Reaching Out to Those Most in Need

Sept. 8, 2005 — -- Like many Americans, Kyle Smart felt compelled to provide immediate help after learning about the extent of the devastation caused by Hurricane Katrina. But he decided sending a check from Southern California wasn't going to be enough.

"I just wanted to physically and tangibly go out there and show people that even out in California, we care," said Smart, a 30-year-old family medicine physician and a married father of three young daughters.

The reality of the destruction on the Gulf Coast hit home for him when he heard personal accounts from an old friend whose family lived in Baton Rouge, La.

"When I heard that he had three cousins missing, it was on my front door," he said.

Though several groups he contacted were organizing volunteers to provide medical support, he was told they would not be ready for another week. So last weekend, Smart joined fellow physician Jared Salvo and his friend James Crawley, a real estate agent, for a trip that started at Houston's Astrodome and moved to Baton Rouge, caring for evacuees with medicine and kindness.

A Holistic Approach

It wasn't the first time Smart responded to a natural disaster. In July, he spent 11 days in Sri Lanka where, six months after the tsunami, victims still had unhealed wounds and were gripped by post-traumatic stress and anxiety.

On this trip, he hoped to treat not just victims' physical needs but their emotional, social and spiritual ones as well.

The group found that people were actually faring better at some of the informal shelters set up in municipal offices and churches than at some of those established by the American Red Cross and other groups, because it is considered a liability for them to provide any assistance beyond food and shelter. Counseling is prohibited, as is dispensing over-the-counter medicines to ease headaches and diarrhea.

"The people who were getting help in a holistic manner were better off than the places that weren't offering those things," Smart said.

"They didn't have TV, Internet access. They didn't know how to begin to find their loved ones," he added. "The spiritual aspect, it depends whether an individual wants to get into that. Certainly that's not going on at the Red Cross and not even at the church in some places."

Altogether, Smart and his companions visited about 10 sites and treated about 220 patients for everything from infected cuts to rashes to chronic illnesses like diabetes and HIV for which people had no medication.

"We hit places that hadn't been touched by health care providers," Smart said.

"I expected just to go and do what I could," he added. "We encouraged the evacuees, but serendipitously we encouraged the other volunteers, the pastors, the Red Cross people, the National Guard."

Now that he's been back for a few days, the full impact of the devastation he witnessed has sunk in. "It was exhilarating. It was emotionally draining," he said.

"I think anytime you do something like this, you take away more than you can ever give," Smart added. "In reality, did we even scratch the surface? No, but I think in Baton Rouge we made a difference because we bridged the gap before the cavalry could get there."

Dispatches from the Southeast

During his trip, Smart sent e-mails to friends and family about his experiences. Below are excerpts from his accounts.

Thursday, Sept. 1

11:19 p.m. PDT

You may think I am some sort of adrenaline junkie, but I am not. I am taking a small relief trip to the southeastern states affected by the Hurricane Katrina. Like many of you, when I first began to realize the amount of devastation, I thought to myself, "I should do something." My responsibilities kept me from taking that urge seriously.

Then I checked up on a friend of mine from New Orleans, Louisiana. James and I have been friends a long time and he and his family have lived in Southern California for many years, but he has many friends and relatives in the south. He told me their accounts about people, survivors, refugees that are on the periphery of the destruction, crowding into churches, YMCAs, wherever. He told me about his three relatives that are still missing.

I soon saw a short, but definite hole in my schedule. We (James and I) are going to leave tomorrow, Friday night/Saturday morning and come home Tuesday midday. I will only have to call off one shift.

Our goals are: 1.To provide tangible support/relief. 2.To provide encouragement, hope, prayer. 3. To provide medical support where/if needed. 4. To gather information and contacts ...

Saturday, Sept. 3

10:01 p.m. PDT

What an awesome day. Today alone was worth the trip, and we still have two more days.

The Houston airport, lending to the stereotype of Texas, is big. A train system connects the five terminals. James and I arrived at 6 a.m. We finally connected with Jared, who arrived at 4 a.m., after searching for over an hour. James and I had some good time to catch up. James and Jared hit it off immediately, we were off to breakfast, then to the Astrodome.

The Astrodome and the surrounding area was amazingly quiet and serene.

We stopped at a Sam's Club, and it was business as usual -- one would not have known 25,000-plus evacuees (not refugees) were across the street.

We pulled into the entrance and were directed to physician check-in without incident. The place was a well-oiled machine -- it had been like that since yesterday. It was organized, coordinated, with a lab, XR, CT, pharmacy and plenty of providers. Most physicians were from Texas, we met one from New York. It was cool to be there. We registered, we networked with other docs, we interacted with the evacuees. I saw one patient, Jared helped organize the cardiac medications in the pharmacy and we bailed. We were assuming our efforts would be better served in less popularized areas. We felt very safe, and based on our first-hand conversations with people, there is a lot of misinformation going on both ways.

The five-hour drive to Baton Rouge was beautiful: open spaces full of lush green forest, which turn into wetlands and marshes, which turn into swamp land as far as the eye can see, which turn into waterways, rivers and bayous. Based on our contacts, we wanted to hit two sites in Baton Rouge, working into the night. One was a church (150 people), the other a university (500 people). Apparently both had not received any health care.

