Saturday, September 03, 2005

COM:New Orleans, Biloxi, Gulfport et al. R.I.P.

Katrina medical help held up by red tape
Doctors waiting to treat victims in tax-funded, state-of-the-art unit

BATON ROUGE, Louisiana (AP) -- Volunteer physicians are pouring in to care for the sick, but red tape is keeping hundreds of others from caring for Hurricane Katrina survivors while health problems rise.

Among the doctors stymied from helping out are 100 surgeons and paramedics in a state-of-the-art mobile hospital, developed with millions of tax dollars for just such emergencies, marooned in rural Mississippi.

"The bell was rung, the e-mails were sent off. ...We all got off work and deployed," said one of the frustrated surgeons, Dr. Preston "Chip" Rich of the University of North Carolina at Chapel Hill.

"We have tried so hard to do the right thing. It took us 30 hours to get here," he said. That government officials can't straighten out the mess and get them assigned to a relief effort now that they're just a few miles away "is just mind-boggling," he said.

While the doctors wait, the first signs of disease began to emerge Saturday: A Mississippi shelter was closed after 20 residents got sick with dysentery, probably from drinking contaminated water.

Many other storm survivors were being treated in the Houston Astrodome and other shelters for an assortment of problems, including chronic health conditions left untreated because people had lost or used up their medicine.

The North Carolina mobile hospital stranded in Mississippi was developed through the Office of Homeland Security after the September 11, 2001, terrorist attacks. With capacity for 113 beds, it is designed to handle disasters and mass casualties.

Equipment includes ultrasound, digital radiology, satellite Internet, and a full pharmacy, enabling doctors to do most types of surgery in the field, including open-chest and abdominal operations.

It travels in a convoy that includes two 53-foot trailers, which as of Sunday afternoon was parked on a gravel lot 70 miles north of New Orleans because Louisiana officials for several days would not let them deploy to the flooded city, Rich said.

Yet plans to use the facility and its 100 health professionals were hatched days before Hurricane Katrina devastated the Gulf Coast, doctors in the caravan said.

As they talked with Mississippi officials about prospects of helping out there, other doctors complained that their offers of help also were turned away.

A primary care physician from Ohio called and e-mailed the U.S. Department of Health and Human Services after seeing a notice on the American Medical Association's Web site about volunteer doctors being needed.

An e-mail reply told him to watch CNN that night, where U.S. Health and Human Services Secretary Michael Leavitt was to announce a Web address for doctors to enter their names in a database.

"How crazy is that?" he complained in an e-mail to his daughter.

Dr. Jeffrey Guy, a trauma surgeon at Vanderbilt University who has been in contact with the mobile hospital doctors, told The Associated Press in a telephone interview, "There are entire hospitals that are contacting me, saying, 'We need to take on patients," ' but they can't get through the bureaucracy.

"The crime of this story is, you've got millions of dollars in assets and it's not deployed," he said. "We mount a better response in a Third World country."

Leavitt, U.S. Surgeon General Richard Carmona, and Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, were in Louisiana on Sunday. Gerberding planned to go to Texas, where many evacuees are now housed.

Many other doctors have been able to volunteer, and were arriving in large numbers Sunday in Baton Rouge. Several said they worked it out through Louisiana state officials.

Dr. Bethany Gardiner, a 36-year-old pediatrician who just moved to Santa Barbara, California, from Florida, had been visiting parents in Florida when the hurricane hit.

"I left my kids and just started searching places on the Web" to volunteer, eventually getting an invitation to come to Baton Rouge, she said.


Law Officers, Overwhelmed, Are Quitting the Force
By JOSEPH B. TREASTER. The New York Times, September 4, 2005


NEW ORLEANS, Sept. 3 - Reeling from the chaos of this overwhelmed city, at least 200 New Orleans police officers have walked away from their jobs and two have committed suicide, police officials said Saturday.

Some officers officially told their superiors they were leaving, police officials said. Others worked for a while and then stopped showing up. Still others, for reasons not always clear, never made it in after the storm.

The absences come during a period of extraordinary stress for the New Orleans Police Department. For nearly a week, many of its 1,500 members have had to work around the clock, trying to cope with flooding, an overwhelming crush of refugees, looters and occasional snipers.

P. Edwin Compass III, the superintendent of police, said most of his officers were staying at their posts. But in an unusual note of sympathy for a top police official, he said it was understandable that many were frustrated. He said morale was "not very good" after nearly a week of deprivation and danger.

"If I put you out on the street and made you get into gun battles all day with no place to urinate and no place to defecate, I don't think you would be too happy either," Mr. Compass said in an interview. "Our vehicles can't get any gas. The water in the street is contaminated. My officers are walking around in wet shoes."

Fire department officials said they did not know of any firefighters who had quit. But they, too, were more sympathetic than critical of emergency workers breaking down under the pressure.

W. J. Riley, the assistant superintendent of police, said there were about 1,200 officers on duty on Saturday. He said the department was not sure how many officers had decided to abandon their posts and how many simply could not get to work.

