A publication for Staff and Physicians of IH
Appreciation for wildfire response from Chris Mazurkewich, Interior Health’s CEO.
The response effort in numbers.
Helping evacuees deal with potential health hazards after returning home.
Relationships key in IH response to help indigenous communities.
IH and partners join forces for vulnerable clients.
A timeline of how the wildfires affected IH.
Wildfire reflections from IH manager Trisha Shetler.
Behind-the-scenes efforts for staff during wildfire evacuations.
Looking after our sites is an important part of taking care of people.
Rick Erland, Director of Health Emergency Management for IH.
Photos submitted from staff and the public during the wildfires.
On the cover: Kamloops Emergency Operations Centre coordinators. Story p. 12.
The @InteriorHealth magazine is a monthly publication created by the Communications Department of Interior Health. Past issues of @InteriorHealth can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please e-mail: IHAcommunications@interiorhealth.ca Editors: Amanda Fisher, Ingeborg Keyser Designer: Kara Visinski IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Erin Toews, Breanna Traynor, Tracy Watson
Every person matters
I
President & CEO Chris Mazurkewich
think it’s safe to say that many of us are more than happy to welcome in September this year.
An entire summer of wildfires has tested Interior Health in ways we did not expect, especially considering many of our sites were still under the threat of floods in June. Despite the lack of warning, it was remarkable how we responded when the wildfires came blazing right up to and sometimes through our communities. I can tell you I have never been more proud of any team that I have worked with. It’s difficult to express the extent of my gratitude and awe to the staff members and physicians who stepped up so efficiently and courageously during this ferocious fire season. Many people were left devastated by this emergency event and it was essential for their sense of security that we were able to ensure patients, clients, and residents in our care were never at risk. Evacuations happened at the right time and as smoothly as possible. Not all patient transfers were as comfortable as we would have liked – it’s not easy for fragile patients to travel over back roads in buses. But in crisis situations, speed takes precedence. I met one patient evacuated from 100 Mile House to Overlander Residential Care in Kamloops who talked about the long, difficult transfer. However, she said her main concern was leaving the site where a wildfire was advancing. Upon her arrival at Overlander, she was tucked into a comfortable bed and her husband and little dog were able to join her in her room to soothe her nerves. It was these little touches from staff for incoming evacuees that helped so much. While the wildfires were beyond our control, we were able to make sure patients were evacuated safely and well taken care of even when we had to improvise and make the best of limited space and supplies. This was repeated across IH West
communities and for all types of patients whether they required mental health services, home support, or primary care. Care was creative, immediate, and compassionate. On Page 14 you’ll find a story about how our Kamloops MHSU team partnered with community agency ASK Wellness to open up a former inn for evacuees with special health challenges. Another story on Page 20 outlines the behind the scenes support available to our staff during the wildfire crisis. Staffing Services, Payroll, and Human Resources teams came together to quickly figure out what was needed and how to help – a common theme in every aspect of our response. Throughout the summer, I’ve shared messages every week in an effort to convey how important all your work has been, whether right in the heart of areas affected or by keeping the operations running as your colleagues’ attentions were elsewhere. It was my way of expressing thanks to our people who put their own fears and losses aside to make sure those in our care were safely transferred out of harm’s way and given a home away from home. You’ve been amazing. Now, we are in the recovery stage and we must continue to look after our patients, our partners, our environment – and one another. When I travelled into the Chilcotin in August and saw for myself the destruction left in the wake of these fires, I realized clearly that this will take time and effort. Whether people lost their homes or returned to property intact, the fear of the unknown, the trauma of evacuation, and the homecoming to a landscape totally changed by fire will have long-lasting ramifications. Our services will be tested. And our staff and physicians will once again pull from their inner strength and stamina to find the right way to help all the people who will turn to us for the support and care they need. After the summer of 2017, I have no doubt we will be there together, proving again and again that every person matters.
192
Patient Care Quality Office calls received
700+ Staff displaced
35
IH info bulletins issued
32,013
Staff hours reported on wildfire
2,000 Air filters changed every 2-3 weeks
182
Helicopters and planes deployed
80+
Alerts or orders issued
$93+
million
880
Donations to Red Cross
Patients/clients evacuated
WILD EMERG RESPO
what it
1
$2.7 Cost to IH for wildfire response
0+
19
Firefighters, personnel fighting fires
15
First Nations communities were under alert or order
IH sites/facilities closed
DFIRE GENCY ONSE
52.37
t takes
1.15
million
Hectares burned
million
7
3,820
111
Highest air quality health index reached
4
Incident command centres
48,000+
Registered wildfire evacuees in B.C. Interior
People involved in IH EOC response
250+
Calls received to HR wildfire employee hotline
The following numbers reflect some of the statistics related to the wildfire emergency in our province and may be approximate. Data gathered from July 7, 2017 to August 31, 2017.
Protecting health in aftermath of wildfires
T
his year an unprecedented number of B.C. Interior residents were forced to leave their communities due to evacuation orders – some out of their homes for days and others for weeks. Returning was often bittersweet. While it was a relief to be home, residents often had to deal with the impacts of the fires, including potential health hazards.
