Communications and power blackouts still causing major disruptions to primary care in Tairāwhiti and Hawke’s Bay

“Communication is non-existent really at the moment”

Communication and power blackouts have brought primary care to a standstill across Tairāwhiti district while in Hawke’s Bay some practices are re-opening with limited hours and services.

Three people have now been confirmed dead in Hawke’s Bay as a result of Cyclone Gabrielle, including a child in Napier, while a body was found this morning by rescuers in the search for a volunteer firefighter caught in a landslip at Muriwai, west Auckland.

The cyclone tore down the east coast of the country on Monday and Tuesday. Many areas have been cut off by slips on roads or power and communication outages, including Northland, Coromandel, Hawke’s Bay and Tairāwhiti, and at least 10,500 people are displaced from their homes.

Many parts of Tairāwhiti are uncontactable with phone lines down and multiple breaks in the fibre internet network. Thousands of copies of the local newspaper will be handed to residents today in an effort to get an urgent “conserve water” notice out to as many people as possible, Gisborne mayor Rehette Stoltz told RNZ this morning.

In a briefing earlier today, emergency management minister Kieran McAnulty said power had been restored to most of Gisborne city, but the “broader area” remained of concern.

Defence minister Andrew Little says 250 defence force personnel are being deployed to the cyclone response.

Pinnacle Midlands Health Network medical director Jo Scott-Jones says the network has not been able to make contact with any of its practices.

“Communication is non-existent really at the moment,” Dr Scott-Jones tells New Zealand Doctor Rata Aotearoa.

“I had a brief conversation with a specialist colleague at the Gisborne hospital yesterday, he said that as far as he was aware there’s no power or internet to any of the practices.

“So ED was the first port of call for primary care, but they weren’t getting overwhelmed at that stage. He was reflecting on the fact that the bridge at that stage, which splits the town in two, was not passable, so of course that meant everybody on that side of town didn’t have access to the hospital or hospital services.”

St John and Wellington Free Ambulance placed people up and down the coast in preparation for the cyclone, says Dr Scott-Jones, but “it’s very frustrating not being able to communicate with anybody”.

He says he is trying to communicate with Gisborne Hospital and St John around providing access to patient records in case people turn up to ED.

“[We’re] trying to tap into any local, regional and the national Civil Defence response to see if we can contribute in what way we can.”

READ MORE:

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• Cyclone Gabrielle closes practices from Northland to East Cape and beyond
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Yesterday Te Whatu Ora Tairāwhiti posted an update on Facebook saying Gisborne Hospital is “open and operational”, but at a limited capacity due to limited power, water and staff.

“Urgent care is available to those who need it,” Lynsey Bartlett, interim lead for hospital and specialist services, says in the post.

“Power, water, internet and phone services are cut to most of the region, however the hospital is running on generators for essential power.

“Bridges are affected in the city which limits mobility so we are working with St John and have nurses available in welfare centres.

“An emergency operations centre has been stood up at the hospital and meetings are being held regularly.”

Te Whatu Ora has been contacted for an update today.

Tairāwhiti Civil Defence this morning said the region remained disconnected from the outside world, with patchy power service and a severed fibre optic cable taking down internet, email and phone services.

Meanwhile, in Hawke’s Bay where there has been major flooding and damage, Te Whatu Ora cancelled all elective surgeries, endoscopy services, and outpatient appointments in Napier, Hastings, Wairoa and central Hawkes Bay, with telehealth services offered instead.

Acute theatre and urgent radiology procedures continue.

Initially it was reported that all the region’s general practices were closed, except for three urgent care clinics: City Medical Napier at the Napier Health Centre (24 hours); Medical & Injury Centre in Hastings; and the urgent care clinic at Hastings Health Centre.

But in a media update at 4pm this afternoon Te Whatu Ora said it had been able to contact and confirm that four practices were open in Napier, five in Hastings and two rural practices in Tukituki and Waipawa. But it noted that some practices were open limited hours and and services were impacted by them operating in "constrained environments".

A number of pharmacies are also open.

Te Whatu Ora has stood up an urgent care centre at Napier Health Centre, and asks medical and pharmaceutical staff based in Napier who have the ability to help with the cyclone response, to phone 06 834 1815 or present to the centre at 76 Wellesley St, Napier, to be added to the roster.

In a statement to New Zealand Doctor, Te Whatu Ora says it appreciates “any and all assistance in the Hawke’s Bay from qualified doctors and nurses”.

RNZCGP chair Samantha Murton says the college has been in talks with Te Whatu Ora and Manatū Hauroa Ministry of Health to see what support is being put in place for practices and how they’re getting information into the affected regions.

“Some of the information we’ve had is limited in that, if a practice is closed and there is no power, they can’t be using telehealth,” she tells New Zealand Doctor.

“So people saying statements like [they can] move to virtual care in a place where there is no power – that’s a nonsense.”

Dr Murton says she is keen to receive assurances from both agencies that they have “a finger on the pulse of what is actually going on on the ground with general practice or primary care services” in the cyclone-ravaged regions.

“From Te Whatu Ora’s perspective, if [primary care services are] not happening, then people will be knocking on the door of the hospital. So they [Te Whatu Ora] need to make sure they have their eye on that ball of what’s going on.”

The college also wanted to clarify what support may be offered to practices which have been flooded or damaged in the cyclone.

“It is the long haul of recovery” for those practices, she says. “And our services are under pressure already. Having to rebuild a practice … when it’s not just your home [that’s been affected] it is your whole workspace as well. That’s enormously difficult.

“But having to continue to provide a service as well, or find some other way of providing a service, is doubly hard.”

- Additional reporting: Fiona Cassie