V E TE R AN S AFFAI R S & M I LITARY M E D I CI N E O UTLO O K
PREPARATION, RESPONSE, RECOVERY: THE VA’S “FOURTH MISSION” VA emergency responders attend to veterans in every phase of a natural disaster. By Craig Collins
n IT’S HARD TO ARGUE ANYONE WAS READY for what happened in Northern California on the night of Oct. 8, 2017, when a series of wildfires broke out in and around the Napa-Sonoma wine country – but the San Francisco VA Health Care System (SFVAHCS) was readier than most. The fires, stoked by dry conditions and high winds, swept through much of the area, destroying an estimated 8,400 homes and buildings. About 100,000 people were evacuated from the area, and 117 veterans lost their homes or reported fire damage, along with 16 SFVAHCS staff members. All told, 793 veterans in the region were affected by the fires. At around 8:00 a.m. on Monday, Oct. 9, as the fires were still burning, Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC, associate director of Patient Care Services at SFVAHCS, received a call from Bonnie Graham, SFVAHCS director, informing her she was the incident commander for the VA’s response to the fires. Her first task was to assemble her team and find out what was going on. Nihart had recently participated in the VA’s response to another huge wildfire, in nearby Lake County, so she knew what to do. “You get the phone bank going, and
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then you have your first call, and that’s when you begin to get the situational information and what you’re going to need to deploy to provide services,” she said. “It’s the acute phase, when we’re evacuating people.” The San Francisco VA had up-to-date lists of vulnerable veterans associated with each clinic in the area. “When they are shutting off electricity, you’ve got to begin to think about who is out there who relies on a ventilator, who uses oxygen,” said Nihart. “You’re thinking about all of those elements for your veterans.” The VA response team reached out to every veteran in the region to see what they needed, and then issued a call for volunteers. One of the fires – the Tubbs fire, which burned through several residential areas of Santa Rosa – came dangerously near the Santa Rosa VA Clinic, which serves 9,400 Northern California veterans. The clinic was closed for several days,
and Air Force veteran Victor Negron, a clinic administrative officer, showed up for work on Monday to begin monitoring the air quality inside the clinic and help in the response. Negron spent much of the next several days driving around in shorts and a T-shirt – he and his family had fled in the middle of the night with only the clothing on their backs, before losing their home to fire – to make contact with other veterans and inform them of the clinic’s closure. By Tuesday, the response team had set up phone lines for veterans to call for information and began arranging shelter for those who had been evacuated or lost their homes. One of the most significant issues for evacuees, Nihart said, was medication. “When you get awakened at 2 o’clock in the morning and told you have to evacuate immediately,” she said, “you forget things like your CPAP [continuous positive airway pressure machine] and your medicines.
One of the fires – the Tubbs fire, which burned through several residential areas of Santa Rosa – came dangerously near the Santa Rosa VA Clinic, which serves 9,400 Northern California veterans.
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