Cameron Parish destruction

Today, I did a driving trip through Cameron Parish. I may have alluded to this driving trip made by others in team 2 when we had a 'day of rest' back in early October. At that time, the water was still high and the destruction nauseating. I guess I wanted to go to see what the Cameron residents went back to after they left our special needs unit and also to shed some light on the loss of these people as so much media attention had been given to the events of New Orleans. This was echoed during the nursing team meeting from the other day, the fact that Rita victims have been neglected in coverage and perhaps clean-up efforts.

Anyway, I did the trip through Cameron Parish and came back up to Lake Charles. I’ve created a narrated slide presentation for you all to check out via the U of MN’s server. Be sure to have the volume up loud enough. The link is here: http://breeze4.umn.edu/p13954177/

There were many songs of the day today that I encourage you to check out: Lucinda William’s 2 Cool 2 Be Forgotten, Howlin Wolf’s Moanin’ at Midnight, Bruce Springsteen’s My Hometown, Bruce Robeson’s Rayne, Louisiana and Lucinda’s Lake Charles. The IPod certainly came in handy during the 6-hour tour!

“Drove my [Lincoln Town Car] to the levee…”

Today was another laid-back day of touring. Carol’s friend Paul lent me his Lincoln Town Car for the trip yesterday and told me to keep it as long as I needed. So I was lucky to have it again to do a little more traveling in the region. I have been attracted to the Atchafalya River and basin since reading John McPhee’s book The Control of Nature and accompanying chapter about the river. Hilton Tacke is the immunization specialist for the region and seemingly the most quintessential Cajun of the people I’ve encountered on this trip. He’s made reference to ‘the basin’ numerous times, referring to it as being one of the best places to look for gators.

So today, I jumped in the Town Car (a much more pimped out ride than my ’93 Topaz!) and went east and north. What a trip! It was really awe-some seeing the giant levees that line the banks of the river. I captured a couple photos of the river, with a picture-perfect setting of the swamps, complete with cypress trees in water up to their bellies. Also, someone had introduced me to a local derogatory term, “levee trash”, which is used to describe some folk in the way ‘white trash’ describes some personalities elsewhere. I may have seen some of those people on my travels today.

I ended my trip in Lafayette, where I swung by the Heymann Center before going out to the Super Target. (The Super Target to re-acclimate myself to Minneapolis as my trip is winding down!) You may recall that the Heymann Center was our home for the first two waves of Minnesota Lifeline and the adjoining convention hall served as the special needs unit. When we had gone for lunch last Tuesday, I noticed a sign saying “Gun Show, this weekend at the Heymann Center”, which was funny to me because I had a dream or passing thought about that very thing before my trip down! The gun show was last weekend and today there was a Home and Garden Show in the same space as the special needs unit. I felt compelled to stick my head in and look around and paused in amazement at how time passes and things return the same.

Last night, on the very same stage that we slept on, Allison Krauss and Union Station played to a sold-out house. Today, there was a theater show that attracted many African-American theater-goers. I’m glad that everyone going into the Heymann Center was going in for a very different reason than we were 6 months ago.

I likely won’t get to journal on my time Monday as I’ll be crashing at Bruce’s place before flying back to Mpls very early Tuesday morning. My plans are to help out at the Lafayette PHU in the morning and most of the afternoon and attend my own class’s lecture by computer videoconferencing in the afternoon. I hope to pass on a little of what I’ve learned to my students.
Thanks all for tuning in to hear about my travels. Though this has all been mostly about my fun times down here, I plan to share the hard, public health details of the trip and where things seem tao be now, six months later, when I return. Love to my family.

Fightin' fowl!

Barbara, Roy and the girls have a pet rooster in the back yard. I upload this solely to embarass her!

Note to family- I tried to get my photo taken with the fowl, but it is indeed a fighting rooster and nearly pecked at me when I crouched next to it. Notice the leg-leash attached. (Thank God bird flu has not hit North America yet!)

Evangeline Oak

Barbara took me by the Evangeline Oak, immortilized in a Longfellow poem of the same name. I found it ironic that Minnehaha Falls was named after Longfellow's Song of Hiawatha and now I find myself standing by a big oak tree with the same historical context.