When environmental disasters or emergencies like forest fires occur, Interior Health’s Health Protection team consisting of environmental health officers, drinking water officers, and licensing officers works in collaboration with medical health officers to ensure local governments, regulated facilities (e.g., restaurants, food stores, water systems, and licensed care facilities), and the public are equipped to deal with any potential health hazards that may be present. “The health hazards our teams respond to after a wildfire and evacuation order will vary. The needs of each community will depend on the size of the community, the resources they have, the length of time evacuations orders were in place, duration of any power outages, and proximity to the fire,” says Dan Ferguson, Manager Strategic Initiatives with Interior Health. “All of these factors and more can result in a risk to health from things like contaminated food or water supplies to poor air quality.” So when more than 11,000 people from the City of Williams Lake and surrounding areas were ordered to evacuate on July 15 due to an encroaching wildfire, the team knew that managing the re-entry, when it came, would not be an easy task. “To put it bluntly, it was a massive undertaking,” says Dan. “One of our first tasks when an evacuation order is issued is to determine just how many regulated facilities are affected and require our support. Williams Lake has nine licensed residential care facilities, 34 licensed day cares, 27 water systems, 107 restaurants, 23 food retailers, and eight recreational water facilities, so we knew managing the re-entry for a community of this size was not going to be easy.” The evacuation order for Williams Lake and surrounding areas was in place for almost two weeks and most facilities were closed. Health Protection staff began preparing for what was going to be a busy re-entry by pulling together information and identifying the most efficient and effective means of getting that information to those who were going to need it. “We knew we needed a variety of tools to get the information out – we worked with our Communications team to develop information for the media and social media, but we also prepared written material for distribution through evacuation centres and local governments and had staff attend community meetings when possible to answer questions about food and water safety as well as air quality.” Just before noon on July 27 the evacuation order for Williams Lake was downgraded to an alert and residents were told they could return home. “We were monitoring the fire situation very closely through our involvement on the various Emergency Operations Centres.
Karen Zabaras, Environmental Health Officer, inspects a kitchen at a fire camp near 100 Mile House, the same community from which she was evacuated.
Despite being evacuated from his own home, Williams Lake Environmental Health Officer Alan Holdal, left, was on the job making sure kitchens in the fire camps were operating safely. With Alan are two staff members from Fireweed, a contractor hired by BC Wildfire Service to provide the camp setups.
“We started hearing reports that the order could be lifted within the coming days so we were preparing to deploy staff to the area within that timeframe. We didn’t expect it to happen as quickly as it did. We found out the order was lifted on July 27 as it was happening, so we had to act quickly to get our teams in place” says Dan. At the time, the Williams Lake Health Protection office had one environmental health officer, one drinking water officer, and one child care licensing officer – all evacuated from their homes and working out of a temporary work space in Kamloops. “There was an incredible amount of work to be done. We had to pull in additional staff from the Kamloops office, find accommodations, and get staff to the community as quickly as possible. We knew residents were already en route and many would be returning to homes where food had spoiled and not bringing food back with them.” For that reason, large grocery stores were identified as a top priority for inspection. Fortunately, the community did not lose power so frozen foods did not have to be destroyed. Perishable and potentially hazardous foods had to be destroyed and the stocks replenished. The remaining food facilities were triaged based on risk – with more than one third of all food facilities inspected that weekend and the remaining either contacted or inspected
by the end of the following week. At the same time, drinking water officers were in constant contact with the City of Williams Lake and small water suppliers to ensure that proper procedures were in place to ensure safe drinking water for community reentry. Similar processes were used for Cache Creek, Clinton, and 100 Mile House when the evacuation orders on those communities were lifted. In addition to supporting evacuees upon re-entry, Health Protection plays an active role in the midst of evacuations by visiting and inspecting Emergency Social Services Reception Centres across the region – often daily, to review housing and food safety. Health Protection staff also inspected the fire camps operated by the BC Wildfire Service to make sure those on the frontlines of the firefighting efforts were protected from potential water and food-borne diseases, as well as other health hazards. “I can’t say enough about how our team came together to respond to this incredible challenge. For many, it involved putting in long hours at a time when they were also dealing with the personal stress of being evacuated from their home communities. I am incredibly proud of this team and the work they did.”
“
“
o say the surroundings were chaotic would be an understatement.
in the system.”
hails from the Bonaparte First Nation, says she would spend the day going from The speed at which the wildfires spread tent to tent, introducing herself and this summer meant Interior Health asking if they needed anything. She All around the Sandman Centre, people needed to react quickly to support watched for those struggling from chronic were on edge, having been abruptly evacuees with health needs. It meant health conditions and connected people evacuated from their homes due to the going with the flow at times, and with resources such as a physician or raging wildfires in the Thompson Cariboo. adjusting at a moment’s notice when new diabetes educator as needs arose. She Those who didn’t have family to stay with needs were identified. also helped at the Sandman Centre and found themselves at the Kamloops at Thompson Rivers University (TRU) arena, seeking the support of the where 25 elders who had been Emergency Social Services (ESS) evacuated from area nations were reception centre. housed. In the midst of this was Londea Riffel, hub coordinator for the Secwepemc First Nation. As the liaison between the health directors of 12 Secwepemc nations and 16 band chiefs, as well as indigenous and non-indigenous community partners, the First Nations Health Authority (FNHA), friendship centres, and Métis associations, Londea was busy trying to arrange aid for those evacuated from First Nation communities – some of whom had never even been away from their reserves before. Londea says her job was made infinitely easier when she walked into the Sandman Centre and saw Kerry McLean-Small, Interior Health’s Primary Care Manager in Kamloops and someone with whom she has worked for 15 years. The historical relationships between Londea and Kerry, and others – such as Kris Weatherman in Public Health; Rae Samson and Tara Mochizuki in Mental Health and Substance Use; and Brad Anderson, IH’s Aboriginal Health Director – were crucial to helping remove barriers to care for indigenous populations impacted by the wildfires. “They said, ‘how can we support you?’” Londea says. “They knew who to direct me to for help with my questions. They understood who I was and how I would react and respond – we had an understanding about each other. It’s easier when you have built relationships
It was an emotional time, she says. “In doing it, you can’t stop and think. You have to detach yourself from what’s happening,” she says, adding that was especially difficult in the face of her own family’s loss with an aunt who lost her home to the fires. At the Sandman Centre, where row upon row of cots were set up to house evacuees, many painful memories flooded back.
