From Canada to Jamaica: Field Clinic becomes critical care hub after Hurricane Melissa

The line of patients snakes from our canvas tent into the parking lot of Cornwall Regional Hospital. In that gap, our small Canadian Medical Assistance Teams (CMAT) field clinic has become an unofficial second emergency department.

And amid the catastrophic damage to the hospitals in western Jamaica is CMAT’s team, a small group of eight Canadian volunteers with an impact that belies its size – our team has been treating roughly one-third to half of the emergency room’s patients in its tent for the past month. Each day, the triage nurses at Cornwall Regional send us a steady stream of patients with wounds, infections, asthma and decompensated chronic disease that are overwhelming the hospital right now.

Hurricane Melissa was no ordinary storm. When it struck Jamaica’s southwest on Oct. 28 as a Category 5 hurricane with sustained winds approaching 300 km/h, it flattened homes, health centres and badly damaged power and water systems. Nationally, 279,000 were displaced, 45 killed, and health facilities were damaged or even entirely destroyed, including five major hospitals in the hardest-hit western and southern regions. In St. James Parish, Cornwall Regional – the only “type A” (tertiary care) hospital for western Jamaica – was forced onto emergency-only services as water poured through damaged roofing into clinical areas and wards were closed.

What began for CMAT on Oct. 31 as a search-and-rescue deployment quickly evolved into something much more familiar to Canadian hospital staff: trying to keep an overstretched emergency department functioning after its physical structure failed. In early November, our first team partnered with Burnaby Urban Search and Rescue and the Jamaica Defence Force, providing medical support to rescuers and survivors. Within days it became clear there were few trapped survivors, but rather, an enormous burden of people with everyday health needs and few places to seek care. By mid-November, at the request of the Jamaican Ministry of Health and Wellness, Pan American Health Organization (PAHO) and the Western Regional Health Authority, CMAT redeployed as a field clinic into the parking lot of Cornwall Regional Hospital.

Our assignment was deliberately focused: become an integrated overflow zone for the emergency department rather than a parallel field clinic. Emergency patients, registered through Cornwall Regional’s usual intake, are triaged by local nurses and then, if appropriate, are directed down the ramp into our tents. Inside, we run several treatment bays with basic pharmacy and diagnostic testing, and with a clear pathway to refer anyone who deteriorates back into the main resuscitation area. On a typical day we see dozens of patients, allowing the in-house team to focus on high-acuity emergencies and those needing inpatient care.

CMAT itself is tiny compared with the needs we were stepping into. Our eight-person rotations – emergency and family physicians, nurse practitioners, registered nurses, a paramedic and a logistician – hail from across Canada. Behind them sits a second, invisible team: volunteer duty officers in Canada (I am among them), who provide 24-hour remote coordination, keep supplies moving and help align our work with WHO Emergency Medical Team standards. All of it is funded by individual donors and a small group of institutional supporters.

Clinically, the work would be familiar to any Canadian clinician. Our team has drained abscesses, washed out lacerations, titrated antihypertensives, and managed fractures, often sustained by those clearing debris from damaged homes. They have cared for staff whose own houses were destroyed but who still show up for long shifts, and for evacuees who arrived injured and then found themselves effectively homeless in the corridors until social workers could find them a bed in the community.

For Canadian hospital readers, the point of this story is not that CMAT is special, but that what we are doing in Jamaica is exactly what our own systems may need when – not if – a major climate-fuelled disaster strikes at home. Hurricane Melissa has been a brutal stress test of health-system resilience in the Caribbean and has exposed vulnerabilities Canadians will also recognise: dependence on hospital-based care, limited surge capacity, and underinvestment in community-based services that might otherwise absorb lower-acuity demand. 

As our team winds down each night in the fading light over Montego Bay, they are acutely aware that they will eventually go home, while our Jamaican colleagues will continue the long, slow work of rebuilding. Our hope is twofold: first, that our Jamaican friends will be safe and sound in the road ahead; and second, that Canadians will continue to support organisations like CMAT so that we can keep showing up when called.

Meanwhile, the way forward is perhaps best stated by Dr. Nicole Dawkins-Wright, the Director of Emergency, Disaster Management & Special Services in Jamaica’s Ministry of Health and Wellness.

“We did, in fact, get probably the worst storm that Jamaica has ever experienced in history… But as Jamaicans, we are strong people, and we will rebuild.”