Apparently, in the story, the hero or heroine stands by the tree waiting for their love to come. Hence, my contemplative pose! (Yes...I've washed my clothes since the other day.)

Not "swamp nurse"

On-campus swamp on UL's campus (Yes...apparently there are gators in there!)

Thurs evening, Carol's house
Sorry for the delayed update, folks. I've had little internet access until tonight when I realized that I can bootleg a neighbors wireless here at Carol's! Couple that with a late evening at a 'drug dinner' (more about the reason why later), I've been too tired to do much else when I get home. Tonight, Carol and I are chillin' with pizza and beer!

The past couple days have included a lot of personal education. A nice thing about the trip this time around is that I get to learn more detail about the public health system and how it works. One of the fascinating programs I learned about is the Family-Nurse Partnership program, which was featured in a recent New Yorker article "Swap Nurse". Though the PHNs here aren't very proud of the sexy title, the work described in the piece and recent Nightline special (www.nursefamilypartnership.org) is pretty accurate of the tough kids/young families these nurses are seeing. Please check out the website and view the TV special, found on the right side of the page.

I had the very cool experience of visiting the UL-Lafayette School of Nursing yesterday and guest lecturing this morning. Though the topic of 'culture' isn't my favorite to speak on, the students were excited to hear about our Minnesota Lifeline experience as many people down here didn't know of the work.

Today, after the speaking gig, I went back to the office to help Carol with emergency preparedness work, was audience with Tina before her big-wig presentation tomorrow and ran out to St. Martinville with Barbara to see Kathy Guidry's beautiful, well-run ship at that PHU.

I'll save the fun day of tomorrow for a later posting, but I can say that it will involve crawfish and Lent. (Remember, Cajun-country is very Catholic.)

A quiet lobby

Despite the foot of snow in Minneapolis yesterday morning, I got out of MSP and flew safely into Lafayette. The weather is much nicer here than up there! (And the people remind me of it nearly every hour!)

Today was my first day at work and I returned to the Lafayette PHU under very different circumstances than when here last October. I walked into the lobby where 50-60 people had awaited primary care services after the hurricanes...there was no one today. It was a very quiet lobby indeed.

I was once again greeted by friendly folks, the real heros of public health. I delved into the 'STD clinic' in the morning and immunization clinic in the afternoon. I even got the chance to play nursing instructor to 6 UL nursing students when shooting up multiple babies with numerous shots!

I retired to New Iberia after my first full day of work. My host is Carol Broussard and I've enjoyed hanging in New Iberia. We finished the evening over at her mom's place were I was filled with much authentic 'Puerto Rican Cajun' food. (That's an inside joke!) I am concerned that I will return to Mpls much chunkier than when I left!

Six months later...

It's now the middle of March, 6 months since many of us were hosted by very generous friends in Louisiana. On Monday, I received a call from our public health nurse friends, Carol Broussard and Barbara Hebert, inviting me to return to help with the many activites that keep them busy. Apparently, there was a meningitis outbreak that proved to be fatal (killing two college students) to add insult to the Katrina and Rita injury.

I'm excited to go down and look forward to helping out again. In a selfish way, I may find closure to my experiences then since I left so abruptly on October 5th. But that will be a small part of simply getting away for a while and doing what I like to do and do best... the 'public health nursing thing'. I look forward to sharing my experiences with you all!

I leave Monday the 13th and will begin work on the 14th. See you then!

Scott

Scott is home

Folks, I apologize for not being able to update the blog since earlier this week. I returned home to SW Wisconsin Wednesday afternoon because of family emergency.

I've emailed others in Louisiana who were interested in keeping the blog and hope they will be able to continue updating us on the exciting news from Lafayette. From what I hear, there is good news coming!

Thanks for allowing me to tell the MN Lifeline story through this week. I also encourage you to visit the Rochester MN Post Bulletin, where a blog has been kept by the reporter and photographer visiting us earlier this week: http://www.postbulletin.com/.