Public Health Nurse Jessi Minnabarriet and Mental Health Clinician Audrey Ward at the Kamloopa Powwow grounds.
It also meant anticipating needs, and especially from a cultural standpoint for First Nations communities. That’s when IH relied on the expertise of its employees with indigenous heritages – and that’s how Public Health Nurse Jessi Minnabarriet and Mental Health Clinician Audrey Ward found themselves at the Kamloopa Powwow grounds, assisting the emergency operations centre (EOC) led by the Tk’emlúps te Secwe̓pemc Indian Band. Jessi, who is Métis and whose husband
“She looked at the cots, and said, ‘this is just like residential school.’ I think this was hard for a lot of First Nations people, leaving your home, leaving your community where things are familiar, being separated from family. But they are resilient and grounded and strong, united and supportive of each other. It’s something to be admired.” Audrey, who also helped at TRU and the Sandman Centre, says the traumatic impact went beyond the physical to include the spiritual and emotional. She approached her work from an empathetic place – understanding the significance of the loss and helping to initiate healing by offering smudging, praying, singing and drumming at the powwow grounds. Audrey says it helped with providing a sense of safety and community in unsettling times. “The whole issue of displacement is hard enough. When you’re as connected to the land as we are, it’s harder still,” says
Audrey, who is an Upper Nicola Band member. “The land is our mother. Without the land, we have nothing. To know it’s being consumed by fire and we have to leave ... we are stewards of the land, we are supposed to protect it. There’s a sense of guilt – do we stay back and help? What could I have done? It brings tears to my eyes to think of all the trees and animals lost in my territory. It’s not just being materialistic. It goes deeper – it’s a connection to the land, connection to spirituality.” This is also the gathering season, she adds. The fires have interrupted the annual rite of picking berries, canning, and freezing. “The loss of food is really impactful because so many live in poverty – we gather out of necessity. It brings us together as a community. We go out, work together, to prepare for winter,” she says. “One elder – he lost a deepfreeze of meat that they had just prepared. It’s a huge loss.” Both Audrey and Jessi were grateful for the opportunity to step up during the crisis, and they have high praise for their many IH colleagues who did the same – Kerry, Kris, Rae, and Tara, as well as Kamloops Health Service Administrator Cathy Thibault; Aboriginal Health practice leads Danielle Wilson, Rose Melnyk, and Darcy Doberstein; Home Health Nurse Amber Lysak; and countless others from across all portfolios. There were many others such as Nurse Practitioner Laura FitzGerald and Family Physician Dr. Janet Bates, as well as community partners such as the FNHA, Secwepemc Mental Health, Kamloops Aboriginal Friendship Society, White Buffalo Society, St’at’imc Health, and Qwemtsin Health Society. “It was very well co-ordinated. It was
wonderful to see it all there,” Audrey says. “I’m proud that IH just stepped up and was there. In a time of crisis, it’s important that we get together to do what we can and support each other, too.” Jessi also admires the Tk’emlúps te Secwe̓pemc volunteers, who provided shuttles, traditional foods, and clothing, not just for the indigenous evacuees, but also for others found themselves staying at the powwow grounds. “One of the elders said we all bleed, so therefore we are all connected in some way, no matter the colour of our skin,” Jessi recalls. “It was profound to see non -Aboriginal people out of their context at the powwow grounds and feeling so well embraced and welcomed.” “They did an amazing job of setting up support at the powwow grounds. It’s a place of healing and ceremony, and it was wonderful to be a part of it,” adds Audrey.
lend a hand or support one another as best as possible to ensure people are safe and taken care of. There has been impressive leadership from our Aboriginal communities who have stood by and guided their communities in a positive and effective manner. IH has worked closely with nations, with communities, and with FNHA to ensure we are responding to requests. I feel honoured to work with such fantastic people.” Londea references the ability to come together in times of crisis as the reason why people were so well cared for during the summer of fire. “We don’t always get along. We don’t always have great relationships. But even in times of crisis, people will be willing to step up and put differences aside, to work together where needed. It’s about team – together, everyone achieves more.”
Brad Anderson describes Interior Health’s wildfire response with words like commitment, passion, and amazement. Everyone worked hard to ensure Aboriginal community members received the appropriate care during very troubling times. “It was expressed many times during the summer of fires about the great staff we have and I cannot stress this enough,” he says. “I’m impressed with how we have all come together to get the job done. I have witnessed countless times the amount of follow up to our Aboriginal communities to ensure they are being heard and receiving the support needed for their community members. “I have also noticed the strength and resiliency of our Aboriginal communities throughout the state of emergency. Many of them have come together to
Londea Riffel, Secwepemc First Nation Hub Coordinator (R), says her work to secure aid for Aboriginal evacuees was made easier because of historical relationships she has built with IH staff, such as Kerry McLean-Small, Kamloops Primary Care Manager.
