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First Person: Nurse Caring for Refugees Shares Experience

Peg Shepherd, a registered nurse who answers questions on WebMD’s Multiple Sclerosis message board, has been volunteering at a shelter in Baytown, Texas, that’s now caring for refugees from Hurricane Katrina. She filed this report.

Spent hours yesterday again at the shelter here in Baytown. I know you are all seeing the horror stories from New Orleans and other points on the Gulf coast. I'm hearing them from survivors as well. A lot of what I've been doing has been just sitting and listening to people tell their stories. I don't know if it helps, but it's something I'm good at and people seem to need to talk.

The shelter is a surprisingly calm place. It is a local community center and currently has about 250 people in it. One large room is set up for meals; the other is set up with wall-to-wall cots. When you enter the building, the noise level is the first thing that hits you. It is not a place designed for that size crowd on a sustained basis. It's not that people are shouting or making undue noise. It is just the sound of 250 refugees plus dozens of volunteers crowded together trying to live life. Many of the refugees spend some time outside, but with the temperature and humidity both in the mid-to upper-90s, no one stays outside for long. Plus, yesterday we had several thunderstorms and just plain rain. Soggy and soggier.

People I encountered yesterday included: a young woman, 20, who is 6 months pregnant, having severe headaches, elevated blood pressure, separated from both her family of origin and her boyfriend. We ended up sending her to the local ER for evaluation. Did the same with a young boy, 8-years-old, who had slammed his thumb in a car door while trying to help his dad move some of their belongings into the shelter. He was trying so hard to "be brave," but the tears were leaking through and it seemed as though his injury might be the thing that tipped him over the edge on top of all the other things he has endured -- and has to continue to endure.

People are beginning to show up with skin rashes, likely from their time in polluted water. People in many cases have now been without their routine medications for days. Those medications include everything from antipsychotics to antibiotics to drugs for cancer, heart disease, depression, anxiety, etc.

Stories of Rescues

I also spoke with a woman whose 22-year-old mentally retarded daughter is having severe anxiety. They have lost everything, including the young woman's medication. But the real issue is their loss of all of the supports that made it possible for them to cope and survive.

A man sat at a table with me for maybe half an hour, telling me of his escape from the roof of his house. He stayed in New Orleans as long as he did because his elderly mother could not be moved easily -- or perhaps at all. He was eventually rescued, as was his mother, but she was taken to a hospital and he has had no word of her since.

A mother brought in a little girl with a cast on her leg. She broke her leg falling out of a tree a month ago and was supposed to go back this week to see the doc to see how the healing was going and whether the cast could come off. We all signed the cast and I listened to their harrowing tales of escape while trying to keep the cast dry.

Also had a long visit with a man in his seventies who is dying of bladder cancer. He has none of his drugs, including pain drugs. He needed urostomy bags. Our efforts to track those down resulted in a visit from a local man who shared his own supplies -- and at one point I looked up to see the two of them with their pants half way down, comparing ostomies!

Every person, every family, has their own tale of loss and horror. Many do not want to return to New Orleans. Others are determined to go back as soon as possible. They are helping each other, but really there is little they can do other than listen and cry -- and sometimes laugh --together. Most came in private cars but many have no money to put gas in the tanks. Some are here (in Baytown specifically) because they simply ran out of gas here.

I'm sad to have to report that yesterday, the political infighting became an issue. It became very unclear who was in charge (the city, which owns the building, or the Red Cross). Both groups became snitty and the Red Cross "reassigned" the two nurses who were supposed to be stationed at the shelter. Before they left, the Red Cross chased off an ER doc who had come to volunteer, saying that having a physician on-site was not "our protocol."

So several local docs, EMTs, and nurses are setting up an impromptu clinic across from the shelter. They are meeting a real need as the Red Cross can only issue vouchers for drugs if the refugees have their prescriptions or med bottles with them-- which means that many people are unable to get needed medication through that route. The volunteer docs can at least do a history (and superficial physical if needed) and write new prescriptions.

I'm sure that the issues are not only territorial but also liability. Regardless, it is making it more difficult to help the refugees. Perhaps things are going more smoothly at the larger centers like the Astrodome. I hope so.

Peg Shepherd, PhD, RN, is a nurse practitioner and expert moderator of WebMD's Multiple Sclerosis message board. Her opinions and conclusions are her own.