Archive for February, 2010

Panic in Paradise: Maui’s non-tsunami!

February 28, 2010

I live on the island of Maui, Hawaii. The state is the most isolated location on the planet, at least 2,300 miles from the nearest land mass (San Francisco). The island consists of two volcanoes connected by an alluvial flood plain, a low lying valley. I live “Upcountry”, on the slopes of Haleakala, the larger and younger of the two volcanoes.

I’ll guess around 100,000 people live along the coast. The largest population lives around Kahului, a harbor. This morning, at 5:30 a.m. I was going down the four-lane highway to work in Kahului and I see car lights coming UP the volcano, as if it were rush hour. I went on to work to find about 10 cars at every pump of every gas station in town. At work I was told I wouldn’t be working today. I drive the road to Hana (I’m a tour guide). There was a tsunami warning.

I probably should have filled up while I was in town because by the time I got to Pukalani, the closest town above the lowlands on Haleakala, traffic was bumper to bumper and cars 20 deep were on line for gas. I knew what I needed to do.

I took every back road I knew to my place (It took me a half hour to travel a mile.), got things a little organized, filled a barrel with water and decided to relax and spend some time writing here, snug at home, listening to the radio while I contemplated the possibility that everything in my life might now change.

Now, a guy on the radio called in to ask, “Does this mean they won’t be delivering Pizzas?” The D.J. answered, “I think it depends. Upcountry is probably okay.”

There is a major run on all the stores on the island. There are roads being closed. They are asking us to not use water because they are going to have to disable the water treatment plants; expecting electrical damage. There’s a guy selling hot dogs off a stand in Pukalani getting rich. And the Police are gathering in Kihei (south shore loaded with condos and hotels), getting ready for evacuation. All the boats in Maaleaea Bay (a marina) have pulled out of the harbor to sea to at least a recommended depth of 600 fathoms.

The report is of a 8.8 earthquake that occurred in Chile early this a.m. We’re anticipating being “hit” about 11:20 a.m. The tsunami sirens have been going off periodically island wide since 6:00 a.m.. Gas stations are running out of gas. So far, the biggest waves reported have been six feet, at Tahiti, about 2,700 miles south. A Chileno called in to the radio station. His family lives in Santiago and they report few deaths, but much building damage.

Tsunamis are a series of waves and you really don’t know how many will hit. At least the experts made it clear they had no data to interpret that would help them to predict anything. It’s all about “Wait and see!” I’m not hearing any official break-ins to local radio programming directing anyone to do anything. Calls come in to the radio asking where the shelters are. The DJ explains there are no shelters until AFTER a tsunami strikes. The question was really “Where do I go?” but no one could say anything except to high ground. High ground, that’s Upcountry, that means more company for me!

At this moment, no evacuation orders have even been issued and everybody on their own is flooding Upcountry. I noted no tension a couple hours ago, but now I hear of gridlock up in Makawao (my town) and Pukalani and people screaming. This is getting fascinating!

t minus 45 minutes

Listening to Hawaii Public Radio, now, they estimate tsunami action to be 1 to 3 meters. They say a number of them can occur. Kahului is expected to be the biggest hit, due to its harbor: “Tsunami” means “harbor wave”

Visitors (tourists) in Honolulu are being asked to NOT use phone or internet. Already they’re having trouble with emergency communications there. The Honolulu PD has not requested additional staffing, though reserves, etc. are on alert.

Things have somewhat evened out here, Upcountry. Pukalani is packed. A lot of people are spreading out and finding positions with a great view of the isthmus. It’s more like a tail-gate party…gotta love Maui.

Hotels and condos on shore are being evacuated “vertically”, that means “Everybody up to the 4th floor, please!” Listening to how little the experts know of what to expect, there’s no way I would go somewhere where if the water didn’t kill me, the fall would!

I figure it’s about time I looked at what the generally available directions are. I’ve seen those yellow colored pages in my phone book for years. And since there were so many of them, I always felt secure that if the shit really DID hit the fan, I had something to rely on!

There’s one page of text about tsunamis (the Hawaiian Islands’ biggest environmental vulnerability!) and nine pages of maps in the phone book. They only show the zones to be evacuated, “Inundation zones” is a more succinct description.  They were clearly identified, but not a word of where to go, or how to get there. Oh…there’s this: “To avoid traffic gridlock, you may want to walk out of the evacuation zone and then wait for further instructions.”

