Reservists critical to medical network
Posted on Monday, January 28, 2008
The Arkansas Medical Reserve Corps was less than a month old when the state faced an influx of evacuees from Hurricane Katrina in August 2005.
The fledgling volunteer corps unit in Fort Smith suddenly had the task of helping state and federal officials serve evacuees arriving by plane and bus from the Gulf Coast.
Some 12, 000 evacuees came through Fort Chaffee those first few weeks, of which about 4, 000 required some medical care, said Dr. Bryan Clardy of the Western Arkansas River Valley Medical Reserve Corps unit.
“Katrina happened, and we kind of had to speed it up,” said Clardy, medical professor at the Area Health Education Center-Fort Smith, part of the University of Arkansas for Medical Sciences. “It was a big, huge effort.”
The Medical Reserve Corps was founded for just such emergencies.
It’s an initiative spurred by President Bush’s 2002 State of the Union address, four months after the Sept. 11, 2001, terrorist attacks. Bush called for every American to commit two years or 4, 000 hours to volunteer service.
“America needs retired doctors and nurses who can be mobilized in major emergencies; volunteers to help police and fire departments; transportation and utility workers well-trained in spotting danger,” Bush said in the address.
Thus the USA Freedom Corps was created, with the Medical Reserve Corps to serve its homeland security mission, sponsored by the U. S. Office of the Surgeon General.
Five years later, there are 717 Medical Reserve Corps Units with 149, 142 volunteers in cities and counties nationwide, said Grace M. Middleton, public information officer for the Civilian Volunteer Medical Reserve Corps.
Volunteers are physicians, nurses, anesthesiologists, veterinarians and other medical professionals. Some are retired, and others work in private practice or areas outside of emergency care.
In the event of a disaster, both natural or man-made, they are called on to augment hospital care and to keep emergency rooms from being overwhelmed. In addition, many Medical Reserve Corps units volunteer for health fairs, flu vaccinations and other events.
Arkansas has nine units and about 80 volunteers, said Steven Strode, statewide coordinator for the Medical Reserve Corps.
While most states run Medical Reserve Corps through their health departments, Arkansas ’ is through the UAMS Regional Programs, which includes seven health education centers around the state.
Some states’ Medical Reserve Corps teams are more established than others. New Jersey, for example, has units in every county, and Ohio is close to it, Middleton said.
In addition to hurricanes Katrina and Rita, units have been mobilized to help with wildfires in California and to alleviate demand from an influx of patients in mental health facilities in Clark County, Nev., home to Las Vegas.
There are 68 units in Arkansas, Texas, Louisiana, Oklahoma and New Mexico, up from 12 units three years ago.
“The most critical thing in developing these teams is people,” said Stacy Sayre, Medical Reserve Corps regional coordinator for the five-state area.
“A lot of people haven’t heard of the Medical Reserve Corps. It’s not a household name like the Red Cross, so having it in the sphere of awareness is an issue.”
EXPANDING IN ARKANSAS Strode, a professor and administrator at UAMS, has worked in disaster preparedness for about six years and has been a family physician for 30 years. “The ideal would be for each county to have one or more” Medical Reserve Corps, Strode said. Since 2005, units have formed in Little Rock, Fort Smith, Fayetteville, El Dorado, Jonesboro, West Memphis, Pine Bluff, Texarkana and Pottsville.
The Pulaski County MRC Team 1 unit was established in Little Rock in September 2006. It has about 20 volunteers, said Jim Bellamy, unit coordinator and nuclear medicine imaging professor at UAMS.
Recruiting efforts are expected to be under way within the next few months.
“We’re still in a position of developing the leadership,” Bellamy said. “Our primary mission is to protect the emergency departments of UAMS, Children’s Hospital and the VA hospital.”
In Northwest Arkansas, Dr. Andre Whiteley and Dr. Ronald Brimberry are in the early stages of developing the unit, and they are seeking volunteers. They have 23 so far.
“Arkansas is just kind of behind the curb in getting this going,” said Whiteley, retired medical director of Northwest Arkansas Radiation Therapy Institute in Springdale.
