UNC Webcast: Lessons from Katrina on Emergency Preparedness and Response

"Learning from Katrina: Tough Lessons in Preparedness and Emergency Response"

As part of the CDC and UNC School of Public Health's "Public Health Grand Rounds" series of public webcasts, today's program was especially valuable for providing perspective on the public health response to Katrina, as viewed by the public health and hospital officials who were directly involved in coordinating the local and state public health response in Louisiana. This webcast features brief interview segments with six members of the Louisiana Department of Health and Hospitals, as well as representatives from the Louisiana Hospital Association, the Louisiana Public Health Institute, and the New Orleans Health Department.

Overall, this program is especially valuable for stressing the need for forms of local planning and preparedness training that build strong relationships and patterns of behavior among local first responders as a foundation for effective communication and coordination of improvised and creative responses to the unexpected aspects of any disaster.

As posted on the website, the six "Objectives" of today's program were to:

1. Describe three communication problems that challenged the Katrina disaster response.
2. Identify three concerns in evacuating vulnerable populations from a disaster area.
3. Describe two strategies to prevent infectious disease outbreaks.
4. Describe the public health response when hospital systems are overwhelmed. 5. Describe two factors that impacted coordination between federal, state, and local public health partners.
6. Discuss the need to anticipate behavioral reactions to a disaster.

The UNC Public Health Grand Rounds website makes this webcast available for viewing, and for the next week until April 7 also has an on-line Post-Program Discussion Forum available for addressing questions raised by the program.

The next Public Health Grand Rounds Program is scheduled for June 9 and will be a follow-up to today's program, and is titled "After Katrina: Building a Better Public Health System for the Future."

LIFE OUT OF CONTEXT

Writer Walter Mosley recently published a short book that challenges all Americans to quit being satisfied with the limited options offered by our two dominant political parties. Life out of Context offers a "Proposal for the Non-violent Takeover of the House of Representatives" that should be read by every citizen concerned about what is and is not happening to support the Gulf Coast, the evacuees, and the next victims of our current government's strategic policy of neglect.

Mosley concludes with these words:

Economic globalism has pressed many lives out of context. It's about time we push back.

What Will It Take?: Seven Months After, and Still Waiting....

Today's front-page article in the New York Times, "Evacuees' Lives Still Upended Seven Months After Hurricane: Burdens and Frustration Linger," only further emphasizes the many reasons people across this country need to be organizing in new and dramatic ways to demand more adequate government support for evacuees and the community organizations and people of the Gulf Coast who continue to suffer from insufficient resources and support seven months after Katrina.

The President has made clear that he would rather continue to support tax cuts for the wealthy and an indefinitely extended war in Iraq, than adequately support the needs of the citizens of this country. If anything is to change, concerned citizens across this country need to organize in dramatic new ways to demand greater government accountability and response at all levels.

Why haven't there been major protests in front of the White House, and in cities across the nation, to castigate the immorality and unaccountability of a federal government that is willing to continue to invest billions of our tax dollars in a failed strategy in Iraq, while the citizens of this country are not being adequately served? Why aren't Washington politicians getting harried by a perpetual barrage of letters, emails, and phone calls from angry constituents demanding major changes of government policy to provide more robust support for Gulf Coast recovery?

Why could President Bush at his Washington press briefing yesterday get away with laughing and joking with the press, without being called repeatedly and persistently to account for the terrible moral wrongs of an executive policy more dedicated to providing tax cuts to the wealthy than to supporting decent health care and housing for the citizens of the Gulf Coast scattered across this country?

Where are the moral and political outrage required to demand a fundamental change in this administration's policy priorities?

Are the people and press of this country sleepwalking through the history of the present? Would the press rather brown-nose and laugh with this President than risk this President's displeasure by demanding that his administration change its policy priorities to serve the citizens of this country most in need?

If the continuing disastrous failure of response (of government, press, and policy) after Katrina is not enough to rouse the citizens of this nation to call for fundamental changes in this administration's priorities, what else will it take? Another Katrina, or worse?

The change that is needed will not wait until the next Presidential election. This year's congressional elections can be part of a change strategy, but even these elections are still 7 months in the future.

