Specialized Disaster Team Undertakes First Mission for San Diego Fires

SAN FRANCISCO– A unique team of Bay Area disaster specialists led by a San Carlos man was dispatched on its inaugural mission last week to San Diego County, where they provided medical support to people displaced from their homes by the firestorms that ravaged the region.

The 43-member California Medical Assistance Team raced to Southern California on Tuesday with a police escort to assist local agencies in meeting the medical needs of thousands of residents forced into temporary shelters.

It was the first deployment for Cal-MAT, which was established this year at the direction of Gov. Arnold Schwarzenegger in response to Hurricane Katrina in 2005, when residents of New Orleans waited several days for help to arrive from the federal government.

Beginning Wednesday, Cal-MAT doctors treated patients, sent out strike teams to perform assessments of medical needs at local shelters and helped the American Red Cross set up a medical clinic at the Del Mar Fairgrounds, the horseracing venue that served as one of San Diego County s major evacuation centers.

In each instance, Cal-MAT s role was to augment local services.

“We go down to the locals and say, We re yours, where do you want us to go? ” said Sam Bradley, disaster response manager for the state Emergency Medical Services Authority, which oversees Cal-MAT. We do whatever they want us to do.

Cal-MAT gives the state the ability to send doctors, nurses and emergency medical technicians within hours to help overwhelmed local authorities manage disasters such as earthquakes and fires.

The teams are equipped to operate for 72 hours, if necessary, without any outside support, bringing their own power, shelter, sanitation, water and medical supplies.

In the event of a disaster that results in mass casualties or renders hospitals unusable, such as the Northridge earthquake in 1994, Cal-MAT crews are now capable of setting up and running a fully functional field hospital with 200 to 300 beds.

Cal-MAT s first mission began early Tuesday morning, when automated calls went out to the program s Northern California roster, which draws from the Sacramento and San Francisco areas. In a matter of hours, team members were assembled at a staging area in Menlo Park. By Tuesday night, Cal-MAT was setting up its headquarters in a conference room at the Del Mar Fairgrounds under the command of Dave Lipin, 41, a trained medic and former executive at a software company, who lives with his wife in San Carlos.

On Wednesday, four-member strike teams were sent to three smaller shelters to see if they were capable of handling evacuees medical needs, from filling prescriptions to treating respiratory problems stemming from smoke inhalation.

Two shelters, one at a high school and the other at a casino, were doing just fine, with not a patient to be found, Lipin noted later. But at the third, in a community center in the city of Poway, Red Cross volunteers and city employees were not prepared to handle any medical crises.

Almost as soon as the team arrived, an 88-year-old man with a history of heart problems collapsed from the heat. Three team members — a doctor and two nurses — diagnosed him, made him comfortable and called an ambulance, which whisked him to a hospital.

The team ended up spending the night at the Poway Community Center, which held about 125 evacuees. They set up a counter for performing triage, established a private room for treating patients and helped make sure the center had the necessary prescription medications.

At Del Mar, Cal-MAT doctors reorganized the shelter s medical clinic, which had been set up behind the intake counter for evacuees, to give patients some privacy. The clinic saw about 30 patients Wednesday and Thursday, according to Dr. Kent Garman, one of three Cal-MAT doctors stationed at Del Mar.

We are less busy than I thought we would be, but that s OK, said Garman, a professor emeritus at the Stanford University School of Medicine. You never complain when you have fewer patients than expected.

Garman, who until recently lived in Half Moon Bay and is helping to establish a medical reserve corps there, said he treated a host of minor injuries, including muscle pulls, scrapes and bruises, itchy eyes and asthma flare-ups.

On Thursday, two-member strike teams were sent out to perform needs-assessments at 11 shelters.

These people want to be challenged, (and) they want to be in the thick of it, Bradley said. If there was an 8.0 earthquake, they would want to be right on the front lines ready to assist those in need.

Most Cal-MAT members have seen situations much more dire than what they encountered in San Diego County, because Cal-MAT s roster is drawn from federal relief teams that served as the model for California s program.

Several team members at Del Mar responded to the greatest disasters in recent American history — the terrorist attacks of 9/11 and Hurricane Katrina.

Barbara Morita, a physician assistant who lives in Berkeley, traveled to both catastrophes with Lipin, who is in charge of the Bay Area unit of the federal program. In New Orleans, they wound up stationed at the Superdome, where refugees endured nightmarish conditions.

We now have this standing joke that we would follow Dave to hell and back — oh, wait. We already did that, Morita said.

But plunging into those sorts of hellish conditions to treat disaster victims is where Cal-MAT members find fulfillment.

You hate for there to be a disaster, but when there is one, you want to be there, said Judy Mahan, an emergency room nurse from Modesto. It s in your makeup.

Erick Digre, an EMT and the husband of Pacifica City Councilwoman Sue Digre, said he simply can t imagine not giving disaster relief.

The team s level of activity picked up Friday morning, as it prepared for the arrival of evacuees from Qualcomm Stadium, the biggest shelter in the county. Qualcomm, which held 10,000 or more evacuees earlier in the week, was being shut down, and the people who remained there were being transferred to other facilities.

By Friday evening, however, only 25 or so of Qualcomm s evacuees had shown up at Del Mar, and the Cal-MAT team was looking to wind down its operation, Lipin said.

Though disappointed that they weren t able to contribute more to San Diego s relief effort, team leaders said their inactivity demonstrated the robustness of the local, state and federal response to the fires.

It s always better to over-respond than to under-respond, and it s always hard to do it just right, said Lipin.

This was a very good test, if nothing else, to prove that we could (deploy) quickly, he said, and that if there was a prolonged or larger need, we would be in a good position to meet it.

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