I suspect there will be a lot of people waiting a lot of places unless somebody mentions where exactly to FIND those intructions.

What I don’t hear is county alert messages getting specific information to the people of the island. Now, there’s a warning to Oahu, they’re ordering evacuation of coastal zones. All emergency personnel are now being ordered out of the inundation areas.

Interesting: two hours ago they ceased bus service throughout Maui. Nobody knows who’s carless or disabled and not able to get to higher ground. There is neither a notification or evacuation plan for the poor, homeless and disabled. Even if you know where to go, unless you move now, you’ll have to outrun a tsunami!

Not a ripple in Hilo and the Estimated Time of Arrival  has passed.

A terrifying thought : Most of Maui’s rent-a-cars are in the inundation zone! Can you imagine an island with 10,000 hitchhiking tourists?

Water has begun receeding on Hilo. (Could be 1 to 6 hr. variance on actual hit time is what they are now saying, since they missed their prediction completely the first time around.)

I just heard that there is only ONE TSUNAMI MEASURING BUOY BETWEEN HAWAII AND SOUTH AMERICA! There are few sprinkled along the West coast of the Mainland, but I suspect they haven’t really figured out how to interpret that date to figure out what will happen here. They say the most vulnerable areas are Hilo, Big Island (Hawaii), and Kahului here on Maui. Kahului they predict about 9 feet. That could mean a solid wall of water, nine feet high, miles long and traveling as fast as a jet plane; but they’re leaving that part vague.

By about 1:00 p.m. there had been 4 noticeable cycles, and STILL nobody really knows what’s going on. There was a neat, streaming Hotel-cam on Oahu that showed a small reef being first exposed as the water receded, and then flooded over completely by a series of surges. There appeared to be no tsunami “waves”, per se. All the experts have been surprised by what has happened.

The largest was a 4.5 ft surge in Kahului, and that peak was at about 9:40 a.m. about two hours BEFORE the tsunami was scheduled to hit! No damage. Boats are coming back in to the Honolulu Harbor, the alert is not off, and still, nobody knows nothing.

…and now I’m listening to Honolulu TV congratulating themselves and everyone else and all the government and all the systems for things having been handled so well. Traffic is moving again and the “All Clear!” has not even been called yet! Governor Linda Lingle is encouraging the tourists to get back out there.

Here on Maui, it was just a hint of the free-for all that would occur if we really got hit. You see, all the Big Box stores are on the lowlands (most commerce as well), along with most of the population. Many are in inundation areas.

But here’s the thing:  In Hawaii 85% of the food we eat comes from the mainland. ALL the stores have gone to ordering foodstuffs on an “as needed” basis, usually with only about two weeks reserve. We have no long-term foodstuff storage facilities. Were we to get separated from the mainland by a catastrophe, any catastrophe, in six months, after having savaged everything with nutritional value on the island,  we’d have no choice but to become cannibals.

Everybody down there, in the inundation zones of course, would come up here, Upcountry. We have one cowboy town (negligible facilities), Makawao, and a predominantly residential district called Kula. Pukalani is the only town with a shopping center, a Long’s Drug and another Mom and Pop food store. There’s a former Sanitarium here called Kula Hospital, with miniscule services.

I didn’t realize the implications of this until about 9:30 a.m., 2 hours to projected ETA of the tsunami. Residents of Pukalani and Makawao started calling in to the radio stations complaining about all the people crowding their roads and neighborhoods. They made requests that people be told to stop coming up here; the stores were getting emptied, the gas was going fast, and yadda, yadda, yadda!

Not exactly Aloha, but not terribly unfounded either because no one ever really projected that something like this could happen and warned us.

Emergency Preparedness on Maui has no provisions for serving a displaced population. Where DO you run to on an island? That could be an important question to examine if you’re going to protect your population.

Nor is there a point — let’s say a central radio resource — that, in a real emergency would be the definitive clearinghouse for the distribution of emergency information and directions to the people to help minimize losses.

The way it stood, local radio stations, not willing to resume regular broadcasting, turned into call-in shows.  Now, the listeners were reporting what they were hearing the experts say on the web or who knows?  The conclusion I came to from listening to the local stations was if there was an official site to go to for instructions they either didn’t know about it or weren’t going to send me there. Could I wonder anything other than “Ratings?”

