Hurricane Harvey has caused extreme flooding in Houston, Texas – the nation’s fourth largest city – and it is wreaking havoc on healthcare and patients alike.

What is it like for people trying to get healthcare there now? It’s tough all around. Here are some of the conditions Houston and other flood-damaged areas are dealing with.

Physicians have waded miles to get to their clinics and to hospitals.

Patients in need of regular treatments, such as kidney-dialysis, have had trouble getting treatment because roads are not drive-able and ambulances are often unable to reach patients.

Hospitals and clinics have been worried about their patients, physicians and staff.

CHI St. Luke’s Health – The Vintage Hospital had to evacuate patients by boat last week, and other hospital evacuations were expected.

Patients who were discharged from hospitals often had trouble getting home or had nowhere to go because many homes were flooded.

Most outpatient procedures and elective surgeries were canceled, and hospitals had to deal with the issue of replenishing supplies.

2,500 hospital workers at Texas Children’s Hospital stayed at the hospital, sleeping on cots, to be able to provide patient care. Texas Children’s also had to deal with leaks and burst pipes.

The flooding continues to cause issues, and the damage will take a long time to repair, just as it did in New Orleans and other areas affected by Hurricane Katrina in 2005.

Katrina left many citizens without access to health care, and changed the health system dramatically.

One year after Katrina, the New Orleans metropolitan area had fewer than half of the hospital beds it had before the storm, and only about one-quarter of the physicians had returned. In addition, there were significantly fewer nursing homes one year after the storm.

Other effects included patients losing health insurance because of lost jobs and hospitals losing federal funding. The loss of funding affected poorer residents who rely on it for health care, as well as hospital staff members who were laid off.

Things had improved by 2015 – 10 years after the storm – according to research findings.

But it is evident that these things take time. Health systems affected by Harvey may have a long road ahead of them to return to full services for their communities.