Mitigating Matthew: 5 Lessons to Help Improve Hospital Preparedness in a Hurricane

Lancer A. Scott, MD, and Florence E. Hutchison, MD


South Med J. 2017;110(8):528-530. 

In This Article


Hurricane Matthew (Figure 1) made landfall in the United States on October 8, 2016 near McClellanville, South Carolina, located just north of Charleston. The storm caused nearly $10 to $15 billion in damages along the southeast coastline, representing the 22nd most damaging storm in US history.[1] The uncertainty regarding the storm's path and strength caused great concern for hospital emergency management officials. Many hospitals in Charleston, such as the subject of this Perspective, are situated at the tip of a peninsula in a flood-prone historic district (Figure 2). Although weather-related emergencies are common in Charleston, the prospect of a significant storm surge was alarming.

Figure 1.

Hurricane Matthew approaching the eastern South Carolina coast in October 2016. At the time the photograph was taken, Matthew was a category 3 hurricane. Courtesy of the Goddard MODIS Rapid Response Team, National Aeronautics and Space Administration.

Figure 2.

Flooding outside Ralph H. Johnson VA Medical Center during Hurricane Matthew.

Charleston hospitals have made several modifications to improve hurricane preparedness. Following Hurricane Hugo in 1989, for example, hospitals revamped generator and electrical switch operations to ensure power and water delivery capability in the face of severe flooding. Interhospital communications were improved to enhance collaboration and ensure sharing of evacuation resources during a disaster. Finally, community-based training initiatives were established to help train providers to handle flood emergencies. Yet no amount of planning can fully prepare a hospital for a hurricane. This Perspective presents the experience of one Charleston hospital that was directly in the path of Hurricane Matthew, the Ralph Johnson Veterans Affairs (VA) Medical Center. The hospital is a 149-bed facility located in downtown Charleston, serving >69,000 military veterans. Matthew taught us several lessons.