Scott Harpin

Cajun Dome shot clinic

Saturday was an especially busy day for the team as we put into place a group effort of mass dispensing of immunizations at the Cajun Dome. After the Superdome in New Orleans and the Astrodome in Houston, the Cajun Dome's name pops up as one of the main evacuee shelters for the hurricanes; Lafayette's honor of being on I-10 between these two major cities makes it a main stopping point for visitors traveling between the two points.

The Dome was dauntnting, yet personable. The folks there were very nice and very gracious. With the help of Hennepin County and U of MN mass dispensing experts as telephone consultant planners, we were able to effectively and efficiently immunize many residents. (I wish I could quote a solid number, but it hasn't been released yet. 1800-2000 people would be a solid, random guess.) Most important, we didn't have long lines, nor clamoring violence from people waiting to get immunized.

The team all pitched in well and worked smooth. It was fun to see a multi-disciplinary group of healthcare workers and non-healthcare workers on the same page. Our fearless leader, Dr. Karyn Baum, can be seen above working with a prospective client in the 'health education' and consent phase of the clinic. A myriad of nurses, physicians, psychologists, counselors, clinical ass'ts, med students and even National Guard members (our friend, PFC. Sylvester, interpreted for us at one point during the day, 12-gauge shotgun en tow!) pitched in to aid the effort.

After this exhausting day, teams and vans scattered to enjoy the fruits of their labor with cheerful team building throughout Lafayette. The following day would be a day of rest as week 1 came to a close.

"Police juries"

Our team has felt a shift in the mission of the group today as we are clearly making a move away from acute care medicine and post-crisis stabilization to more of a public health model and healthcare sustainability within the public health units. There is still great need in emergency shelters, but we have felt all along that the main mission of working closely with the PHUs is a chief goal and one that must remain center on the radar screen. Today, we continued discussions with public health leaders in various parishes and consciously made efforts to complement services in PHU physical space as opposed to creating new clinics in alternative locations.

While out talking to PHN leaders, we learned of 'police juries', the former name of the parish councils or our equivalent of county boards. In St. Martin's parish, our van even went to meet the parish council leader who offered some great insights into the public health needs of that parishs' residents. In Vermillion parish, our team met with a local mayor to talk about what is going on in that community. As a public health nurse myself, it is great to see the shift to public health thinking in our team which tends to lean as having more experience in acute care settings.

Tomorrow, we'll continue our work in the communities and partner with the local agencies to build their effort. We hope that we lay the groundwork so that team 3 can come in and pick up where we left off with ease.

Day of rest

Sunday was a cathartic day of rest after a highly successful, yet tiring day of mass immunizations at the Cajun Dome. (Check out the yet-to-be posted post on that effort.) Teams slept in and gathered up van loads to go out and tour various sites in Cajun country. Many vans went south into the extremes of 'death and destruction' left by Hurricane Rita along the Intercoastal highway, especially in Cameron Parish which we've heard is virtually condemmed. Many happy, excited tourists returned very sober and moved after viewing these sites during their trips. Luckily, we've heard that there were no human deaths with Rita in Louisiana.




Scott's van-mates on the Gulf Coast south of Franklin, on the way to Morgan City.







At days end, nearly the entire team found themselves at local eating joint Prejean's for cajun food and atmosphere. There were no late nights as we, exhausted from the busy weekend, had to motivate for a new week and gear up for a renewed mission. (More about that in a later posting.)

We send our hearts out to one of our Lifeline team members who had to return home for her father's funeral. Wendy, we're with you in spirit and you're with us the rest of our days here in LA.

Vaccinations galore!

Our team is gearing up for a grand adventure of mass vaccination at the Cajun Dome tomorrow. To build team for this effort, we've started a pool to guess the total vaccinations given by Team 2 over this two week period. Following a brief inservice, we practiced on each other by giving annual flu shots. This effort will be all the more extraordinary as we are staffing our Lafayette clinic and Special Needs Shelter minimally so the entire team can be a part of the day. We anticipate much revelry tomorrow evening after a successful event.

Friday night was also a night for more team-building, at "Downtown Tonight" and at the now-infamous Blue Dog Cafe.

