By Manuel Rueda
Before the childrens´ emergency room at Wycoff Heights Medical Center was renovated, Dr Sol Gourji and his staff had to improvise to treat the growing number of asthma patients here, hauling around oxygen tanks that were kept in a room at the back of the ER.
“If I knew I had a lot of asthmatics that day I would set up a couple of chairs and put oxygen tanks in front of them and use them as what you call asthma stations,” he recalls.
When Wyckoff’s ER room went through a 1.7-million-dollar renovation last summer, eight extra oxygen points that provide relief to asthma patients were installed on a wall in the children’s emergency room. Each of the 11 beds in this ward also has at least one oxygen point next to it, meaning that the small ER can treat more than 20 asthma patients at a time.
Gourji, who says he’s always looking for ways to make his emergency room more efficient, recently trained nurses to deliver asthma medication to incoming patients while they await a doctor’s attention. He also designed an asthma handbook that helps his staff deal with patients more quickly.
Located in Bushwick, where the asthma rate almost doubles the city average, Wyckoff Heights is one of several hospitals in low income neighborhoods, that is adapting its facilities to treat large numbers of asthma patients.
Dr Benjamin Ortiz, a clinical pediatrican and professor at Columbia Unversity´s Mailman School for Public Health, says that emergency rooms across the city are actually adding extra floor space for asthma patients to be treated.
“In at least three hospitals I’ve worked with, my own in Harlem, Mt. Sinai and Elmhurst, the ERs have sectioned off separate areas for kids with asthma,” he explained.
But Ortiz says that adding extra space for asthma patients and providing facilities like oxygen points is not enough to combat the disease, because emergency rooms are only the “last resort” when it comes to treatment for children and adults.
“A lot of good asthma management happens in the community, it happens in the home, it happens in churches, in schools and in community centers,” he says.
Ortiz directs the Harlem Children’s Zone Asthma Initiative, which has a dual strategy of prevention combined with policy advocacy on issues like air quality and housing standards.
Among its activities, social workers visit patients’ homes to identify asthma triggers such as mold, rat infestations or even smoking in the house, and work with families to eliminate these problems.
Dr. Gourji, who speaks Spanish, said he is particularly concerned with the day-to-day practices of some immigrant families who have brought their children suffering from asthma attacks to the Wyckoff Heights emergency room. “I’ve had to pull the parents aside and tell them to stop smoking in the apartment,” he said.
According to public health researchers, prevention efforts like those undertaken by Dr. Goujri and Dr. Ortiz are slowly helping to decrease the incidence of this lung disease in areas long known for high asthma rates.
The latest figures from the New York Statewide Planning and Research Cooperative System show that the number of asthma hospitalizations among children decreased by 14 percent in central Harlem and by more than 18 percent in Bushwick and Bedford-Stuyvesant from 2005 to 2008.
Children from low income neighborhoods, however, are still more likely to suffer from severe asthma attacks, compared to those in well-off neighborhoods the New York State survey indicates, with hospitals in Bushwick, Williamsburg, Bedford-Stuyvesant and Crown Heights registering 8.6 and 7.7 asthma hospitalizations per 1,000 children, while those in more upscale Greenpoint and Bensonhurst registered fewer than two hospitalizations for every 1,000 kids.
This means that ER rooms in low-income neighborhoods have relatively large numbers of asthma patients even as they expand their overall capacity and improve the quality of their service.
Dr. Gourji of Wyckoff hospital still keeps the oxygen tanks he used to haul around before oxygen points were installed in his ER’s walls. Although his 11-bed emergency room has taken up to 40 asthma patients in a 12-hour shift, Gourji says he’s always ready to face any inconveniences.
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