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December 11, 2015

Class of 1966’s Llewellyn Stringer heads innovative mobile disaster hospital

When a disaster strikes, the medical community leaps into action. Hospitals brace for an influx of patients, emergency medical teams seek out those that may be injured and doctors provide care to their community in a time of great need. But what happens when a tornado, earthquake or hurricane destroys a community’s hospital and prevents people from getting the care they need?

In steps Llewellyn Stringer, M’66.

Stringer is the project manager for the National Mobile Disaster Hospital, which is designed to deploy anywhere in the country when disaster strikes. The mobile hospital contains all the familiar elements of a normal hospital, such as an x-ray unit, blood banks and pharmacy. This one, however, can be loaded on tractor-trailers, sent to a disaster area and begin receiving patients within days.

Llewellyn Stringer, M’66, outside the National Mobile Disaster Hospital

The mobile hospital project was conceived in 2005 after hurricane Katrina hit New Orleans and left many without access to medical services. FEMA decided it needed to find a way to respond to such disasters, when local hospitals are either damaged or overwhelmed by the number of patients.

Stringer, who served for 10 years as commander of the National Medical Response Team and was the senior medical advisor to FEMA under the Department of Homeland Security, was an obvious choice to lead the project. He retired from FEMA in 2006, but went back to work for the North Carolina Office of Emergency Medical Services. In 2008 FEMA moved the hospital from Fort Detrick to North Carolina, and Stringer took charge again.

The hospital is made up of large tents and mobile hard structures. It features a 21-bed emergency department, 10-bed critical care unit, two operating rooms, full digital X-rays, a small lab, blood bank, a pharmacy and a central medical supply with enough stores for 72 hours of operation, a morgue and an administrative and command control unit.

“We can perform just about anything other than open heart surgery,” says Stringer.

Flexibility is key for Stringer and his team. Their home base in central N.C. allows them to quickly respond to tornadoes in the Midwest and hurricanes on the East Coast or in the Gulf. “The goal is to deploy within 24 hours of receiving an assignment, bring all units, except the ICU, online within 48 hours after arrival on site and have the ICU operational within 72 hours.”

Collaboration is another central part of the project. It is funded by FEMA when deployed, but maintained by NCEMS with funding from the US Department of Health and Human Service’s Assistant Secretary for Preparedness and Response grants. Much of the grunt work of unloading and setting up the hospital is done by volunteers from the N.C. Baptist Men’s Disaster Relief organization, who travel with the hospital when it’s deployed.

The volunteers include plumbers, electricians, carpenters and other tradesmen ready to solve any problems that might slow down the hospital’s deployment. Stringer has even partnered with a local N.C. hospital to make sure he can maintain a stockpile of medical materials that are ready at a moment’s notice.

Stringer and his team got their first taste of action last year when the hospital deployed to Louisville, Miss. The town and its local hospital were badly damaged by tornados and in need of help. Within days of being deployed the hospital was able to offer basic services and soon after was able to accept a wide range of patients.

Officials plan to have a temporary hospital open in some capacity until 2018 when construction of a new hospital in Louisville is complete. “Quick response time is obviously an important part of our mission, but maintaining a presence in the affected communities can be equally important. One of the major obstacles to New Orleans’ recovery after Katrina was that many of the health care workers had left town. There weren’t hospitals for them to work in.

“In Louisville we’ve managed to keep 100 of the 140 hospital employees. These people have relationships with their patients and it’s important that they stay in this community to continue providing care.”

The deployment in Louisville also provided an important opportunity to see what worked and what needed to be improved. Nurses told him that showers need to be wheelchair accessible and that they prefer simpler, single-channel IV pumps. Patients requested more private rooms. Doctors asked for improved access to electronic medical records.

Perhaps the biggest problem is one you wouldn’t expect. “Truckers. We have all the equipment loaded and ready to go, but it’s hard to find drivers and rigs to haul 23 trailers across the country at the drop of a hat. That hurt our response time.”

Despite the problems he encountered, says Stringer, the first deployment was a success. “I was the senior medical officer for many natural disasters in the country for 10 years, and I can honestly say that the collaboration and sense of community I witnessed on this project was the best I’ve ever seen.”

By Jack Carmichael

Virginia Commonwealth University
VCU Medical Center
School of Medicine
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Updated: 04/29/2016