Through hurricanes, VA continues efforts to care for Veterans

For the latest on VA’s response and inspiring stories of service to Veterans impacted by the hurricanes, read more on the blog.

Millions were affected by Hurricanes Irma and Maria, storms that occurred at the height of the 2017 hurricane season that set astounding records and impacted every VA hospital and community clinic in VA Sunshine Healthcare Network’s 64,000-mile service area in Florida, South Georgia, Puerto Rico and the U.S. Virgin Islands.

Despite the destruction caused by these monster storms, Veterans continued to receive vital health care and other support, thanks to the selfless efforts of thousands of dedicated VA employees who rallied together to provide around-the-clock care for patients sheltered-in-place in the eight large, hurricane-constructed VA hospitals and to get services back up and running in dozens of outpatient clinics impacted in the Southeast corridor of the U.S. and the Caribbean.

Hurricane Irma: construction-hardened VA hospitals fare well

On Sept. 6, Hurricane Irma intensified to a Category 5 storm with the first impacts to St. Thomas, the U.S. Virgin Islands and Puerto Rico, where the eye passed just north of the island as a Category 5 that evening. Although the island missed the worst of the storm, it sustained some damage from the heavy rain and powerful winds with widespread power outages affecting nearly 900,000 of the island’s 3.5 million people.

Fortunately, the San Juan VA Medical Center was prepared, had backup generator power, plentiful supplies and only minor damage. Operations soon returned to normal at its main campus and clinics on the island and beyond, with the exception of the St. Thomas Community Outpatient Clinic, which is scheduled to open Oct. 2.

On Sept. 10, the hurricane made landfall on the U.S. mainland in the Florida Keys as a Category 4, traveled to Marco Island as a Category 3, and moved up the state as a Category 1, leaving Florida on Sept. 12 as a tropical storm.

Irma spent 8.5 days as a major hurricane, the second most in the satellite era (since 1966) and trailing only Hurricane Ivan in 2004, according to the Tampa Bay Times.

All of Florida’s VA hospitals weathered the storm well with only minor damage. One reason is that the exterior buildings, roof and windows of all VISN 8 hospitals are constructed to withstand hurricane force winds ranging in intensity for their specific locations.

Located in the heart of Hurricane Alley, if there’s one thing the VA Sunshine Healthcare Network is – it’s prepared.

Before the storm hit, robust emergency plans were activated and validated. Emergency operations centers stood up at each of the main hospitals and at the networks’ emergency management coordination center. Tim Liezert, Orlando VA Medical Center director and the acting VISN 8 director, served as incident commander while the response and recovery effort was coordinated by Victor Ramos, VISN 8 emergency manager.

A minimum of seven to 10 days of fuel to support emergency generator backup power, boiler operations and water were the lifeblood of VISN 8 hospitals during the hurricanes as it enables us to maintain the level of care for our patients for a specified amount of time – regardless of the state of commercially-provided water and utilities, according to officials.

Over 50 community clinics were closed to ensure VA staff remained safe until the storm passed.

And while all VAMCs continued to operate during the storm, the C.W. Bill Young VA Medical Center in St. Petersburg—which was in an evacuation zone – transferred more than 100 of their most vulnerable patients on Sept. 10 to sister VA facilities in Tampa, Orlando, Gainesville and Lake City, Florida. After the storm passed, those patients were safely returned to the Bay Pines VAMC.

During the height of emergency operations, VA staff deemed essential spent several days “living” at the VA medical centers in order to provide seamless care for their patients sheltered-in-place. Family support centers were set up inside the hospitals to temporarily house families of essential staff who wanted to be there for their patients, but didn’t want to leave their loved ones behind.

As the storm passed, damage was assessed, Veterans were contacted to reschedule appointments, and within a week, most VA facilities were operating normally except for those in the hardest hit areas. And there were some very hard hit areas with downed power lines, blocked roads and significant flooding. Over 13 million Floridians lost power, making this the biggest outage in the state and one of the largest in U.S. history.

Disseminating vital information: missed appointments, prescriptions and status reporting

Providing impacted and displaced Veterans and VA employees with vital information on what to do regarding missed medical appointments and procedures, prescription refills and, especially for staff, reporting their status, was a top priority during the storms.

VA’s pharmacy disaster relief plan was activated. Eligible Veterans who needed an emergency supply of medications could go to any retail pharmacy open to the public for a refill. The VA National Employee Accountability Hotline was also stood up as a resource for displaced employees to report their status and for Veterans to obtain vital information.

