In the Haze of the Saddleridge Fire, Helping Patients Breathe

LOS ANGELES — After causing more than 100,000 people to evacuate, destroying dozens of home across the San Fernando Valley, burning more than 8,400 acres, and leading to at least one fatality, the Saddleridge Fire is now 45% contained and all evacuations orders have been lifted, according to the Los Angeles Fire Department.

Though the fire is less of a threat to large population centers now, the situation appeared much different last Friday and Saturday to Dr. Christian Espinoza, chief medical officer at MEND, a free clinic in the San Fernando Valley, as the fire’s toll and path were yet to determined.

Espinoza recounted to Direct Relief how a line of patients were already waiting outside when he got into work on Friday morning. He remembers thinking, correctly, that his team would run out of asthma medications before everyone in line could be treated.

“Medicines, dental care, medical care are really more of a luxury than anything else. It’s very unfortunate,” Espinoza said, referring to the patients at MEND, which serves one of the lowest income areas of the San Fernando Valley.

Natural disasters such as the Saddleridge Fire disproportionately impact vulnerable populations, such as those with low incomes or who experience language barriers. Of the 700 people MEND treats annually, 79% are Latinos and about half of them do not speak English, according to Espinoza.

As an example of the kinds of hardships faced by their patients, Espinoza said that many live in garages or other substandard units, which often have poor ventilation. For these individuals, N-95 masks, which are optimized for fire debris, can take on an increased level of importance.

“They sleep with their masks on,” he said.

MEND was also running low on these masks by mid-day on Friday, when they were forced to close, due to staff needing stay at their homes to protect them from the fire or to pick up their children from schools, which also closed early.

Coordinating with Direct Relief, MEND — which does not receive federal funds as a free, non-federally qualified health clinic — was able to get resupplied with masks and asthma medication by early Saturday morning, with further deliveries set to arrive this week from Direct Relief’s Santa Barbara warehouse, including insulin and more medications, personal care products, and other medical supplies.

According to Espinoza, the supplies were a “godsend” over the weekend, given the uptick in patients and rash of cancellations from volunteer health care providers at the clinic, which also serves as a food bank and clothing distributor.

“People weren’t aware of if the winds would shift or not,” he said, adding that many stores had closed, leaving people without access to a car with fewer options to purchase food, if they had the means to do so. Even with the resupply from Direct Relief shipment, MEND still ran out of masks — 200 in total — by noon on Saturday.

“It’s a simple thing, the masks, you can get them cheap, but they cant afford this. It’s just something we are able to provide for them, until they figure out their next steps,” he said

Espinoza said the facility was able to respond more effectively to this fire than to the ones that plagued his community last year. Despite having been raised in the San Fernando Valley, Espinoza said he was unprepared for the onslaught of now-annual fires.

“Last year, we weren’t ready for this. I was living out of state and was unaware of the yearly nature of these fires,” he said.

Assessing the coming days, Espinoza said he already has a list of asthmatic patients, a condition irritated by the smoke and debris, who need critical medication. He anticipates many more patients coming in to seek treatment for that and other chronic condition, as it typical after natural disasters.

With the challenges, however, Espinoza said that he was looking forward to being able to care for more patients.

“During our Wednesday diabetic clinics, we can’t always give out enough, so patients have to find the means of purchasing it. This time, I was able to secure some insulin from Direct Relief,” he said.

“A lot of people are going to be very happy this coming Wednesday.”

In addition to MEND, Direct Relief was also able to support health care and evacuation operations at the Simi Valley Free Clinic, American Red Cross shelters in Los Angeles, and for farm workers in Ventura and Oxnard counties, with Emergency Medical Backpacks, medications, medical and personal hygiene supplies, and a back-up power unit.

Reflecting on the past weekend, Espinoza said one interaction stuck with him the most. It was a patient, a mother of two, to whom he gave MEND’s last asthma inhaler. The medicine cannot be purchased for less than $200, and he knew that would mean the patient would have to go without.

“The minute I showed her the box, she didn’t say anything. But her face just lit up,” he said. “It was the relief that she would be able to breathe.”