On the scene
Mobile clinic at evacuee center redefines ‘house call’
Dr. Jamaal El-Khal will never forget his first day of real-world training.
A native Oregonian attending medical school overseas, El-Khal arrived at St. Mary Hospital in Hoboken, N.J., for what he thought would be an introductory shift. He wasn’t yet a physician; as a third-year student, on his first clinical rotation, there wasn’t much he could contribute to patient care.
“I could take your blood pressure,” he recalled recently.
He’d wind up doing more—much more.
That day was Sept. 11, 2001.
“Here I am, coming from Oregon, and I knew nothing about New York except what I heard on TV,” El-Khal said, running down a list of crimes and unpleasantness. “So when they said a plane crashed into the World Trade Center, I didn’t think anything of it, because I thought, ‘OK, this stuff happens in New York.’ But when it went on [longer], with the second plane, it became surreal to me.”
Victims arrived at St. Mary (now Hoboken University Medical Center) with burns, deep wounds pierced by shrapnel and eyes full of dusty debris. For his part, El-Khal treated injuries—cleansed wounds and irrigated eyes.
“That was my first real big disaster,” he said, noting it was far greater than the hurricanes that struck his medical school’s campus in the Caribbean, as well as the anthrax threat that followed 9/11—for which he and other medical students had to swab people who’d opened packages, sent by mail, suspected to contain the virus.
Unfortunately, it wasn’t his last big disaster.
El-Khal, a primary care practitioner for Ampla Health, was driving back to Chico from Ampla’s Orland clinic when he noticed two unusual things: darkness in the early-evening sky, emanating from eastern foothills, and heavy traffic heading opposite from him. Earlier that day, a meeting he was supposed to attend was canceled because of “the fire”; too busy seeing patients to check the news, he thought, OK, whatever, what fire?
That day was Nov. 8, 2018.
“The fire” was the Camp Fire, which drove more than 50,000 people off the Ridge and forced others—including El-Khal, who lives in southeast Chico—to evacuate temporarily. The blaze later was determined to be the deadliest, most destructive wildfire in California history.
He got a call the next morning at 7 asking if he’d be willing to come to the Chico clinic (where he also works) on his day off to help prepare for an influx of patients. Without hesitation, he agreed. As with 9/11, El-Khal found the Camp Fire aftermath “a tough, surreal thing.”
People came in suffering effects of the fire: direct, such as smoke inhalation, and indirect, such as needing medicines left behind in the haste of evacuating. Plus, of course, emotional impacts—“everyone you’d see all had a story,” he continued. “You try to remain professional and cheerful, but at the same time, you feel helpless, like what more can you do?”
At the Silver Dollar Fairgrounds, El-Khal and his colleagues have found more to do. Ampla Health dispatched a mobile clinic to the site where the Red Cross opened a shelter for people displaced by the fire. The unit arrived on Dec. 11, a week after the facility opened. After seeing just a handful of people the first few days, the team soon was treating a dozen before lunch.
“The word is getting out,” El-Khal said, “which is good. With the evacuees, they don’t know where to go—their doctor isn’t [back practicing]; some will say, ‘Check my records’ … but [the office] isn’t there anymore.”
El-Khal spends one day a week at the fairgrounds, typically Friday. Other Ampla doctors come practice there, too. Huda Abdullah, a medical assistant and receptionist from the Chico clinic, is among the staff on-site daily (Monday through Friday, 8:30 a.m.-4:30 p.m.). She, like El-Khal, eagerly accepted the invitation to work the mobile unit.
“Over here, there’s been a lot of positivity,” Abdullah said. “People for the most part have been very polite, very nice, telling us how they appreciate us being here. That’s good to hear, that we’re actually helping people in need.
“Most of the Camp Fire victims don’t have the money or the access to get into a home or don’t have cars so they can just go and rebuild their lives. These are people who already didn’t have anything and now they really don’t have anything; so [our] being here is for them to be at peace, [knowing] now they can get more help.”
Evacuees seeking the mobile unit—parked in the southwest corner of the fairgrounds, where President Trump visited the Camp Fire’s incident command center—literally walk up. Being on-site is key, El-Khal said, because many people displaced from other communities don’t have a way, or know the way, to get to medical facilities in Chico.
Ampla doctors have provided a wide range of services. Many evacuees just need prescriptions refilled or medications replaced, in the absence of their primary physicians. Others seek treatment for conditions related to the fire and living in tight quarters of a shelter: difficulty breathing, colds, flus, stomach ailments. Some require care for chronic conditions such as diabetes, open wounds, even cancer.
Ampla assists those who don’t have insurance with enrollment in plans such as Medi-Cal.
The overall goal is to provide stop-gap medicine—a bridge until evacuees establish, or re-establish, with a medical provider.
“They have the option of following up with us, because once they come in here, they’re already an established patient,” El-Khal said. “But we’re not doing it as patient recruitment; we’re doing it because that’s our mission at Ampla Health, to serve the underserved….
“I just want to do my job and help.”