THE BEGINNING

This is George reporting from Houston. This is our second day here at Houston. It is a big city with a huge heart. We arrived here at Houston on late Monday afternoon. After checking in at the hotel (right next to a very busy highway, you can image how noisy it can get at nighttime when you try to sleep), we went to a planning meeting during which we were sworn in as Federal officers. We were introduced to various departments here in Houston, including the U.S. Department of Human Services. We were briefed about the massive need here at Houston. Houston has open their arms accepting 200,000 evacuees here and they are planning to accept even more here since they are so organized. Currently, they are trying to relocate evacuees and integrate them into their Metropolitan area. They have several community based health clinic which are running on a very tight budget to take care of many uninsured citizens. In Houston, it is estimated that 30% of their people are not insured. With the influx of 200,000 evacuees, the stress on the already saturated health clinics is more than they can bear. The health care providers here at Houston have reached a break point. Health resources have been stretched very thin. I am very impressed how they help these evacuees with compassion and a great deal of organization. I truly believe Mayor White of Houston is an undeniable force behind this mass effort.

On the second day, we divided and conquered according to our specialty and language ability. Since I am fluent in Chinese, I was sent to the local Asian community center to help out in their clinic. It is a community health center not funded by the government until recently. They have been growing fast in the past year and they finally got funded one month before the Katrina disaster to offer a walk-in clinic three days a week. However, they never expected that their funding would be so quickly diminished due to the influx of evacuees. They are not clear on what is going to happen in the next few months. Some of evacuees may go back to rebuild their homes and some of them basically have no home to go back to since it has been completely destroyed.

At the clinic, I saw both adults and children. I spoke to many of them and try to find out their stories. They are very proud people. They have lost everything but they never lost their dignity. They are not demanding and they really appreciate everything that I can offer them in both biosocial and spiritual ways. There is one loving beauty, a four year old girl, so polite and so cheerful even though she is sick. She just lost her mother to stomach cancer two months ago and now her whole family lost their house all together.

There are many sad stories. These stories hit you hard when you witness them face to face. Their stories become your stories. They suffering becomes your grief and you feel the anguish and pain they are experiencing.

I am so proud to be part of this effort. I witness the community at work first hand. There are so many housewives working here as volunteers to help fill out forms and application for assistance. Some of them bring in home cooked meals to feed staff at the clinic. I witness the beauty of human decency. It reveals itself vividly during such a trying time. I am humbled and honored to be able to do something to share the cross with them. It is like one more hand to help carry this heavy load.

For the next three days, I will be going through different Asian community clinics in the city to provide my services. I can really identify the need of this community. There are not many doctors who can speak Chinese here. They only have one. If I did not come down, she would have to see all 50 patients by herself. This is not counting the people who are blocked outside of the clinic which stops registering at 4:30 PM and closes at 8 PM. I finished the last patient with a medical student at 8:30 PM on Tuesday night. They really hope that I can stay here for a full two week assignment and pray that there will be someone to come over to take over my position. They need doctors and mental health workers who can either speak Chinese or Vietnamese for this particular population.

Of course, the efforts I'm writing about only reflects a very small portion of this massive operation that Kaiser Permanente is involved with at all different levels of care.

FRIDAY, SEPTEMBER 16th, 2005

Since my last report, many things have taken place. They are positive rather than negative. If there is anything good come out of this disaster, it will be the human spirit thriving in the ashes.

Our team has split into two teams. One team of four (Bruce Emerson, Bill King, Monique Semien, and Sarah Lebo) took a drive into Louisiana today since we were able to contact some small town local officials where Federal help is not available or being seriously delayed. Last night on 9/15/2005, we went to the medical command center to pack up as much medical supplies as possible and this morning we sent the team and the supplies to the flood damaged area. At this time, we heard that they have reached a small town north of New Orleans. Their small town hospital was so happy to receive them and put them right to work. The team will provide two 12 hour shifts in the Emergency Department (ED) until Sunday so their over worked ED physicians can take a small break. They are also planning to perform physical exams for 300 evacuee students so they can attend local schools to continue their education.

The Kaiser Permanente team has been quite creative. Sameer Awsare and Mary Boyd took the initiative to start a mobile clinic at Local FEMA processing center where several thousand people are waiting in line under the brutal Texas sun. The line starts at 2 AM in the morning. People sleep on the sidewalk just waiting to get registered. The mobile clinic becomes a very popular place for both people who need urgent attention or who have chronic medical needs. There are fragile elderly with chronic illness who wait in line for hours and then become seriously ill. It is a sight that you thought would not happen in the land of America.

All our team members are very energized by the local effort which has contributed so much of their resources. How could you feel tired when the air is infiltrated with energy?

