On Ocracoke Island, the streets stink of dead fish, and water still laps at houses.
People walk through dirty water in bare feet and flip flops. That will breed its own health problems, as snakes, sewage, and debris swim in that same water.
“The first floor of every home and building has water in it,” N.C. Department of Public Safety spokesman Keith Acree said. “Most people on the island probably lost their vehicles. Everywhere you go, you see cars and trucks with doors standing open and hoods up, trying to dry out.”
But some 60 miles north, the Outer Banks Hospital remains undamaged. And in New Bern, at the confluence of the Neuse and Trent rivers, CarolinaEast hospital is unscathed.
“We dodged a bullet. It could have been so much worse. Look at the Bahamas,” CarolinaEast Health System spokeswoman Megan McGarvey said. “We just hunkered down, and when the storm died down enough, patients came into our [emergency room] to get treated.”
CarolinaEast Medical Center regularly sees people from Carteret County, and it’s currently is treating one man from Ocracoke Island.
“We’re pretty full. We have 44 patients in our ER right now,” McGarvey said. “I would think that there might be some relationship, but we also have times when our people need us. It doesn’t take a hurricane for us to be full ER.”
The hospital never had to stop running its ambulances during the storm. It never even left the city power grid. Some 300 extra workers came into the hospital to work the storm, where workers rolled out 200 sleeping cots, and accountants baked cookies.
It’s a far cry from the devastation Florence unleashed, when the hurricane smashed into the coast near Wilmington, killing more than 50 people and leaving some $24 billion in damage to the state.
Last year, when they stayed at CarolinaEast, at least two hospital workers knew they wouldn’t have anything to go home to.
“She came in as a Category 1, and she sat on top of us. She didn’t move. So many people lost their homes,” McGarvey said. “Florence was absolutely — I’ve been here all my life, and I’ve been through a lot of hurricanes, and while she wasn’t the strongest, she was the worst.”
Even after the storm left, the death toll climbed. Roughly half of those who died because of Hurricane Florence did so because of injuries related to cleanup, said Acree.
But this time around, the main concerns revolve around the hurricane damage that can’t be seen.
“A lot of people think we’ve recovered from Florence, and we haven’t,” McGarvey said. “If you walk through downtown New Bern, it looks good from the outside, but if you look at some of those storefront windows, half the walls are still missing. You go out into the more rural areas, and there’s still a lot of blue tarps on roofs.”
The physical damage is only the most obvious wreckage left by the storm. The state is increasingly concerned for residents’ mental health. Responders stress the importance of the state’s crisis-counseling services.
“The thing everyone is concerned about from a mental health point of view is people who have been hit by three storms in three years. What kind of toll is that taking on people?” Acree said. “To be hit a third time, when you’re still trying to fix your house from a storm two or three years ago, that’s mind numbing and hard to comprehend.”
Three years of storms have also played havoc on the revenue for rural hospitals along the coast. Many of them qualify as critical access hospitals.
The hospital in the Outer Banks sees most of its patients in the summer, when the resort destination fills with tourists. Hurricanes usually land as the season draws to a close, but whenever the storms come, patients don’t.
“Anytime there is a storm and patients are not coming into the hospital, we aren’t generating any revenue,” Outer Banks Hospital Director of Marketing Wendy Kelly said. “We make it up by tightening the belt.”