Associate Professor Jean Davision, DNP, RN, FNP-C, and the students in her service learning course gathered on Martin Luther King Jr. Day to pack 300 gift bags as part of their Hurricane Florence relief efforts. The bags included soap, shampoo, lotion, tooth brushes, tooth paste, insect repellent and sun screen.
This effort was supported by Christ United Methodist Church and supplies were donated by the Hampton Inns in Chapel Hill and Carrboro along with Aloft Hotel in Chapel Hill and a local dentist in Southern Village.
Davison also authored an article in the winter 2019 edition of Tar Heel Nurse titled “The “Cost” of Hurricane Florence — A Nurse Practitioner’s Perspective.” Text of full article below.
The “Cost” of Hurricane Florence — A Nurse Practitioner’s Perspective
By NCNA Member Jean Ann Davison, DNP, FNP-BC; DNP Council Chair
Article originally appeared in the winter 2019 edition of the NCNA’s publication Tar Heel Nurse.
Hurricane Florence brought approximately 35 inches of rain to the Carolinas and Virginia in September, with 50 reported hurricane related deaths and damage estimated at $22 billion. Hurricane Michael followed in October, also causing significant damage. For many, the 2018 hurricane season will be remembered as a “before” and “after” milestone in our lives.
Who can really put a price tag on the cost of these hurricanes from a physical and spiritual health point of view or calculate the true morbidity/mortality associated with these disasters? I have led or been on short term medical teams as a registered nurse and nurse practitioner five times, starting in Honduras in 2000 (after Hurricane Mitch) and most recently at a medical shelter in Wilmington after Hurricane Florence. Each volunteer experience made me keenly aware you can never really comprehend the impact of a disaster. the effects last for years and the most vulnerable populations suffer the most.
Two years after the 1998 Hurricane Mitch, orphaned children were still living on the streets in Tegucigalpa, Honduras. That had the most heart-breaking impact on my psyche and established my path as a nurse practitioner. Many would run up to me asking for help finding their parents or begging for food. there were 7,000 deaths associated with Hurricane Mitch in Honduras alone.
I had different, but equally shocking experiences in new Orleans after Hurricane Katrina, in North Carolina after Hurricane Matthew, and in south Florida after Hurricane Irma. With all of those post-hurricane recovery experiences, I noted depression, asthma, diabetes and hypertension were often exacerbated by the stress, anxiety, homelessness, food insecurity and difficulty accessing care.
That trend continued in 2018 when i volunteered at a medical shelter in Wilmington. A large percentage of those sheltered from Hurricane Florence were low income; many had been displaced by flooding and could not get their life-needed dialysis or medications until they came to the shelter. Few could sleep at night with hallways full of cots and anxiety palpable. The true heroes of that shelter were the EMS personel who helped transport those patients and the caseworkers who helped find placement for those with no safe residence to return to.
Hurricanes have a way of exposing the social determinants of health inequities such as income level, economic instability, environment, education, and barriers to health care. The syndemic framework can be used to examine health consequences on chronic diseases when disasters impact ones’ social, environmental and economic well-being (https://www.thelancet.com/series/syndemics).
For example, if you rent rather than own a home, you do not qualify for home repairs; even non-profits cannot repair your residency without permission of the owner. You may end up living in a flooded home with mold and unsafe drinking water. low wage jobs often do not include health insurance. If you are a farmworker or have an hourly job and can’t work due to flooding or power outages, you won’t get paid. Many low- income residents lack transportation and might not be able to leave before the hurricane or relocate afterwards.
Many counties affected by hurricanes have vulnerable populations with food insecurity, and this is made worse by flooding and income loss. For example, 28% of Robeson county’s residents and 38% of its children live in poverty. Chronic diseases become more difficult to manage under stress, which increases the risk of depression, hopelessness and premature death.
Puerto rico’s estimated death toll rose from 64 to 2,975 indirect deaths in Hurricane Maria when the George Washington University’s (GWU) Milken School of Public Health study included sepsis, pneumonia, breathing disorders, diabetes and increases in suicides; we may look back at Hurricane Florence and report similar outcomes from the 2018 hurricane season. As healthcare professionals, we must include depression screenings and seek to decrease barriers to self-management care to mitigate the morbidity and mortality associated with hurricanes.