The barrage of recent wildfires in Northern and Southern California wrought widespread environmental havoc, and also spurred major health challenges in communities ravaged by the blazes. Throughout the state, practitioners representing a wide range of disciplines are on the front lines, trying to restore health and balance.
"The psychological impact was the most severe, but the toxic air quality was a close second, and compounded the first," observed Isaac Eliaz, MD, Medical Director of the Amitabha Medical Clinic and Healing Center in Santa Rosa, where he is treating many people affected by the fires north of San Francisco.
Located in Sonoma County, one of the areas hardest hit by wildfire last October, the practitioners at Eliaz's clinic treated fire victims' physical ailments and also served as a critical source of community support. "A number of our patients, colleagues, friends, and fellow practitioners were affected by the fires," he said. "Many lost everything."
Communities of Support
Thousands of health professionals have stepped up to provide emergency care to patients at medical facilities and evacuation centers throughout the state. Many of them were the expected first responders: EMTs, paramedics, and emergency physicians. But practitioners of holistic modalities also jumped into the breach, proving -- as others have in past disasters -- that these approaches do have a place in emergency care.
Catherine Herbin, LAc, who is Acupuncturists Without Borders's Disaster Relief Coordinator for the North Bay wildfires in Sonoma County, found that "the most significant impact of the fires on patients' health was on their breathing and on their emotional wellbeing." In addition to treating fire victims herself, Herbin organized 28 volunteer acupuncturists who provided treatments to more than 200 patients at 14 clinics across the county.
"The air quality was extremely poor and almost everyone had a cough, shortness of breath, and a sore throat, even if they were wearing the best masks -- which most people were not," Herbin recalled. "People were emotionally distraught having either lost their homes, loved ones, and cherished belongings, or experiencing the looming threat of this loss."
Changing weather patterns and the unpredictability of wildfire paths from hour to hour created inordinately high stress as people attempted to quickly move from high-risk areas into safer zones. Among those most profoundly affected were undocumented evacuees who feared their immigration status would be revealed to FEMA workers while they were trying to access medical and evacuation services.
Many of were the expected first responders: EMTs, paramedics, and emergency physicians. But practitioners of holistic modalities also jumped into the breach, proving -- as others have in past disasters -- that these approaches do have a place in emergency care.
"Evacuees, volunteers, first responders -- everyone in the region experienced trauma," said Jenny Harrow, MA, co-founder of the Integrative Healers Action Network, a coalition of more than 2,000 holistic health professionals from around the greater Bay Area who volunteered their time and resources to treat fire victims. Harrow's grassroots network helped organize 15 integrative healing clinics for evacuees, first responders, second responders, and others impacted by the fires.
"I spoke with and worked alongside many practitioners, as well as Red Cross officials, firefighters, National Guard men and women, and volunteers," Harrow told Holistic Primary Care. She spent many hours at the Red Cross's main Sonoma County shelter at the Santa Rosa Fairgrounds. "During the fires, acute and chronic pain, especially for the first responders, as well as stress, lack of sleep, and lung injury from excessive smoke" were some of the most common complications she witnessed.
A certified Integrative Health Coach, Harrow noted that most of the fire victims and volunteers she met "were not completely in their body." As a health coach, I was able to help bring them back to their center and find ways to bring support to their fried nervous systems, often by recommending different types of integrative care such as acupuncture or massage therapy, but also by just holding space and listening to their stories."
Melatonin: An Invaluable Ally
To treat evacuees and firefighters alike, practitioners drew on a wide range of modalities and techniques.
"Most patients simply needed their allopathic needs met: refills, inhalers, housing, antibiotics, food, and most importantly, advocacy -- especially for those with mental disorders and non-English speaking evacuees," reported Wendy Kohatsu, MD, Associate Clinical Professor of Family and Community Medicine at the University of California, San Francisco (UCSF), who volunteered alongside other integrative medicine doctors at North Bay evacuation shelters.
Kohatsu, also the director of the Integrative Medicine Fellowship at Santa Rosa Family Medicine Residency, observed that at shelter sites, one of the most beneficial nutraceutical treatments was a basic one: melatonin.
