LAUREL — Prior to Hurricane Katrina, I told others that I always felt that South Central Regional Medical Center was more than “just a hospital.” That message came to life during this event.

Each of these challenges was met with creativity and just plain hard work by all of our employees. The following is a personal summary of the events we faced. The time lines are to the best of my recollection, but it is very hard to remember all that happened and still keep track of time.

The storm was not considered a factor for Mississippi until Friday afternoon, August 26. We sent e-mails and text messages to all members of our management team asking that they watch the reports regarding the storm and be prepared to work over the weekend. Because we had been through this drill multiple times before, each member of the management team was familiar with the requirements.

On the morning of Sunday, August 28th about 6:30 a.m., our administrator on call for the weekend, called stating that Slidell Memorial Hospital wanted to transfer patients to us. We met at the hospital, evaluated our capacity and agreed to take up to 10 patients (4 ICU patients and up to 6 Medical/Surgical patients). Six patients were actually transferred to our hospital. Our inpatient census was around 170 at the time. We considered that if transfers were already being requested, there was a strong likelihood that there would be a greater need as the storm progressed.

At 4 p.m. that Sunday afternoon, the management team was assembled and we discussed the information we had about the potential impact of the storm. Each member of our management team was asked to make sure their area was prepared for the storm. Many of the directors had already been at the facility working on preparations.

The majority of our management team had left the building by 8 p.m. Sunday night. They returned to the medical center Monday morning between the hours of 2:45 a.m. and 8 a.m. While we had plans for handling disasters, we were not prepared for an event of this magnitude.

The driving rain created a tremendous number of leaks in our facility. The wind was driving the rain through window seals and cracks in caulking. The wind blew open two of the front doors and broke them.  Two windows in patient rooms were blown out. One was in a patient room on the OB floor which housed a patient and the other was a room on our Senior Care Unit. We handled the broken windows by placing steel plates in the frames and screwing the plates in place. All leaks had to be contained by buckets, towels, sheets, garbage cans, and wet vacs. Considering the winds and rain we faced, the buildings held up relatively well, but we did sustain damage.

The power went out at 12:40 p.m. — the generators, which were approved for purchase by our board of trustees the previous year, came up full speed within 7 seconds. We had full power to all circuits, including the chillers during the entire storm. The generators performed flawlessly for 39 hours. During this period, they burned between 3,000 and 6,000 gallons of diesel fuel.

Incredibly, we had some local phone communication with our nursing home during the storm, but lost all other communication. There was no communication available by cell phone, pager or the Internet. This created several problems including an inability to communicate with other facilities, including our own, about the need for patient transfers. 

Some of our patient transfer requests had to be handled via the state wide emergency radio network. We were eventually able, through the help of a patient who was technologically gifted, to get one satellite phone working which allowed us to communicate with other facilities during the storm.

While that was a huge problem, perhaps the biggest issue was that we could not reach our medical staff. Many of our physicians made their way to the hospital and made arrangements to be housed in our facility until phone service could be reestablished. One of our pharmacy technicians was able to secure a SouthernLINC phone. SouthernLINC, which is Mississippi Power’s Cell Phone network, stayed operational and we were able to order medical supplies from Dallas.

About 48 hours after losing phone service,  BellSouth had us up and working again, although service was spotty. Cell phones for some came up about 72 hours after going down. Pagers for some were still not operational and we had to move those to another functioning service.

The lack of water and water pressure was the most critical issue for us during the storm. Going 60 hours with no water and inadequate water pressure was never contemplated in our scenarios. Without water, we had no fire suppression, no way to flush toilets, no water for cooling towers and no way to run the laundry. We had no way to cook food requiring water, no way to wash dishes, no way to give water to our patients or staff, and no way to run certain lab tests, sterilizers, or our vacuum system. In short, water was a critical factor. We handled our water issues as follows:

• Working with the Red Cross and the management team at Wal-Mart, we were allowed into the store about 1 a.m. Tuesday morning. While there, using flash lights, we were able to acquire two pallets of water, large quantities of paper cups, paper plates, napkins, plastic utensils, and rice and pasta to “stretch” meals.  With paper products, washing dishes was no longer an issue.  The pallets of water were used in conjunction with the water that had been ordered in preparation for the storm. Our immediate patient needs were met.

