Again we are watching a disaster unfold in the gulf country, with Hurricane Harvey dumping masses of water onto Houston. The city is inundated, and once again we see people forced to rooftops as the water rose, and scenes of tragedy as people and animals were left behind. IT will be interesting to see how the new President, and his administration respond to this disaster. At least there are no “both sides” with this one. These floods, pale, however, with what is happening in South Asia, with 2/3s of Bangladesh under water, and thousands killed. That makes you stop and reflect.

One of the interesting things about Houston, is that it was quite a small town, and Galveston was Texas’ preeminent city. In 1900, though, Galveston was destroyed by Hurricane Issac, metres of water were pushed through the city from the storm surge. As a result of the depopulation, people moved to Houston, and became the US’ fourth largest city, Galveston became a small city.  Erik LArsen’s Isaac’s Storm is compelling reading. Particularly when he describes the flooding and drowning of the orphanage.

One truly awful photo is of nursing home residents sitting waist deep in water. Thankfully all were rescued, not before the son in law of the owner took to twitter to call for help. This has seen some criticism, and on face value, it is justified. We, however,  don’t know about the events leading up to the photo. Did the nursing home have a plan? Did they enact it? Did the plan work? Were they overwhelmed? Was the nursing home in a flood zone, or was flooding unexpected (think Toowoomba in QLD, it is on a plateau, and does not consider itself at flood risk. The micro burst had a different idea), did 911 respond, did they have the resources to evacuate? What is the city’s plan for nursing homes? These questions will hopefully be answered in any inevitable inquiry. If they were negligent, then they should go to jail.

This storm has sent out some confusing signals. It was going to be a major Category 4 Hurricane, but it was downgraded to a super storm. Like Sandy, you think ah, downgraded, may not be so bad. Then it has dumped a truck load of water, somewhat like Cyclone Debbie.

When I was a nurse, we had 8 fire trucks turn up at 3 am on Sunday morning. Being on an orthopaedic ward, we had many bed ridden patients. Our training was that you could take one patient down on a mattress, per nurse, and once you were out, you could not return. That meant out of the 20 patients we had to choose 2. I seem to remember there were 5 or six who may have been able to manage the stairs. That left choosing 2 from 14. It was a very uncomfortable few minutes as my colleague and I went through the patient list. Who do you choose? It was like playing God. The 78 year old loved grandmother, or the 60 year old dickhead? Fortunately it was a false alarm.

Evacuation of nursing homes was always the nightmare of emergency management planners at local government, and regional state government levels. They need to have plans to get people out to the car park, but not beyond. Its part business continuity planning, part EM planning. One council, in a high fire risk zone, would actively have the exercises around evacuation of nursing homes. There were major challenges in just getting people to the carpark, this took up most of the exercise. The good operators have plans, the not so good ones, I suspect don’t. And if you tried to make it mandatory, I am sure there will be cries of “red tape” and “drowning in regulation”. But to paraphrase Monty Python, “what did regulation ever do for us?” Oh, apart from saving lives…

The residents are dry and fed now, and I’m hoping their psycho-social needs are being taken care of, now, and into the future. Being immobile, and watching the water rise around can only be truly frightening. And being old and infirm, doesn’t mean you don’t have a right to validating your experience.