Copyright 2006 THE DALLAS MORNING NEWS
Chronic illnesses posed biggest problem, forum participants say
By EMILY RAMSHAW
The Dallas Morning News (Texas)
Medical leaders from across Texas and Louisiana relived their emergency response to Hurricane Katrina on Friday, speaking frankly about the successes and failures that plagued their departments — and the health crises they could never have prepared enough for.
They joined emergency medical experts from the White House, the FBI, the Secret Service and 25 major U.S. cities for a two-day “State of the Science” symposium, an annual conference sponsored by UT Southwestern Medical Center and hosted by its chairman of emergency medicine, Dr. Paul Pepe.
‘Greatest rescue effort’
Katrina, the hot topic at Friday’s event, was unlike any disaster most emergency officials had ever seen. In “traditional disasters” — an explosion or an airplane crash — people are “either killed outright, or are the walking wounded,” Dr. Pepe said. In the aftermath of Katrina, tens of thousands of people needed short- and long-term health care.
It was “the world’s greatest rescue effort,” he said.
The biggest medical challenge during the mass evacuations wasn’t triage or trauma, experts said Friday. It wasn’t providing water or food. It was trying to treat the routine, chronic illnesses of an enormous elderly population — people who had left home or been evacuated without medical records, prescriptions or even an idea of what drugs and dosages they needed.
“There was a woman who called up and said, ‘I need my chemotherapy,’” Dr. Pepe recalled. “When you asked her what kind or what doses, she said, ‘A red one and a white one.’ Starting from scratch like that is just heartbreaking.”
As ominous clouds rolled over New Orleans, Dr. Jullette Saussy, the city’s emergency medical director, kissed her daughters goodbye. Leaving them behind was always tough — her job is filled with unknowns. But that day, a sense of horror filled her gut.
She rode out the storm on the floor of a New Orleans Police Department building, she told officials at Friday’s symposium, watching the driving wind and rain beat against a thick glass window. Hundreds of calls for help came in on the police dispatch system — one woman’s baby had stopped breathing; another person was struggling to breathe and trying to change the regulator on her oxygen tank. The calls came in vain. For officials charged with saving people’s lives, being unable to respond was crushing.
When the levees failed, Dr. Saussy and her colleagues centered their activity on the Superdome, evacuating stranded people in everything from industrial laundry baskets to rolling office chairs. They overtook postal trucks and changed them into makeshift ambulances.
The sight of rescue helicopters racing overhead made her swell with patriotism, Dr. Saussy said — and she wasn’t feeling very confident in her politicians in those days.
“If the government says they’re here to help, check their shoes,” she remarked. “Because if they’re wearing loafers, they’re not there to help.”
Dr. Saussy’s story was the most localized account of the Katrina crisis on Friday. National emergency officials who responded to the crisis in New Orleans painted even more morbid pictures. Of shelters with overflowing toilets and no hand soap. Of doctors at airport hangars-turned-hospitals choosing which sick evacuees were treatable, and which should be black-tagged and left to die.
Some black-tagged people took up to three days to die, with no medical attention or comfort in the interim, said Dr. Michael Olinger, Indianapolis’ medical director.
“There were people languishing, left out in their diapers, stretched out before the media,” Dr. Pepe said. “There was the knowledge that they were probably going to die in front of us.”
National emergency
Katrina was, on its face, a local crisis: An entire American city was underwater. But it quickly became a regional and national medical emergency, as neighboring communities struggled to absorb New Orleans’ population.
In San Antonio shelters, Dr. Donald Gordon said, doctors wrote 25,000 prescriptions worth $100,000 in one day - and tackled everything from respiratory and gastrointestinal illnesses to patients needing dialysis treatments and methadone to curb drug addictions.
In Fort Worth, Dr. John Griswell said, they set up a rape crisis center for people who’d been abused at the Superdome or en route to Texas.
In Houston, Dr. David Persse recalled, evacuees traveling to Texas by bus were so parched and hungry they turned over guns, marijuana and cocaine — their most valuable possessions — for a glass of water and a promise of safety.
Cities are used to preparing for their own natural disasters, said Dr. Persse, who said he remembers thinking, “Wow, that stinks for them,” when he first saw Katrina heading for New Orleans. The biggest emergency management lesson from the 2005 hurricane season is that “you need to make plans for when your neighbors get hit,” he said.