"Katrita" effects

During our command team meeting this evening, one team member referred to the bulk of people we are seeing these days as being "Katrita" victims, an amalgam of victims from both storms in many cases fleeting both storms this past month. The stories of double-upheaval are striking in an already trying time.

Wednesday saw the beginning of our effort in two new communities: Kaplan and Mamou. The needs were as great as expected in the southern parish town of Kaplan and the team in Mamou could've spent another day seeing folks. However, our focus continues to be taking care of the special needs unit back 'home' and further establishing our presence at our flagship Parish Health Unit (PHU) clinic at the Public Health Unit here in Lafayette.

Our special needs unit saw many discharges throughout the day, giving us a bit more breathing room to reach out to our other sites with precious staff. We reserved shots until reinforcements arrived from Baton Rouge; gearing up for our mass-immunization clinic at the Cajun Dome (yee-haw!) this coming Saturday. Thank you to Hennepin County and MDH folks who offered a wealth of information to aid us in planning this effort!

Finally, we've had an integration of teams with teamwork that is clearly evident in our work and play. We come from the University, Mayo, Fransiscan Skemp in LaX, Eau Claire and Mankato, but we feel like 'Minnesota Lifeline' and are 'the folks from Minnesota' to the locals.

Health protection & promotion

We've seemed to hit the apex of admission needs over in the special needs unit. One person described it in healthcare linugo: "It is like a giant medical unit in a hospital," as medical needs have increased as has acuity these past two days. Yet, this night shift has seen no new admissions and the day shift was amazing at d/c-ing folks.

But we are not forgetting our colleagues working out and about in various parishes, getting primary care needs met and introducing health protection amongst the people. I can't cite exact numbers at this time, but client acute care visits have numbered in the 90s in the local public health for two days straight, up from 60-70/day by report from last week. (This is all in a 8-9 hour shift.) Vaccinations...an amazing story. It is now common practice to have the vaccine coolers of 200-300 shots come back empty from vans coming back from rural parishes. We estimate 600-700 individual shots given Tuesday at Lafayette Parish PubH Unit, most by one nurse as our staffing has felt the effects of less folks in round 2.

One particular community to think about, and pray for (if you pray for things), is the small town of Kaplan in Vermillion parish. The town was visited by Team 1 admin folks yesterday and they spoke of abject poverty and high-needs in the people holed-up in the VFW shelter there. Please pause to consider their lives.

A shift in focus

We've heard that Hurricane Rita was bad. We've heard it through the stories of the people we see in Lafayette, in Abbeville, in New Iberia, in Ville Platte. Yet, these stories didn't seem much different than the ones we heard from folks living in New Orleans affected by Katrina.

Rita became more real as we witness the dramatic increase of patients coming into our Special Needs Shelter. You saw the photo of the FEMA helecopter drop two days ago. Now we've seen an amazing run of patients in the past 24 hours that has made us pull resources to staff a near-literal hospital unit, full of respiratory cases, med cases, psych cases, etc as the hospitals in town are busy and full themselves.

We've shifted our focus to help in this extreme time of need. Nurses getting back to basics, being true generalists, physicians, NPs, the entire team pulling together in a way that would write the book on 'teamwork' for the School of Business.

Note to family: Yes...it took me only two days to pull off a 24-hour day. No...I promise I won't repeat it!

The torch is passed!

As we near midnight of the first day for team 2, the torch is passed. The team 1 Mayo buses left this afternoon to head north and the U folks have one more morning trip planned to head south for the striken towns of Abbeville and New Iberia.



This officially signs-off Dr. Eric Meininger (left, above) as the "keeper of the blog" and charges Scott Harpin as the current torch-bearer. I hope I can keep it nearly as well.

Hats off to you, Team 1! Safe travels home.

Happy Hour

Kevin Smith and Cristina Baker discussing the patients of the day (yeah, right!)

After a record breaking day of just shy of 100 patients at the Lafayette Clinic, we stopped off for happy hour at the Filling Station, a local watering hole while waiting for the rest of the team.