Recalling the scenes of "evacuees lined up in rows and rows of cots after cots" -- including "175 people in one high school gym!" -- she and others offered melatonin supplements to patients "who had difficulty sleeping with all the other people around, and the necessary amount of low-level emergency lighting that was left on during the night."
"It's during times of disaster that patients are in most need of our volunteer services, and it was a gift to be of service to my community during such a time and to witness the positive effects of our medicine." -- Catherine Herbin, LAc, Acupuncturists Without Borders
Kohatsu's colleague Ben Brown, MD, Associate Clinical Professor at UCSF, assisted with medical supervision at shelter sites and recalled the challenges of the first night after the fires. "Many older patients were evacuated without time to gather their medications. We had a sweet couple that was nearly 100 years old -- they had to sleep on blankets stacked up on the floor because we did not have cots yet," he said.
Brown, also the Director of Integrative Medicine, Global Medicine and Career Development at UCSF-Santa Rosa, said that for most patients, the primary need was for "TLC and connection -- connection being the biggest healer."
"We also got them medications at the pharmacy and treated a lot of anxiety and respiratory issues," Brown added, noting that he offered ear acupuncture for anxiety and has treated many patients for stress-related issues since the fires occurred.
At the Amitabha Medical Clinic, practitioners "focused on detoxification support and anti-inflammatory therapies, in addition to emotional and psychological support, with emphasis on mind-body medicine, to help address trauma and PTSD," Dr. Eliaz explained.
Detox & Inflammation Control
"Central to this approach was the use of modified citrus pectin (MCP) with alginates and without alginates, to remove toxins, repair damaged tissues, protect the liver and kidneys, and prevent any lingering inflammation and fibrosis," he said. MCP is an indigestible, water soluble polysaccharide derived from the peel and pulp of citrus fruits, that can bind toxic heavy metals and excrete them from the body without disturbing essential mineral levels.
"Oxygen therapy was also very beneficial for patients suffering from smoke inhalation," Eliaz added. Other treatments offered at Amitabha included infrared saunas as well as IV therapies for detoxification.
At the Heart To Heart Medical Center, another Santa Rosa clinic, Shiroko Sokitch, MD, combined homeopathic remedies, acupuncture for PTSD, and herbal supplements to treat people affected by the fires. Sokitch noticed that acupuncture treatments in particular offered tremendous benefits: "People felt much better afterward."
Herbin reported similar results. "Acupuncturists Without Borders treats patients primarily with auricular acupuncture, a five-point treatment called the National Acupuncture Detoxification Association (NADA) protocol," which is used to treat post-traumatic stress, anxiety, pain, insomnia, and many other ailments. Patients sit together in a healing circle, where they rest for up to 45 minutes after the acupuncture needles are inserted by trained and experienced practitioners.
"Patients commented that they could breathe easier in the days after the treatment," Herbin said. "First responders were able to take a restorative break and in some cases, finally let tears flow. Everyone in the circles, patients and providers, came together in community to support one another and heal."
"Symptoms in areas of respiratory, cardiovascular, nerve, cellular health, and other key systems can emerge immediately following exposure, as well as later on down the road. With that in mind, it's imperative to adopt proactive strategies as soon as possible in order to mitigate the harmful effects of toxic exposure." -- Isaac Eliaz, MD, Medical Director, Amitabha Medical Center, Santa Rosa
Harrow recounted the story of a woman treated by energy healers, bodyworkers, and a homeopathic practitioner at the Red Cross shelter in Santa Rosa. "She was so deeply traumatized by her house that just burned down that she could barely speak. I witnessed her transformation as she started by laying on a table and receiving energy healing. From there, she was able to be in her body enough to receive a massage. I saw the life come back into her eyes and she was able to speak to a homeopathic doctor about what had happened. The herbal team gave her some supportive teas and tinctures, and the woman, who came in with her eyes glazed over, left our integrative healing clinic able to think about what she would do next."