Calvary Community Church Kitchen Manager Katie Winston, ASK Wellness Executive Director Bob Hughes, ASK Wellness Evacuation Centre Supervisor Kevin Watt with Lucy, IH MHSU Manager Tara Mochizuki, and ASK Outreach Worker Varinder (Sabi) Singh all worked together to accommodate 50 vulnerable residents evacuated from Williams Lake in July.
A Maverick Approach
H
ere’s the scenario: A woman is panicking about being separated from her pets; a couple just got kicked out of their third motel for odd behaviour; a family of 17 are really upset about being separated; mental health clients suffering severe anxiety can’t go into a dormitory with 500 people.
That was his response many, many times over the next two days after his boss Bob Hughes, ASK Wellness Executive Director, offered the Maverick site as a shelter for marginalized evacuees. Until that point, Kevin lived alone at the inn while developing a new employment program for ASK clients."
Bob knew there were going to be people who wouldn’t fare well in an evacuee dormitory, and conversely, the other That’s the appeal from Kamloops Mental evacuees who may not be comfortable Health and Substance Use Manager Tara with all of them. Mochizuki to ASK Evacuation Centre Supervisor Kevin Watt, as she triages “We had a building. It just made sense people evacuated from Williams Lake by to help these people out,” says Bob. wildfires. She’s looking for appropriate housing. It was a monumental task to outfit a barren hotel that was prepped for Kevin is located at the former Maverick hardhats and sledge hammers, but with Inn, which was two days away from his business management background being a construction site for ASK and capacity for solving problems, Kevin Wellness Society’s latest affordable and a team of ASK Wellness volunteers housing program when the evacuation moved queen-size beds and bedding order was given. into 35 rooms in two hours. Can you take them?
“Oh sure, I’ll find a room,” replies Kevin. Bob drove people up to their new
temporary housing and Tara kept the rooms filled, every so often calling Kevin to prepare him for a particularly challenging tenant. “He was amazing,” she said. “He never said no. He always said we’ll make it work. And they did.” The Kamloops team also got great help from their counterparts in Williams Lake. Interior Health MHSU clinicians Scott McLaughlin, Scott Taylor, Heather Robinson, and Gail Zowty, evacuees themselves, arrived at the evacuation centre in Kamloops and told Tara they were ready to start work. “We said we need to take care of our clients because they are vulnerable right now,” recalled Scott McLaughlin. The Mental Health & Substance Use team in Williams Lake had been preparing their clients for the real possibility of evacuation as soon as the first fires appeared on the hills outside of town. Nonetheless, many clients were
shaken up by the events when it actually happened and the MHSU clinicians made regular visits to check on them at ASK’s Maverick evacuee site. The clients were also in good hands with Kevin, said Scott.
backwards for us. I just can’t say enough about how kind they all were.
“I’m not one to be around so many people. The anxiety level was extreme. I am really thankful that they happened to be there,” said Koreann While the IH team dealt with mental who also pitched in and helped keep health issues, Kevin managed the the dining room tables wiped down logistics of food and entertainment and and the floors swept. any conflicts that arose from people living together in close quarters. Over “Kevin was a saint to put up with the next two weeks, ASK welcomed 50 people with very different more than 52 evacuees. personalities. He was working so hard. He would be up first thing, making us “Kevin was phenomenal. He worked coffee. He did all the cleanup and they well with all clients. Communication did this out of the goodness of their was fluid. Everything went so well,” hearts. I wanted to do said Scott. what I could to help out.” Kevin is a matter-of-fact kind of guy who might also be described as a strategic thinker. Once the rooms were outfitted, his next priority was food.
finding a friend with a huge DVD collection), or creating zones in the yard for people to walk their dogs or socialize. He was also able to help a couple of brothers in their 20s who came to Kamloops, not knowing their dad who was in palliative care was transferred to Prince George. They thought they might not see him again. “We found out where he was and I gave them my cell phone to take to their room so they could talk to their dad in private.”
Kevin said he set a few rules, held a group meeting about expectations, and after that dealt with problems if On Day 1, ASK treated each evacuee they occurred. He also had to a dinner for one from the nearby a secret weapon – his pet Beijing Restaurant. Day 2, the banquet Lucy who seemed to know room was filled with food from the which evacuee needed a food bank. Day 3, the Calvary little dog to snuggle. Community Church pastor Marco Bessa and kitchen manager Katie Winston “We definitely had some came by to suggest “you do the very challenging people shopping and we will do the cooking.” when it came to mental health, but we (ASK) Katie and a slew of church volunteers decided it didn’t matter cooked breakfast, lunch, and supper what their issue was, we and as fast as one meal was over, ASK had space for them and we Wellness Outreach Workers Kira Haug would deal with issues and Varinder (Sabi) Singh were after they arrived.” IH’s Williams Lake Mental Health & Substance Use team headed out the door to do more of (L-R) Scott Taylor, Heather Robinson, Gail Zowty, and grocery shopping. Kevin says the food When one young man was Scott McLaughlin fled the wildfires from around their city and immediately went to work with clients was wholesome and tasty – lasagnes, pestering the other lodgers soups, and the crowd favourite – meat for handouts, Kevin offered a evacuated to Kamloops. loaf. friendly reminder that he had a choice, “behave or head downtown A computer was set up in the lobby Williams Lake residents Koreann to less comfortable accommodations.” where people could register with the Tremblay and her husband Ted ended A similar reminder was given to Red Cross and, as well, Emergency up at the Maverick just by luck. An someone who got rowdy with the Social Services sent a liaison officer IH employee noticed she was pale, help of alcohol at 3 a.m. “That won’t right up to the Maverick to handle the exhausted, had mobility issues, and happen again,” Kevin told him. “And necessary paperwork for clients, a was anxious about being separated it didn’t.” service that also alleviated their stress. from her pets. But laying down the law was a minor Many evacuees were sad to leave “Bob was notified and he asked if role. More of his time – once all the when the evacuation order was lifted, I wanted to stay at a hotel. I said dishes were done – was spent chatting but ASK had work to do. A day I would love to. They took us all as with people and hearing about friends after the last person went home, a group, my two cats, my dog, me, and families that they missed or construction crews started work on and my husband. They bent over setting up DVD players in rooms (and the affordable housing project.
