fourth shelter."
Foreman heard the countless horror stories from victims who escaped New Orleans, where anarchy reportedly reigned for days as scores of people were left to fend for themselves without food and water. Those who went hungry and dehydrated were the lucky ones, compared with evacuees who recounted stories of rape, robbery, battery and murder in the New Orleans Convention Center.
"The stories were terrible and heart wrenching. We heard them over and over again," she said.
A month after Hurricane Katrina, however, the Associated Press reports that some of the stories about the violence in the convention center and Superdome in New Orleans may have been rumors. Read the full story
here.
Asked why victims didn't leave when given mandatory evacuation orders before the hurricane struck, Foreman said, "I don't think they had the means or understood the gravity of the danger. These are largely uneducated poor people, who perhaps had limited resources or coping skills and they believed when they were told that the 'shelter of last resort' would protect them. That couldn't have been further from the truth!"
To create a safe place in Monroe, Foreman's husband, Peter, a former MP officer in the US Air Force, joined the security team that included local and state police, the National Guard, Homeland Security and the FBI. Everyone's belongings had to pass through an X-ray machine and the evacuees were screened for contraband before entering the shelter. About one-third of the evacuees declined to go to the new shelter in Monroe upon hearing of the heightened security measures ahead, Foreman said.
"On our first morning, we had a guy so stressed from the move that he had a heart attack, we had one evacuee treated for respiratory distress, a drug overdose and twin newborn babies, who had pneumonia," Foreman said. "All were sent and treated at a hospital a couple miles away and were returned to the shelter for the nursing staff to provide their care."
Disparity of Care
Fortunately, Foreman said, no one died at the State Farm shelter while she was there. But she did have to make tough decisions to triage the ill and injured, working 15- to 18-hour days.
"What struck me was the disparity of care," Foreman said. "I am not accustomed to thinking about people and deciding who gets immediate care and who has to wait. Those types of decisions are extremely distressing."
Cases ranged from those needing shots for hepatitis and tetanus for having been in toxic water from New Orleans, to those suffering from post-traumatic stress disorder, to minors requesting aspirin for headaches. Foreman had to turn away children who were not accompanied by an adult who could give consent for treatment.
As for the widespread criticism of the government's initial inept and slow response to the disaster, Foreman says there is enough blame to go around.
"It took FEMA a couple days to get there, and the problem with FEMA staff is that they came with laptop computers," Foreman said. "By and large, this was an illiterate community, they can't read, they are not computer literate and they can't fill out electronic versions of forms. That was a problem and it caused significant slowing of the process."
Despite long lines of evacuees waiting to process their emergency declaration forms, Foreman said that FEMA staff stationed at the shelter "packed up and just left after working an eight-hour shift. This caused a lot of frustration with the evacuees who had waited hours to be seen by FEMA only to have to repeat the process the next day."
And speaking as a first-line responder, Foreman says she thinks the American Red Cross should have a well-trained team of disaster experienced health professionals to be the first wave of responders to mega-sized national disasters, rather than relying exclusively on a mostly volunteer workforce.
"I personally think that the Red Cross needs to be better prepared to handle a mega-catastrophe by taking the approach to deploy proven, experienced reserve responders who are paid to practice and train for emergencies."
As for her role, Foreman says it was hard to leave such an underserved and needy population on Sept. 15. "But based on my experience, I understand that you give it your all and let another wave of volunteers come in. I knew going in I would have to leave the responsibility off to another nurse to supervise and manage."
Source: Lisa Cisneros