While legions of health professionals worked tirelessly to provide critical front line treatment during the fires, this is just the beginning of the healing process fo people affected by the catastrophic blazes.
Two months after the fires that devastated Sonoma, Napa, and Mendocino counties, the Santa Rosa Holistic Chamber of Commerce held a Sonoma Strong Healing Fair, a free event for victims of the disasters. "We had about 450 people who attended, with about 45 practitioners, including MDs, massage therapists, energy healers, EFT, chiropractors, and more. Most of the people who attended the fair had been impacted by the fires in some way," said Cherri Pedrioli and Diana Borges, President and Vice President of the Chamber. Their event was just one of many powerful examples of local groups springing into action to assist their neighbors.
Along with the intense shock and psychological trauma, ongoing physical health challenges still plague many people injured during the fires. "It's important to recognize that exposure to wildfire smoke can have long-lasting negative impacts, even if not immediately apparent," Eliaz cautioned.
"Symptoms in areas of respiratory, cardiovascular, nerve, cellular health, and other key systems can emerge immediately following exposure, as well as later on down the road. With that in mind, it's imperative to adopt proactive strategies as soon as possible in order to mitigate the harmful effects of toxic exposure," he added. "Detoxification, anti-inflammatory and antioxidant support, as well as respiratory therapies are all key in helping to prevent long-term damage."
Despite the best outreach efforts of individual clinicians and healthcare organizations, Harrow noted that there are still many individuals in Sonoma County--and other afflicted areas--who have experienced fire-related trauma and who are not being treated.
A Chronic Problem?
The harsh reality is that extreme wildfire seasons like the one California just endured could become a norm, rather than a rarity.
In 2017, the US spent approximately $306 billion -- a new annual record -- addressing 16 major weather and climate disasters, according to a new report from the National Centers for Environmental Information, a division of the National Oceanic and Atmospheric Administration (NOAA). Last year's natural disaster total expenditures shattered the previous annual record cost of $214.8 billion, "established in 2005 due to the impacts of Hurricanes Dennis, Katrina, Rita and Wilma," the report notes.
The 2017 wildfires in the west alone resulted in total disaster costs of $18 billion, tripling the previous US annual wildfire cost record. Many point to climate change as a key factor behind this upsurge in weather-related natural disasters.
Dr. Sokitch believes the recent fires offer invaluable guidance to patients and practitioners on how to be prepared in the future. "We always learn from traumatic experiences," she said. "I think a lesson that goes across the board is that if you take excellent care of your health as a preventive measure, it really helps when a disaster or traumatic event occurs. Encourage people to build their health, to build resilience -- it will make a difference," she urged.
Looking ahead, Dr. Brown recommended that practitioners "have a place nearby to get medications," for instance, through partnership with a pharmacy, since so many patients had to leave their homes without critical supplies or belongings. "Be prepared to set up a makeshift hospital and expect to treat mostly respiratory and anxiety issues," he added.
Health practitioners who live in wildfire prone areas might consider deepening their knowledge of trauma, toxicity, and lung support treatments.
"The trauma of a wildfire lasts well beyond the incident itself, whether through the emotional trauma or the lingering impacts of environmental toxins," Harrow stated. She encourages healers of all types to "learn as much as you can about detoxing and how to lead your patients through a safe detox program."
Dr. Eliaz echoed that theme. "Whatever you can do to support your communities in the aftermath of a disaster, whether it's facilitating support groups, holding classes for self-care, offering specialized treatments, or raising donations to support survivors, can be of great benefit during traumatic events."
Herbin called on health professionals who treat fire victims to "remember how powerful integrative medicine truly is to treat symptoms of difficult breathing and trauma, and to support and ground patients."
"As strange as it may sound, those smoke filled days were some of the best and empowering of my life," she reflected. "It's during times of disaster that patients are in most need of our volunteer services, and it was a gift to be of service to my community during such a time and to witness the positive effects of our medicine. The same advice goes for providers outside of high fire hazard zones. Global warming is creating more natural disasters that ever, and we have a lot of power to help our communities with integrative medicine."