Written by Doug Char, MD, FACEP
Sitting in the airport at Narita (Tokyo), Japan, I had a few minutes to reflect on what I had been doing the past 18 days on Saipan and Guam in the Commonwealth of the Northern Mariana Islands. Super Typhoon Yutu (Category 5 super storm) made a direct hit on Tinian and Saipan on Sept 25th. It was the most powerful and destructive storm to hit a US territory this year (more powerful than Florence or Michael). Saipan is a 45 square mile tropical island with a population of 55,000, approx. 6,000 miles from the continental US (15-hour time difference, crossing the date line).
Getting help to the people of Saipan was a logistical challenge and privilege. Think Puerto Rico only smaller and much further away. I was fortunate to deploy as the Chief Medical Officer for Dept. of Health and Human Services, Incident Management Team (IMT). The IMT is the administrative group that reports to the Assistant Secretary for Preparedness and Response (ASPR). I was the senior clinician overseeing the HHS response to Typhoon Yutu. My primary focus was determining how best to augment existing health resources on the island (there is only one hospital) and what additional assets from the outside where required. I worked with Saipan Dept. of Health leadership to determine which shelters needed medical attention; where to place special need individuals; whether we should initiate a flu vaccine campaign for those in the shelters; maintained awareness about food and water safety; monitored disease outbreaks (especially gastrointestinal and respiratory infections); and worked with the FDA to ensure that the three pharmacies on the island were ready to reopen.
The IMT was based on Guam – 135 miles to the west of Saipan and home to Anderson Air Force Base. Commercial air traffic (United Airlines) resumed a few days prior to our departure. I flew between the two islands three times during my deployment, twice aboard C17 cargo planes that were ferrying supplies and equipment to the devastated island. The Federal Health Coordinating Officer (FCHO) and Deputy FCHOs lead the IMT for mission generation and mission execution. The Chief Medical Officer advises and supports the FCHO. Disaster Medical Assistance Teams (DMATs) from Hawaii and Oklahoma, as well as a cadre of U.S. Public Health Service clinicians where divided into a number of Health Medical Taskforces (HMTF) staffing clinics, shelters, back-filling the emergency department, and working with local environmental and behavioral health teams.
Much of my time, especially on Guam, was spent analyzing data from the field, anticipating the need for personnel, vaccinations and medications, community behavioral health workers, and the needs of deployed personnel. It was critical maintaining communication with the Saipan government while providing situational awareness back to HHS Headquarters in Washington, DC. There are reports and more reports that need to be generated (it is the government) to “feed the beast.”
The IMT is on call throughout the year ready to respond to natural and man-made disasters. I recently transferred to this group after many years as the Team Medical Director for Missouri 1- DMAT (now Midwest-1 DMAT). While others hear and see news about disasters, as part of the National Disaster Medical System (NDMS), DMAT members get to be part of the solution. If you would like to learn more about, NDMS and being part of a DMAT check out this link. https://www.phe.gov/Preparedness/responders/ndms/Pages/default.aspx