As Francine Bears Down on New Orleans, A Health Center Braces for Impact — and Plans for Uncertainty

Tropical Storm Francine was sweeping towards New Orleans on Tuesday morning, but the city's Lower Ninth Ward, Teresa Bovia kept her health center's doors open.

Six new patients had already needed walk-in appointments at Baptist Community Health Services, Inc., where Bovia is the chief operating officer. Most needed to refill their medications before hit, but hadn't been able to contact their regular doctors. The health center's existing patients also needed insulin or other medications, or wanted to check their blood pressure, before sheltering in place.

"The people we serve, they don't have the means to leave," Bovia explained.

Even as BCHS providers met with patients and filled prescriptions, staff members were carrying out emergency preparedness measures for an extreme weather event that had, thus far, proven difficult to anticipate or prepare for. Tropical Storm Francine was expected to strengthen into a Category 2 hurricane and make landfall on the U.S. Gulf Coast on Wednesday, but expert predictions of its path had shifted repeatedly.

Bovia was hoping to keep at least one clinic open for patients, but if storm damage made that impossible, staff were prepared to set up a temporary clinic with tents and portable generators. They'd done it before, Bovia said, in the aftermath of one of Louisiana's many hurricanes. "I wish I could tell you the name of that storm, but I can't remember at this point," she said.

Two of BCHS's six locations have generators, funded through Direct Relief and Abbott's Disaster Resiliency grants, so Bovia had already transferred vaccines and other temperature-sensitive medications to the refrigerators safeguarded by the backup power system. She estimated that the generators would preserve close to $65,000 worth of vaccines.

Doctors and nurse practitioners were checking on or refreshing their Direct Relief field medic packs; each BHCS provider keeps one of the packs in their car for emergencies. (When Direct Relief spoke to Bovia on Tuesday, 10 additional emergency medical backpacks were being prepared for shipment at the organization's California headquarters.)

During previous storms, Bovia said, providers had used the packs to suture wounds, dispense emergency medications, and prevent infections.

A Direct Relief hurricane preparedness pack, staged at BCHS in advance of hurricane season, had been loaded into tactical jump bags for easy transportation.

Health centers in tropical storm-prone areas develop detailed preparedness and response plans to ensure that patients are prepared in advance, have a resource to turn to when an emergency strikes, and can receive immediate and continuous care in the wake of a storm. Over time, Bovia said, staff and leadership learn valuable lessons, but she stressed the importance of flexibility.

"Every storm brings a new set of circumstances, and something you thought was going to be great didn't work" in an unforeseen situation, she said.

But experience had taught her that essential medications and heat relief would be her patients' most urgent needs in the aftermath of Francine. "If a pharmacy doesn't have power, they're not going to open, so there might only be one pharmacy within 20 miles and most of our people don't have transportation," she explained. Public transportation was likely to stop - "they want you to stay home" - and the September heat would be treacherous without working power.

In New Orleans's Lower Ninth Ward, where Bovia works, patients are always vulnerable. She explained that life expectancy in the community is fully 20 years lower than it is for residents of her home neighborhood 15 minutes away. "We know [the inequity] is there and it's our responsibility to do something about it," she said.

BCHS was founded in the aftermath of 2005's Hurricane Katrina, when local faith leaders who'd responded to the crisis drew attention to the urgent need for community health care. "This was the area of the city that had been most ignored," Bovia explained. Katrina had flooded the Lower Ninth Ward with six feet of floodwaters in some places.

"We're very strategically located," Bovia said.

Many of the health center's patients struggle with food insecurity and other socioeconomic challenges that experts have shown contribute to worse health outcomes. If a neighbor seems dehydrated, or a friend needs medicine, community members are likely to call BCHS to ask for guidance.

Because BCHS chose locations that would be easily accessible to vulnerable patients, flooding and power loss are regular risks during hurricane season. Like their patients, health center staff have learned to adapt. "It's storm season, we all know" what to expect, Bovia explained.

A mobile medical unit, supported by an Abbott Disaster Resiliency Grant and currently in the process of being outfitted, is BCHS's next disaster preparedness and response project. When it's completed, Bovia said, health center staff will be able to drive it into affected neighborhoods and offer on-the-spot care.

"This is what we do," Bovia said.

Since 2017, Direct Relief has supported Baptist Community Health Services, Inc., with $2 million in funding, medications, and supplies.

Through the Abbott Disaster Resiliency Grant program, a multi-year initiative aimed at mitigating the impact of disasters and ensuring continuity of response, BCHS has received three grants totaling $190,000. These grants were used to purchase two generators that have helped sustain power and preserve cold-chain medicines, and, with the most recent round, to support the purchase and outfitting of a mobile medical unit that will be used for community outreach and deployed as part of disaster relief efforts.

During the Covid-19 pandemic, Direct Relief supported BCHS's community care with a $500,000 operating grant.

The organization has also supported BCHS's disaster resiliency and accessible health care services with hurricane preparedness packs and emergency medical backpacks; chronic disease treatments and other medications; PPE; nutrition support; and an additional range of requested medications and supplies.

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