Our pediatric team (Pat Mullin, Chada Gay) joins the local relief effort at Sugarland Township. I have visited their resource center on my down time. I have to report to you that the residents of the township truly live up to the name of their town. They were able to pull all the resources together and provide the evacuees services ranging from medical care to job employment. It runs so smoothly. It is stunning. The people of Sugarland really appreciate what Kaiser Permanente has done for them. Kaiser Permanente has won their hearts. I am so proud to say that aside being the help to the evacuees, we also severe as good will ambassadors for Kaiser Permanente.

Our Psychotherapist Jennifer Brown has working tirelessly to provide mental heath to the evacuees. She has going from community to community, center to center, to chat with evacuees and provide them much needed consulting. Many evacuees are still in denial. They have lost everything. They are exhausted from running from place to place trying to get assistance, to find their family, to apply for housing. They have no clue what is going to happen in the future. Many of them have no jobs for them even if they go back. They are n shell shock at this point. Jennifer has provided them counseling while they are waiting in line. Many of them broke down in tears when asked how they are holding up. We certainly sense the tremendous need for mental help for these evacuees.

We have a daily meeting. Our team leader Brian Hertz gives us briefing on what is being planned for the evacuees, everything from medical clinics, food, shelters, to employment. Brian has also met with various local leaders to find out how Kaiser Permanente can be of help for them in the near future. Each one of us gives a brief report about our projects and what is going to be done and what is needed including manpower or medical supplies.

After one week, I am so happy to say that we have made a tremendous difference on the communities that we have served. I am very proud to be a Kaiser Permanente member and to associate with these wonderful team mates that I am working with.

As far as me, we will open the Asian community HOPE clinic to four days per week starting this week and next week we will make it five days per week... all this change from one week per day in the past two years. This is an 800% increase. I don't think you can see any practice anywhere in the country growing so fast practically over night once the word is out there in the community. Our great organization Kaiser Permanente has pledged to send another physician to replace me. We have raised the awareness among city official that this is a great pocket of underserved people. The city medical command center has agreed to ship part of office supply to HOPE clinic since we have been operating with bare bones budget. We do not even have an otoscope in our office. Things that I grew accustomed to cat Kaiser have become a luxury here. This morning, the HOPE clinic director and I did an outreach to a Vietnamese Church where it shelters about 200, people feeding them and clothing them. However, they do not have any medical help to attend their sick. We went there with limited supple and we saw about 10 sick children and adults. I also did a health education about community acquired illnesses and how to avoid them. The priest of the parish is very glad to know that he can take his sick people to our HOPE clinic in the future.

Frankly, the work here is exhausting. However, it is truly a rewarding experience. Quite often, we are so overwhelmed and desensitized by the media about the ill of society. For me, I have often lost the ability in my heart to feel for the suffering and pain. We as a society can open our pockets to donate money to the needy or donate our time to attend the sick; however, if there is no compassion inside of our hearts our words become empty lip service and all our efforts mean nothing at all.

From what I have seen among these people who I care for, healing their physical pain or giving them what they need materially does not really lift up their spirits. What lifts up their spirits is the meeting that deep need we all have inside of us to strengthen our human bonds. A simple hug, a pat on the back, holding their hands, encouraging words, tissue paper for their tears, or a listening ear, these are the true marks of compassion that I have witnessed here between fellow human beings that make these evacuees thrive in ashes. I have learned a very valuable lesson in life that I will never forget.

SATURDAY, SEPTEMBER 17th, 2005 Today is Saturday. Houston is unusually hot. The air is permeated with moisture which makes your skin sticky and clammy. However, I feel that I need to write down something about what I have seen today and experienced.

The H.O.P.E. clinic that I am working at is closed today. This clinic has expanded so rapidly within one week to accommodate the medical need of Katrina evacuees, particularly Asian population. By the end of this week, our staff is pretty exhausted from helping these evacuees in mapping out their next step of care after being seen in the clinic. They deserve much needed rest.

Since there is no clinic for me today, I decided to join Sugarland Medical Clinic in the morning and then go to the Kaiser Permanente-initiated medical mobile unit at the FEMA registration site at St. Agnes church in the afternoon.

As I have mentioned before in my last report, the Sugarland resource center is run by the township with help from volunteers. It is a very well organized clinic. It is very impressive to see how people are working together. Each person has an assignment and I can see them take their assignments seriously and with pride. When people are taking pride for what they do in a very massive and complicated operation without arguing or fighting for the spot lights, you then know this level of commitment is sincere and it can only be found in a place where people feel like home. They do not ask how to be rewarded but they step up and instead ask what they can do to help. The people of Sugarland are not just living up to their name but also they have shown the true meaning of compassion and human kindness. I am deeply touched by the people of Sugarland.

