By Nina Wu
The Honolulu Star-Advertiser
MAUI, Hawaii — It’s all hands on deck for Hawaii’s healthcare workers, who have mobilized in the aftermath of the Maui wildfires.
Healthcare workers in Hawaii and elsewhere are heeding a call for help after the horrific wildfires that erupted Aug. 8 left thousands homeless and resulted in a death toll of more than 100 and growing. These needs are expected to grow in the weeks and months to come.
Maui Health’s Maui Memorial Medical Center is still treating patients with fire-related injuries and medical concerns in its emergency department.
The center has seen about 130 patients, many of whom needed help with prescription refills. Most patients are treated and released, according to Dr. Michael Shea, chief medical director of Maui Health. Currently, six have been admitted for fire-related medical needs.
Maui Health opened two outreach clinics at Napili Plaza and Lahaina Gateway, which will be open 9 a.m. to 4 p.m. for the rest of this week.
Maui Health is working with the state Health Department and other healthcare partners to evaluate community needs, and will adjust its clinics’ schedule and locations in coming weeks, he said.
“We are committed to providing care and resources to our community on the west side for as long as the critical need exists,” said Shea.
Last weekend, Kaiser Permanente deployed its Mobile Health Vehicle, which is currently at Lahaina Gateway, and set up first-aid stations at the War Memorial Gym, Hyatt Regency Lahaina and Napili Market.
The services are available to Kaiser members and nonmembers at no charge daily.
There have been patients with minor to moderate and sometimes severe burns, according to Dr. Jason Egloff, Kaiser Permanente Maui’s physician in charge. Doctors and nurses have also been treating respiratory symptoms from smoke inhalation and injuries suffered while escaping the flames.
A significant challenge, according to Egloff, has been refilling medication prescriptions, particularly for those with chronic conditions. Many evacuees lost all of their medications and medical supplies to the fire.
To address these needs, Kaiser said it has a team of pharmacists, pharmacy techs and couriers that can deliver medications to and from Lahaina as prescriptions come in.
But this might mean longer waits at clinic pharmacies on Maui as these needs are fulfilled.
On Sunday, Gov. Josh Green signed a fifth emergency proclamation allowing pharmacists to refill up to a 30-day supply of prescriptions for people directly affected by the wildfire, even if unable to obtain refill authorization from the prescriber.
This has been helpful, according to Hilton Raethel, president of the Healthcare Association of Hawaii trade group, and pharmacists statewide are coordinating efforts to improve access and delivery of medications to Maui patients.
The proclamation also gives marriage and family therapists, mental health counselors, medical examiners, nurses, physician assistants, radiographers and others with active, out-of-state licenses waivers to practice on Maui without state licenses to address staff shortages.
It also discourages nonessential travel to West Maui to free up accommodations for displaced residents and emergency workers. It remains in effect until Aug. 31.
Some of Kaiser’s Maui-based doctors, nurses and staff are working at shelters and other mobile sites around the clock, while staff from Oahu are filling in for their roles at the clinic.
On Oahu, meanwhile, nine burn patients from Maui have been admitted to Straub Medical Center’s Burn Unit since the wildfires began. Doctors there told The New York Times it was the largest influx of patients from a single incident in the unit’s history.
The situation remains dynamic, according to Raethel, and it changes day by day.
There is generally an initial wave of critical care needed from the disaster, followed by a second one from patients who realize they need health care in following weeks.
Maui Memorial is as full as it was during the peak of the pandemic, he said, and will need more health care workers.
Additionally, there are some frail and elderly patients that are now displaced, whether they were in care homes or living with children that lost their homes to the fire.
It doesn’t help that the number of COVID-19 patients being admitted to Hawaii hospitals has ticked up the past few weeks, adding to the demands. But few COVID-19 patients are in intensive care, Raethel said.
The impacts on health care will be felt statewide as resources are diverted to the emergency on Maui, which includes short-term and long-term needs.
“There are the immediate needs which is very fluid because people are moving around, and then there are the long-term needs,” he said. “Behavior health needs are huge not only for the residents, but for first responders because this is their community. You’re talking about the firefighters, police, emergency workers, health care workers — some of them have lost their homes, too.”
Raethel said he is looking into bringing additional health care workers into the state with federal help and expects they will be needed for months to come.
Kaiser Permanente’s Lahaina and Kihei clinics, meanwhile, are shuttered.
Kaiser’s Lahaina Clinic was destroyed by the fire. Kaiser’s Kihei Clinic remains closed so staff can help care for patients at the Maui Lani Medical Office.
Kaiser’s patient care services, meanwhile, have been redirected to virtual platforms and to the Maui Lani and Wailuku medical offices.
On Monday, the state Maui District Health Office and community partners opened a coordinated health clinic for wildfire patients at the Lahaina Comprehensive Health Center on Akoakoa Place, below Lahaina Civic Center.
It will offer first aid, pharmacy services, mental health and other general health care services from 8 a.m. to 5 p.m. daily. No appointment is necessary and health insurance is not required.
Maui Economic Opportunity, meanwhile is offering transport buses — at no cost — to those sheltering at the South Maui Community Park Gymnasium and Mayor Hannibal Tavares Community Center in Pukalani to get to medical appointments. The service, by reservations only, begins today.
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