A national report released Dec. 18 gave Arkansas poor rankings in seven of 10 measures of public health emergency preparation.
The Trust for America’s Health, a Washington, D. C.-based health advocacy research group, cited Arkansas and 12 other states for not having 14 Medical Reserve Corps volunteers for every 100, 000 residents.
In a statement responding to the report, Robert J. Tosatto, director of the Office of the Civilian Volunteer Medical Reserve Corps, called the group’s measure “arbitrary and fairly artificial at this point.”
“We have never promoted a ‘quota’ for the number of members that an MRC unit should have or that a state should have a certain number of MRC volunteers per 100, 000 people,” Tosatto said.
“MRC units are communitybased, and we believe that it is best for the unit leaders to determine and set their own recruitment goals based on the needs of their community and the availability of potential volunteers,” he said.
Strode said Arkansas has focused on getting the corps leaders in place and trained before large-scale volunteer recruiting. TRAINING AND PREPARATION
Arkansas has funding from the U. S. Department of Health and Human Services and the U. S. Department of Homeland Security to help pay for corps units startups.
Most units have gotten $ 23, 000 over the past three years, Strode said. Some city and county governments also have provided money or supplies.
Several Arkansas units, including Little Rock and Fayetteville, have received $ 15, 000 from the National Association of County and City Health Officials.
Jack Herrmann, senior adviser for public health preparedness with the association, said it will have given $ 3 million to Medical Reserve Corps units nationwide between August 2007 and July. The funding comes from a cooperative agreement with the Surgeon General’s office.
“Over the past few years, especially after Hurricane Katrina, it was very obvious the need to provide a strong volunteer base to respond to the multitude of needs after a disaster,” Herrmann said.
In Northwest Arkansas, the money pays for training and a stockpile of medical supplies, such as syringes, dressings, splints and crutches that are stored at a Fayetteville facility, Brimberry said.
The Pulaski County unit also got $ 30, 000 from the Metropolitan Medical Response System, which is being used to purchase a trailer that could be used as a mobile medical facility, Bellamy said.
Corps units statewide are working with first responders, county emergency managers, emergency medical technicians, fire and police officials to plan for potential disasters, Strode said.
Volunteers must have an active medical license and undergo training on the National Incident Management System within 90 days of signing up. The system outlines who would be in charge of coordinating response to an emergency.
“They want everybody to be speaking the same language,” said Whiteley, an Air Force colonel with 23 years service as a flight surgeon and radiation oncologist.
Units are working to identify sites — such as arenas, gymnasiums or parking decks — that could be used as triage centers, makeshift clinics or shelters.
“We’re not going to take over what the hospital’s doing. We’re going to help in the community,” Whiteley said. “The hospitals could be overwhelmed pretty quickly in the event of a tornado or earthquake or other disaster.”
Clardy said the Fort Smith unit has a core of about 15 regularly active volunteers, and 48 volunteers registered to respond in an emergency.
In a disaster, volunteers would focus on the “three T’s: transportation, triage and treatment centers,” Strode said.
They would treat people with less serious injuries who can walk and still are stable, and those who may have been exposed or feel that they are showing possible symptoms.
Counties that don’t have hospitals or health centers would benefit especially from having a unit ready to respond to medical emergencies, he said.
“It’s all a work in progress,” said Kim Havard, coordinator of the AHEC South Arkansas MRC unit.
The El Dorado unit was established in April 2006. It has 53 volunteers, including 13 physicians, said Havard, unit coordinator and advanced practice nurse. “We’re all kind of battling the same thing on when to do what and when,” Havard said. “Our biggest thing is the community doesn’t know who we are, and getting the word out is probably the biggest obstacle we have.” Clardy said finding medical professionals with time to commit to volunteering is a challenge. “Arkansas is a medically underserved state,” Clardy said. “If you have disaster situations, you are not going to have a lot of spare people just sitting around. We don’t have enough people to serve our regular medical needs on a daily basis.”
To contact this reporter: cpark@arkansasonline. com
FEEDBACK:
Something to say about this topic? Submit a Letter to the Editor online