This afternoon I join the Kaiser medical mobile clinic at FEMA registration site at St. Agnes church. At this mobile unit we provide medical care and referral to evacuees. The city of Houston also has an immunization mobile clinic right next to us, providing vaccinations to people who are returning to New Orleans. Both mobile units park at the parking lots with very little shaded area for those who wait in line to be seen. It is burning hot in the parking lot. Cold bottles of water are provided by FEMA for these people. We try very hard to get everyone seen as soon as possible or squeeze them into the mobile clinic, as many as the space will allow. Across the parking lot from our mobile units is the maze for evacuees to walk through to get into the main registration area where the air conditioning is provided. However, before you can get into the air conditioned area you have to go through these lines. Even though it is covered under tents, the line is so long. To go through these lines will take you at least 6 to 7 hours. I can hardly picture myself going through these lines. It is like sitting in a hot steaming spa with the sun hovering over you. I can not image how these evacuees feel after losing everything and they still have to go through layers of hardship to get the assistance that they desperately need.

However, the most striking realization that I have witnessed is not how long the waiting line is or how many patients that I have seen the day. Rather, it is how many of these people that I have seen who have no medical insurance at all, even back in New Orleans. The care they received back in New Orleans was very limited. They do not see doctors unless they are seriously ill. Even after being treated at a charity hospital or clinic, the treatment they receive cannot even be compared to what Kaiser Permanente provides to its patients. The difference is like heaven and earth. This population has very limited medical knowledge. Many of them do not know what medication they are taking or what it is for, not to mention not having mammograms, Pap smears or any basic health maintenance check ups. They have no concept of what health is. Medical care they received back home seems to me as having no continuity at all. It appears to be acute care with no education or follow up on their illness. It is very difficult and heart breaking to see the level of poverty among these evacuees and its impact on their overall health and well being. Two simple things that we take for granted - education and health care - are an absolute luxury to them. I feel that I have left the United States of America and stepped into a third world country. I don’t know how this population can ever get out of poverty without a healthy body or a decent education. Through this Katrina relief effort, I have witnessed the very sad and ugly side of this wonderful land of opportunity. It is like a cancerous tumor spreading in the bone of this great nation in a very fast path. This vicious cycle will continue on for generations and it will generate more social unrest if we as a nation do not wake up and face the challenge today.

WEDNESDAY, SEPTEMBER 21st, 2005

Hello Houston, we've got a problem.

In past few days we have been watching the development of Hurricane Rita on CNN closely. The news became more discouraging as days gone by. Last night, Galveston, Sugarland, and Clear Lake areas had ordered mandatory evacuation. This morning, it has become very clear that Houston is going to be on direct path of Rita. We were ordered to be evacuated today. All the volunteers in this area are ordered to leave. We were notified around 10 AM in the clinic. All clinics operated and staffed by the U.S. Health Service are closed. The U.S. Medical Corp. are moving in. We were told to be packed and waiting in the hotel for the flight information. I watched Rita grow from category 3 to 4 then to 5. The voice of TV anchorman goes from calm to pressured speech. In my opinion, it adds an unnecessary panic factor. Houston has been stretched thin by Katrina and now with added threat from Rita I really wonder how they are going to hold up. As a medical relief worker for Katrina, I am stressed just from their experience, thinking about how these quarter of a million Katrina evacuees must feel after running away from one deadly event straight into the arms of another. It is beyond my comprehension.

We finally got the words about out flights. All the flights are booked but we were able to scramble onto different flights out of Houston at different times. We all went our separate ways. On the way to the airport, the traffic was so jam packed with cars. We were moving about 10 miles per hour. Any highway heading away from Houston became a parking lot. I saw many cars packed with people's belonging. It looks like refugees running away. The normal trip to airport which takes 20 minutes has taken us more than two and half hours. We all missed our original flights. Luckily, with the help from Michelle at Kaiser Permanente in Oakland we all are able to get on flights out of Houston later that day.

Once airborne, I looked out the window at the city of Houston. The highways are jammed with cars. From the stagnant headlights, I know the traffic is not moving at all. Now I am on the way home, I do not feel any sense of relief. My life has been changed by this mission and forever tied to the Katrina evacuees. Through their suffering I see the world they live in. I see their pain and struggles. Their stories humble me. On the other hand, I am so inspirited and rejuvenated by the kind spirits and compassion that I have witnessed.

Finally, I have a clear understanding how the human race has survived the past millions of years, especially the past few thousand years. Mankind has gone through so many atrocities of wars, hatred, misunderstanding, and bigotry against one other. We see how society is deteriorating because of poverty and hatred from intolerance and lack of compassion. To sum up, the root of all evil is selfishness. It destroys trust and generates hurt and revenge. Fortunately, among these dark pages of human history, there have always been angels among us. They serve as lights and coconsciousness to guide us through. They work tirelessly to promote justice and lend their voice to the oppressed. They are not afraid to stand out among the mass to encourage understanding and tolerance. It is this voice of kindness, compassion, and love that conquers all evil. It is this force that has sustained the human race for generations. I know there is hope arising from ashes for I have seen it, felt it, and been touched by it at Houston, Texas.

It strives.

George Chuang