By Mark Green

Last updated at 18:51, Friday, 27 November 2009

It looks like a war zone – or at least a battleground. For a time – a frightening, bone-chilling day and a night – it was a battle: man against nature as floods swamped Cockermouth.

Dr John Howarth

Heavy metal fencing now seals Main Street off.

Men in hard hats and big boots prowl the houses, shops and stores, fixing up water pumps and clearing away debris.

The street, windowsills and floors of homes and businesses are covered in sludge.

An elderly man pushes a shopping trolley loaded with what ornaments and pictures he could save from his house past a pile of ripped up carpeting outside one doorway and a pile of sodden furniture by another.

Skips squat outside the bigger shops and stores, loaded with a sprawl of decorations and display cabinets, gifts and the shelves they stood on.

Everything was swept away, clothes, food, possessions, basics like gas, electricity and even medical care.

Medical services for about 15,000 people in the town have been washed away.

In the Cottage Hospital up the hill just out of the town centre, a medical team is working flat out to provide vital medicines, health advice and a bit of calm reassurance.

Dr John Howarth is leading the team.

The 40 staff are dealing with a situation that has left two doctors’ practices swamped, medicines lost and details and records on patients swept away since Thursday night.

Instead of having 29 rooms to see patients in, they are reduced to just four.

Filled with dozens of mainly elderly patients, it is hot and steamy, but everyone has a nod and a brave smile for each other and everyone is patient.

Dr Howarth, 50, has worked as a medical director for emergency aid operations in 11 war zones, including the Lebanon, Afghanistan (he helped rebuild Kandahar hospital) and Angola.

In Rwanda he was faced with 20,000 victims of a brutal machete attack.

In Chechnya he headed a medical team that dealt with the horrific aftermath of the bombing of Grozny.

He says he quit working for the emergency charity teams after six years for a “quiet life”.

Some quiet life...

The medics of Cockermouth have been working long hours, fuelled by trays of tea and coffee and biscuits.

“I think I’m on my 66th hour of work in four days,” smiled the father-of-four grimly.

“We worked all night on Friday – 24 hours. Saturday was 8am until 8pm, and Sunday and this week.

“I was up until 2am last night and couldn’t sleep for the amount of coffee I’d drunk.

“I was in here at 6am this morning with everything worked out and a clear idea of what needed doing.”

He has written a book and lectured on emergency medical care in war zones and disaster areas, so he is the perfect man to lead the Cockermouth team.

Of course, this is not on the same scale as those man-made disasters.

But working under hellish conditions abroad prepared him for something he never dreamed he’d face so close to home.

For six years during the 1990 he worked for emergency aid groups Medecins Sans Frontiers and Merlin.

“I have worked in the worst disasters in the world.

“We used to deliberately seek out the worst places.

“In Chechnya, the whole massive city was destroyed.

“In Africa, 20,000 people hacked to bits with machetes turned up one morning.

“This is a disaster in international terms, but there’s a big difference between what happened in those places and what has happened in Cockermouth.

“There are a lot more resources here than in the other places, but many of the principles are the same.”

“The biggest difference is that I’m part of the community. This is my town.”

His control centre for managing his resources is the physio room of the hospital. In the centre are two long tables pushed together covered with copies of the emergency help and health recovery plan.

At one end, three men are hunched over plans to build a new medical centre out of portable buildings.

There’s a flip chart and a couple of square tables are shoved in another corner with two laptop computers set up.

At the other end of the room, a sink, a microwave oven, two kettles and giant jars of coffee and bags of teabags.

Engineers and telecoms workers come and go.

Mobile phones chatter into life regularly, but despite everything, there’s a feeling of ordered calm.

“The key resource you have in any disaster are the people in the community and your team,” said Dr Howarth.

“It can’t be managed from the outside, it has to be local-led.

“We have the best team working here. Between us we have the skills to manage this.

“The main health risks from flooding are diarrhoea because sewage has been mixed with water and you get large groups of people coming together.

“We have had three or four cases so far, but we have confined it.

“Extra people die brought on by the stress levels if they already have respiratory or heart disease or if there is an interruption of their drugs supply.

“Respiratory diseases can be caused from stress and easily passed round.

“But the economic aspects of this are massive.

“The flood has ripped the economic heart out of Cockermouth and that has a direct impact on health.

“If you don’t get the economic recovery, people will become poorer and that has a direct consequence on public health.

“It is very important from the health point of view to support the local economy.”

The psychological impact of the flooding is another major concern.

It is only natural for people to feel depressed at the damage caused to their homes and businesses.

“When you stress a population like this it has an impact on psychological health and then physical health.”

The shock of the flood could leave some people as traumatised as war victims.

Counselling sessions are being arranged to take place.

“It has ripped the heart out of our beautiful town and one colleague said it will never be the same again.

“But they are not victims,” insisted Dr Howarth.

“They have to be helped to get back on their feet, but we want more people involved in their own recovery.

“Looking after your neighbour is important – there have been fantastic examples of that going on already.

“We need it to continue.”

Anyone who needs a doctor in Cockermouth can call the Cottage Hospital on 01900 822226.

First published at 14:06, Friday, 27 November 2009
Published by http://www.cumberlandnews.co.uk