By: David Ostrowsky

Well before Hurricane Helene, one of the deadliest storms in modern American history, ripped through Western North Carolina earlier this autumn, decimating scores of residences and businesses and washing away entire neighborhoods, the largely impoverished Appalachian region was grappling with a precarious healthcare infrastructure. To this day, Asheville, North Carolina, and its surrounding mountainous communities have never fully recovered from the devastation of the Great Recession of 2008, resulting in a grave health disparity among other societal ills. And, yes, the recent ferocious tempest of which Western North Carolina bore the brunt has only exacerbated the region’s already fragile healthcare system.

In the immediate aftermath of Helene, thousands of residents whose cars were buried under their collapsed homes found themselves bereft of medication refills, IV fluid bags (there’s been a lot of publicity about this in particular), insulin supplies, and dialysis equipment among so many other life-saving resources. In addition to the scarcity of options for reliable transportation to medical appointments – or the inability to walk safely along public roads laced with downed trees and electrical wires – survivors have faced the heightened risk of exposure to sewage, toxic industrial waste, and mosquito-borne illnesses stemming from the raging, out-of-control floodwaters. Meanwhile, the blunt force of the storm’s impact has caused a bevy of short-term injuries that, because they have not received immediate medical attention, could mushroom into chronic, far more severe issues. This is to say nothing of the severe mental health problems many residents are surely experiencing in the wake of losing loved ones and having their lives uprooted. To put it another way, instead of shopping for holiday gifts in the coming weeks, many will be busy filing insurance claims.

As North Carolinians whose lives have been upended continue to endure such apocalyptic circumstances, nearby healthcare facilities (or those that are accessible) have faced their own mounting problems. While the physical infrastructure of nearly all community health centers in Western North Carolina remained unscathed, there has been a universal struggle for facilities to obtain clean potable water for sanitizing equipment, cleaning wounds, washing hands properly, or even making an adequate amount of coffee for providers to stay alert. For over a month now, it has been an endeavor of colossal proportions for Asheville’s Mission Hospital, the only designated trauma center in Western North Carolina, to obtain clean, usable water while other facilities − such as Asheville's Planned Parenthood clinic and local birthing centers – were relegated to slashing critical health services due to the lack of running water. By all accounts, the dearth of potable water has been the chief culprit behind the systemic woes bedeviling the region’s healthcare landscape. (It also bears mentioning that there were some North Carolina nursing homes still without an adequate supply of running water for several weeks after Hurricane Helene made landfall.)

In addition to clean water, another all-important resource in drastically short supply for such healthcare facilities is that of adequate manpower. For an area of the country that was already struggling mightily to recruit and retain medical staff, Helene dealt a devastating blow. Truthfully, many of the healthcare workers in Western North Carolina themselves were personally affected by Helene. Some tragically lost their lives while many others have struggled to help victims as they and their families have been experiencing unimaginable distress. Certainly, volunteer doctors, nurses, and psychologists have descended on the region to help hospital patients – as well as those who are housebound often without internet, reliable phone service, electricity, and running water – but a severe staffing shortage, one that may portend a wave of hospital closures, still looms large in the storm-ravaged region.  

“How do we attract someone to come into the area at this moment?” Kim Wagenaar, the chief executive of Western North Carolina Community Health Services, which serves 13 counties in the region, shared with the New York Times in an October 28 piece. “It’s just going to take a long time to really mitigate the effects of this disaster.”

Though hurricane season may be winding down, we can’t lose sight of the legions of victims of Helene who want nothing more than adequate healthcare services this holiday season.