Historic Devastation: On the Ground with EMS Responders in Maui

Within 48 hours of the onset of the fire in Lahaina, Maui, a Mobile Medics International (MMI) crew consisting of a doctor, paramedic, EMT and a nurse had boots on the ground and was ready to get to work.

It would take 72 hours before they were able to do so.

“It took us a day or so to get permission to go into the hotspot because they closed Lahaina and weren't letting anybody in or out,” says Teresa Gray, MMI founder and executive director. “We had to work with the Maui Emergency Management Agency and get permission.”

Launched in 2017, the Anchorage, Alaska-based MMI specializes in providing disaster response, humanitarian aid such as a refugee crisis, and medical self-sustainability. The organization is 100% donation-funded and volunteer-based.

Coordinating the ‘New Normal’

Upon waking up in the morning, the MMI crew met with the Maui District Health Office on their assignment to walk through a section of Lahaina, looking for and helping those who either couldn't or wouldn't evacuate.

“Not only does that help with the infrastructure, knowing where all the players are and what they're capable of doing, it also helps with language barriers, because some of the elders still don't speak English,” says Gray. “They were able to interpret for us. They have been the most welcoming, amazing people.”

The crew reported any bodies that were found and people in need of medical treatment, and spread the message to people about the location and hours of the makeshift medical clinic as the established clinic had been evacuated, with no medical assistance available.

“In a disaster, people need all kinds of help. They lost it all,” says Gray. “It’s about helping them coordinate their new normal and where to find the resources.

“We’ve been buying diapers, formula and insulin. We source it from a local pharmacy and buy it for them. We like to spend money in the community because it helps the community reengagement. It’s a direct contribution to the people of Maui.”

Some Lahaina residents had to flee so quickly that everything got left behind except the clothes off their back, notes Gray. Some fled to the water because it was the only place they could go, and had to be rescued by boat.

“They're finding burns on hands and faces and ears, and smoke inhalation, and exacerbation of any respiratory condition affecting people with COPD or asthma,” says Gray. “It’s heavy smoke because all of these buildings were burnt so severely. House fires create the most toxic smoke environment because of the furniture and the things inside it. That beautiful Hawaiian air doesn't exist anymore in Lahaina right now.

“These people haven't just lost their material possessions. A lot of them are multigenerational Hawaiians who have lost their heritage, their family homes. Aside from the physical things, they've lost some spiritual healing and emotional connections, not to mention physically moving neighbors and loved ones from a tight-knit community.”

MMI sends a small team in the beginning; Gray says she expects the team to be there a short time before asking the health department whether it needs more assistance.

“We are committed to sending teams for as long as they need us,” she adds. “We don't do long-term missions. We specialize in going in almost immediately or as soon as we can after a disaster and help them reestablish infrastructure, which is exactly what we’ve done in Maui.”

To rest and regenerate, the crew debriefs nightly.

“Unfortunately, we're experts at this,” says Gray, whose work has led to her being honored in 2022 as Alaskan of the Week and CNN Top 10 Hero of the Year. “We sit down and talk to each other. ‘What did you see today? What was good? What was bad? Anything bothering you?’ Because as most of everybody in EMS knows, sometimes it's not the big horrible trauma that you lose sleep over. It may be that Hawaiian who absolutely lost everything at 85 years old and how is she going to rebuild? She doesn't have family. That stuff will make you lose sleep at night.

“The same thing happens on medical missions. You’re seeing burns, inhalation injuries and encounter some horrific stuff—accidentally stumbling across bodies. We don't do search and rescue. But as you're walking the neighborhoods, you find them.”

Two weeks after a mission, Gray calls each crew member to check in with them. MMI has a licensed psychologist on staff who touches base with crew members and is available to them whenever they need it.

“A year and a half from now, if all of a sudden something comes up for them, then they're free to call our psychologist on staff 24/7,” says Gray. “If they need more extensive professional help, we'll make sure they get that.”

‘I’m On It’

MMI is constantly looking for medical professionals interested in volunteering for medical missions, Gray says. Those interested can sign up at https://www.mobilemedicsinternational.org/

“My paramedics and EMTs are the ones usually able to get time off quickly because of Kelly Shift Schedules, and they also pivot really well and go with the flow,” says Gray. “I love my EMS crews because they can just say, ‘I’m on it.’ The unpredictability of this type of business lends itself well to EMS personnel.”

The site also accepts donations, including a GoFundMe campaign for Maui. As of the end of last week, it was about $20,000 short of its $75,000 goal.

Ongoing donations to MMI help provide the medicine needed on missions.

“We treat people where we find them to help keep the minor things out of that medical infrastructure so it doesn't get overwhelmed,” says Gray. “We send more people if that’s what they need and all of that costs money.

“We take over-the-counter and prescription medications. When we leave, we leave it all there—a couple thousand dollars’ worth. We make sure that everything that we take is what they need. We need to replace that in preparation for the next the next emergency.”

The missions are expensive. The biggest costs come in baggage fees, as volunteers take their own equipment, supplies and medication—what Gray calls an “ambulance in a pack.”

MMI provides team members food, lodging and transportation during the mission and endeavors to keep out-of-pocket costs for volunteers to less than $200 for personal travel-related expenses.

‘Mahalo’

Collaboration with other agencies and assistance groups in Maui has worked out well, Gray says.

“One thing you don't want to do in a disaster is to show up unannounced and uninvited,” she says. “It disrupts the system, it disrupts the flow. Nobody knows where everybody is. It’s best to coordinate the efforts. My mantra is ‘together, we're better.’”

An example of how the work of MMI in Lahaina has been positively received is a text the organization received from a member of the local health department.

The text reads: “Aloha from Lahaina, Maui. Mahalo (thank you) for sending angels to assist us. I was fortunate enough to be on their team as a Department of Health member. I cannot express the gratitude and appreciation for these amazing people. They brought skills, supplies, knowledge, experience, and most of all, they already have the Aloha spirit. I will never forget these angels that swooped down…they came here to help and they did. I've made friends for life. I consider them ohana (family). Mohalo, Stephanie.”

Gray says the MMI crews learn lessons from previous missions that are applied to subsequent ones.

“We’ve been on 37 missions on five continents. Not all of them have been disasters, but the vast majority are,” she says. “Unfortunately, we're disaster experts. Because of that, we've worked with a number of other players within the field—World Central Kitchen, Doctors Without Borders—all of the people you think of when you think of who responds to an emergency and who we've got connections with. We know who's on the ground and who's available. So we can collectively use all of our resources to get as much help to people as needed.”

Giving Them a Chance

This disaster has been different, notes Gray.

“When it’s a United States response, they’re all hard,” she says. “This one is really difficult because this was such a historic town. These people were so connected—not only to their town, but to their culture.”

Symbolic of that is the burnt Banyan tree in Lahaina Banyan Court Park, considered the country’s largest.

The tree had been a gift from missionaries in India, planted in 1873 to mark the 50th anniversary of the arrival of first American Protestant mission. It covers 1.94 acres and stands 60 feet tall, and its canopy spreads over more than a half acre. It sustained severe burn damage.

Yet there is hope. Arborists have determined that with some care, the tree has a reasonable chance of regeneration.

And through the efforts of organizations such as MMI, those who survived the Lahaina fire also will have a reasonable chance of regenerating their lives.

Carol Brzozowski is an award-winning writer and frequent contributor to EMS World.