On the evening of March 1, severe thunderstorms rumbled over southwestern Georgia, spawning a tornado that ripped through seven counties. Classified an EF 3 with winds ranging from approximately 136 to 165 miles per hour, the twister tore a path of destruction 37 miles long and as much as a mile wide, reaching its maximum strength and width as it reached Americus, the seat of Sumter county. Along the way, the Sumter tornado—part of a storm system that killed eight in a high school in Enterprise, Ala.—demolished or seriously damaged more than 200 homes and dozens of businesses in Americus and the surrounding area, causing two deaths and many more injuries.
Not only did it leave the local Winn-Dixie grocery store without its façade, but it also reduced a 1,600-foot-tall public television tower to a 150-foot stump, sheared the tops off trees, downed power lines, knocked out telephone service, and deposited a burning tractor in the middle of Highway 520.
More important, it destroyed Sumter Regional Hospital in Americus, a rural city of 17,000 residents. Thanks to Sumter Regional’s staff, including its four hospitalists, all 70 patients were evacuated from the 265,000-square-foot, 143-bed complex.
The Terror Begins
The tornado, which struck Americus between 9 and 9:30 p.m., did not arrive without warning—but the town did not sound its tornado siren. A firefighter dispatched to activate the warning was called back because it was too late to do any good. Sumter Regional’s staff was alerted a tornado might strike, and they had moved patients away from the windows.
Hospitalist Mukesh Kumar, MD, who had joined Sumter Regional two weeks before the tornado struck, rode the storm out in the hospitalists’ office—a small space on the same corridor with a number of patient rooms.
“[Dr. Kumar] was the poor guy on duty that night,” says Amanda Davis, MD, head of the hospitalist program, who was not in town that evening.
As soon as the storm passed, an emergency call went out via the local broadcast media, requesting that physicians and nurses report to the severely damaged hospital to aid in the evacuation and treat the injured.
Hospitalists Kathy Hudson, MD, and Rick Oster, MD, among others, rushed to help. Getting to the hospital wasn’t easy. The surrounding area had become a maze of downed trees and power lines. First responders who could use their cars had to park outside the devastated area and hike to the hospital in the dark. Others arrived on bicycles. Some could not make it because they were trapped in their driveways.
With the power out at the tornado-ravaged hospital, as it was in much of Americus, first responders helped those on duty carry many of the 70 patients down the stairs of the four-story complex. Outside, Dr. Hudson worked with the staff, suturing the injured. Sumter Regional Hospital was evacuated by about 1:30 the following morning.
Patients were loaded into the town’s four ambulances and others from around the region and transferred to facilities in southwest Georgia. The closest of these was Phoebe Putney Memorial Hospital in Albany, about 40 miles from Americus.
Wind and water had compromised nearly every part of Sumter Regional, leaving only the chapel intact. Much of the roof was ripped off, nearly all the windows were blown out, and part of the complex collapsed. Damage was so severe the entire health center was rendered unsafe.
Not only did the storm leave Americus without its hospital, it also devastated virtually all the town’s private doctor offices, as well as the Sumter HealthPlex—a new, 8,000-square-foot, $3.1 million facility owned by the hospital. The HealthPlex provided outpatient imaging and laboratory services to the community.
In the days immediately following the tornado, the Middle Flint chapter of the American Red Cross—whose headquarters were also badly damaged—set up an emergency response center in the First Baptist Church of Americus that featured a makeshift emergency room. Dr. Davis and her staff of hospitalists, employed by TeamHealth’s Hospital Medicine Division, helped get the Red Cross center up and running. They also played a significant role in setting up a temporary urgent-care center in tents provided by the Federal Emergency Management Agency (FEMA), supplemented by two tents belonging to the Boy Scouts.
By Any Means Necessary
Although local physicians with their own practices were well represented among the first responders, they were (for the most part) not involved with staffing the tent hospital, according to Dr. Davis. Most of the work in the tents was done by the emergency department (ED) physicians and TeamHealth doctors, in conjunction with Sumter Regional’s four hospitalists.
As soon as the tents opened, the ED “regulars” started showing up in droves,” explains Dr. Davis. Because a significant number of private physicians’ offices in town were destroyed there were no other healthcare options for many residents.
“It’s a difficult situation,” says Dr. Davis. “There are people in the community without cars, for example, whose cars were destroyed. So they have no other way to get to another hospital. They were astonishingly grateful to have us there.”