Mr. Riley said some of the officers who left the force "couldn't handle the pressure" and are "certainly not the people we need in this department."

He said, "The others are not here because they lost a spouse, or their family or their home was destroyed or they don't know where their spouse is."

Police officials did not identify the officers who took their lives, one on Saturday and the other the day before. But they said one had been a patrol officer, who a senior officer said "was absolutely outstanding." The other was an aide to Mr. Compass. The superintendent said his aide had lost his home in the hurricane and had been unable to find his family.

Because of the hurricane and the flooding, many police officers and firefighters have been isolated and unable to report for duty. Others evacuated their families and have been unable to get back to New Orleans.

Still, some officers simply appear to have given up.

A Baton Rouge police officer said he had a friend on the New Orleans force who told him he threw his badge out a car window in disgust just after fleeing the city into neighboring Jefferson Parish as the hurricane approached. The Baton Rouge officer would not give his name, citing a department policy banning comments to the news media.

The officer said he had also heard of an incident in which two men in a New Orleans police cruiser were stopped in Baton Rouge on suspicion of driving a stolen squad car. The men were, in fact, New Orleans officers who had ditched their uniforms and were trying to reach a town in north Louisiana, the officer said.

"They were doing everything to get out of New Orleans," he said. "They didn't have the resources to do the job, or a plan, so they left."

The result is an even heavier burden on those who are patrolling the street, rescuing flood victims and trying to fight fires with no running water, no electricity, no reliable telephones and only a small fraction of their patrol cars and fire trucks still operating.

Police and fire officials have been begging federal authorities for assistance and criticizing a lack of federal response for several days.

"We need help," said Charles Parent, the superintendent of the fire department.

Mr. Parent again appealed in an interview on Saturday for replacement fire trucks and radio equipment from federal authorities. And Mr. Compass again appealed for more federal help.

"When I have officers committing suicide, I think we've reached a point when I don't know what more it's going to take to get the attention of those in control of the response," Mr. Compass said.

"

The National Guard has come under criticism for not moving more quickly into New Orleans to help stem the upheaval. But Lt. Gen. H. Steven Blum, the head of the National Guard Bureau, told reporters on Saturday that the guard had not moved in sooner because it had not anticipated the collapse of civilian law enforcement.

"The real issue, particularly in New Orleans, is that no one anticipated the disintegration or the erosion of the civilian police force in New Orleans," General Blum said.

Some patrol officers said morale had been low on the force even before the hurricane. One patrolman said the complaints included understaffing and a lack of equipment.

"We have to use our own shotguns," said the patrolman, who did not want to be identified by name. "This isn't theirs, this is my personal gun."

Another patrol officer said that many of the officers who had quit were younger, inexperienced officers who were overwhelmed by the task.

But the stress is clearly getting to most of the officers on the force, especially those who patrol the streets and have found little or no support services, no place to billet and limited radio communications

At dusk on Friday, officers at one precinct in the French Quarter cordoned off the block where their precinct sat and, armed with shotguns, stopped and inspected every car that passed.

"We're not writing tickets anymore," said one officer who pointed a shotgun into a car carrying two newspaper reporters. The journalists were allowed to proceed, but were warned not to pass the checkpoint again.

Both the police and fire departments are being forced to triage the calls they get for help.

The firefighters are simply not responding to some fires. In some cases, they cannot get through the flooding. But in others, they simply decide not to send trucks because they are needed for more serious fires.

Moreover, without running water and having to rely on water they bring along in 500-gallon tanks, the firefighters cannot hope to put out fires. Instead, they often spray water on adjacent buildings in an effort to keep the fire from spreading.

"We can't fight every fire the way we did in the past and try to put it out," Mr. Parent, the fire department superintendent, told a group of firefighters on Saturday morning at a promotion ceremony in the Algiers section of New Orleans, a dry area. "We've got to use our resources the best we can."

Even facing much more work than could possibly be handled, he said, it was important for him to take time out for two promotion ceremonies.

"The men need reinforcement," said Mr. Parent, who put on his last clean uniform shirt on Saturday morning for the ceremonies elevating 22 officers to the rank of captain. "They need to see their leader and understand that the department is still here and not going to pot."

Susan Saulny contributed reporting from Baton Rouge for this article, La., and John DeSantis from New Orleans.



What Happens to a Race Deferred
By JASON DePARLE, WASHINGTON, The New York Times, September 4, 2005

THE white people got out. Most of them, anyway. If television and newspaper images can be deemed a statistical sample, it was mostly black people who were left behind. Poor black people, growing more hungry, sick and frightened by the hour as faraway officials counseled patience and warned that rescues take time.

What a shocked world saw exposed in New Orleans last week wasn't just a broken levee. It was a cleavage of race and class, at once familiar and startlingly new, laid bare in a setting where they suddenly amounted to matters of life and death. Hydrology joined sociology throughout the story line, from the settling of the flood-prone city, where well-to-do white people lived on the high ground, to its frantic abandonment.