But I suspect there wasn’t even somewhere for the media to go to to get specific instructions to the people on this island that could  minimize everyone’s loses.

Now, they’ve called off the Alert. Personally, I think it just began; all that’s missing are the sirens.


After Acts of God; we do God’s Work!

February 19, 2010

We always speak of tending to the sick, injured poor and forsaken as doing “God’s Work!” There is no better metaphor to examine that metaphor than the disaster in Haiti. There, we ascribe the disaster to God, of course. We call it an “Act of God”. In this case, God has done His work, and now, we do clean up in His name. Go figure!

What got me thinking about this was an article sent me by one of my paramedic partners from years ago. He’s still in the business, believe it or not! It’s called “How the Ethics of Triage Play Out in Haiti”

Triage, as any Emergency Worker will tell you, is among the most harrowing things a medic is called upon to do. Arriving at the scene of multiple illness or injury, the first medics present must move swiftly through the chaos, treat no one, and assess everyone.

It’s not a full assessment by any means. Most agencies use a Color coded or Numerical or Alphabet-based grading system to sort through the severity of the victims. Most have five or less categories. “Immediate Attention” is top priority and reserved for those who can not only survive with intervention, but can also get back into some form of productivity. At the bottom of the gradient is the Do Nothing category; essentially those whose injuries are serious enough to suggest any intervention would offer no tangible good to anyone. This is the “It’s God’s Will” class.

But whose will is it really? This is the crazy-making, burn-out facilitating stuff that haunts practitioners who thrust themselves into the midst of one of God’s little tantrums. For every one of their patients they think they might help, there are hundreds more who they suspect will be literally condemned to slow, agonizing deaths because the resources, time, personnel or whatever are simply not available for them to expend.

In a disaster like Haiti, however, you cannot afford to waste a precious moment contemplating the things you can’t do. There’s only one thing to cling to, the one you actually CAN help, and that means keep the line moving until that One appears. You are searching for a fleeting moment where an action you take appears to make a difference. Along the way, you can offer the others tokens of caring, if nothing more than that you are there.

So many of the decisions being made by the physicians on scene in Haiti of who to treat and who to ignore are being based on available resources. Oxygen, for example, is reserved for those who need it to get to the next stage of recovery, which needs to be right around the corner. For the thousands of others whose use of oxygen could relieve them of suffering as they progress to certain death, well…

My favorite quote from the show was from Dr. Millin, one of the interviewees. His response to the need for mental health assistance for the volunteers was: “I’m not a mental health professional, though I’m fortunate to be married to one.”

The good Dr. will have many safety nets, fortunately. He will be one of the very few who was actually there and could help, if only a little. Most everyone else, rendered impotent beside the enormity of the calamity if not totally immersed in self-preservation, will certainly be limited to being witnesses, rather than actors. He didn’t sound cold (I listened to the show) but he was quite clinical, which, in this case, is absolutely appropriate.

Still, every triage decision the doctor made brought some one closer to life and many others closer to death. He explained his actions in terms of the “appropriate allocation of resources”, but in the long term, no I don’t think that will help him sleep at night.

The absolute fact is we’re all going to die unless something quite radical shifts. (Even if it does, prolonged life wouldn’t become available to anyone other than the rich and powerful for a few generations, if at all!)  In a calamity such as Haiti, all that is happening is there’s a lot of people meeting their Makers all at once. It’s just an accelerated rate, happening at a specific place, for a limited (hopefully!) amount of time. I would think, under those circumstances, the best you would be able to do is to play loving witness and reduce as much pain and suffering as you could along the way.

But the doctor’s job was not to reduce pain and suffering, it was to find some people who were fixable. Odds are the images that will haunt him are the faces of those for whom he had no relief to offer.

Many of those the Doc did not treat were referred to the Painful and Prolonged Death Ward (in Haiti’s case, the streets). At some point, he will probably realize this. How could we spare him from such devastating consequences born of his heart-felt desire to serve?

Were we to be truly honest with ourselves, we’d frame the definition of healer to include the certainty of death, which could mean, in a disaster such as Haiti, relieving suffering would be at least equally important as getting the few fixed. Today, unrealistically and at much cost — medicine is designed to keep TRYING, this, that, its mother and the other as if death were not an inevitability and pain didn’t matter.

What would we do, how would we act, if we truly accepted we’re all going to die?