A Busy Afternoon

The Mobile Pharmacy

We made it back to home sweet Heymann Center and were deployed almost immediately, this time to a shelter in the New Iberia Senior High School. Driving down, it was apparent the amount of damage from wind and rain the area had sustained. I'm glad we evacuated.

We had a busy afternoon. One patientt I saw had been staying with his sister in Abbeville, hitchiked down to New Orleans just before the hurricane, came back to Abbeville when his home was flooded - now her home is under water.

A mix of patients was about half evacuees from New Orleans, and about half that were either from Texas or the flooded local areas. A number of folks were from Port Arthur where hurricane Rita made landfall.

It's our last night in Louisiana - the next team should be on the bus heading down here by now.... Hopefully we will be able to have a good time debriefing tonight once we gather our bags.

Returning to Lafayette

FEMA now has a presense in Lafayette

We broke camp early this morning in Mississippi, and arrived back in Lafayette early in the afternoon.

Along the way we dodged a few tornadoes (just kidding!) - but we did pull aside because their was a tornado supposedly following the same road we were driving on. We pulled off at a church which looked like a good shelter, but it turned out to be open only the third Sunday of the month. We stayed there about a half hour until the threat of tornados was past. As we were leaving, the sheriff pulled up because several townspeople had called to report suspicious activity.

On the way out of town, we stopped to get gas (they were out) - When he asked where we might find gas, one of our docs who is of Panamanian descent had his license run we suspect because he isn't Caucasian.

How to be fluid

Dr. Wilkenson shows us his prize for fluidity, "the wacky water wienie" - rumour has it that the Mayo wouldn't sanction it for the official Mayo Clinic blog.

By the way, if you haven't seen the Mayo blog, written by Carolyn Petersen, the link is on the right along with the ARC website.

Category Five

Theresa Wytaske and David Hilden after the fraternizing rules got lifted. The forward team left, and our licensed sexologist, Simon Rosser was added as a team leader. We decided that we had reached category 5 status, and threw a hurricane party.

No, they weren't delivering a baby.... The wine was a little stubborn :)

Plans are that we will relocate tomorrow at 7 am if the forward team feels that things are safe. Apparently the National Guard has taken over digs at the Heymann center, so rumours are that we may be sleeping at the Cajun dome.

Evacuated Again

As hurricane Rita wanders North, she spun off several tornadoes. One was sighted 4 miles west of the camp we are staying in. We evacuated, once again - this time to the designated shelter using Simon's public health evacuation plan we had set up only the night before. Fortunately, the tornado was heading west of us.

Camp

Here is a picture of the cabins we are staying in to ride out the storm. Not quite the luxury accomodations we were led to believe. The air-conditioners are big swamp cooler units on the roof, and the showers are less than desirable.

Hopefully we'll be able to relocate back to Louisiana soon. I'm looking forward to the new team coming in - two weeks has been brief and an eternity at the same time.

High Water Mark

I picked up a copy of 'Good Poems for Hard Times' selected by Garrison Keillor. I flipped it open almost eerily to this poem by David Shumate:


High Water Mark

It's hard to believe, but at one point water rose to this level. No one had seen anything like it. People on rooftops. Cows and coffins floating through the streets. Prisoners carrying invalids from their rooms. The barkeeper consoling the preacher. A coon hound who showed up a month later forty miles downstream. And all that mud it left behind. You never forget times like those. They become a part of who you are. You describe them to your grandchildren. But they think it's just another tale in which animals talk and people live forever. I know it's not the kind of thing that you ought to say . . . But I wouldn't mind seeing another good flood before I die. It's been dry for decades. Next time I think I'll just let go and drift downstream and see where I end up.

(reprinted without permission)

Waiting for the Rain

One of the drive-thru liquor stores we drove past in eastern Louisiana yesterday

We stopped at Barnes & Noble after driving around Jackson, Mississippi this afternoon. If I'm going to spend a day inside during the storm, and possibly 20 hours on the bus, I needed a few books. I didn't plan on having large segments of down time, and while I've been able to amuse myself by answering e-mails for short periods of time, there is no cellular internet ouside of the big cities here, and only 8 laptop that Mayo brought. I picked up the new Harry Potter and the DaVinci code - I should be able to keep myself entertained for a while...

