Response, recover and rebuilding Baltimore

Baltimore's health commissioner details how her department responded during the riots.

There have been many accounts of the city's response on April 27th and the days following. In this last of my six-column series, I'd like to share the story of the Baltimore City Health Department's immediate response and ongoing recovery efforts.

When we received word of possible rioting on the day of Freddie Gray's funeral, our first concern was the safety of our employees and the residents we serve. Druid Health Clinic is located at Penn and North, and many of our nearly 1,000 employees work throughout the city doing transport to doctors' appointments, treating HIV patients and conducting home visits. That afternoon, we decided to close Druid early and to send all nonessential staff home. (Druid ended up unharmed; our other health center, Eastern, had a fire outside.)

Under Mayor Stephanie Rawlings-Blake's direction and in close coordination with other city and state agencies at the Emergency Operations Center, we ensured that life-saving services such as chemotherapy and dialysis were not interrupted. Together, we developed a security plan for Baltimore hospitals. The Health Department convened phone calls with hospital emergency planners and CEOs to provide up-to-date information about riot activity, to share information (including hospital capacity and injuries being seen in the ER), and to identify and solve problems (including making sure staff can get to their shifts).

One problem we immediately identified was that residents were unsure of which hospitals and clinics were open. We developed the Baltimore Healthcare Access List and spread the message through radio, TV and social media.

Over a dozen pharmacies were closed, and people were rationing their insulin and inhalers. We worked with the Maryland Department of Health and Mental Hygiene and the city's 311 system to set up a service for prescription medication access. We mobilized volunteers throughout the city (including public health students from Johns Hopkins) to answer phone calls, conduct outreach at churches and senior buildings, and hand-deliver medications to hundreds of residents.

As other needs emerged, our staff worked around the clock to meet them. Seniors told us that that they relied on pharmacies for food and supplies like Ensure and adult diapers — we delivered thousands of emergency meals to seniors and worked with the state Department of Aging and private partners to coordinate shuttles across the city. Community leaders told us about the need for mental health services — we worked with Behavioral Health System Baltimore to implement the Mental Health/Trauma Recovery Plan, with a 24/7 crisis service and healing circles and group counseling free of charge to schools and community groups.

Our public health recovery efforts intensified even as calm came over the city. As part of the mayor's OneBaltimore efforts, we hired three fellows to lead our agency's community engagement and launched biweekly townhalls to convene hospitals, anchor institutions, faith leaders and community members to work together to fight health disparities. Mayor Rawlings-Blake has committed to Baltimore becoming a trauma-informed city; we obtained federal support and have already trained hundreds of city employees to understand, recognize and treat the effects of trauma.

The unrest has also added urgency to our focus on the deep-rooted problems that contribute to poor health. Three weeks ago, Mayor Rawlings-Blake announced recommendations from her Heroin Task Force. While we have implemented some of them, including a citywide overdose prevention plan and a public education campaign, there is much we must continue do to treat addiction and mental illness.

Similarly, while the city's B'More for Healthy Babies partnership has received accolades for record-low infant mortality, we do not have nearly enough services to assist all at-risk mothers and babies in Baltimore. Our children must be physically and mentally healthy to learn, and there is much to do as we develop our city's comprehensive youth wellness campaign. As we look to long-term efforts to enhance the health of Baltimore, we continue to seek state and federal funding to assist us with our critical priorities of behavioral health and youth wellness.

A lot has happened since April 27th. As we reflect on those tumultuous days and the road ahead, I hope others will see what I have seen: the commitment, dedication and hard work of so many to protect health and overcome disparities for a stronger and healthier Baltimore.

Dr. Leana Wen is the Baltimore City health commissioner. She can be reached at health.commissioner@baltimorecity.gov; Twitter: @DrLeanaWen and @BMore_Healthy.

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