Well, we arrived at the church, where we were definitely needed. As Jared and I began to see patients, James went ahead to the university to scout it out. We were the first physicians that these New Orleans evacuees had seen -- they couldn't believe that we came from California. Wespent five hours there and saw almost 60 people. Approximately half are coping well. The others needed emotional and physical help -- there was a lot of hugging and crying. Most people in the latter group are still missing relatives (see next email).

We treated blood pressure, diabetes, muscle aches, wounds, skin infections, bug bites that have turned into skin infections, STDs, sore throats and ears and a lot of situational anxiety. This church is a great contact for anyone that wants to give directly to evacuees.

Needless to say, we are going to the university tomorrow as we are exhausted and ran out of time. The info James gathered on that site is that it is much like the Astrodome. The Manning brothers made an appearance there today, and there are plenty of providers. We are still going to go, but will look for sites that have not received any aid.

Finally, one of those little perks that inevitably shows up on these kinds of excursions: we ate at a very authentic Creole restaurant. The setting was right on the bank of the bayou, the climate was perfect and the food was delicious. Seafood gumbo, jambalaya, etoufee, shrimp, crayfish, catfish, oyster (cooked), frog legs and hush puppies.

The people are friendly and so far have received us well. The need is great. Thanks for all of your thoughts and prayers.

Saturday, Sept. 3

10:24 p.m. PDT

I probably do not need to send this to all of you, but it is the reality of the situation. All people listed below gave me permission to post their name and the names of the missing on the Web. They do not even know where to begin to look/find their loved ones. Please note the missing are likely only separated, not dead. I believe there are sites devoted to helping people find each other, and I am hoping one of you will forward this there. All of the people listed below can be contacted at:

St. John's Missionary Baptist Church

820 New Rafe Mayer Road

Baton Rouge, LA 70807

Pastor: Donald R. Ruth

Phone: (225) 775-9756

Marilyn Berry is missing grandson Allen Dequeie (5 years old), last seen with his mother, Trachell Williams (28 years old).

Alfred Galmon Jr. is missing girlfriend Raneeka Marsh, newborn Asia Marsh and children Alfred Galmon III and Antwon Galmon. Also sister Wanda Galmon and her boyfriend Lawrence Brown Sr and their six children Leonard, Joseph, Timothy and Lorenzo Galmon, and Lauren and Lawrence Brown Jr.

Darcell Brown is missing son Kenneth Brown (5 years old), last seen with godmother Susan Brock. Also mom Lorraine Brown and grandmother Marion Brown.

Nonya Grove is missing mom Nicole Winsey, stepfather Darrin Winsey, brother Darrin Winsey Jr. and sister Gabriella Winsey.

Akela George is missing aunt Sheka George and cousins Artamus and Amahd Rainey.

Sunday, Sept. 4

10:21 p.m. PDT

Another wonderful day. We spent 10 hours going to two Red Cross sites and three churches. I think it was unique to find a site that had not received any health care, as we did on the first night.

Hence, all of the sites today had previously seen physicians -- thankfully. We still saw 70 people.

Today we treated some higher acuity patients. A hospice patient dying of prostate cancer, an HIV patient that had been without her antiviral medications and a bipolar patient in an acute manic phase.

All of our objectives are being met. I have many reliable contacts for those of you looking to come out and help.

Monday, Sept. 5

10:04 p.m. PDT

We are back in Houston in time to get some rest. I am back to work tomorrow night. It has been a whirlwind, but we all feel like it was well worth it. We hit two sites today and saw another 70 people. Unfortunately, we were never able to get to the "waterfront" where the 5,000 were.

Sadly, today we came across two evacuee sites that had not yet received any health care -- that is six-seven days. We were overwhelmed by the need and by the people. These people were broken, and there were many emotional outbursts. I took care of one lady and her eight children, who poked and prodded Jared and I, while I wrote out all of their prescriptions. Jared worked with one patient that couldn't talk because of her uncontrollable sobs. James and his sister, Ladeta, were able to work with her, allowing Jared to keep seeing patients.

The five-hour drive back to Houston gave us time to debrief. We made some important realizations. One, the culture of the affected region, especially Louisiana, has deep and large family bonds. Where we might define immediate family as mom, dad, siblings and maybe grandparents, they define immediate family as the above plus aunts, uncles, cousin, etc.

So now you have a family group of 20 to 40 people living in and around their great-grandwhatever's home, that are now separated because of the chaos. Not only are these people traumatized, in emotional shock and have lost everything, but now [they] are left without a primary coping mechanism: family. Until this concept is identified and begun to be rectified, the emotional recovery will be hindered.

Secondly, we have visited approximately 10 evacuee sites, and the ones that have addressed all of the evacuees' needs were far more positive and better off than those that did not. In other words, it's great to house and feed people, but it's better to do that and give some basic medical and emotional support. The medical term is biopsychosocialspiritual approach (bio: medical; psycho: mental/emotional; social: family/finance; spiritual: beliefs/values). At one site, the volunteers just didn't know how to do this. At other sites, it was against protocol. Any help is appreciated, but there were definitely different levels of support out there.