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Doctors get chance to shine

(ran T edition of Tampa Bay and State)

Hurricane Andrew offered thousands of doctors and nurses a reminder of why they went into health care.

And it gave the public a glimpse of what has gone wrong with the health care system, which is strangling in the grasp of the Almighty Dollar.

Health workers in the disaster zone had no paperwork. Bureaucratic rules were gleefully tossed out the window.

Computers were down. Phones didn't work. So if you saw something that needed to be done, you did it. If it was a tough job, you created a solution.

"Patient care is all we had to focus on in Miami and that felt really good," said Kim Curry of Tampa General, who served as a relief nurse at Baptist Hospital in south Dade County.

Pat Mabe of Bayfront Medical Center in St. Petersburg was impressed with the dedication of health care workers who had lost everything they owned, yet still kept helping others.

"I was very proud to be a nurse," she said.

Consider Catherine Philpot of Baptist, who kept working even after hearing her neighborhood in Homestead had been destroyed. As soon as roads were clear, she drove down to find that her home was gone. But her husband and children were okay, so she returned to work.

And then there's obstetrician Lilliam Sanabria, who delivered babies around-the-clock at Baptist between Sunday night and Friday, when she finally left. During that week, she slept only one night.

Common themes emerged in interviews with doctors and nurses who worked in the disaster zone:

Health care workers from around the country reported eagerly for duty. In fact, many would-be volunteers couldn't get through on the phone lines. Some went anyway. As platoons of volunteers left Miami, more arrived. And that continues. Nurses from as far away as Michigan are still living in tents, working the night shift at Homestead Hospital.

Hospitals and clinics offered free care for days or weeks after the storm. They didn't ask for insurance cards and wouldn't accept cash. They just treated everybody who needed it without question, in order of the severity of injury or illness. Patients responded with gratitude.

No one said "That isn't my patient" or "That isn't my job." Nurses were particularly impressed when doctors pitched in on unpleasant tasks _ cleaning patients, helping move them from one place to another, sweeping up broken glass, unloading relief supplies.

Many poor people received consistent, high-quality primary care for the first time in years at the makeshift clinics that sprang up all over south Dade.

Nurses and doctors organized themselves into teams that went out to residential areas, from subdivisions to migrant camps. That gave them a perspective on sanitation and nutrition problems that never would have been apparent in an office visit.

"That is what public health is and what it should be," said Mike Nilsson, a nurse at the Pinellas County Health Unit in Clearwater. "But we have drifted away from that. It takes something like this to bring it home."

Nilsson and half a dozen other Tampa Bay nurses were on the first disaster-relief team sent in by state health authorities on a convoy that left Orlando on Monday, Aug. 24, the day of the hurricane, and arrived in a vast wasteland early the next morning.

"You think you're prepared, but a catastrophe of this magnitude is very, very difficult to prepare for," he said.

His team stumbled across a makeshift shelter with no power, no water, no working toilets and no communications. The middle school in Richmond Heights, just above Homestead, housed 500 people, 100 of them sick, weak patients evacuated two days before from a nursing home.

Five of the nurses remained at that shelter while others moved on to find other survivors who needed help.

Many of the elderly people in the shelter were incontinent, Nilsson said, so by the time they were found, the floor was covered in urine and feces. They had had no medical attention since Sunday, the day before the storm struck. Two were in a diabetic coma, another had had a stroke, and several others were near death from the lack of water and medicine.

Many of the nurses normally work in public health jobs that are long on paperwork and short on patient care. But they not only swung right into treating patients, they learned how to scavenge for diapers, drugs and other necessities.

Rules went out the window along with the glass. They commandered vehicles for transportation. They broke into a clinic for insulin to save the diabetics' lives.

Through a ham radio operator, they sent out pleas for transportation that finally arrived that Wednesday afternoon. Buses took patients to other shelters that had power, water and medical supplies.

Wednesday night, the nurses were able to sleep on the floor of a fire station _ their first opportunity since Sunday night to get anything more than a catnap.

"I just think these nurses were so heroic," said Kathy Mason, director of public health nursing for the state. "They saved lives, protected the public under utterly disastrous conditions. It's an overwhelming thing."

Dr. Charles Mahan, the state health officer, hopes Hurricane Andrew will lead to a better system of providing care to the poor. And he hopes the public health nurses who were pulled out of poor communities when the recession started can return.

"When public health nurses came to (storm victims') door it was like the cavalry had come," Mahan said. "It would really be nice to have those folks back on the streets, in community centers, in homes and in schools."