emergency preparedness a theoretical or practical issue ... · emergency preparedness a theoretical...

Emergency preparedness a theoretical or practical issue?

– A Katrina case study. Jeanette H. Magnus MD, PhD

Professor & Head MCH Section, Tulane University School of Public Health and Tropical Medicine

Program Director, Tulane Leadership Education in Maternal and Child Public Health Program

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Timeline—August 28, 0900hrsSunday

Hurricane Katrina upgraded to Category 4 storm with later intensification to Cat 5

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Hurricane Katrina Facts

• First Category 5 Hurricane (sustained winds > 156 mph) of 2005 season

• Made first landfall north of Miami as Category 1 (74 – 95 mph) on 8/25/05

• Made landfall on Louisiana coast on 8/29/05 as Category 4 (131-155 mph) storm

• Third most intense storm to ever make landfall (918 mbar)

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Post Katrina

• No power• No phone service• No cell phone service• Radio AM band connection• Two hours in line at Wal-Mart in 95degrees• Our hosts got the last generator available in

Magnolia, Mississippi• TV brought horror and reality

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The water city

AP photos

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To higher ground

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Rising water

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9,500 were airlifted by the coastguard alone

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Water around

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Where to go?

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Post Katrina 2

• No gasoline• Collect call to friends in unaffected area• Internet connection• Posted message on NOLA.com and other

web sites looking for staff and faculty• Within one week after Katrina everyone

had been located and communication established

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Post Katrina -3

• Tulane Leadership Education in Maternal and Child Public Health Program (MCHB)

• The Tulane MCH Epidemiology Doctoral Training Program (MCHB)

• The Tulane National Center of Excellence in Women’s Health (DHHS)

• The Tulane K-12 BIRCWH (NIH)• All active as virtual programs before

September 15, 2005

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Virtual programs

• 24/7 phone number courtesy OWH, DHHS– Large conference calls– Small meetings

• Contacted some key K-12 programs and got permission to listen in to their Scholar seminars

• Yahoo web site• Yahoo shared folder for each program

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Lessons learned

• Roster with staff’s out of town relative • Roster of staff’s non institution e-mail• Have a “yahoo” web site available to launch

immediately• Have a portable hard drive or CDs with all vital

information related to Department, Center, key programs and research at your home

• Your organization needs to have an out-of-state data backup

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Personal lessons learned

• Have your photos, personal, property and medical information on a CD or portable hard drive

• Have cash• Do not pack 4 pair of shorts!

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AP photo

Emergency Preparedness in New Orleans

= to Community Preparedness?

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Emergency preparedness• City plan for Hurricane Preparedness

– Phase I: Training, Exercises and Education– Phase II: Warning, Evacuation and Sheltering– Phase III: Recovery– Phase IV: Mitigation– http://www.cityofno.com/portal.aspx?portal=46&tabid=26

• Post Katrina response failure due to:– Lack of preparedness in the community– Vastness of damage– Breakdown of communication– Lack of prompt action from local, state and federal leaders

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The day storm hit, Bush was worried about leveesTranscript shows gap in concern, actionWednesday, March 01, 2006 By Bill WalshWashington bureau

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Post Katrina

• Women and children hard hit• “They said it was a hurricane –what is a

hurricane?”• “We are hungry and have nowhere to go”

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Days of rescue

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Babies• Woman’s Hospital in Baton Rouge received 121

newborn and premature evacuees within the first days after the storm

• They expanded their NICU from 60 to 80 babies within 24 hours

• 29 babies from the University Hospital NICU were taken by boat and helicopters before triaged further from Woman’s Hospital

• No plan on what to do with population prior to Katrina

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Children

• Food storage– MRE?– Baby food?

• Breastfeeding initiatives?

• Diapers and sanitary napkins?

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Seniors and disabled

• Death toll during and after Katrina high among seniors and disabled

• Many elderly on medication or oxygen did not evacuate

• Several nursing homes did not have hurricane disaster or evacuation plans

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Senior or disabled

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1,326 dead as of 03.01.06

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Still 7,000 reported missing

Louisiana weekly, 2/27/2006

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Emergency preparedness - 3• The 100 year storm

scenario described in newspapers and reports years before Katrina

• Forecast correct, but not as fast as feared

• Disaster post Katrina was perhaps manmade

AP photo

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Hurricane Katrina Facts• Official death toll: 1,326 - Still 7,000 missing• Damage estimate: Over $212 billion for

rebuilding• Over 1 million people displaced• Federal disaster declarations covered 96,000

miles2

• Five million people without power after the storm• Described as “probably the worst catastrophe, or

set of catastrophes” in the country’s history by Homeland Security Secretary Michael Chertoff

LA weekly, 2/27/2006

We lost the preparedness phase can we win the recovery phase?

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September 15, 2005

“The work that has begun in the Gulf Coast region will be one of the largest reconstruction efforts the world has ever seen,” Bush said…. Rebuilding across the devastated region is expected to cost $200 billion or more in the near term…Congress has already approved $62 billion for the disaster, but that is expected to run out next month.

- Associated Press, 9/16/2005

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January 25, 2006

Donald Powell, President Bush’s choice to oversee the Gulf Coast’s recovery from Hurricanes Katrina and Rita, said grant money already appropriated by Congress would be “sufficient” to take care of homeowners who suffered most in the storm. As much as $6.2 billion of that money is slated for Louisiana.

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Post Katrina damage

• 350,000 households displaced• 96,000 acres of wetlands lost• 10-25% of houses beyond repair

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Post Katrina neighborhoods

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Road to Recovery

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Road to recovery

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Road to Recovery

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Recovery?

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Post Katrina New Orleans

• Great job opportunities• Limited housing• Limited daycare possibilities• Limited school availability• Everything has post Katrina prices• 40% express they do not intend to return

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Post Katrina Civic Activity

• An unprecedented level of engagement by returning citizens

• Neighborhood committees• Town hall meetings• Bring Back New Orleans Commission

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Post Katrina MCHLT Activity• MCHLT Faculty

– Bring Back New Orleans Commission• Urban Planning Committee• Health and Human Service Committeehttp://www.bringneworleansback.org/

– Framework for a Healthier Greater New Orleans• Primary Care Work Group• Specialty Care Work Group• Core Public Health Work Group• Health Promotion and Healthier City Work Goruphttp://www.stayhealthyla.org/framework.php

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Thank you!