How it all unfolded Williams Lake July 8
Due to impacts of wildfires in the area, transfer begins for hospital patients, Williams Lake Seniors Village and Deni House residents, outpatient clinics, community care patients, and mental health centre. 498 patients and clients relocated.
July 7
Evacuation alert issued. Transfer begins for hospital patients; Mill Site Lodge, Fischer Place and Carefree Manor residents; and home support clients. ED remains open. 310 patients and clients relocated.
July 9
Evacuation order issued. Hospital closes.
July 10
July 22
Evacuation alert issued. Lab and DI services suspended, ED and maternity remain open.
Evacuation order downgraded to an alert. Hospital ED re-opens.
July 15
July 25
July 24
Hospital ED and primary care clinics re-open.
Lab and DI services re-open. South Cariboo Health Centre re-opens, including home support, home health, mental health, and public health nursing.
July 27
July 29
Evacuation order issued. Hospital closes.
Evacuation order downgraded to an alert.
July 28
Outpatient lab, DI, and community services re-open.
August 2
Specialist clinics, mental health services, and ambulatory care re-open.
August 15
Evacuation alert rescinded.
August 16
Planning begins to phase in remaining health services.
August 18-19
Williams Lake Seniors Village and Deni House residents move back home.
August 28
All health services resume at hospital.
Evacuation alert rescinded.
July 31
Ambulatory care, telehealth, and urology re-open.
August 5
Carefree Manor assisted living patients move back home.
August 9
Residents move back to Mill Site Lodge and Fischer Place. Phased re-opening of hospital begins.
August 14
All health services resume at hospital.
100 Mile House
Ashcroft/ Cache Creek
July 9
Evacuation order issued. Alexis Creek Health Centre closes.
July 11
July 7
Evacuation order issued for Cache Creek. Ashcroft hospital closes due to power outage. Transfer begins for hospital patients, Jackson House, and Thompson View Lodge residents. 46 patients and clients relocated.
July 18
Evacuation order downgraded to an alert. Ashcroft hospital re-opens. Patients and Jackson House and Thompson View Lodge residents return home.
August 25
Evacuation alert rescinded for Cache Creek.
Due to wildfire activity in the area, West Chilcotin Health Centre (Tatla Lake) closes.
July 27
Alexis Creek evacuation order downgraded to an alert.
July 29-30
Evacuation order issued for Clinton. Health centre closes.
July 31
Alexis Creek and Tatla Lake health centres re-open.
August 12-13
Evacuation order issued for Alexis Creek, health centre closes. Evacuation alert issued for Tatla Lake.
August 15
Evacuation orders downgraded to alerts for Clinton and Alexis Creek.
Clearwater
August 17
Health centre re-open in Alexis Creek.
August 18-19
Evacuation order issued for Tatla Lake. Health centre closes.
July 15
Evacuation alert issued. Transfer begins for hospital patients, Forest View Place residents, and community clients. ED remains open. 26 patients and clients relocated.
July 24
Evacuation alert rescinded.
August 21
Health centre re-opens in Clinton.
August 24
Evacuation order downgraded to alert for Tatla Lake.
August 26-27
July 25
Health centre re-opens in Tatla Lake. Evacuation alert rescinded for Clinton.
July 26
Cariboo/Chilcotin
Community health and home support services resume. Forest View Place residents return home.
* This timeline does not reflect all the fires thoughout the IH area that impacted communities and residents over the summer, only those that directly impacted our health-care services.
&
Smoke Silver Linings
Story written and submitted by Trisha Shetler, Health Services Manager, Cariboo/Chilcotin Hospitals and Communities Integrated Services.
O
n July 6, I was in 100 Mile House as our CEO was here on a tour. I was working with my team when someone asked, "Have you seen the fire smoke outside?" I looked as I was about to leave to travel home to Williams Lake. After seeing the smoke, I came back, put my bags down and said, to my team, "We are going to plan for the worst and hope and pray for the best."
