Mobile Medicine to the Rescue
A year ago, none of the 26,000 residents of Louisiana's Plaquemines Parish knew what a disaster medical assistance team was. But "everyone around here knows what a DMAT is now," says Gina Meyer, superintendent of emergency medical services on the skinny spit of land, which was nearly obliterated by Hurricane Katrina. "And they're glad of it. The teams treated diabetics in crisis and heart patients. They were mobile emergency rooms and had so much passion."
DMATs are federal medics, called from across the country when local services are overwhelmed. Volunteer teams of doctors, nurses, paramedics, pharmacists, and other health professionals are organized within states and coordinated by a Department of Homeland Security division. "We head into the eye of the storm when everyone else is heading out," says Tim Tackett, commander of an Arkansas DMAT that was deployed after Katrina.
But there are worries about DMATs as the new hurricane season looms. Several government reports in the past few years have warned that the teams are underfunded, undersupplied, and mismanaged by their bosses at Homeland Security who--critics say--focus on terrorism rather than medicine. "The people are great! It's the system that's broken," says Jeffrey Lowell, a St. Louis surgeon and former DHS medical adviser.
Low supplies. One team from San Diego had a hard time maintaining a field hospital at the New Orleans airport. "We were having major supply and communication problems," pharmacist Michael Sohmer wrote on the team's website. "Our morphine supplies were dangerously low, and all I could think of was the suffering patients." He noted that the team "struggled with the powers that be" to be allowed to use drugs offered by the U.S. Air Force, losing valuable time.
One big problem cited by critics: Planners haven't given DMATs resources to respond to a variety of catastrophes. Teams need to be quickly tailored to each situation--more trauma surgeons after quakes, more paramedics after hurricanes. Right now the system isn't that flexible.
Jack Beall, who heads the DHS arm immediately in charge of the DMATs, vehemently disagrees. "We treated 160,000 patients during Katrina. We saved lives, and you can't dispute that." Some DMAT staff who were on the ground, like Tackett, back him up. But Beall does admit his agency has learned lessons and made changes. One is that teams this year will have five days' worth of supplies, not three.
But far-flung teams will still take days to get to a disaster site. So North Carolina, regularly battered by big storms, has created state medical assistance teams, using local hospital staff and supplies cached in trucks. "They're designed to get in there quickly, set up a field hospital, and be self-sufficient for 72 hours," says Drexdal Pratt, chief of the state's Emergency Medical Services. That should give the federal medical cavalry time to arrive.
This story appears in the May 1, 2006 print edition of U.S. News & World Report.
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