The pictures of the suffering vied with reports of marauding, of gunshots fired at rescue vehicles and armed bands taking over the streets. The city of quaint eccentricity - of King Cakes, Mardi Gras beads and nice neighbors named Tookie - had taken a Conradian turn.

In the middle of the delayed rescue, the New Orleans mayor, C.Ray Nagin, a local boy made good from a poor, black ward, burst into tears of frustration as he denounced slow moving federal officials and called for martial law.

Even people who had spent a lifetime studying race and class found themselves slack-jawed.

"This is a pretty graphic illustration of who gets left behind in this society - in a literal way," said Christopher Jencks, a sociologist glued to the televised images from his office at Harvard. Surprised to have found himself surprised, Mr. Jencks took to thinking out loud. "Maybe it's just an in-the-face version of something I already knew," he said. "All the people who don't get out, or don't have the resources, or don't believe the warning are African-American."

"It's not that it's at odds with the way I see American society," Mr. Jencks said. "But it's at odds with the way I want to see American society."

Last week it was how others saw American society, too, in images beamed across the globe. Were it not for the distinctive outlines of the Superdome, the pictures of hovering rescue helicopters might have carried a Somalian dateline. The Sri Lankan ambassador offered to help raise foreign aid.

Anyone who knew New Orleans knew that danger lurked behind the festive front. Let the good times roll, the tourists on Bourbon Street were told. Yet in every season, someone who rolled a few blocks in the wrong direction wound up in the city morgue.

Unusually poor ( 27.4 percent below the poverty line in 2000), disproportionately black (over two-thirds), the Big Easy is also disproportionately murderous - with a rate that was for years among the country's highest.

Once one of the most mixed societies, in recent decades, the city has become unusually segregated, and the white middle class is all but gone, moved north across Lake Pontchartrain or west to Jefferson Parish - home of David Duke, the one-time Klansman who ran for governor in 1991 and won more than half of the state's white vote.

Shortly after I arrived in town two decades ago as a fledgling reporter, I was dispatched to cover a cheerleading tryout, and I asked a grinning, half-drunk accountant where he was from, city or suburb. "White people don't live in New Orleans," he answered with a where-have-you-been disdain.

For those who loved it, its glories as well as its flaws, last week brought only heartbreak. So much of New Orleans, from its music and its food to its architecture, had shown a rainbow society at its best, even as everyone knew it was more complicated than that.

"New Orleans, first of all, is both in reality and in rhetoric an extraordinarily successful multicultural society," said Philip Carter, a developer and retired journalist whose roots in the city extend back more at least four generations. "But is also a multicultural society riven by race and class, and all this has been exposed by these stormy days. The people of our community are pitted against each other across the barricades of race and class that six months from now may be last remaining levees in New Orleans."

No one was immune, of course. With 80 percent of the city under water, tragedy swallowed the privilege and poor, and traveled spread across racial lines.

But the divides in the city were evident in things as simple as access to a car. The 35 percent of black households that didn't have one, compared with just 15 percent among whites.

"The evacuation plan was really based on people driving out," said Craig E. Colten, a geologist at Louisiana State University and an expert on the city's vulnerable topography. "They didn't have buses. They didn't have trains."

As if to punctuate the divide, the water especially devastated the Ninth Ward, among city's poorest and lowest lying.

"Out West, there is a saying that water flows to money," Mr. Colten said. "But in New Orleans, water flows away from money. Those with resources who control where the drainage goes have always chosen to live on the high ground. So the people in the low areas were hardest hit."

Outrage grew as the week wore on, among black politicians who saw the tragedy as a reflection of a broader neglect of American cities, and in the blogosphere.

"The real reason no one is helping is because of the color of these people!" wrote "myfan88" on the Flickr blog. "This is Hotel Rwanda all over again."

"Is this what the pioneers of the civil rights movement fought to achieve, a society where many black people are as trapped and isolated by their poverty as they were by legal segregation laws?" wrote Mark Naison, director of the urban studies program at Fordham, on another blog.

One question that could not be answered last week was whether, put to a similar test, other cities would fracture along the same lines.

AT one level, everything about New Orleans appears sui generis, not least its location below sea level. Many New Orleanians don't just accept the jokes about living in a Banana Republic. They spread them.

But in a quieter catastrophe, the 1995 heat wave that killed hundreds of Chicagoans, blacks in comparable age groups as whites died at higher rates - in part because they tended to live in greater social isolation, in depopulated parts of town. As in New Orleans, space intertwined with race.

And the violence? Similarly shocking scenes had erupted in Los Angeles in 1992, after the acquittal of white police officers charged with beating a black man, Rodney King. Newark, Detroit, Washington -all burned in the race riots of the 1960's. It was for residents of any major city, watching the mayhem, to feel certain their community would be immune.

With months still to go just to pump out the water that covers the city, no one can be sure how the social fault lines will rearrange. But with white flight a defining element of New Orleans in the recent past, there was already the fear in the air this week that the breached levee would leave a separated society further apart.

``Maybe we can build the levees back," said Mr. Carter. ``But that sense of extreme division by class and race is going to long survive the physical reconstruction of New Orleans."