Nov 22, 2017
by Gary Pace M.D.
As we cope with the massive impact of the fires in our community, the current and future health impacts have started to come into focus.
First, we start with acknowledging a profound grief for the people who died, and for those who lost their homes and businesses. At the same time, we express deep gratitude for the protection offered by the firefighters and first responders who selflessly protected the community.
In the context of these harrowing events and the floods in Houston, Miami, and Puerto Rico (likely also exacerbated by climate change), it seems useful to look at the impacts on the public’s health. Last month, we talked about longer-term strategies for trying to shift the trajectory of climate change (mitigation). Here will will be looking at more immediate health impacts of the fires, with a few thoughts about how to cope (adaptation).
On the night of October 8 fire ripped through the community. Immediate health effects were starkly illustrated by the iconic pictures of nurses at Kaiser and Sutter wheeling patients on gurneys out through the flames to transport them to other facilities. The loss of major health facilities for up to two weeks demonstrates the vulnerability of our system during disasters. These institutions all did remarkable jobs in getting people to appropriate levels of care, shutting down the hospitals until safe to reopen, and diverting patients for emergency services.
Evacuees went to community sites, with approximately 4000 people in public shelters at the highest point. Many of these people had medical issues, and often they didn’t have their pills with them. The vulnerability of people with mental health needs, addicts in treatment, and medically fragile patients who barely make it in normal times, all were increased in these settings.
Health effects from the fire persist, even now that the immediate danger has passed. Smoke inhalation was a major concern for a few weeks afterwards. Environmental toxins from the ash contaminate the soil and will eventually enter the watershed. What are they going to do with all of the topsoil from the burnt areas, anyway?
The fallout can take months to years to resolve. As a cautionary tale, Puerto Rico still has about 80% of its population without power, and a high percentage without access to clean water. Lake County still has not fully recovered from the last round of wildfires.
The protracted discouragement from homelessness, employment loss, PTSD, and grief will have a profound impact on the wellness of our community. Longer term disruption of usual medical services (VISTA Clinic, a source of care for thousands of patients was damaged and will be closed for months), and a predicted loss of medical providers due to housing shortages may be significant
Conclusions: Probably support will be scarce from the federal level, with President Trump not even offering public condolences for the disaster. County and state leaders have been very involved, and a special acknowledgement to Sheriff Giordano for standing up to federal harassment during the crisis.
Probably the most important lesson from this cataclysm is the value of local community resilience. The incredible outpouring of neighbors helping each other has been phenomenal, and fund-raisers and donations keep flowing. In the days immediately following the fires, volunteers were showing up at shelters and food distribution sites non-stop.
As examples from my small perspective, I watched the Ceres Project help prepare and distribute hundreds of meals daily to evacuation sites and community hotspots; HPEACE helped organize medical volunteers for the evacuation centers; Graton Day Labor helped organize the UndocuFund to direct resources to undocumented people who lost homes and jobs. Each of this column’s readers can probably list multiple examples of selfless giving by neighbors and organizations during this time of need.
These community structures need to be nurtured, communication lines and decision structures strengthened, and disaster plans developed. Fires and floods will likely be returning, and with greater frequency and ferocity. We have experienced what works best in these situations – our natural human caring and ingenuity. This is a great antidote to our current political climate, and a potent force for positive change for coming challenges.
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