• On Tuesday morning, we contacted the Calhoun and Powers Volunteer Fire Departments. They delivered water to the hospital for two uses: First, the cooling towers required water to keep the chillers working, and second, a pool was established for water to flush toilets.  The volunteer fire departments brought approximately 3,500 gallons of water every 3 hours. That same day a representative from the local Coca-Cola Bottling Company stopped by and asked what we needed. We asked for water and beverages and within an hour and a half he had emptied his warehouse of bottled water and supplied four pallets of drinking water.  He also provided other Coca-Cola products. Southern Beverage brought canned water, and we had loggers from Ohio show up in the middle of the night to drop off about 20 cases of water. Our employees were instructed to limit water use as much as possible so that our patient care areas would have what they needed.

• The availability of lab tests was reduced because the instruments that run the tests require a pressurized water source. The medical staff was informed about what tests were available and worked with us to insure that appropriate tests were ordered.

• Toilet flushing was a broad effort by many. A pool was set up in the back lot of the hospital using a water retention pond supplied by the volunteer fire departments. Plant operations set up a pump that was used to fill any available waste basket, bucket or other water bearing vessel that could be lifted to flush toilets. The vessels were loaded on buggies of all types and then transported to various patient rooms to flush toilets. People from all departments including plant operations, environmental services, administration, the business office, nursing, etc. participated in an endless parade of buggies to floors to flush commodes. The term for the process was the “potty patrol.” It was not always done with precision, but the toilets got flushed. On day two, we brought in portable toilets and closed the public restrooms within our facility. While it was very odd to see portable toilets in the front and back of the hospital, they worked very well. We were able to limit our flushing/cleaning requirements to the patient and staff restrooms which reduced the work load tremendously for all involved. Hauling the water was a very labor intensive effort.

• We typically kept three days of laundry supply on hand. However, we went two and a half days without water, and used a tremendous amount of laundry — towels, sheets, and blankets to dry up or stop leaks during the storm. Our critical need by Wednesday was laundry. When the water was restored to the hospital, we made the decision to keep the water to the west wings shut off and to continue the potty patrol until enough water pressure could be developed to run at least one boiler and two washing machines. The boiler was essential for three reasons — first steam was necessary to run our sterilizer; second, steam was required for our dryers and finally steam was needed for hot water. After we were able to build enough water pressure and steam to run the laundry, we ran the laundry from 7 p.m. Wednesday evening until about 1 a.m. Thursday morning with five laundry employees, and as many as 11 volunteers. Within six hours, laundry produced over 2,200 pounds of finished linen.

• By Thursday afternoon, we were able to turn on the water supply to the west wings and had adequate pressure to flush all commodes and run our normal operations. We maintained the pool in the back for staff that needed water for their homes.

With the exception of emergency surgery, all surgeries were postponed. Our physicians had to perform emergency surgeries and C-sections during the storm which lead to a critical shortage of sterile supplies and surgical instruments. Because we had no steam, we could not run our sterilizers and that created a shortage of sterile instruments. At one point during this period, we were in a position that we could only perform one more C-section or surgery case. To make it through until we had sterilizers, our surgery personnel was very creative — preserving sterile instruments from other packs, and finding what disposable supplies they could.

Getting staff to and from work was a monumental problem because fuel was not available. The only stations pumping gas were the stations set aside for emergency vehicles. Our staff was not allowed to use those stations. We met with representatives of the EOC who were working on acquiring fuel for us, but they were unable to do so.

Numerous business and industry representatives in the community tried to secure fuel for medical center employees to get back and forth to work. We were able to secure fuel through the Exxon station on Highway 11 and later South Central acquired use of the Shell station on 16th Avenue. Our employees were allowed to buy up to 10 gallons of gas through payroll deduction. On day two and later, we allowed Ellisville State School employees, local clinic employees, physicians, Clearview recovery staff, and Hattiesburg Clinic Dialysis nurses access. South Central employees pumped the gas and kept record of the expenses. We estimated the total fuel used was approximately 23,000 gallons of gas.

It became obvious early in the aftermath of the storm that a special needs shelter was needed for oxygen dependent residents. On Tuesday August 5, our employees worked with the Salvation Army to move the evacuees at the Salvation Army shelter to our daycare center once the power was restored at the day care. Our day care center was needed to house the children of medical center employees so the shelter was moved to St. John’s Episcopal Church.

