Months after Hurricanes Helene and Milton battered the Southeast, pediatricians and the families they serve continue to deal with the aftermath.
Clinics have been closed and temporary locations set up. Children are adjusting after missing school for weeks. And health care providers are cleaning up their own homes.
As they reflect on the devastation and the work ahead, pediatricians credit the resilience of their staffs and preparedness plans for getting them through.
Lives turned inside out
While hurricane-related storms are not unusual for North Carolina, the rains brought by the remnants of Hurricane Helene in late September were unlike any storm in recorded history, said Dustin Alderson, M.D., FAAP.
Hendersonville Pediatrics, where he has worked for the past eight years, lost its main clinic when five-and-a-half feet of flood water damaged the practice and surrounding neighborhood (pictured below courtesy of Jim Marshall).
“Everything in the office was destroyed,” Dr. Alderson said. “It got so much worse so much more quickly than anybody really thought was possible.”
The area was without power and running water, and cellphone and internet communication was out for days.
“It was very weird to feel so disconnected from the typical resources we would generally think of,” Dr. Alderson said. “It’s largely been just problem-solving with what we have to work with.”
The main clinic was deemed a total loss. So, Hendersonville Pediatrics, which serves about 16,000 patients, opened two temporary locations. Providers and staff are back to seeing dozens of patients each day, while some deal with the loss of their own homes and vehicles.
“From a clinical standpoint, we take very seriously our commitment to take care of our patients,” Dr. Alderson said.
In addition to treating typical illnesses, Dr. Alderson said they also are offering families emotional and psychological support as the region begins to rebuild.
“We’re still kind of shell-shocked that this could happen,” Dr. Alderson said. “There are so many people who lost everything, whose lives are turned completely inside out. It adds a layer of complexity that isn’t really treatable. The whole team has worked tirelessly to make sure we can take care of patients and there’s space for them to be seen. Every day since the storm has been nonstop, and I’m amazed at what our team has been able to do.”
‘It’s been very surreal’
About 30 miles north in Asheville, N.C., Mission Children’s Hospital lost power and water service after Helene.
The hospital was able to continue operating on generator power, and first responders used the building as a “safe haven,” said Ansley Miller, M.D., FAAP, medical director for pediatrics.
After losing water, a well was dug onsite and water trucks were brought in to supplement the building’s water system, Dr. Miller said. Food trucks helped feed patients and staff when supplies ran low.
“Our neonatal intensive care unit remained open, our pediatric intensive care unit remained open, and we thankfully only had to ship out a couple of patients we thought would be better served elsewhere, but we were mostly able to take care of our population,” Dr. Miller said. “It’s been very surreal. I just didn’t anticipate the level of destruction.”
Dr. Miller said she’s now seeing the impacts on children, including those with special health care needs. She also is worried about the loss of school time, as Buncombe County schools remained closed for several weeks following the storm.
“We saw the struggle that families had and children had with COVID, and this time they weren’t able to stay in a virtual school because we didn’t have any connectivity,” Dr. Miller said. “I think families have really struggled with not having child care, not having kids in school and issues with having food and clean water. I think we’re still in the recovery phase and still have some ongoing challenges. For all the devastation and tragedy the storm brought, I’ve been grateful to see collaboration.”
One-two punch
Meghan Martin, M.D., FAAP, an emergency medicine physician at Johns Hopkins All Children’s Hospital in St. Petersburg, Fla., is familiar with the effects of hurricanes. Yet, dealing with Hurricanes Helene and Milton only a few weeks apart brought myriad challenges to the state, she said.
Since her home flooded during Hurricanes Idalia and Ada, her family was not taking any chances with Helene. Her husband and children evacuated inland, but Dr. Martin remained at the hospital in temporary accommodations.
“I do disaster medicine on the side,” Dr. Martin said. “My niche part of it is emergency preparedness and disaster management, so I’m always going to be at the hospital during these events.”
When Hurricane Milton hit Florida in early October, Dr. Martin again was at the hospital — this time with her family.
“We hunkered down with probably two dozen other kiddos of people that were working at the hospital,” Dr. Martin said. “Our child life and social work team did an amazing job making sure they were good and had activities and all kinds of fun stuff to do.”
When the city sewer system began to fail during Milton, Dr. Martin said the hospital emergency operations center began to create a plan to conserve water and evacuate if necessary, which they did not have to do.
The recovery phase has brought its own challenges.
Getting prescriptions has been difficult since many local pharmacies remain closed, Dr. Martin said, and patients who evacuated need their medications sent elsewhere.
After families returned to their homes, Dr. Martin said she saw patients with gastrointestinal illnesses, skin infections, lacerations, broken bones and bacterial infections. She believes many of the illnesses and injuries were storm related, as families moved debris and walked through or drank contaminated water.
“People tend to use hurricanes as timestamps,” she said. “They may say they’ve been coughing since Helene, or they had this start just after Milton. We’re also seeing secondary impacts related to stress and displacement. Some people are now living an hour away from where they go to school or work, so kids are not sleeping as much, and their diets are disrupted. In general, life is not what it’s supposed to be right now for many of them.”
On a personal note, Dr. Martin said having a disaster plan helped ease some of her stress at work. Unfortunately, her house was uninhabitable after Helene.
“With Milton, we didn’t have anything left to lose house-wise, which is sad, but kind of true,” Dr. Martin said. “… It stinks, but also, it’s a house. We’ll be able to put it back together at some point. My husband and the kids were safe, and that’s the most important thing.”
Resources
- AAP hurricane disaster management resources
- AAP Pediatric Preparedness Resource Kit
- Infant and Young Child Feeding in Emergencies toolkit from the Centers for Disease Control and Prevention
- Virtual drop-in support for clinicians caring for children and families who have been impacted by Hurricane Helene
