In early March, an atmospheric river hit Santa Cruz and Monterey counties in California, inundating the area, and breaching a levee adjacent to the towns of Watsonville and Pajaro.

The abundance of water caused widespread flooding and displaced residents from their homes. Local news outlets reported hundreds of people were told to evacuate the area.

Watsonville and Pajaro are small, rural areas, and their communities are predominantly Hispanic. Many are migrant farm workers who maintain the area’s strawberry crop. This is the fourth time in 30 years that the area has been evacuated due to major flooding.

In 1995, there were 2,500 evacuations and millions of dollars worth reported in damaged buildings. A Presidential disaster was declared in 1998 when the levee overflowed in multiple places. And in 2005, the City of Pajaro observed evacuation orders. Some worry that the continuous flooding and evacuations cause repeated trauma to the local community.

In response to the severe flooding, community-based organizations like Salud Para la Gente and Santa Cruz Community Health Center, both federally qualified health centers, have coordinated disaster response. Both provide healthcare services regardless of a patient’s ability to pay.

SCCH, which predominantly serves the north side of the county, had few patients affected by the flooding, given the organization predominantly serves an area less impacted by the flooding. However, Dena Loijos, chief strategy and impact officer, said a significant portion of the health center’s workforce lives in the southern region.

Loijos shared that some staff received paid leave as they were forced to evacuate their homes.

“Several of these staff reside in Pajaro and were forced to evacuate,” she wrote in an email to Direct Relief. “Others live in the Santa Cruz Mountains or a pocket in Scotts Valley that was ‘cut off,’ leaving staff stranded at home, mostly without power.”

SCCH was forced to temporarily close clinics due to flooding, high winds and intermittent power. Patients who needed to see providers were moved to a telehealth system.

Salud Para La Gente sent two mobile units to flooded areas to provide care, including medication refills, supplies, substance use supports, behavioral health services, vaccines, and non-medical emergency supplies like water and diapers.

Health conditions exacerbated, like skin conditions, exacerbated by the flooding, are still common. Providers reported that evacuees had to walk through dense water, soaking their feet. In children, colds and runny noses have been common. Medical staff reported that field medic packs sent by Direct Relief had been used in the first round of storms in January, and that quick access to medications helped patients gain control of chronic conditions like diabetes.

Amy McEntree, Salud’s Chief Medical Officer, said the health center’s partner organizations have organized support, service and supply distribution for people at shelters in Pajaro.

McEntree said that many people had to flee their homes and didn’t have time to grab medication for chronic conditions, which has exacerbated their primary care needs.

Providers are also reporting higher rates of stress and anxiety after the floods as patients sought medical attention for increased heart rate, hyperventilation, weakness, and sweating. Some patients showed early signs of post-traumatic stress disorder, including nightmares, flashbacks, insomnia and anxiety.

“The stress of uncertainty with their situation created significant pressure for many families,” McEntree wrote in an email to Direct Relief.

The organization has reported an evolving list of immediate needs from financial, housing and clean-up assistance. Residents who have been affected by the flooding are likely in need of temporary places to stay, rental assistance, cleaning and repair materials for their homes, and reimbursement for lost wages for missed work and the lack of work given the flooded farms.

On April 3, President Joe Biden announced a Major Disaster Declaration for California, increasing access to federal support for residents in eight counties affected by severe flooding, mudslides and winter storms. That includes Monterey and Santa Cruz, whose nonprofit organizations feared residents would not receive federal support based on their large immigrant populations.

The Federal Emergency Management Agency opened Disaster Recovery Centers in Monterey and Santa Cruz and is accepting individual applications for assistance for basic needs like repairs to primary homes and personal property.

In response to this year’s floods, Direct Relief shipped essential medications to Salud Para La Gente and Santa Cruz Community Health Center, including insulin, vaccines, field medic packs for triage care, PPE and more.