We moved all evacuees to St. John’s where the shelter remained opened until September 13, when the last four evacuees were moved to assisted living rooms in our nursing home. At its highest point, the shelter had as many as 50 patients. During this time we provided supplies, oxygen equipment/generators, an electrician to address electrical problems, linen, and nursing/medical staff support. The department of health provided nursing support, as did the Surgeon General’s office. Also, Jones County Medical Supply was instrumental in meeting many of the needs of those in the shelter.

The American Red Cross opened the Magnolia Center to house individuals who were in need of shelter. At its peak, the center had 1,026 registered evacuees. By September 14th, there was less than 80. We provided supplies, medicines, nursing and medical support to the shelter.

On Monday, September 5, we received a call from Glade Baptist Church asking for some assistance with evacuees from the Milne Asylum For Destitute Orphan Girls. The school which had more than 20 feet of water in it was located near the New Orleans Fair Grounds. The administrator and key nursing personnel had connections to Laurel and had evacuated to Glade Baptist Church before. We provided medical supplies, medical equipment, and set up Physical Therapy, Activities Therapy, and Speech Therapy at the church  to meet the needs of this group. In addition, members of our nursing staff and our medical staff provided care to those housed at the church.

The ER became a shelter and the only source of healthcare as all clinics were closed. We had an incredible volume on Tuesday with more than 220 registered patients and many unregistered shelter patients. During this time we had  numerous medical evacuees, including dialysis patients, and patients seeking oxygen supplies. One of our scheduled ER physicians could not make it to our ER due to the storm. We handled the volume by opening an outpatient service for medical evacuees, and by enlisting members of our medical staff to help in the ER. The volumes remained high for the next several days and we were able to open the outpatient area with nurse practitioners to handle the increased volume.

Because we were uncertain that our vendors could get food to us on a regular schedule, we made the decision to limit access to our hospital cafeteria. Monday, before and shortly after the storm, we saw a record number of people go through the cafeteria. We were the only source of hot food available to many. Prior to any delivery trucks making their way to us, the Jones County Schools offered the food in school freezers for our use. This food was the staple for two days. On day three, both Sysco and US Foods made deliveries and the food situation began to improve.

To assure everyone was well aware of what was going on, our management team, some physicians and other key personnel met twice daily. The briefings were generally 30 minutes or less. We discussed the progress made on issues and we assigned resources as necessary when new issues occurred.

Our staff was tired, and concerned about their personal affairs. We decided that we had to address those issues to assure that we had an adequate work force to handle the patients. Toward that end, in addition to the fuel above, we undertook the following steps:

• We anticipated that our employees would need cash so Bancorp South agreed to cash employee checks up to $250. On Thursday, we took checks from staff totaling over $45,000. Since our payroll could not be processed locally due to the internet being down, members of South Centrals management team drove the payroll disk to Jackson where the disk was transmitted to Tupelo for processing.

• While ice was freely available at “distribution points” our employees could not get to the distribution points before all of the ice was gone. We made the decision to acquire ice for distribution to staff. J & R Trucking rented refrigerator trucks to us for storage and Endom Trailer provided us an ice storage/distribution box.  Staff was allowed to get two bags of ice at a time. The ice distribution began on Saturday September 3 and concluded on September 8.

• Because most of our staff had no power or water at their homes, we set up the South Central Washateria in the back parking lot of the medical center so they could wash their uniforms and other work clothes.

• We made a decision before the storm to offer day care on a 24-hour basis for South Central employees that needed the service. At one point, we cared for nearly 100 children of various ages. The daycare staff slept at the hospital and had help from many other South Central employees and volunteers. When the number of children had grown to unmanageable proportions, and power was restored at our daycare, we moved the service to our day care facility.

There were numerous other things that occurred during that time. I slept at South Central Regional Medical Center for six days during and after the hurricane. It was without question one of the most memorable periods of my life. I saw incredible efforts by many caring and dedicated professionals. I learned more about our organization during that time than I had ever known before.

Our employees and physicians did everything necessary to make sure we met our mission which was not only to provide for our patients, but to also lend support to our community. South Central Regional Medical Center is much more than just a hospital. I continue to be proud to be part of an organization that cares so much for others.