County of Marin Health and Human Services

Impressions from the MMRC Deployment to Middletown, CA

By Ann Eichhorn

I had seen the news of the valley fire happening near Middletown, California and knew there were over 1,000 evacuees tent camping on the Calistoga fairgrounds. Surely there are unmet medical needs and an overwhelmed system happening now, I thought. When will they need more outside help?

“We have officially been asked for assistance,” MMRC Program Manager Kate Garay informed me. “Let’s get our team together and get there.” So, on Tuesday morning Sept. 22, at 5 a.m., nurses, Kate, Jeanne Krafft, Lucy Edwards, and myself, along with MMRC Communications Chief Rick Moses, and Dr. Lisa Santora (who has only been on the Public Health Department staff a week), left for Middletown. We were joined that afternoon, by MMRC Pharmacist, Paul Lofholm, now living in Placerville. We had been asked to set up a temporary medical clinic at the Twin Pines Casino which has been designated a new shelter area for evacuees returning to the devastated area.

We were met there by MRC volunteers from Contra Costa County who had been previously deployed to Calistoga and who, after a full week’s worth of service, even though they were being released to go home, had traveled to Middletown to help us set up the clinic and bring us their supplies. After their debriefing we began to receive people needing prescriptions filled and minor medical care (new bandages for burns, wounds, allergy and headache relief, cough medicine, antibiotics, etc.) I was assigned to a Red Cross intake area in another location a couple miles away. Within the first hour of being there, a Red Cross worker walked a pregnant teenager over to me and said, “I think she needs to talk to you.” As a former obstetrical nurse, I discovered that while the teen was a couple weeks away from her due date, her water had broken the day before and while she wasn’t having regular contractions, her back was really hurting her. I sent her and her mother, plus her fiancé who had both lost their homes, to the nearest hospital 40 minutes away to be checked and probably admitted in early labor. They had no place else to go.

I spent a good deal of my time talking with people about their experiences and listening to their stories. Everyone I met had a horror story to tell. Whether or not they had lost their homes, they were dealing with some kind of great loss.

The Red Cross workers, from the intake specialists to the shelter manager, set up crews, etc. were fantastic! They never stopped! I was in fact concerned that I never saw the intake folks take a break, eat, or step out for a breather. The lines for aid were nonstop. The Salvation Army was also on board with food for everyone. By the end of the day, the casino had its restaurant up and going to feed returning residents and volunteer fire fighters.

I think the evacuees’ basic needs for clothing, food, immediate hygiene needs (toothbrushes, combs, soap, etc.) were being met. Thankfully, somebody was sending in much-needed pallets of water in the heat of the day.

However, there is still much to be done for the communities to recover their resiliency and return to a new normalcy and many gaps to be filled that will continue to surface as time goes on. Three glaring gaps for me yesterday were:

  1. More temporary housing for people and their pets. For many good reasons, Red Cross shelters cannot house people with their pets. That is one of the reasons 1,000-plus people were in tents while the Red Cross shelter in the fairgrounds pavilion had less than 50 people. People learned from the Katrina event that being separated from their pets might mean they never would see them again. Also, from my conversations with a few people turned away from the shelter site I was in, their pets were the only thing they saved and they weren’t about to let them out of their sight. One lady, holding her little terrier whose back paw had been burned, said, she is “my baby and we’re sticking it together, even if we have to sleep on the ground up here someplace tonight.” It was also clear, from talking with a couple of veterans who sort of live “off the grid” in the area, that their dogs serve as PTSD companions and are necessary to tend to their daily emotional needs.
  2. Tend to children. A second gap area I observed was meeting the needs of children affected by the disaster. While there was an official site and volunteers available to work with 3-8 year olds while their parents filled out the laborious forms, records, and reports necessary to get some financial assistance, many people were understandably reluctant to have their children leave their sight. I was at a play table at the church where I played with and talked to a few of the children who had lost their homes. One little boy, about six, shrugged his shoulders and replied, “yes, our house burned all down, and everything there is gone, but mommy said we will soon get some new toys.” His 10-year-old sister, clutching two dirty stuffed animals, wouldn’t talk and simply paced the room nervously waiting for her mom to finish the paper work. Half the children waiting didn’t speak English. All of them appeared to me to be a bit shell shocked and uncomfortable.
  3. Transportation. The intake centers at the Middletown senior center, church, and shelter areas are a couple of miles from each other. The Calistoga fairgrounds is 15 miles south on a winding road. Many people lost their means of transportation in the fire so getting around any distance is a considerable hardship. A lot of the returnees to the area were older adults, some who had younger adult family members accompanying them, others alone.

From just one day’s experience, I believe MMRC’s response was a good one. It allowed us to be in a real-time situation, to address needs, and to gauge whether or not we had the resources to adequately help people. Our own EOC office, the Public Health Dept., and MMRC had the opportunity to work together to gather what we needed, bring together the responders, and assist the folks “on the ground.” We saw first-hand the importance of being able to work together with other first-responders and to find ways to relieve each other when energy, resources, and momentum decline. In closing, I share two pictures remaining in my head. First, an older woman in a wheelchair, accompanied by an adult daughter, was waiting in the Red Cross intake line. I asked her how she was doing. “I lost my life partner to death, a month ago. Last week I lost my home, my pets, and everything we had…there’s not much more but me I can lose, and at this point, I’m not sure I have the energy to go much further.”

Second, a long-haired, bearded man with a dog on a leash, came to the Red Cross shelter door and asked if he could come in, indicating he had come from the Calistoga fairgrounds. When he was told he could not bring his dog in, he asked if he could get some food. He also asked where he could go for shelter, the answer being that the nearby golf club was apparently offering to house people in tents with animals. He said he didn’t have a tent or a car. He was given a take-out breakfast box and walked away. About an hour later, as I was being driven to a different site to administer services, we drove by the man and his dog. He was sitting under a burned-out tree on the charred land, with a collapsible water bowl for his dog and the two of them eating his breakfast. I weep at that picture of silent needs still unmet. There is much to do in the work of responding to and preparing people for the results of unexpected disasters.