The citizens of the Gulf Coast need and deserve greater support from their/our government NOW, not seven months from now. The pressing question is: What will the citizens of this country do NOW to make sure our fellow citizens get the support they need?

Nothing much will change unless every one of the politicians up for reelection in November is clearly put on notice that he/she will not be reelected unless we begin to see major changes in policy priorities.

While the evacuees and residents of the Gulf Coast continue to suffer, no politician should feel secure about reelection.

So long as the evacuees are insecure, no politician should rest secure in office.

Future National Preparedness at Stake

According to the Associated Press, Senator Lieberman said that "nothing less than the future preparedness of our nation to respond to a terrorist attack or another catastrophic natural disaster is at stake" in what we learn from our failures post-Katrina.

That "Future" will be here within three months when the next hurricane season arrives--

Meanwhile, Congress is still busy writing reports. While The U.S. House of Reps. released its Katrina report A Failure of Initiative on February 15, the Senate committee on Katrina is only now beginning to wrap up its "investigation" into the failed planning and response to the hurricane. What will the Senate report be titled?

Rationale for Community-Based Participatory Process of Disaster Recovery

The Natural Hazards Center at the University of Colorado has produced an excellent resource on Holistic Disaster Recovery for use by all citizens, community-based organizations, and government leaders interested in Building Local Sustainability After a Natural Disaster. This publication gives explicit attention to:

--Engaging Participatory Processes in Disaster Recovery, with emphasis on:
--Using Disaster Recovery to Maintain and Enhance Quality of Life
--Building Economic Vitality into Recovery
--Promoting Social and Intergenerational Equity During Disaster Recovery, and
--Protecting Environmental Quality During Disaster Recovery.

IF WE FORGET or Turn Away...

Michael Eric Dyson concludes his book Come Hell or High Water: Hurricane Katrina and the Color of Disaster with the following warning:

The only way Katrina can be kept from becoming a passing moment of self-reflection along the national path to even more carnage is if we continue to tell the truth about poverty, race, class, environment, government, the media, and our culture. Memory warfare pits us against the forces of cultural, racial, and class amnesia.... If we forget, then poor people of color become little more than fodder for the imperial imagination of a nation that has exploited them and thrown them away. God forbid we count ourselves in that number (p. 212).

Louisiana's Coastal Tribes Appeal for Help

Louisiana's Coastal Tribes have been calling for aid ever since the devastation of six months ago, but have been receiving little help. See the website of Four Directions Solidarity Network--

Oxfam Report: Recovering States? The Gulf Coast Six Months After the Storm

According to a new report by Oxfam America titled Recovering States? The Gulf Coast Six Months After the Storm, state and federal agencies are continuing to neglect poor communities six months after Hurricane Katrina displaced more than 800,000 people from their homes:

"Despite critical reports and investigative hearings of government failures, despite the flurry of commitments to confront poverty in the U.S.--six months after Katrina, little has changed," said Minor Sinclair, director of Oxfam America's Regional Office. "It's unconscionable that the same vulnerable people abandoned in the height of the storm could again be neglected in the recovery. There are still thousands of people who don’t have a place to live and don’t have answers to the most basic questions about their futures in the Gulf Coast."

Rebuilding New Orleans

New Orleans residents are not waiting for help from a delinquent federal government to begin the work of rebuilding. Residents of many neighborhoods are meeting to discuss their needs and plan their next steps in the stuggle to rebuild their lives and homes....

So What Can We Do?

What can the PHAST students of the School of Public Health do now to begin to build sustainable working relationships upon our one-week experience in the Gulf Coast? What can we do to make sure that our brief trip to the Coast becomes the basis for providing sustainable assistance to the people and organizations of the Gulf Coast calling out for assistance from the rest of the country?

In New Orleans we met some of the wonderful people who are trying to save and rebuild this city, in spite of all the challenges they face, and the slow and largely inadequate governmental response on all levels--local, state, and federal. We met and talked with Dr. Mary Abell of the St. Thomas Clinic, Kimberly Richards of the People's Institute for Survival and Beyond, and Adam Becker of the Louisiana Public Health Institute. But we also met with local citizens who shared with us their rich stories of survival and struggle. (I will note some of these stories in future entries).

