Tosa Fire Officer Staffs Medical Center in Storm-Ravaged New Jersey

The phone call came on a Friday night, Nov. 2. Wauwatosa Assistant Fire Chief Jim Case needed to be on a plane to New Jersey in the morning to assist with disaster aid in the wake of Hurricane Sandy.

It was not a request. It was an order.

Two years ago, Case volunteered for the Wisconsin-1 Disaster Medical Assistance Team, part of a federally coordinated, state and locally supported emergency response system under the overall direction of the U.S. Department of Health and Human Services.

"It is just like military service," Case said. "Once you volunteer, you have to go when you're called up."

Case keeps his bags packed, both his personal articles and the equipment of a medical emergency responder. Eight hours after he got the call, he was on that plane.

Military, fire training make Case a commodity

Case just got "lucky" in this instance. Not all of WI-1 DMAT was called up, just him and five other members. WI-1 DMAT has two sister teams, one in Minnesota and one in Florida. They back one another up when called on.

"The Florida team was the one actually called in," Case said. "But they were a little short-handed, so the six of us went."

Case spent nine years in the armed forces, where he got his first paramedic training. But his primary training was in logistics — organization of personnel, equipment, the supply train, transportation, fuel, power — all the crucial underpinnings of any military operation.

After he served, Case became a firefighter paramedic, his career for more than 20 years, the last 12 with Wauwatosa. Rising through the ranks to second-in-command here, he has continued to draw on and build his logistical skills.

And, well, Team Florida needed a logistics specialist.

When Case arrived in the storm-struck Northeast on Saturday, Nov. 3, just four days after Sandy's landfall in New Jersey, things were still fairly chaotic, with broad swaths of the area without power.

"We spent all day Saturday at the airport, assembling the team," Case said. "Then we were driven to our lodging, got a little sleep, and we spent Sunday setting up the Emergency Medical Center, a 250-bed hospital. By Sunday night, we were already taking in patients."

DMAT becomes a MASH unit

The Federal Emergency Management Agency (FEMA) keeps 12 disaster aid staging centers around the country stocked with the equipment and supplies needed to address large-scale emergencies.

Among the systems stockpiled are mobile emergency medical centers — just like military MASH units.

On schedule, Case said, two semi-trailers arrived containing all the beds, linens, surgical equipment and supplies, a fully stocked pharmacy, generators — everything that makes up a hospital, plus everything else needed to make it to operate off the grid.

The emergency center was set up in a large gymnasium at Middlesex County College in Edison, NJ — just west of Perth Amboy, which is at the head of Raritan Bay, at the foot of Staten Island, NY.

The bay acted like a giant funnel for Sandy's already massive storm surge. Tens of thousands were homeless throughout the area, everyone was without power, and the storm cleanup had barely begun.

"There was no place for us to stay anywhere near there," Case said. "Our lodgings were about a two-hour drive away. We work in 12-hour shifts, so with two hours travel each way, in and out, that's really a 16-hour day."

"FEMA is paying me," he said, "but not very much."

A storm on top of a storm on top of a storm

Case said he was averaging about five or six hours sleep between those rugged shifts, but that's when things go according to plan. In emergencies, events don't always follow the script.

On Wednesday, to add to everyone's woes, another nor'easter storm, much like the one that ran headlong into Sandy a week before and blew it up even bigger, struck the area.

"It only dropped a couple of inches of snow," Case said, "nothing we'd get too excited about in Wisconsin — but out there, and under those conditions, it pretty much shut down everything that was still running.

"Our relief couldn't make it in, so we ended up pulling a 30-hour shift."

Besides being logistics coordinator, Case is called on to use his medical training.

"I do perform triage on patients as they arrive," Case said. "That's really part of logistics, because I can see what a patient is going to need, and therefore what the doctors and nurses are going to need, what the pharmacy is going to need."

The medical cases the team sees are of all kinds, Case said. People are sick with every sort of ailment, some contracted, some pre-existing conditions exacerbated by lack of attention since the storm, some injured, of all ages and from all walks of life — but many the old, the too young, many the poor, most not only ill but cold, tired, hungry, weak, despondent.

By the end of last week, Case said, the hospital was about half full, with more patients arriving hourly.

A commitment kept by the community

Case is slated to work in New Jersey through next Monday — if things go as planned. As mentioned, as a DMAT member, Case is obliged to serve.

Case stressed that he serves on WI-1 DMAT with the full blessing of his department and the city.

"Not only Chief (Rob) Ugaste, but also the mayor, the city administrator — everyone has to be on board, and they are, 100 percent," Case said. "They know the terms. If we're told to go, I go, and I really have the full blessing and support of the city.

"It's something we all wanted to do when I joined two years ago."

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Besides the directing Office of Preparedness and Response, U.S. Department of Health and Human Services, and FEMA, Wisconsin-1 Disaster Medical Assistance Team partners with:

• Employer Support of the Guard and Reserve (for USERRA information)
• Medical Reserve Corps (U.S. Dept. of Health and Human Services)
• National Disaster Medical System (U.S. Dept. of Health and Human Services)
• State of Wisconsin Medical Reserve Corps (WI Dept. of Health Services)
• Wisconsin Emergency Assistance Volunteer Registry (WI Dept. of Health Services)
• Wisconsin Emergency Management (WI Dept. of Military Affairs)
• Wisconsin Hospital Emergency Preparedness Program
• Children’s Hospital of Wisconsin
• Froedtert Hospital
• Medical College of Wisconsin
• University of Wisconsin Hospital and Clinics (UW Health)
• University of Wisconsin School of Medicine and Public Health

For more information about WI-1 DMAT, visit the team website at www.wi1dmat.org.