"Wrenching": Kaiser Permanente Redwood City doc returns from disaster

 Dr. Carol Tabak reflects on typhoon disaster medical mission

                The first thing that Dr. Carol Tabak noticed about the Philippine patients coming in to Kaiser Permanente’s emergency care clinic in the typhoon disaster area was their hands.

                “A lot of them had hands that were very swollen,” says Dr. Tabak, a thoracic surgeon at the Kaiser Permanente Redwood City Medical Center.

                Dr. Tabak was part of a 30-member team of Kaiser Permanente physicians, nurses, and staff that organized an emergency medical mission to the Philippines, to areas that were hit hard by the large Typhoon Haiyan in November. Dr. Tabak returned a few weeks ago and shared her experiences.

                “I finally learned that during the storm, many people were desperately hanging on to trees or other large objects for hours on end to protect themselves from the powerful winds,” says Dr. Tabak. “It left their hands swollen and raw. It was very wrenching to me seeing these cases.”

                The patients were in the beginning stages of lymphedema, where their blood circulation in their hands had been impeded as they held on for dear life, explained Dr. Tabak.

                “They needed to start exercising their hands,” she says, “maybe get physical therapy.”

                But that could be difficult because the typhoon, aside from destroying the towns, left the local medical community in shambles. Philippine doctors and nurses were dealing with the destruction of their own homes and family anguish. International medical teams stepped in. Israel and Australia set up portable hospitals in Tacloban, and China docked a hospital ship offshore.  The Kaiser Permanente team worked in a damaged hospital in nearby Carigara.

                Dr. Tabak, who lives in Burlingame, said one wall of the hospital had been blown away in the typhoon and the damaged roof was covered by a blue plastic tarp. She saw 25-to-30 patients a day, mostly minor-to-moderate injuries.

                “We dealt with a lot of infections,” says Dr. Tabak. “People who’d been hurt in the typhoon, or gotten injured treading through the debris afterwards.”

                Between the emergency clinic in Carigara and a mobile clinic prowling the streets of Tacloban, it’s estimated Dr. Tabak and the Kaiser Permanente team saw more than 3,000 patients and provided psychological help to 500 more.

                                “The patients were so grateful, and so gracious to us, says Dr. Tabak. “It definitely made up for the challenging conditions we all faced: limited electricity, contaminated water, heat and humidity.”

                And the smoke:  Dr. Tabak says debris from the typhoon was being burned to clear the land, but the smoke filled the air and many of her patients were having breathing problems and asthma.

                “They were happy for any medication we could give them. Even a little Band-Aid would make them glad and thankful,” she says.

                Even though her specialty is thoracic and general surgery, Dr. Tabak did none of that during her two weeks in the Philippines. Not much surgical equipment was available.  Instead, she and the team found themselves providing modern Kaiser Permanente emergency medicine to the typhoon victims.

                All of the Kaiser Permanente volunteers brought mosquito tents with them, because dengue fever is endemic in the Philippines, and it was expected there’d be no rooms to rent and the team would have to sleep outside. The team did find a relatively undamaged hotel in Tacloban.

                “We pitched those tents in our beds because without electricity and air conditioning, the windows were open much of the night,” she recalls. “Oh yes, and we took bucket showers because the water supply was damaged and contaminated.”

                She and the others were working with Relief International (www.ri.org), an American non-profit that responds to international disasters and provides humanitarian relief and long-term rehabilitation.

                “I’ve been a doctor here at Kaiser Permanente Redwood City for 22 years,” says Dr. Tabak. This is the first time I’ve ever gone on a medical mission. And I’ll do it again.”