A medical team from Massachusetts General Hospital is in the small city of Rosenberg, Texas, about 45 minutes southwest of Houston. The city was badly flooded during Tropical Storm Harvey when the Brazos River overflowed. In the weeks since the storm, the MGH team has set up a mobile clinic in a local church. And the team is finding the storm exacerbated health problems that already existed in the low-income community.
“I have a problem to get the medication,” Magdalena O’Neill told nurse practitioner Jean Bernhardt. O’Neill explained she came to the mobile clinic at Our Lady of Guadalupe hoping to get a prescription she needed. “This medication help [sic] me for all the pain,” she says.
“This is something that we don’t have here, and we can’t prescribe here,” Bernhardt says. She recommended a clinic in Houston that could provide the meds and the dental care O’Neill needs, free of charge. But it’s 40 miles away from O’Neill’s home.
“Whatever would be closest for us,” says O’Neill’s husband, Terry. “We’re senior citizens. Whatever be [sic] convenient. We just can’t get to Houston all the time.”
It’s a problem this temporary clinic sees a lot.
“Access to health care for this population of people is limited,” says Lindsey Martin, the team leader for the group of nurse practitioners and pharmacists from Massachusetts General Hospital who were sent to Texas by the international non-profit Project Hope to run the clinic. “And then you bring in something like a flood or a hurricane — so whatever stock of medications they had is then wiped away,” Martin says. “They don’t have the financial resources, and they don’t have the access to obtain those again.”
Martin says they keep seeing patients with chronic conditions like diabetes or hypertension that went untreated in the weeks after the storm, and minor injuries that have gotten worse over the last few weeks. “Because now we’re in the phase where if they were hurt during the storm and they didn’t get treated now they’re coming in and they have infections and cellulitis and that kind of stuff.”
Dr. Harry Owens, Jr. is at the clinic from Oregon, and has responded to health crises all over the world for Project Hope. He said, as with any disaster, the patients are stressed. “They’ll say, ‘I’m anxious, I’m having some chest pain, my heart is beating very fast.’”
Providing care for that kind of thing means more than just prescribing pills. “One of the most important things is to ask, ‘What is your story? Please tell me your story. Tell me what’s going on.’ And listen, actively listen. Their being able to tell the story to somebody — like a nurse, a doctor a priest, a deacon, somebody like that — helps.”
Of course, sometimes what patients really need is medication. And the clinic’s been having a hard time keeping enough in stock. Carmela Berlin is a pharmacist with the Mass General team. She picked up some of the bottles in the makeshift pharmacy and shook them to show how few pills were in them.
“This is it,” she says. “I have one tablet of that medicine. These are all the blood pressure medications we have and for the populations that are coming in it’s like, every other prescription is for high blood pressure medication.”
They’re also running low on insulin, which a lot of diabetic patients lost during the storm, because it needs to be refrigerated, and people lost power.
The medical team visited homes in Rosenberg to get a sense of the needs and to invite people to come in to the clinic. Lindsey Martin of MGH said she met a family that was flooded out last year.
“They were living in this storage shed outside of their house because their house had been condemned from the previous storm,” she says. The couple was talking about what to do next. The husband said it was time to move somewhere else. “And the wife said I want to stay because this is all I have. And the next storm will come, and we’ll ride it out because there’s nothing else out there for me.”
Martin says she’s been struck by the fact that some people here just don’t see any opportunity for themselves outside of the home they know, even if it’s been completely devastated.
Another woman came into the clinic with blood pressure so high that she was in danger of having a stroke. But she was undocumented, and didn’t want to go to the emergency room because she was scared she’d be deported.
“And I keep reminding myself I’m in Houston, Texas, that this is the United States of America,” Martin says. “And, you know, I think we sort of pride ourselves on taking care of our people. And I’m just seeing a lot of people that are not being taken care of.”
The clinic will be open in Rosenberg at least through the end of the week. But after it’s gone, the community will still have some significant health needs. Martin said she now sees there are some systemic problems that need to be addressed before Rosenberg can fully recover, so they’ll be in better shape when, inevitably, the next storm comes.