And VISN 8 Telecare, normally an after-hours nurse advice line, began operating 24/7 to assist displaced Veterans and employees alike seeking information.

Information was disseminated using all available communication channels including social media, the internet, and the news media.

To bring services directly to Veterans impacted by the storm, to include VA clinics, several VA mobile medical units, a Mobile Vet Center, and a 33,000 pound multi-use vehicle were deployed to provide primary care, mental health services and mobile command/control capabilities.

VA’s fourth mission is to provide emergency management support to non-Veterans in times of disaster. The Miami VA Healthcare System provided medical care, services and supplies to the Florida Keys as part of the federal emergency response in Monroe County.

And in San Juan, VA Caribbean Healthcare System staff were part of a team of federal, state and local partners that coordinated the patient reception, medical triaging and relocation of evacuees from other parts of the U.S. Virgin Islands impacted by Hurricane Irma. Evacuees were transported to the San Juan VA Medical Center and community hospitals in Puerto Rico.

And unfortunately for San Juan, the crisis was not over yet.

Hurricane Maria: ‘like a nuclear bomb went off’

While many in Florida and elsewhere seemingly dodged a bullet, on Sept. 20, barely two weeks after Irma struck, Hurricane Maria ravaged the island of Puerto Rico as a Category 4 storm with 155 mph sustained winds, the strongest storm to ever make a direct hit on the U.S. territory in almost a century.

The hurricane slammed the territory with such intensity that it reportedly broke two National Weather Service radars there, according to CNN.

The island lost complete power, the AP reported that 85 percent of 1,600 cellphone towers were down, and almost 90 percent of above ground and underground phone and Internet cables were knocked out. Worst of all, extreme flooding, toppled power lines and roads blocked by debris made reaching people — and assessing damage – extremely difficult. Other than satellite phones and a few spotty cell phones, nearly all communication was cut off.  Water and food were scarce with cash-only as the only accepted currency on the island.

“It was like a nuclear bomb went off across the island. The trees have no leaves. Houses have no roofs,” noted Cosme Torres-Sabater, emergency manager for the VA Caribbean HCS.

During and after the storm, the San Juan VA Medical Center continued to operate on backup generator power. Over 300 patients were sheltered-in-place there and about 800 employees hunkered down overnight for five days, caring for their charges.

Despite the hurricane’s thrashing that flooded the city with over 20 inches of water, the damage to the hospital was limited to minor flooding in the cafeteria and in a few hallways. The clinics didn’t fare as well.

“As a result of our preparations for Irma, we were operationally ready for Maria,” said Torres-Sabater. He noted the staff is working hard to meet Veterans’ needs. Mental health and spiritual services are also being provided to Veterans and any employee who may need them.

“Morale is very high. Employees are happy to be here to take care of our Veterans. They wanted to work despite their personal situations,” the 15-year VA employee and retired U.S. Army Reservist, said.

Puerto Rico’s challenges are not over, however. Recovery efforts are ongoing across the island, the living environment is primitive, and infrastructure repairs could take months, if not years, according to officials.

As of this writing, because of challenging communication and resource issues, medical services at the San Juan VAMC were limited. Some outpatient clinics have opened and others, badly damaged, remain closed.

Help on the way

VA is working with the Federal Emergency Management Agency and Department of Defense coordinating the ferry of water, food, medical supplies, mobile communications and other equipment to Puerto Rico as part of U.S. Government relief efforts there.

Meanwhile, more than 100 VA staff from across the country — and that number continues to grow–volunteered to travel to Puerto Rico to provide services there as part of the Defense Emergency Medical Personnel System (DEMPS), the Veteran Health Administration’s deployment program for clinical and non-clinical staff in an emergency or disaster situation.

To provide care to those hardest hit in Puerto Rico, mobile medical units from VA hospitals in Orlando and Tampa are also deploying to the island as is a large mobile medical shelter from the West Palm Beach VAMC. A mobile VA pharmacy, Vet center and other units are also in the works.

This chapter in Puerto Rico’s history is still being written, however, one thing is certain: these destructive storms are a reminder of what a positive difference people can make.

Hats off to the many selfless, generous and caring VA employees across our network who despite the storms remained at their patients’ sides, ever vigilant and committed to “Caring For Those Who Have Borne the Battle.”

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About the author: Susan Wentzell is VA’s VISN 8 deputy communication manager and content manager,