One clear thing I learned from my time in New Orleans is that since government has been so slow and inadequate in fulfilling its responsibilities to support and assist all citizens in their rebuilding efforts, it has been the work of citizens and community organizations that has made it possible for New Orleanians to nurture the hope that the city can rebuild, and do so in a way that addresses the racial and class inequities that have plagued its past, continue to plague its present, and threaten its future.

You need only compare the rebuilding efforts going on in the white or wealthy areas of the city with the relative lack of attention to the hardest hit black portions of the city (especially the ninth ward) to note the tremendous disparities and inequities evident in the current rebuilding effort. Parts of the lower ninth ward look like they have not been touched since the flood waters burst through the industrial canal in August 2005. Decimated houses still sit astride the same streets into which the flood waters moved them over six months ago.

If the rebuilding of New Orleans is to occur in ways that address class and racial inequities, instead of preserving or aggravating them, there is much citizens of the rest of the country need to do to insure that the people and organizations of New Orleans and the Gulf Coast get the resources they need for a just and equitable rebuilding. As students of the UM School of Public Health, we can participate in this process over the weeks ahead by helping our School and University begin to build the kind of sustainable relationships with the people and organizations of the Gulf Coast that will support equitable rebuilding efforts.

As individuals alone, each of us may be at risk of feeling overwhelmed by what we witnessed, and feel frustrated about how little we can do to address the great needs of the region. But if we work together, we can each contribute something positive to the work of rebuilding by uniting our individual efforts--however small they may seem--to help our School and University develop the kind of sustainable relationships that will support the work of the people and organizations of the Gulf Coast dedicated to a just and sustainable future for all the people of the region. This is, at least, what I hope PHAST and other interested students at the School of Public Health will begin to work toward in the busy short weeks ahead before the end of the term.

A Disaster of Government and Citizenship?

I reacted to what I witnessed on the TV screen after Katrina with a deep sense of betrayal because I recognized that the deaths we were witnessing were not the result of any natural disaster, but a disaster of our own making--a disaster of government stemming from a long-developing failure of policy vision and policymaking--a disaster stemming from a fundamental failure of citizenship by all Americans. For me, the voices of the people abandoned to death or hunger after Katrina screamed of the failures of policy and political vision that had been preparing this disaster for many long years, and that will continue to prepare many disasters to come until we, as citizens, change this country's policy of wilful blindness and neglect toward the poor and uninsured.

I take our current and ongoing failures of government initiative personally because I know we can do better, in this culturally and materially wealthy country, than this. We not only can do better, we must do better--if we want a future for this country that will be worthy of what the citizens of this country have to offer each other and the rest of the world.

As I prepare to head to New Orleans tomorrow, I've begun to read Michael Eric Dyson's new book, Come Hell or High Water: Hurricane Katrina and the Color of Disaster. Dyson begins by discussing the long history of our nation's blindness to the structural politics of race and class, along with the short-sighted practices of policymaking, that long before August 2005 paved the way for the failures of response to Katrina (which continue six months later).

Most valuable in Dyson's opening chapter "Unnatural Disasters" is his move to look beyond the immediate failures of government to the failures of citizenship and civic responsibility that made the response and policy failures not only possible, but inevitable. Dyson underlines the naivete of the majority of white middle-class and wealthy Americans who were surprised to see their government leave behind the most vulnerable poor and black citizens of Louisiana and Mississippi, and he indicts a culture of "blissful ignorance" that keeps so many Americans "deliberately naive about the poor while dodging the responsibility that knowledge of their lives would entail."

And Dyson quickly moves to the heart of the matter when he underlines the blissful escape from responsibility embodied in the framing of what happened to the Gulf Coast six months ago as a "natural disaster." When we frame what has happened to a million of our fellow citizens over the last six months as the result of a natural disaster, we can be angry about what happened without feeling responsible for what happened:

"We are thus able to decry the circumstances of the poor while assuring ourselves that we had nothing to do with their plight. . . . We are fine as long as we place time limits on the origins of the poor's plight--the moments we all spied on television after the storm, but not the numbing years during which we all looked the other way. But we fail to confront our complicity in their long-term suffering. By being outraged, we appear compassionate. This permits us to continue to ignore the true roots of their condition, roots that branch into our worlds and are nourished on our political and religious beliefs" (4).