After ensuring IH Emergency Preparedness Coordinator Colin Swan was aware, our team quickly pulled into a huddle and tasks were designated to everyone. It was very surreal. Our team was focused on ensuring that our 80 frail and elderly clients, who together receive 100 hours of care at home every day, would be safe. While we were not faced with a crisis in that exact moment, we were preparing as if the fire would be around for a few days. Within 15 minutes we had completed our designated tasks and we were ready in case things changed. I headed back to Williams Lake. As I was driving into 150 Mile House, I participated in a call with other leaders to set up Incident Command in 100 Mile House. I was designated Incident Commander for the 100 Mile site (community, residential, and acute care). I quickly drove home, grabbed my first grade son's backpack, filled it with three days of clothes (thinking I was packing too much for one night) and a toothbrush and drove back to 100 Mile. The fire quickly progressed on Friday, July 7. Our staff were being personally affected as well, many with homes in the areas that were under evacuation order. Other team members jumped in to cover to allow staff to get home to attend to their families, animals, etc. The teamwork was remarkable. I continued to evaluate our staffing levels in collaboration with our colleagues. With the fires changing and staffing
levels dropping, we began evacuating on Friday night. I don't think I've ever filled a notebook and my voicemail so quickly! By 5 p.m. on July 8, we had safely evacuated 91 long-term care residents, 37 assisted living clients, and 16 acute patients. Our Emergency Department remained opened and we still had community health services in place where it was safe to do so. The sirens, helicopters, smoke, and emergency response vehicles were always in view. It became our new normal for those 48 hours in 100 Mile. Williams Lake is home for me, but after finishing at the hospital late at night on July 8, I stayed in 100 Mile House. The highway closed the next day due to the fire, so like many folks, I was not able to get home. At the same time, the Williams Lake teams were working through the same process and fires were starting in neighbouring communities. My husband was away working north of Williams Lake, my kids were safe in the Okanagan with their grandma and aunties, who were also all under evacuation order, so I called on my parents to gather our 100-pound St. Berdoodle in case things changed for Williams Lake. I am honoured to have worked with the professionals in the command centre who took on leadership and/or pivotal roles in 100 Mile House: Karen Brunoro, Teressa Allwood, Amber Harker, Deb Trampleasure, Sherree Zeis, Angie Evans, Joanne Gaudreault, and Monica Klassen. These folks, among many others, did whatever needed to be done — the synergy was remarkable. Many others were also involved in co-ordinating transportation, driving buses, and getting patients organized and settled. By Sunday, July 9, the community of 100 Mile House was ordered to evacuate. Unable to return home to Williams Lake due to the highway closure, I joined others in Kamloops. I was able to work from Kamloops leading and supporting the planning for the Williams Lake Home Health operations. Our team quickly pulled together evacuation lists and contacted each of our clients to ascertain their whereabouts. We were able to identify which community clients could go with family and/or who needed our support to relocate to a safer distance from the fires. The team dedication did not end with the evacuation work. We recognized that while the District of 100 Mile House and the 103, 105, and 108 Mile areas were under evacuation, there were many people, patients, and staff, who were not evacuated at that time because they were in the south 100 Mile area. We continued to provide both home support and home health services to clients remaining in the region. RN Sandra Nichol from Home Health presented an innovative idea. She called me and asked, “Can you help me get into the hospital to get wound-care / palliative-care supplies and an IH vehicle? If so, I will stock the car and nurses who live in the south region can take turns doing a mobile clinic and palliative care visits where safe.” We also determined that if she
picked up some home health laptops and air cards we could have our team retrieve care plans for clients who required care in Prince George or Kamloops. With the help of Colin Swan, Emergency Preparedness Coordinator, we got Sandra access to the hospital to organize the mobile unit. Throughout the evacuation weeks, our team was in close contact — lots of phone calls, texts, and emails to orchestrate the temporary community health delivery model. This is the work that excites me. Despite a wildfire crisis, innovative patient and client care was at the forefront. In Williams Lake, our Home Health team was instrumental in supporting the evacuation of our most frail and elderly community-based clients. A special thank you to Tammy James, Acting Team Leader Home Health; Janice Laurie, Home Support Scheduler; Alison Woods, Home Health RN; Dolores Berkelaar, Home Support Supervisor; and many others who were instrumental in this work. On Friday, July 14, I was able to see my children, aged five and eight. It felt great to give them a big hug and spend time with them. When the Williams Lake evacuation order was given on July 15, my husband joined us with our St. Berdoodle riding shotgun. Now that I have proven I can live out of a first grader's backpack for a month, I am sure my husband will have new expectations on my luggage next time we go on a family vacation! This summer challenged the Cariboo Chilcotin, but I believe we have all strengthened through this process. It hasn't been easy or joyful, but through these fires I have learned about myself and my team members. My new catch phrase is “smoke and silver linings,” looking for positivity in uncertainty and chaos. I am proud to work with dedicated, committed, and passionate people who truly ensure that "Every Person Matters" and who go above and beyond to honour patient and staff safety.
Trisha and her family reunited.
t the peak of the wildfires this summer, more than 700 Interior Health employees were evacuated – leaving behind their homes, their possessions, and their places of work. Williams Lake, 100 Mile House, Ashcroft, and Cache Creek were hit first – and hit hard – followed by Clearwater, Alexis Creek, Tatla Lake, and Clinton. As our hospitals, health centres, residential, and assisted living sites closed, many staff wondered: where do I go; where do I work; and, what if I can’t work? To support staff and answer these questions, the Staffing Services and Human Resources teams sprang into action. “One of the first things we did was send automated calls and text messages to staff in impacted areas,” says Matt Wilkie, Corporate Director, Staffing Services. “It was imperative that Staffing Services know who was evacuated and their whereabouts, so we could help them in the best possible way.” In addition to phone calls and text message, Interior Health’s Facebook and Twitter sites helped broaden our reach.
a huge impact on capacity and created a great need for more staff,” says Nitha Karanja, Coordinator, Northern Health Staffing Services. “IH and NH collaborated to schedule IH staff to work at our sites. I can’t thank IH Staffing Services enough for their hard work and dedication – we would have been in a pickle without you.” In the end, more than 300 Interior Health employees were redeployed to work in health-care sites, with 78 sent to Northern Health. Human Resources also played a major role to support managers and staff with questions relating to employment processes during the current wildfire events. A toll-free, employee hotline was set up and several question and answer documents developed. More than 250 calls were received to the hotline since it opened on July 12 – half of which were in the first week.
