Erik Larsen, MD, FACEP, spends most of his days as the assistant director of emergency medical services at White Plains Hospital, the busiest ER in the county. But he’s also invested nearly 30 years on the frontlines of disaster relief, both domestically and internationally. He was National Disaster Medical System (NDMS) medical director of operations at the airport’s main evacuation center for the 40,000 people trapped in New Orleans during Hurricane Katrina. He responded to earthquakes in Haiti and Pakistan. He aided the International Humanitarian Aid Foundation’s relief efforts after Hurricane Irma hit the Virgin Islands. And last October, as a regional deputy chief medical officer in the NDMS, he was called to action when Hurricane Maria devastated Puerto Rico.
“I had been to the Virgin Islands. I saw the complete devastation… lives and infrastructure just strewn all over the place. So I was somewhat prepared when I arrived in Puerto Rico,” he says.
In a town named Manatí, about an hour from San Juan, Larsen’s Disaster Medical Assistance Team (DMAT), a division of HHS, established an emergency hospital inside the huge Coliseum Bencito. Sleeping in cots in locker rooms, subsisting on ready-to-eat meal packages and food donated by community churches, DMAT personnel oversaw a massive, multi-agency effort to treat more than 300 emergency patients and inpatients a day.
Access to food, water, fuel, and electricity was cut off, and local hospitals were overwhelmed. “The folks who died of ‘natural illnesses’ actually died because they lacked access to adequate medical care,” says Larsen, citing medical equipment that had no power source, prescriptions that couldn’t be filled, and water that was unsafe to drink.
“What I found the most striking compared with past responses,” he adds, “was the delay in getting the electrical, communication, and fuel-supply grids back up and running. That had a profound effect on medical care…. It also had a huge effect on the ability to run water-purification systems and sewage-treatment facilities, which was also a big source of medical problems…. After every other mainland hurricane I have been involved in, there was a much more vigorous effort to return power. If those types of issues had been solved — and they’re still not — early on, there would have been a lot less damage, suffering, and death.”