Medical Needs Swell on Hurricane-Ravaged Gulf Coast

Tens of thousands of people with advanced medical needs have been displaced by Hurricane Katrina, and thousands more are hurt or will sustain injuries and illnesses during the long recovery ahead for the four-state zone hammered by the storm.

Yet over much of the affected Gulf Coast region, hospitals, nursing homes and group homes have been left so damaged or cut off from supplies that they must be abandoned. Some 4,800 patients have been evacuated to other cities, or are still trying to get out of the disaster zone in and around New Orleans, officials said.

Staff and patients at Charity Hospital in New Orleans who were trying to leave Thursday faced sniper fire, according to several reports.

Some critically ill patients have been airlifted hundreds of miles _ as far away as Washington, D.C., and Kansas City, Mo. _ but most have been relocated inland a few hours away.

Normally, disaster plans expect that most hospitals and other health facilities will survive a storm and continue to operate, although perhaps with reduced capacity because of power outages and staff shortages, after the hurricane passes.

In fact, thousands of people who were not patients took shelter in hospitals from Katrina, particularly in New Orleans. But in the days since the storm, generators have run out of gas, supplies have run out, floodwaters have risen and violence has left the health centers more festering prisons than places of refuge. Elsewhere, in places like Gulfport and Biloxi, Miss., some hospitals have sustained too much damage to operate safely, even with generators.

In an unprecedented effort to care for those evacuated and injured as a result of the hurricane, the federal government announced plans to open as many as 40 emergency medical shelters throughout the region, with each facility staffed by about 100 doctors and nurses and having 250 beds. The first shelter, staffed primarily by U.S. Public Health Service officers, has already opened on the campus of Louisiana State University in Baton Rouge.

Several national associations representing hospitals, doctors and other health providers are working with the Department of Health and Human Services to line up volunteer teams to work at the field hospitals.

“There are a tremendous number of technical issues to resolve in setting these up, and we don’t know how long they’ll be needed, but we’re talking about as many as 2 million displaced Americans to care for,” said Jim Bentley, a senior vice president of the American Hospital Association involved in the relief effort.

HHS has also mobilized 39 disaster medical assistance teams from around the country, and the Navy is sending several warships as well as the hospital ship USNS Comfort to provide medical services to the Gulf Coast. The Air Force is also setting up several field hospitals and assisting with medical evacuations from hospitals.

“We’re focused on the immediate health-care needs of people in the region, augmenting state and local efforts,” said HHS Secretary Mike Leavitt. “Patients that are requiring additional treatment beyond what that which will be available in the medical shelters will be transported to hospitals throughout the country.”

Leavitt said there are at least 2,600 hospital beds currently available in states in and around the disaster zone, and another 40,000 beds are available nationwide, if they’re needed.

But the scope of Katrina’s damage and the number of people affected may create demands for help in sheltering people with special needs that go beyond traditional disaster medical care.

Officials in Florida found themselves overwhelmed at times last year by the number of frail evacuees who had no safe place to go other than shelters until their homes were repaired and power was restored. According to the Census Bureau, 15 percent of New Orleans’ residents aged 5 and older have some type of disability, and it appears certain that much of their city won’t have any housing to offer them for months, perhaps years.

“I don’t think there’s any recent precedent for taking care of a large, medically fragile population like that for the length of time they’re likely to have to be in temporary shelter,” said Patrick Libbey, executive director of the National Association of County and City Health Officials. “We may have to rethink what we mean by the terms ‘temporary’ and ‘interim.’ ”

In addition, federal, state and local public health officials have to make plans for everything from spraying for mosquitoes to avert outbreaks of West Nile virus in the region to restoring sanitation and water supplies in damaged areas.

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(Contact Lee Bowman at BowmanL(at)