“The response we received was staggering,” says Matt. “I felt very humbled hearing from employees who were evacuated, immediately volunteering for redeployment so they could continue to care for their patients and residents.” Additionally, human resource business partners (HRBPs) were on the ground supporting staff and managers at every Across IH, employees were reaching out to Staffing Services turn. offering assistance. “The work of the HR Operations, Labour Relations, and Kelly Bradley, Director, Laboratory Operations, IH West, Workplace Health and Safety staff to support managers also witnessed some great work from the Kamloops and their employees was above and beyond,” says Cathy Staffing Services office at Royal Inland Hospital. Stashyn, Corporate Director, Human Resource Operations and Recruitment. “From facilitating the evacuation “This team is truly amazing. All of them are on their phones processes, assisting with staffing and HR business talking to anxious employees, while updating timekeeping at processes, to ensuring supportive programs were in place the same time. They are doing their very best to make sure for from a staff safety and wellness perspective, to people are getting a proper pay cheque and working with planning for re-entry – the HR teams were fantastic.” the redeployments. The room is very noisy and yet they are all calm – truly some of our shining stars in this crisis.” While Human Resources and Staffing Services were working with managers, co-ordinating staff information, scheduling, In total, nearly 900 of our patients, clients, and residents and re-deployments, our Finance and Payroll teams were were affected by wildfire evacuations, many of whom were also working hard to develop systems and processes to help relocated to other health-care facilities in IH and Northern us report on financial and human resource impacts from the Health (NH). fires. “The influx of IH patients and residents to our facilities had
“One of our roles in Financial Services is to track,
Team members from the Staffing Services Centre at Royal Inland Hospital in Kamloops.
summarize, analyze, and report wildfire expenses to the Ministry of Health and to our senior management teams,” says Cindy Rephin, Controller, Financial Services. “The organization is responsible for achieving a balanced budget, so the sooner our leadership teams know the financial impacts of this emergency response, the sooner we can plan and manage the outcome at year end.” “It took some creativity to develop new processes to respond to quickly changing priorities,” says Cindy. Meanwhile, the Payroll team was working hard to develop new wildfire payroll codes and processes. “This was the first time we’ve ever sent our employees to work in another health authority,” says Susan LeBlanc, Payroll Manager. “It took coordination between both Interior Health and Northern Health Staffing Service offices to send timekeeping reports to Payroll. “Our team follows the ‘Every Person Matters’ philosophy of IH, which served us well during the wildfire events as we worked to accommodate the needs of our employees and provided assurances during an unpredictable time.” Susan goes on to explain that this was an unprecedented situation for Interior Health and the protocols in place were limited. However, after working closely with other IH departments, changes have been made that will improve our response to similar events in the future. “Overall, this has been an incredible collaborative effort between Staffing Services, Human Resources / Labour Relations, Finance, and Payroll, as well as with our partners in Northern Health,” says Matt. “Kudos to everyone for their response and dedication to ensure we continued to provide quality care for our patients, clients and residents, while also looking out for each other.”
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After a delay due to wildfire evacuations, during which they helped as best they could, the new security team has now been introduced at CMH.
Taking care of facilities The Role of Security After months of planning, the Cariboo Memorial Hospital (CMH) security team was eager to get started this summer. The new service was set to launch on July 10, providing 24/7 security coverage at CMH for the first time. Who could have predicted that, instead of starting their new jobs, the team and other residents of Williams Lake would be asked to evacuate that week? With the towns of both 100 Hundred Mile House and Williams Lake on evacuation order and hearing news of looting in some areas, Protection Services wanted to ensure facilities were protected without having security officers remain on site. Facilities were remotely secured and access cards were temporarily suspended. Anyone requiring access to CMH or OMH advised Protection Services, who could remotely open doors or reinstate access for individuals on an as-needed basis. Remote video patrols of the evacuated facilities were performed regularly from the security office at KGH. Meanwhile, the new CMH security officers remained in contact with Paladin management, IH’s contracted security provider, throughout the evacuation order period. “As soon as repatriation planning began, they were scheduled to start working at Cariboo Memorial,” says Andrew Pattison, Manager of Protection, Parking and Fleet Services. “The security officers returned home and quickly reported for their first shifts, some without much time to settle back home, working long hours to maintain security coverage in the initial days while the remainder of the team worked to return home.” Although these actions went a long way in keeping facilities safe, for a team that is used to being heavily involved in major incidents, Andrew says it was tough feeling trapped on the sidelines wanting to do more. “I know myself and my security/protection colleagues all wished we could have done more right out of the gate,” he says. “But given the remoteness and facilities that were impacted, there wasn’t much we could do. We remained on standby to assist where we could.” “When Logistics requested access to a fleet truck that was not being used in Salmon Arm, James Ferriday and I drove out on a Sunday afternoon to pick it up and deliver it to Kamloops, so it could be used to move beds, air filters, and other equipment around our facilities as needed. We wanted to help and it felt like the least we could do.”
