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RD Proves Value of Volunteers in Wake of Disaster

By Valerie Yeager

These days, there seems to be no shortage of tropical disasters, leaving parts of the Atlantic region without electricity, functioning hospitals, or sufficient nutritional resources. Shortly before Hurricane Gustav struck the Caribbean, Florida, Louisiana, Mississippi, Alabama, and Arkansas in late August 2008, Joe Frost, MPH, RD, journeyed from Vermont to Louisiana for a two-week venture, lending a hand and nutritional guidance to those victimized by the storm and ultimately proving the immense value of volunteers.

Deployed with a team of the Public Health Service Commissioned Corps, Rapid Deployment Force 3, Frost and his fellow volunteers set up a medical shelter in the field house on the Louisiana State University campus just prior to the hurricane making landfall. Having stayed throughout the duration of the storm, Frost recalls seeing some of the damage take place firsthand: “[A] few pieces of the roof actually flew off the building we were in during the hurricane, and there were some significant leaks.”

One week later, the university’s shelter closed—it was never intended to be a long-term shelter—and everyone moved next door to a medical shelter in a basketball arena that was initially staffed by state employees. Frost and company took over, allowing the state employees to rest and attend to their regular state duties.

A first-time volunteer during such a disaster, Frost, an FDA investigator, was initially prepared to be a foodservice officer. Instead, he assumed the role of clinical dietitian, assessing patients’ feeding needs and assisting with patient and staff feeding.
He was greeted by a wide range of medical concerns. Many patients came to the shelter because they were unable to meet their medical needs at home during the storm. A common concern was that the lack of electricity wouldn’t allow patients to operate oxygen pumps and other medical equipment.

Frost and his fellow volunteers were delivering upward of 200 meals without a single patient service cart or staff. Getting creative, they laid pediatric stretchers on top of wheeled baby cribs and loaded the stretchers with meals.

The limited resources certainly didn’t end there. The shelter’s food was limited to the university’s dining facility, and there was no allowance for special diets. Hence, there was no sodium, fat, or carbohydrate restricted; mechanically altered; or renal diets. They got their hands on baby food and pudding for patients requiring a dysphagia diet, and meeting the nutritional needs of patients on dialysis was also a challenge.
As expected, all nutritional needs could not be met perfectly in the emergency environment. According to Frost, the meals were generally fairly well balanced, but patients on dialysis likely exceeded their recommended sodium intake. Many patients simply avoided eating a portion of a meal that was of concern. Most meals were only moderate in potassium and phosphorus content, and patients on dialysis did receive it at an outpatient center.

One patient at the shelter, a man in his late 30s who had been newly diagnosed with diabetes, had not yet spoken with a dietitian and was concerned about what he could and couldn’t eat to control his blood sugar. In addition to educating this patient about his condition, Frost was able to keep the man healthy during a time when resources were extremely limited by monitoring his blood sugars and keeping a careful eye on his diet.

Frost says that getting everyone a tray at mealtime was the greatest achievement of his stay, and he also held a meeting with shelter residents about preventing dehydration and maintaining electrolyte balances during disasters.

Because of safety reasons, many volunteers didn’t leave the shelter for up to four straight days. When Frost did journey into town, he remembers seeing long lines outside unlit, non–air-conditioned convenience stores. Despite the dire circumstances, people in the community were sure to let Frost know how grateful they were for the volunteers.

Sadly, just as Frost and his team were heading out of Louisiana, Hurricane Ike came storming into the already-downtrodden Atlantic region. The seemingly neverending storms during the Gulf Coast region’s hurricane season and Frost’s experience shows that volunteers—especially those specializing in nutrition—are not only helpful, they’re essential.

— Valerie Yeager is an editor and freelance writer based in Philadelphia.