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Not Your Usual Halloween 
 
Alice Teich


Hey Manisha,

Last night--Halloween--I went and volunteered at a shelter in a school basement/gymnasium in the Nineties on the Upper West Side. 

There were more than 100 folks staying there, mostly evacuated from the Lower East Side. The shelter, run by the City, had some volunteers at the front desk, a few security people, a medical team that consisted of myself, one other doctor and a nurse (volunteers through the NYC Medical Reserve Corps--if you're a provider, you can sign up online; it only takes fifteen minutes), and more than twenty awesome volunteers of all ages. 

It was a mess. 

Quite a few folks staying there were evacuated from flooded shelters--i.e., they were homeless even before the storm. 

Some of the older folks with chronic diseases, who'd normally have home attendants, are there without anybody (and without any ID, much less their medication lists or their medications). 

Only one guy had a home attendant. She got evacuated with him--very unhappily, as she is stuck away from her family and is not sure if she's getting paid for this time. She thought to bring his medications, thank goodness, but other folks weren't so lucky as to have a well-organized supervising adult with them. Grim. 

There seemed to be a lot of tension in the room. The evacuations had brought in quite a mix of people from different situations, and a few folks expressed distress at being thrown together. There were folks coming from their own individual family apartments (including a family of five, with their PETS); the older, infirm senior citizens; and some younger folks (very obviously mentally and physically infirm) from the shelter system. 

As the night wore on, the tensions turned into drama. Lots of yelling and threatening and cursing and crying.

When I arrived, there were crates and crates of City emergency packs with supplies--mostly aspirin, acetaminophen, Band-Aids, heating pads, a few pediatric and neonatal backboards, and several unopened boxes of walkie-talkies. 

We called the local Walgreens, and they donated--hand-delivered within thirty minutes!--a glucometer and test strips, blood-pressure cuffs (which, of course, I'd left at home), a pulse oximeter and batteries for the walkie-talkies. That was very helpful. 

Summary of my doctorly actions last night:

(1) I gave a few people diphenhydramine to help them sleep (because the lights were on all night, and they were trying to sleep in a gymnasium with other people yelling). I told some others that they should try to sleep without it. I was nervous about sedating them in the shelter; it wasn't the kind of place you'd want to let your guard down.

(2) I did a medication reconciliation for the one guy who'd brought in all of his pills. This meant going through all of the medications he'd grabbed and thrown into a shopping bag before being evacuated. He was Spanish-speaking and hard of hearing. He had a lot of faded pill bottles--old prescriptions mixed with new ones, in different doses, provided by different doctors. There were medications for high blood pressure, diabetes, high cholesterol, pain and stool softeners, to name a few. He seemed very unsure about how he needed to take them.

(3) I convinced all the sweet volunteers to stop giving cookies to the guy with diabetes. (I'd spent an hour trying to figure out how much insulin he took, then giving it to him.)

(4) I convinced other volunteers to help me clean up, change diapers for and find clean clothes (from the donated clothing pile) for an older gentlemen with depression or dementia (I'm not sure which), and aphasia, impaired ambulation and urinary incontinence. He was soaked in his own urine, not having had anyone to help him clean up in the days since the storm.

(5) I convinced the parents and volunteers to keep shoes on all of the kids and toddlers who were running around the gym and cafeteria barefoot. 

(6) I reassured the other volunteers that one of the little boys staying there probably didn't have a super-infectious disease. (He did have bad chronic eczema. And before long we had several confirmed cases of scabies or body lice, so their worry wasn't unfounded.)

(7) I opened the boxes of walkie-talkies and loaded them with batteries. With the help of a volunteer school-safety administrator, I set up a communication system among the volunteers at the front desk, the security crew, the medical team and the head volunteers across this huge school basement.

One interesting story shared by another volunteer: On Monday, when the evacuees first arrived, they were given formula and milk for the babies and young kids. Apparently none of the babies would drink the bottles, and no kids would drink the milk. The volunteers were perplexed, and the parents were upset. 

Then one of the parents requested packets of sugar and shared the fact that parents always put sugar in the milk so that the kids will drink it. The others agreed: They said they put eight to ten sugar packets in a bottle on average, and they said that their kids would not drink milk or formula without it. The volunteer got some sugar, and sure enough, all the babies drank their bottles. 

WHAAAT? Has anybody else heard parents talk about doing this? Here we are worrying about people putting powdered cereal into their babies' formula before they're six months old, and meanwhile parents are pouring straight-up, refined white sugar into their children of all ages. WHOA. We should watch out for this and ask about it in clinic.

You'd asked about donating clothing. I've heard that some shelters are unable to give out donated clothing or coats due to regulatory issues (I don't know if it's fear of lice in schools, or what). 

But people definitely do not have laundry services or showers, which is very distressing to them. 

So I think that warm, clean clothes and good shoes (I've seen a lot of flip-flops) and socks and underwear (in packages) would be appreciated. Maybe you could send some sort of bath product that people could use to clean up without needing a shower--some of those cleansing cloth wipes? Probably some decent, gently used backpacks or duffels would be appreciated. Lots of folks are schlepping their stuff in paper or plastic grocery bags.

The people here are eating Army rations and snacks that the volunteers bring. As I said, they're in pretty low spirits, and tensions are running high. Very sad. 

The most heartening thing is the volunteers. There are tons of them. The teenage volunteers were playing with the kids. People had brought Halloween costumes, and the kids were all wearing them--everything from Spiderman, Batman and Cinderella to witches and skeletons. 

Hopefully it will get better sorted out today, so people can get back into their homes or back to their routines and familiar shelters soon.

As of now, it's not a pretty scene. 

Hope you are staying safe and warm. 

Best, 

Alice

 

About the author:

 

Alice Teich is a family physician in the Bronx. She also works in the research division of the Department of Family and Social Medicine at Albert Einstein College of Medicine. Her research and practice interests include family-centered maternity and well-child care, breastfeeding promotion and contraception and family-planning access. "I consider myself a reader, not a writer, with one exception: I love to write long, rambling, train-of-thought, epic emails (like the piece above) to family and friends whenever I'm traveling or in the middle of powerful experiences in new or exciting situations. I credit my mom, stepdad and dad for my interest in writing."


Story editor:

Diane Guernsey