Flooding serves up pub-based healthcare

Hospital bar staff. Sally (2nd left) with the team – Michelle, Sharon, Priya and Denise

Elizabeth Brown | Senior Communications Advisor

Hospitals don’t normally have pool tables, a jukebox, and a fully stocked bar, but during the record-breaking floods in Westport, doctors and nurses found themselves caring for patients out of the local pub.

On 17 July the Buller River was flowing almost 13 metres above normal – the largest flood flow on any New Zealand river in almost 100 years, according to NIWA. The unprecedented flooding inundated large parts of Westport, leaving hundreds of red and yellow stickered homes in its wake. Formerly a rural hospital, Buller Health is now an integrated family health centre, but still the only place to get emergency health care for miles around. The floodwaters filled the building’s basement, taking out the boiler, affecting electrical systems and spilling sewage.

Time to evacuate

With a civil defence emergency already declared, the decision was made to evacuate to the only suitable building on higher ground – Club Buller, a community bar and restaurant. According to Rural Generalist and Emergency Medicine specialist Dr Sally Peet, the health centre was especially busy at the time. With flooding imminent, many households had been evacuated to the local school, but elderly and disabled people were brought to the health centre. So instead of the usual 2–6 inpatients, there were 15. “They tried to send ambulances up from Greymouth to retrieve patients, but they became stuck in the floodwaters and couldn’t go back. The bonus for us was that we had additional paramedics in town, which was invaluable,” Sally says. Evacuating patients out of the floodaffected building was no easy task. Pushing beds along the street was impossible, and with the flooding too much for the ambulances, the Army transferred patients in Unimogs. Once they reached the club, patients were cared for on mattresses on the floor. “That meant nurses getting down on their hands and knees to roll patients and help them to the toilet etc. One nurse couldn’t get home so stayed and worked for nearly 30 hours. She said her back was terrible by the end.” There were personal challenges for some of the staff as well as they worked through, knowing their own homes were being flooded. Many others wanted to come in and help but simply couldn’t get there.

M*A*S*H* in a bar

Once all the patients and equipment were transported, Club Buller was quickly transformed into a makeshift hospital. Dr Peet says fortunately none of the patients who had been evacuated was too sick. A few were able to be taken to

M*A*S*H* in a bar Whole households out on the road

the local rest home, and by the end of the weekend others had been choppered out to Greymouth, leaving just three inpatients behind. “A colleague called it ‘M*A*S*H in a bar’ – it was a spot-on description!” Dr Peet says. Staff quickly renamed it ‘Club Med’. “It was a great big room with a bar and three beds in it. One was a resuscitation bed which personally terrified me because I was looking at the set-up and thought wow, this is real basic stuff.

“There we were, working out of a good old Kiwi workingman’s club with the bar behind us, so there were a lot of jokes”

“We were having to borrow a defibrillator from the ambulance rather than have our own because there was too much interference from the games and the TVs and stuff. We also had a lot of equipment laid out on the pool table.” In one corner a birthing suite was set up with a mattress on the floor with a neonatal Resuscitaire in case a woman went into labour.

In the slightly separate dining room, an inpatient ward was set up. For the first few days, staff spent time running back to the old hospital building to fetch equipment and supplies they realised they’d left behind, and eventually the beds were pushed across. Dr Peet says while it all felt very rudimentary and there was some anxiety about the possibility of a patient coming through the door needing resuscitation, they were comforted by the amount of backup they had. “Because of the state of emergency, the Army was there, and we had lots more paramedics than we normally have. “I had a guy come in with pneumonia who was looking pretty rough. The ambulance crew would normally have to dump and run because they are just so busy, but they were able to stay and help and then we made the decision to send him down to Greymouth, so the turnaround was very quick,” Dr Peet says. There was also a lot of team spirit. “There we were, working out of a good old Kiwi workingman’s club with the bar behind us, so there were a lot of jokes, and we were inundated with care packages and cakes from the community and other DHBs.” And then there were the extra-special moments.

Dr Peet says a young medical student who was in a rural medicine immersion programme opted to stay during the civil defence emergency. Not only was he invaluable when it came to moving equipment but during a bit of downtime, he found a piano in the corner of the club. “Turned out he was the most beautiful piano player, and that was such a nice experience for everyone.”

Devastating scenes

One thing Dr Peet won’t forget is the devastation she saw. She describes entire households piled up outside houses – carpets, drawers with clothes coming out, teddy bears, kids’ toys – all ruined by floodwater containing sewage and farm runoff. “You could smell it as you walked around.” “What makes it worse is that Westport is a poor area where houses were either uninsurable because they are in the flood plain or people just can’t afford insurance,” she says. Dr Peet works at Buller Health Hospital every other week for 2–3 days, rotating between there and Te Ni -kau Hospital further south in Greymouth, as part of a rural health medical team.

She says while the community spirit and support has been amazing, medical staff are preparing to see patients coming in needing treatment for depression, anxiety, and social problems.

“A colleague called it ‘M*A*S*H in a bar’ – it was a spot-on description!”

“Initially people just get on with it and there’s a bit of an adrenalin rush, but now nearly every patient is stressed and sad.” After a novel and challenging two weeks of treating patients from the inside of a pub, the staff at Buller Health were given the all-clear to return to their original building. Dr Peet says while it was a perversely enjoyable experience, it’s one they hope never to have to repeat.