Mobilizing for a disaster.(GUEST EDITORIAL)(Brief Article)

North Carolina had much to offer flood-ravaged states in the aftermath of Hurricane Katrina. What we weren't prepared for were the hurdles we had to face to successfully deploy our medical resources in an area of need.

Our statewide trauma and disaster delivery system comprises eight regional advisory committees (RACs) that function to coordinate care across our state. This system can be augmented by a unique mobile surgical-medical hospital facility currently based at Carolinas Medical Center (CMC) in Charlotte, which was funded in part by a $1.5 million federal grant. No one else really has such a system, and until Hurricane Katrina, ours had never been formally deployed.

When Katrina struck, our inclination was to gather our disaster preparedness resources, with the mobile hospital serving as a hub, and deploy to New Orleans to create a much-needed hospital amidst the destruction. The plan was to amass state disaster response resources in Charlotte on Sept. 1, then head south.

When we arrived in Charlotte from all across the state, we assembled our entourage of SMAT-2 [state medical assistance team] trailers, ambulances, support vehicles, and MED-1, the mobile surgical hospital. Accompanied by our own SWAT team for security, we rapidly became part of a massive convoy of 22 vehicles.

While in communications with Louisiana, state officials told us they were unsure if they needed our resources. I was not directly part of the conversations that took place that day, but I waited along with nearly 100 other caregivers as the drama unfolded. The rumor was they wanted maybe 40 paramedics, not an entire mobile hospital.

Ironically, at the same time, physicians from New Orleans were contacting us individually, desperately asking for our help. From any vantage point, there appeared to be a huge need for medical resources, but we waited on the hot tarmac without a place to go. The state medical director of the mission was on the phone to Louisiana along with representatives from our state emergency medical departments while we sat with our convoy in Charlotte most of the day. The closest information I could gather about the situation was that Louisiana officials were worried about the legal implications of authorizing entry of another state's mobile facility. Louisiana became a no-go.

Mississippi in the meantime heeded our call, "If Louisiana doesn't want you, we'll take you here," is what we were told. After a 30-hour journey from Chapel Hill that encountered some major technical and logistic problems, we finally ended up in Hattiesburg, Miss.--a stone's throw from the I-10 corridor that links Gulf Coast ...