Most recently, Saundra Maass-Robinson, M.D., offered her expertise to survivors of Hurricane Katrina by helping evacuees at the Lost Mountain Recreational Center northwest of Atlanta.

"In the past, the Red Cross has defined itself as a service agency only, but this time it suspended its limitations and allowed physicians to treat patients and prescribe medications," said Maass-Robinson, a caregiving veteran of last December's Indian Ocean tsunami (see story above)." The Red Cross was overwhelmed. You had to take charge on your own."

Along with two psychiatric nurses, she formed an impromptu mental health team at the shelter and walked between the rows of cots, talking to evacuees and screening patients to see if they needed psychiatric or somatic medications.

The Red Cross provided prescription vouchers, and the local Wal-Mart provided free prescriptions to the evacuees in the shelter, she said. The Walgreen's drugstore chain had a national patient database that allowed volunteer doctors to determine just which "nerve medicine" existing Walgreen's customers had been prescribed at home. No one who needed medications was denied them, she said. Red Cross policy dictated that nurses could not distribute medications, so doctors or patients handled that task themselves.

Just days after Katrina hit, people became more agitated as the reality of their situation set in. "This is just the beginning of a crack in the veneer," Maass-Robinson said. "The gulf will widen, and we'll see more mental health problems in the next couple of months."

Like all the relief workers, she had to cope with her own emotions too." You can't cross boundaries and get sucked into [the evacuees'] misery," she said. "Later, you cry some, but you don't want to do it there, because then you can't help people."