Katrina exposes crisis in public health

WASHINGTON (PAI) — Hurricane Katrina shows the U.S. public health care system, which is supposed to handle millions of people in event of a calamity, is in great danger, Dr. Georges Benjamin, executive director of the American Public Health Association and a former Maryland secretary of public health said.

Benjamin issued this dire warning at a health care symposium sponsored by the AFL-CIO Department for Professional Employees on Nov. 9. He challenged unions, and indeed the entire country, to do something about it.

Katrina’s devastation wrecked Louisiana’s public hospital system, leveled at least one New Orleans hospital, and left tens of thousands of residents of Mississippi, Louisiana and Alabama without basic health care services.

“There was a failure beforehand” to plan for catastrophes, Benjamin said. “There was a failure of implementation” of those plans that had been created. And “there was a failure in environmental planning,” which resulted Katrina’s floods releasing poisonous chemicals from many toxic waste sites in the New Orleans area.

You have a real fundamental failure in public health, and this is just the tip of the iceberg in the U.S.,” he warned.

The other panelists — Fire Fighters Occupational Safety and Health Director Patrick Morrison, AFSCME industrial hygienist Denise Bland-Bowles, AFGE communications specialist Adele Stan and AFT/UFT industrial hygienist Ellie Engler — discussed the specific hazards they found in New Orleans after Katrina.

Morrison cited the dangers of water-borne disease to first responders. School district bus drivers had to come back after the flood waters receded, said Bland-Bowles, but “they’re not trained to deal with sludge, slurry and mold.”

Benjamin noted health problems in the wake of Katrina: Were people even safe? Were those still in the city [New Orleans] getting health services? Could people move back into their homes, given all the toxins?” he asked.

Many of the same problems described could recur in other disasters, including hurricanes and terror attacks, the panelists said.

Morrison said that even now, four years after 9/11 — where his union lost 343 New York City Fire Fighters plus their priest when the World Trade Center towers collapsed — telecommunications systems between first responders crashed in Katrina. That failure must be fixed, he warned. The National Incident Response System created after 9/11 “looked great on paper, but it wasn’t there” when Katrina hit, Morrison said.

A second facet of the communications breakdown was failure to get the word to the most-vulnerable groups, particularly the poor, and to help them to move away from danger. “I don’t know where FEMA was. They’re still trying to get organized,” Morrison said.

The public health system - its hospitals and clinics, which were damaged or destroyed by Katrina - is practically the entire health system for the poor in areas such as New Orleans’ Lower Ninth Ward. But public policy in terms of aiding that system and equipping it to treat massive numbers of people in a disaster does not recognize that fact, Benjamin noted. In the Katrina-hit area, Bland-Bowles said, the public health system needs to be completely reconstructed. That would hold true for other disasters, too, panelists added.

When a major city is evacuated and smashed, as New Orleans was, it needs basic public health workers — sanitarians, restaurant inspectors, environmental health specialists — to help ensure it is habitable again. But its own employees are scattered all over the country, the panelists noted. That leaves inspection often in the hands of private industry, which may be unable or unsuited for the job.

The key decision is whether to restore mold-devastated buildings, or tear them down as completely uninhabitable and build again from scratch. The mold devastation affects not just plaster walls but basic structural supports of buildings, Bland-Bowles said, but many area insurers are resisting findings that buildings must be condemned.

The panelists said that, given federal budget cuts and the Bush administration’s attitudes towards the poor, unions may be left with the task of stepping in and ensuring public health care in future disasters. They also have to stand up and defend public services, which people rely on when disaster hits. We need to be brave enough to fight for those services, despite the catcalls,” Stan concluded.