By Ali Jaffe-Doty

Ali Jaffe-Doty is the Emergency Operations Manager for the Preparedness Section at Public Health – Seattle & King County. Last week, she deployed in response to a request from the state to assist the Confederated Tribes of the Colville Reservation.

 Monday, August 24, 1200: Briefing from the emergency manager

I check in to the Red Cross Shelter at Lake Roosevelt High School in Grand Coulee which will be my home for the next day. I am here to support a team of Public Health Reserve Corps nurses deployed to assist with the wildfire response. Bill Joseph, Emergency Manager with the Tribal Health Program, Confederated Tribes of the Colville Reservation, meets me at the shelter and briefs me on the situation:

• The North Star and Tunk Block fires are burning on the reservation and on land adjacent to the reservation’s borders. Emergency managers are concerned that the two fires –three miles apart at the nearest point—will merge.
• The 1.3 million acre reservation, home to 6600 people, faces an array of health challenges. The tribal convalescent home has evacuated, local Indian Health Service clinics have been closed for five days, two shelters and a firefighter base camp require medical support, areas of the reservation are without power, and residents’ have day-to-day medical needs, like getting to chemotherapy appointments and managing diabetes. Local health resources are stretched thin.

Bill shares his current list of health and medical missions underway:

• supporting evacuated nursing home residents in their temporary locations;
• procuring and delivering air scrubbers, respirator masks, and asthma medications to multiple locations; and
• prioritizing the activities of tribal community health workers.

Assuring access to care while the clinics are closed weighs heavily on his mind. He explains that few people can afford to drive to the next town to see a doctor.

Monday, August 24, 1500: Shadowing Bill

All Public Health Reserve Corps nurses have now arrived at the Lake Roosevelt shelter, but it’s too late to be sent into the field today. Response sites are over an hour away, and operations are scaling down for the afternoon. Our team will begin work tomorrow morning.

For the rest of the afternoon, I accompany Bill as he delivers air purifiers and masks, checks on tribal community health workers, visits the incident command site in Nespelem to obtain the latest fire maps, drops by his office to respond to emails, and visits the Colville Reservation Emergency Operations Center (EOC) to speak with his boss and determine if the shelters he is staffing will remain open beyond tomorrow.

I remark on the very efficient operation, noting that it’s just like we do it in King County.

He smiles. “Well, what did you expect?”

Monday, August 24, 1800: Thanks, Grandma!

Our team enjoys a delicious hot meal at the Red Cross shelter, prepared by a volunteer named Dee who Bill affectionately calls Grandma.

Monday, August 24, 1930: Evening briefing

Bill and I depart for the 8 pm daily fire briefing in Nespelem. The briefing focuses on fire operations with little discussion of health and medical issues, so we sneak out the back and head to the Colville Reservation EOC to get his marching orders for tomorrow. The EOC is standing down for the evening. Most staff have departed. Bill still has questions about the status of operations for the next day, so he makes a round of calls at this late hour.

Monday, August 24, 2100: Evening entertainment

We arrive back at the Red Cross shelter. Joseph is too tired to accompany me to the educational laser light show on the Grand Coulee dam, staged every night during tourist season. The four volunteer nurses and I trek to the dam for the full laser light experience, infiltrated by smoke from the wildfires, then come back and crash on our cots.

Tuesday, August 25, 0700: An early start

I am awakened by shelter personnel saying Bill is en route to take us to our work sites. I rouse the nurses and we prepare to depart. Shelter staff serve us a hot breakfast and Dee/Grandma sends us with sack lunches for the day. At breakfast, the shelter manager puzzles over a piece of paper I left behind which says responders are to report to the shelter for all their meals.

“There’re 500 firefighters at the Nespelem base, and almost as many support personnel,” she gasps, rapidly developing a grocery list to cook for such a large crowd. That’s not the case, I assure her, explaining that the document described the support plan for our tiny team of four nurses, and not the 1,000 hungry responders working at the Nespelem fire base.

We drive to Nespelem and drop off the nurses who will partner with Tribal community health workers to conduct home visits, then bring the other two nurses to the shelter in Omak where they will conduct respiratory checks and provide medical consultation and first aid.

Tuesday, August 25, 0900: Busy day ahead

Once the nurses are in place, I accompany Bill on his daily rounds. Today we are:

• visiting an Omak fire station to check on his fellow volunteer firefighters;
• returning to the Tribal EOC for situation information and direction; and
• visiting Bill’s office so he can catch up on email, provide updated guidance for his community health workers, and request additional personnel from the Spokane Medical Reserve Corps.

As we cover the miles, Bill grows reflective. During this second year of wildfires in the region, he wonders if this is a new normal. “I am sick of fighting sagebrush fires,” he admits.

On our rounds, we learn that additional evacuations were ordered last night as the fires continue to spread. The City of Republic is now under Level 2 evacuation orders (evacuation strongly recommended), and the Lake Roosevelt shelter will remain open for another day to receive newly displaced residents. Nursing home evacuees temporarily housed at the hospital are overtaxing staff and resources there, and may need to be moved again. Indian Health Service clinics are still not seeing patients, but their pharmacies have reopened to refill prescriptions. Clearly, Bill has another busy afternoon ahead of him.

Tuesday, August 25, 1130: Time to go

Bill drops me off at the Red Cross shelter. I am preparing to return to Seattle after one night, but this has been his home for seven days. Friends are caring for his pets. He hopes to return home soon but estimates the incident will last at least another 14 days. It’s easier for him to stay in centrally located Grand Coulee than drive to his home in Omak every night.  His staff are worried about him. They confide that he only catnaps in his truck for 30 minutes at a time.

I leave after exchanging contact information, Facebook friend requests and a hug, and extract a promise that he will promptly call Public Health – Seattle & King County if more assistance is needed.

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