The Role of Plant Services Plant Services/Facilities Management employees have had their hands full this summer preparing for evacuations and repatriation; dealing with air quality issues; and other pressing needs brought on by the wildfire situation. For example, at Royal Inland Hospital alone there are 400 air filters being swapped out every two to three weeks to manage air quality throughout the building. Across Interior Health, maintenance is changing over 2,000 filters every two to three weeks due to smoky conditions. Although each hospital already has several air scrubbers, Plant Services purchased a dozen more of the HEPA air scrubbers for the Thompson/Cariboo region, doing whatever they could to mitigate low air quality. (On Aug. 3 air quality in Kamloops reached 49 – the worst in recorded history.) They also played a key role in preparing space to accommodate evacuees at sites in Kamloops and Merritt. “Plant Services staff worked until the wee hours of the morning making sure the vacant third floor of Ponderosa was suitable for patient care, for example, fixing plumbing fixtures, making sure all the electrical was working, ensuring there was a nurse call system in place. Everything going into and out of Ponderosa had to be shipped using a very small elevator, making it even more challenging,” says Director of Plant Services Steve McEwan. “The large gathering space at Overlander was also transformed to accommodate additional residents. All the Plant staff stepped up. They were very dedicated to patient care, even though their personal lives were being impacted as their homes were under evacuation orders or alerts.” The situation presented unique challenges as the sites were evacuated ahead of orders, meaning they were emptied but not completely shut down. “Plant staff had to stay to operate and maintain the facilities until an evacuation order was given. Once the evacuation order came, the facility operator shut down all non-critical systems while leaving a number of systems functioning in order to protect the assets,” explains Steve. Moving resources through road closures via whatever means of transport they could find was a logistical challenge, as was tracking both equipment and people in a situation that was rapidly changing. “There will definitely be lessons learned from this experience,” says Steve.
Above: Quick work transformed space at Overlander into a temporary patient care area to accommodate evacuees.
BEFORE
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Rick Erland
Director, Health Emergency Management Tell us a bit about yourself and the experiences that led you to IH.
I joined Interior Health in 2006 in a project support role for Health Emergency Management (HEM) and subsequently moved into the emergency preparedness coordinator role in 2007. In 2009, IH restructured its HEM program and I took on the responsibilities as the IH HEM Lead. Prior to IH, I served for 26 years in the Canadian Army (Tank and Reconnaissance). Interspersed with tours with the regiment, I was an instructor at the combat training centre in New Brunswick, served on the staff at various headquarters levels (Canadian and NATO), and participated in various domestic operations across western Canada and overseas deployments to the Balkans and Afghanistan.
What does IH’s Health Emergency Management program do?
Our goal is to provide timely, reliable, and trusted advice to Interior Health leaders so they feel comfortable and prepared to face an emergency. The trick is to provide efficient education and training that can be applied to different emergencies.
Rick compares a map of IH facility locations to the fire map and evacuation orders issued by the regional districts with Lori Motluk, Acute Services Executive Director and rotating EOC Operations Section Chief, and Carolyn Courtemanche, Administrative Assistant.
pandemic, like Ebola or the current overdose crisis, can stretch on for months, even years.
What do you like most about your role? What’s been different about this year’s wildfire The interaction with staff and managers, supporting the season, compared to others? response process, and being able to see that we’ve made a This year’s wildfires are beyond anything we’ve ever experienced. Not just in IH or even B.C., but across Canada. The number of communities impacted, the number of facilities evacuated, and the timeline in which everything occurred is unprecedented.
We thought this spring’s flooding around Kamloops, Enderby, and Lake Okanagan in Kelowna was abnormal, but everything changed on July 7. Fires near Ashcroft, 100 Mile House, and Williams Lake led to the evacuation of all our sites in these communities. An evacuation of one community with health-care services is a huge feat, let alone three all at the same time.
difference. Because we meet and work with all leadership teams and staff at all levels within IH, we get a very global perspective on the health authority. After an emergency response training session, I hear participants say they feel far more comfortable and prepared. In the end, everything we do is for patient, resident, and staff safety – if we do that, we are doing our jobs.
What is available for emergency response resources and training in IH?
Each fall, my team reviews the flood and fire season, sets priorities and focus areas for the annual training sessions, and updates the IH Emergency Response Management guide. In additional to the available training, all employees How are wildfires different than other are asked to read the Emergency Response Codes emergencies? overview, as well as get familiar with their site emergency Wildfires are probably the most challenging. They start and response plan. These documents are a starting point to spread quickly and are weather driven, which makes them provide guidance and a framework for how to respond to very unpredictable. Wildfires and floods both are shorter an emergency – keeping in mind that no two responses are lived, usually lasting a few days to weeks; whereas a the same and we have to adapt as necessary.
Command Centre Emergency Command Centres are virtual in nature. Pictured here is Emergency Response Coordinator Samantha Read at the flooding response EOC in Kelowna earlier this year.
2,054
Staff received emergency response training
14 264
Leaders & managers received emergency response training
Numbers as of September 7, 2017.
Health Protection events (e.g., tanker spills)
5
Code Orange (mass casualties) responses
3
EOCs set up: overdose, flooding, and wildfire
1,000+ Fires within IH area this season
Photo credit: BC Wildfire Service
Photo credit: Darwin Nicholas/Castanet
Submitted by: Don Fletcher
Submitted by: Amanda McDougall
Photo credit: Canadian Forces
Submitted by: Wilna Ruttan
Photo credit: CBC
Submitted by: Tina Marsh
Submitted by: Jane Barnett
Photo credit: Stephen Casson/Castanet
Submitted by: Debra Donald
Submitted by: Kecia Turunen
Submitted by Dr. Nicole Robbins
Photo credit: Carole Rooney/100 Mile Free Press
Submitted by: Trisha Shetler
Submitted by: Tina Marsh
Submitted by: Jason Giesbrecht
Photo credit: Allie Keeley/Castanet Photo credit: David Jurek/Castanet
Submitted by: Darcie Barbeau