Relief Team Finally Puts Talents to Work : Kobe: L.A.-area medical volunteers get permission and supplies to run clinics.

Officials managing the medical relief effort here have finally decided to let doctors be doctors, giving physicians and nurses from outside the region the tools and opportunity for the first time since the earthquake to practice medicine as they see fit.

Signs of increased assistance are everywhere:

* At a vast downtown exhibition hall, forklifts moved about, filled with palettes full of prescription drugs.

* Physicians from as far away as Hokkaido and Fukuoka prefectures took command of suddenly well-organized neighborhood clinics.

* And in a breakthrough after half a week of frustration, Kobe officials allowed several members of a team of U.S. trauma specialists to spend Wednesday and Thursday running their own clinics to treat some of the 310,000 people left homeless by the massive Jan. 17 temblor.

“Patients don’t care about the hometown of the doctor who treats them,” said Dr. Masanori Okazaki, 33, a neurology resident in Hiroshima. He noted that Kobe officials declined his own hospital’s offer of help for nearly a week.

“I really apologize to the foreign doctors for the rude way they were treated until now--though in some ways we weren’t treated any better.”

Okazaki and two dozen colleagues bunked on the same Japanese coast guard ship housing the 18 Southland doctors, nurses and paramedic in Kobe harbor.

The pairing resulted in late-night bouts of shop talk and toasts that brought an unexpected international esprit de corps to the relief mission just when the Americans were feeling shut out.

But the U.S. doctors got a real shot in the arm early Wednesday when local officials let them into a Price Club-size storehouse containing $30 million in prescription and over-the-counter medication donated to the relief effort by Japanese companies, universities and prefectural governments.

Officials gave the Americans carte blanche to haul away all they desired for their daily rounds, barely checking the inventory as it went out the door.

It was an anesthesiologist’s dream.

“This is my stuff--I love it!” said Johnny Harrison, a UCLA Medical Center anesthesiologist, happily walking up and down the aisles piled with codeine, antibiotics, suture kits and morphine derivatives.

“We’re like kids in a candy store,” said Chitra Rao, a Northridge Hospital Medical Center nurse, who marked the Japanese-language boxes with English names and instructions under the guidance of an interpreter.

“I’ll take a few of these, and these, and those, and a dozen of those and, oh geez, what’s that, the Japanese version of Valium? We’ll need a lot of that too,” said Carol Turek, an anesthesiologist at Northridge Hospital, handing stacks of boxes to another physician who packed them tightly into a backpack big enough for a 10-day trek in the Himalayas.

The doctors had gained a solid understanding of refugees’ medical needs during two days spent backing up Japanese physicians at tent cities and refugee centers.

The difference now was that the Americans--organized into squads of one doctor and two nurses--could fly solo at some of them.

A corner of Kitano Elementary School, for instance, became Kathy’s Clinic. Kathy Alfe, a labor and delivery nurse at Northridge Hospital, set up a three-chair operation there on a day that the Japanese Red Cross had broken its promise to see patients there.

She dispensed a lot of sedatives, cough syrup and a hypertension drug to people who had lost their homes--and medicine cabinets--in the earthquake.

All day long patients lined up to tell their stories, receive blood-pressure checks, have dressings changed and feel a reassuring hand extended from across the ocean.

“This is meatball medicine--we need to calm people down to give them time to adjust,” said Turek, explaining why the Valium-like drug Cercine was widely distributed. “Almost everyone is very stressed-out.

“They’re not sleeping well because of the noise and the cold, they’re constipated because they’re not at home, and they’re catching the flu because they’re constantly breathing each other’s air.”

Harrison said she has seen the danger of an ugly influenza epidemic grow each day. On Monday, she saw no flu victims. On Tuesday, elderly patients had productive coughs.

On Wednesday, young people had the same symptoms, and by Thursday, sore throats--possibly strep--were rampant.

“A lot of people are going to die of the flu here,” said Barbara Pohlman, an independent physician based in Laguna Niguel.

As the Americans’ education in earthquake epidemiology grew, so did their understanding of Japan’s medical culture and the social organization of Kobe.

Each city ward has at least one school whose blanket-carpeted hallways and classrooms are now home to whole quake-flattened neighborhoods. Many wards also have slapdash, bitterly cold tent cities that house people who either fear flu outbreaks at the schools or feel excluded because they are Korean, Vietnamese or South Asian immigrants.

The hardy, earnest American medical teams have walked up to 15 miles against an icy wind each day to make painstaking rounds at these sites, largely eschewing taxis because hundreds of street closures had caused a maddening gridlock.

By the end of the week, however, so many Japanese doctors had arrived in drug-stuffed vans to assist in Kobe that the Americans’ efforts were often in vain.

On Thursday, for instance, a team from Harbor-UCLA Medical Center that included Los Angeles County trauma care expert Dr. Stanley Klein and the hospital’s trauma coordinator, Debra Gilmore, walked for hours in fire-devastated Nagata-ku neighborhoods and found only three or four patients to treat.

Still, they felt they’d done some good if they could sort through the hundreds of people who just needed Tylenol to find those who reluctantly confessed that they were truly hurting.

Through interpreters, they pressed refugees hard for honest answers. “A hypertension patient who lost her meds in her bombed-out home could easily become a stroke victim if she forgets or is too depressed to ask for more drugs,” said Harbor-UCLA surgeon Dr. Michael Hurwitz.

With the medical situation stabilized and the screech of ambulance sirens replaced by the buzz of bulldozers clearing rubble, the American relief team planned to return home Saturday. But most felt that they had made a small, important difference in the lives of at least a few victims.

“You know that you’re not doing anything terribly unique, but in the small-scale human drama of day-to-day life, we let these people know that Americans cared about them,” said Harrison.

* RELATED STORIES: A8, A22