The Park Fire Creates Urgent Health Needs, And Long-Term Threats

The clinic was under an evacuation order — and so were some staff members’ houses — but smoke and stress from the Park Fire were already hurting Shingletown Medical Center’s patients.

Via telemedicine calls, patients were describing asthma or COPD symptoms worsened by air quality. “We have a lot of respiratory disease up on the mountain,” said Denise Highfill, Shingletown’s chief operating officer.

Behavioral health providers from the health center were calling patients — some of them still recovering from the Camp and Dixie Fires, which destroyed whole communities in this mountainous part of northern California — to check in and talk through anxiety.

Staff members helped patients access inhalers and respiratory medicines, and prepared to distribute hygiene kits to people displaced by what is thus far the fourth-largest blaze in California history.

The Park Fire, which began more than a week ago, has been helped along by high temperatures and strong winds, destroying hundreds of structures and displacing thousands of people across Butte, Tehama, and Shasta County, despite a massive containment effort.

In 2018, the Camp Fire became the deadliest wildfire in California history, killing 86 people — many of them older adults — and destroying the Butte County town of Paradise. The blaze contaminated water and air quality, left many struggling to find housing and rebuild their lives, and increased or worsened substance use disorders, mental health concerns, and chronic disease in the area. Repeated emergencies — including the Thompson Fire in Butte County earlier this year — have threatened the area.

Now, safety net providers and public agencies, informed by past experience, are working to meet the most urgent health needs — while keeping an eye on the future.

Community Response

Because Shingletown Medical Center couldn’t operate its emergency food pantry and resource center — and local groups working to address food insecurity couldn’t reach patients either — Highfill was worried about patients going without food as well.

Home visits are an essential part of Shingletown’s medical services — providers offer everything from chronic disease management to wound care for ulcers — but getting to patients with mobility problems wasn’t possible amid the fire.

Highfill explained that many of their patients were under evacuations or warnings, but some had chosen to stay, unwilling to leave their animals behind or undergo another displacement. “Our community is a very, very rural, self-sufficient community. We also have a lot of elders,” she said.

Shingletown was working with local agencies to find a safe place “to be able to actually see and touch our patients,” Highland said. She was worried about patients who weren’t getting wound care.

At Ampla Health, a health center network with 20 Northern California locations, staff were focused on making sure patients were receiving needed medical care. Rocio Valdez, director of communications at Ampla, explained that people displaced by emergencies frequently lose access to their medications — along with their insurance paperwork and identification. Getting patients reconnected to health services, and transporting them to appointments and pharmacies, were priorities during an emergency.

Direct Relief has supplied two of Ampla’s facilities with resilient, solar-powered systems via the organization’s Power for Health initiative. (Shingletown Medical Center is also a Power for Health partner.) John Fleming, Ampla’s director of planning and development, explained that public safety power shutoffs, as well as the wildfire risk, have repeatedly affected their clinics. But all their locations were currently operating at full capacity and seeing patients affected by the Park Fire, he said.

Staff were also prepared to dispense hygiene kits, provided by Direct Relief, at community events.

The Butte County Public Health Department had set up a shelter last week at a church in the city of Chico, which housed about 200 people at one point. There, nurses focused on triage. People who’d inhaled smoke needed respiratory treatments. Some had left home without wheelchairs or CPAP machines, a number had wounds, and others needed transportation to a hospital or other medical setting, said Monica Soderstrom, a community health division director.

In addition, public health workers were monitoring to prevent the spread of infectious disease — displacement during the Camp Fire had led to an outbreak of norovirus — and working to connect people with their home care agencies or primary care providers.

Behavioral health needs were also widespread, responders noted. Butte County has a dedicated behavioral health department that was providing support to affected and displaced residents.

Soderstrom explained that being prepared to respond to emergencies quickly and effectively — without sacrificing ongoing programs — was key. “We’re making sure that every staff member understands that they are a disaster service provider,” she said. Simulations and trainings for shelter settings and other emergency measures are key to their work.

“Unfortunately…we get a lot of practice,” Soderstrom said.

A Long-Term Outlook

Direct Relief has focused on increasing resilience and meeting health care needs in this area of California since the days of the Camp Fire, including providing support for a temperature-controlled warehouse for storing medicines and supplies that Butte County Public Health staff said was integral to their response work.

To help meet emergency health needs during the Park Fire, Direct Relief is providing emergency medical backpacks, hygiene kits, replenishment supplies, a wildfire kits, and requested medicines to responding organizations.

Highfill, at Shingletown Medical Center, was anxious to return to home visits and in-person care. In particular, she said, the emergency medical backpacks, which are designed to treat a variety of chronic and acute conditions, are ideal for home visits.

Shingletown was also preparing to meet increased needs for mental health services and substance use disorder treatments. The health center recently hired a new psychiatrist. But Highfill explained that it’s hard to find specialty care providers in the area, and residents rely on local behavioral health providers for a range of needs.

Fleming said that Ampla was also working to increase its behavioral health capacity, with a Chico clinic primarily focused on behavioral health services. For patients who lost property or were in harm’s way, or who are reminded of past disasters and evacuations, post-traumatic stress is a particular concern.

Butte County Public Health is preparing for the aftermath, arranging for debris removal and water system testing, dispensing safety information for residents, and working with local partners.

Community ties are strong in this area, Soderstrom and Highfill said. Health care providers have lost homes in past events, and some have been subject to evacuation orders during the Park Fire.

“We have a small enough county that, for everyone, this is our home,” Soderstrom explained.

Highfill described a nurse storing emergency medical supplies in her home and staff members showing up to implement emergency plans despite being displaced themselves.

“It’s their community, it’s the people they go to church with and see in the grocery store,” she said. “That community wouldn’t have care…if we weren’t there.”

In response to the Park Fire, Direct Relief is providing Shingletown Medical Center with emergency medical backpacks, hygiene kits, prescription medicines and supplies, and a wildfire kits. Ampla Health will use Direct Relief-supplied emergency medical backpacks and distribute hygiene kits as part of their response work. To support Butte County Public Health Department, Direct Relief provided disinfectant supplies for shelter use and replenished emergency medical pack contents.

The organization has also supported local health care resilience through its Power for Health initiative, which outfits community health care facilities with resilient solar power systems, a temperature-controlled warehouse used to store medical supplies, grant funding, and a wide range of medicines and supplies.