As residents cleaned up more than a month after the disaster, the urgent-care facility in the tents still functions as Sumter Regional’s ED. Routine lab work and X-rays were provided, and staff also monitored patients on blood thinners and gave injections to cancer patients.
In a pinch, the tents have served as an impromptu obstetrics suite. One woman delivered her child there after being unable to travel to Phoebe Putney Memorial Hospital, which is providing obstetrical services to mothers who would have gone to Sumter Regional.
Care of the center’s cancer patients—a number of whom must take a bus to Albany for treatment—is now overseen by Phoebe Putney’s oncology department. Surgeons, too, have had to travel to other hospitals in order to operate. “It is a logistical nightmare,” says Dr. Davis.
While the urgent-care unit has been able to provide basic services, it has not been an easy task for the physicians and nurses who work there. Telephone lines have not been restored, making it virtually impossible to send faxes. Hospitalists and ED physicians staffing the tents have had to read their own films, essentially serving as their own radiologists. As Dr Davis notes, “You have to do the best with what you have.” Often, that is a bare minimum. Indeed, she once had to put in a central line to stabilize a patient. “It was pretty surreal treating (the patient) in a tent,” she says.
FEMA Director David Paulison, who toured the devastated hospital with President Bush, says the immediate response was indicative of the “new FEMA.”
Bush declared Sumter County a disaster area the day after the tornado. Residents were urged to apply as quickly as possible for grants and low-cost loans to aid in recovery. Local, state, and federal officials opened a disaster recovery center March 5 in Americus, staffed by representatives of FEMA, the Georgia Emergency Management Agency (GEMA), and a number of other agencies. As of April 4, FEMA, GEMA, and the U.S. Small Business Association (SBA), had approved more than $6.58 million for disaster recovery.
A May 16 update by Sumter Regional on its Web site indicated progress in the construction of modular care facilities.
“By the end of May, there will be five modular buildings in the Mayo Street parking lot for use by physicians, each consisting of two single-wide modular buildings joined together,” the memo stated. “Currently, two of the five physician modular buildings are in place with both halves assembled, and three of the single units are on site ready for placement and assembly. The other three halves that will be used to construct the remaining three buildings are on the way. We are still seeking bids from contractors to do the plumbing, electrical and other utility work, and anticipate having the buildings functional by the end of May for physicians to begin seeing patients.”
On April 30, Sumter Regional opened its Sumter Regional East facility. Sumter East provides 24-hour urgent care, radiology services, clinical lab services, physical therapy, speech therapy, occupational therapy, and cardiopulmonary services, according to the hospital’s Web site.
An interim hospital is slated to open in mid-September, according to a May 10 statement by the hospital. The facility, to be built on the former site of the HealthPlex, is to include approximately 65 inpatient rooms, nine LDRP/obstetrics/nursery rooms, eight CCU rooms, four operating suites, and a fully functional ER.
Whether or not the center’s hospitalists will have a place in the modular health center is unclear. Maintaining the hospitalist program is expensive, explained Dr. Davis. Although she has been assured Sumter Regional’s hospitalist program will continue in some capacity, she is still unsure of the program’s status. Currently, Sumter Regional’s four TeamHealth hospitalists are without a hospital.
Eventually, Sumter Regional Hospital will be rebuilt. Shortly after the tornado destroyed the health center, its president and CEO, David Seagraves issued the following message to the community: “Sumter Regional Hospital is not closing. We are currently assessing the damage to our facility from the tornado, and we are also looking at temporary alternative sites to provide services. We will update our situation in the current days, but I repeat that we fully intend for Sumter Regional Hospital to be back better than ever as soon as humanly possible.”
But reconstructing the hospital will be costly, with damage estimated at more than $100 million. The center and its equipment are covered by a $90 million insurance policy, as well as $37 million in service interruption insurance—some of which is slated to pay the hospital’s 700 employees. The state Senate has authorized $11 million in emergency funding for the town, some of which may go toward re-establishing healthcare in the region. It will take far more than that to restore a fully functional hospital. Sumter Regional is seeking financial donations through its Web site (www.sumterregional.org) to help community members and to go toward rebuilding. Citizen’s Bank of Americus has donated $100,000, half to the hospital and half to aid the community. Wachovia is also active in the reconstruction effort.
Dr. Davis could not be more pleased with how Sumter Regional’s hospitalists responded to the disaster. “I am real proud of the doctors I work with,” she says. “They really stepped up to the plate—above and beyond the call of duty. No one complained. No one worried about getting paid. No one worried about their malpractice insurance. I am very proud.” TH
Roberta Newman is a frequent contributor to The Hospitalist.