Henry S. Jacob Camp

We're here -- we've arrived in Utica, Mississippi. A group went into town -- and turned back around. It's going to be a slow few days. I'm hoping I can scare up a good book somewhere before the rain starts.

I have several posts that haven't made it up on the blog yet -- sorry. As soon as I have cellular internet connectivity I'll beam them up.

We're looking forward to the arrival of the next team. It's not clear yet whether we'll move back to Lafayette, or stay here and fly back home from here.


I talked to Scott Harpin from the wave 2 team this evening - I'm hoping that he'll be able to continue the blog through the next 2 weeks so that those of us from the first group can continue to follow vicariously, and the folks from the third group will have some idea what they're walking into.

Everyone evacuated safely

Everyone evacuated safely. We are enroute to Utica, Mississippi. We are all safe, well in advance of the Hurricane. I won't be able to post pics for a while until I have access to wireless internet again.

Goodbye to the Heymann Center

Because of the evacuation and the impending hurricane, this will likely be the last time we see the Heymann center in Lafayette, although I anticipate that wave 2 of deployed providers will likely stay here until other accomodations are arranged, or the theater needs the space to put on a production.

Interestingly enough, it's still sunny and warm outside, with no sign of rain. It all looks normal until you realize that the clouds are moving from East to West - opposite of the way they usually go. The meteorologists are predicting a significant storm surge (in addition to all of the rain). They say the ocean could come inward up to 50 miles - we were much closer to the coast than that, so it's good, I suppose, that we're relocating for a while.

Pit Stop

One of the gas stations we stopped at while evacuating also sold bait.

I've been to Louisiana a number of times - between interviewing for my residency, and a number of conferences, but as I reflect on our experiences - the people we've met and the countryside we are seeing - I realize how little of it I know.

Hi to Beth's mom

As I said, there was a lot to be done packing up, yet we were mostly milling around waiting to leave.

The long road home

Simon Rosser catches 20 winks enroute to Utica.

As we drive to Utica there is a significant amount of traffic heading in the same direction, making the going slow. Normally it would be a 3-4 hour trip, but I suspect it will be evening before we get there.

For those who are wondering, here are some stats on what we had accomplished through Tuesday, September 20th (courtesy of the 'News from Camp Cot' newsletter):

¤ A total of 3,433 immunizations were given
¤ At 4:30 Wednesday morning a team immunized workers at the Cajun Dome who were on their way to New Orleans to assist with clean-up

For those who are following on a map, we're just about to cross into Mississippi - almost 2/3rds of the way to our evacuation site. Now we're evacuees too...

Demonstrating the correct use of the satellite phone

Here is Jon Hallberg demonstrating the more effective way of using the satellite phone. Unfortunately, the sat-phones have not been particularly reliable.

Making sure the communication equipment is working

Here is Tim Schacker making sure the satellite phone is working.

Striking Camp

Here is the men's side of the stage about half packed up.

As has been the history, upon return it was hurry up and wait. There really was a lot of work to be done, but it wasn't well organized. It felt more like we were milling around. Eventually we had all of the bags packed, loaded in trucks, and we are off. Everyone is now on the road as we head to the Henry S. Jacob camp in Utica, Mississippi.

Evacuation!

With Hurricane Rita reaching category five status then suddenly veering North, many of the Parishes of Louisiana south of interstate 10 declared either voluntary or mandatory evacuations.

New Iberia and Vermillion parishes had been under voluntary evacuation since early morning, so we called off the clinics that day at the Iberia Inn, the New Iberia public health department, and Sacred Heart. As a result, the entire UofM team (along with some of our Mayo colleagues) went to staff the Lafayette Public Health primary care clinic.

We called in at noon as requested from a busy clinic and were told that the decision had been made that we would evacuate immediately. I must say, I've never seen a clinic emptied that quickly. I practically turned around with my last patient, and suddenly the entire building was empty.

National Guard

We've been kept safe by the Louisiana National Guard. Here is Corey Suire, a guardsman from New Iberia, Louisiana.