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Former Yale Fellow leads medical Response during Hurricane Harvey

Yale Medicine Magazine, 2017 - Spring


Texas Medical Center in Houston is the largest such center in the world. Its sprawl of more than 100 acres encompasses multiple institutions, including Baylor University, Rice University, and the Texas Children’s Hospital. It is also home to the Michael E. DeBakey Veterans Affairs Medical Center, where since Hurricane Harvey arrived on the night of Friday, August 25, almost 700 physicians, nurses, lab techs, and support staff have stayed to care for roughly 400 patients. Among those who stayed is SreyRam Kuy, M.D., M.H.S. ’09, FW ’09, the VA center’s associate chief of staff.

Holcombe Boulevard, a main drag that traverses the Texas Medical Center, turned into a raging river, workers stayed, Kuy said, knowing full well that their homes, cars, and all their wordly goods may be gone. “What is amazing is the resilience and the courage of the people who are working here,” she said. “Some of the staff have no idea if their homes are affected. Others have watched news footage of their flooded neighborhoods. If they go home they can’t get back on the roads, and there won’t be anyone to run the ventilators, see that instruments are clean, and take care of patients. I am so amazed and grateful for all the staff who are so selfless.”

Hurricane Harvey has exhausted the superlatives so often applied to natural disasters, with relief officials calling it unprecedented. When it made landfall it was a Category 4 storm, with winds as high as 130 miles per hour. It is the first major hurricane to reach the continental United States in 12 years, and, with up to 50 inches of rain falling in some areas, the wettest tropical cyclone on record in the contiguous 48 states.

Kuy, who was a Robert Wood Johnson Foundation Clinical Scholar during her time at Yale, stayed at the hospital since the hurricane hit landfall on Friday August 25 working to ensure the hospital stayed operational. She experienced the flood waters firsthand on Sunday, August 27, when she drove 14 miles to her home to evacuate her mother. Water often rose above the wheel wells of her SUV, she said. She has no idea what has become of her home since then. She returned to the medical center, and has remained in the medical center, sleeping in her office, where she described herself as “gross and smelly.”

Kuy counts herself fortunate. “I have running water and electricity and there are 10,000 people in the convention center who don’t have homes to live in,” she said, referring to the George R. Brown Convention Center, which has become a shelter. She marveled at the struggles and dedication of others. It took the husband of one of the nurses 12 hours to reach the hospital to deliver needed medications to that staff member. Hospital residents who live nearby walked through flooded streets to work their shifts. An Army veteran with a ruptured appendix swam through chest-high waters to reach the hospital for emergency surgery. “As a former Ranger, he went into total survival mode,” Kuy said.

For Kuy, the storm was a jarring welcome to Houston. She’d moved there only a few weeks earlier from Louisiana, where she had served as chief medical officer for Louisiana Medicaid, based in Baton Rouge. And just a year earlier, she’d lived through the Great Louisiana Flood of 2016. “That was a very important learning experience for me,” she said. “I learned a lot about emergency response while coordinating Louisiana’s medical relief efforts at the shelters, leading public town hall discussions around flood health hazards, and ensuring that our Medicaid patients had access to vital prescriptions and medical equipment lost during the flood. It was truly a trial by fire, but I learned so much about leadership under duress.”

When Harvey arrived on that Friday night, the VA center was prepared. The leadership team, she said, had met in their command center to make plans, chief among them ensuring adequate staff to stay with the patients. All elective appointments were rescheduled and services at nine outlying clinics were consolidated. For staff—ranging from health care providers to electricians and janitors—who stayed, the implications were clear. “It’s going to be a long haul. It’s going to be a marathon, not a sprint,” Kuy said. “If they go home and the storm hits and they can’t come back, that will cripple the medical center.”

The remaining staff concentrated on the well-being of their patients, and Kuy made regular rounds of all departments to check on morale. “Some of our staff have been here in the hospital for six days straight. I’m amazed by how strong these people are.” Workers asked if the center’s store could be opened so they could buy toiletries. “Every warm body” was recruited to serve food in the center’s canteen, said Kuy, who took a post on the tray line. When food started running out, the VA national office organized a resupply convoy. By last Thursday, when exhaustion began to set in and some roads had cleared, nurses arrived from VA centers in Dallas and San Antonio. Kuy also made regular visits to the George R. Brown Convention Center and the NRG Stadium, leading the VA’s efforts to help homeless vets who sheltered there, providing social work, and mental health and primary care services.

In addition, Kuy mobilized a Mobile Medical Unit, bringing the VA’s resources to veterans affected by the floods in Pearland, Texas. Primary care providers treated flood victims with cellulitis, back injuries, and anxiety and stress. Social workers helped veterans and their families find housing and connect with recovery resources.

What the future holds remains unclear. The scope of devastation is beginning to sink in. CNN reports more than 100,000 homes damaged or destroyed. The official death toll is just over 50, and expected to rise. Some people are still stranded in their homes, awaiting rescue, while others have been able to return and begin cleaning up.

“Now the waters are going down and we have road access to our homes,” Kuy said, adding, “Now, it is recovery. This is going to have an impact for quite a while. But, what I’ve witnessed amazes me. The human capacity for compassion is extraordinary. Hurricane Harvey tore off roofs, spilled waterways into schools, and submerged homes; but in the aftermath, I’ve seen hope and humanity. As a nation, when we’re hurting, there’s no you and me. There’s only us. This is the heart of America.”

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