Dyson then moves immediately to restating a basic fact: "There are 37 million people in poverty in our nation, 1.1 million of whom fell below the poverty line in 2004."

Meanwhile, as we all know, our federal government has dedicated itself for more than four years now to enriching the wealthiest among us with tax cuts, while cutting what little remains of the social safety net of government programs that were created once upon a time when the citizens of this country still understood what it meant to use government as a common instrument for helping all Americans to share with each other the responsibilities and privileges of being citizens.

As I have watched the political game of failure and blame play itself out over the last six months in Washington, my long-developing fears and despair about the future of this country have only been compounded. I fear we now live in a country where the most advantaged individuals, who have gained the most from living and doing business in this country, no longer feel they owe any duty or responsibility to either their fellow citizens, or the social infrastructure (which includes public health), that has made their success and wealth possible. Why else would they accept increasing tax cuts while the least advantaged of their fellow citizens go without health care and fight their wars overseas? And based on the way those with the most power in our society and government have been devoting ever-increasing fractions of the tax dollars some of us pay (along with the lives or our fellow citizens) to fighting wars overseas while ignoring the poverty and suffering that increases among our own fellow citizens, I have lost faith in our current national "leadership" (of both parties).

My only hope (and this is why I am going to New Orleans this week) in the future of this country is that we can learn from each other as citizens to allow Katrina to teach us all to be citizens of a common country. 9/11, for all its trauma, and for all the media-inspired celebrations of patriotism that followed, apparently failed to do this. Otherwise we would not be allowing our government leaders to continue to abandon our fellow citizens as we have been since 9/11. While near 3000 died that day, how many more of our citizens have died since then of poverty and lack of access to proper health care treatment? How many more have died from despair at watching their government leaders talk of promoting democracy in the rest of the world while the most basic of human services are denied them at home?

And by abandoning our fellow citizens, I mean not just those from the Gulf Coast, but those 37 million in poverty (including the 1.1 million new poor in 2004), and the 46 million of our fellow citizens without health insurance, all over this country, who are suffering because of a national policy of wilful neglect and failure. Until we all, as citizens of this country, take responsibility for summoning the collective will to create a government and a policy structure worthy of the people of the United States, I will continue to live in despair of this country's future--for the poverty of other Americans is my poverty. Until we begin as a nation to understand and feel the poverty of others as our own, we will not escape our current national state of spiritual impoverishment. And this spiritual impoverishment is already showing its very material hand.

For no matter how much American citizens like to criticize their government when it does badly, and take it for granted when it serves us well, our government and our policy are what we make of them, for better or worse for all of us. Our government's failures (at local, state, and federal levels) to serve the most vulnerable of our fellow citizens only underline our own failures as citizens to create the kind of government that will not leave our fellow citizens (us) behind in their (our) times of need--

And so I continue to take our ongoing failures of government policy and vision personally. We can do better, in this rich country, than this. We owe it to ourselves and to each other, as citizens, to make sure our government does better in the future. We owe it to ourselves and each other to join together as citizens to demand new political vision and new policy frameworks for addressing the suffering of our fellow citizens. And so I am going to New Orleans to learn from, and contribute to, what the citizens of New Orleans are already doing to rebuild and demand better of this country, and better from all of us.

And lest we make the mistake of thinking that doing better for the citizens of the Gulf Coast would demand that we all become selflessly noble and philanthropic, we need simply to remember that a country filled with increasing numbers of poor and impoverished people, without hope, and living in despair, can not long continue to be a prosperous and successful country on any level. We should demand of ourselves that we do better for the citizens of the Gulf Coast because one day we will depend on the citizens of the Gulf Coast to do their part to help the rest of us in our time of need. This is the meaning of citizenship in common.

The great Mississippi flood of 1927, and the government failures of response after it, preceded the Great Depression by only a few years. But the market, policy, and political failures that brought on the Depression were already firmly in place by 1927. One need only compare the economic policies of Coolidge during the 1920s to those of today to begin to see the much larger failure toward which we may be heading in an era which seems to think there is little reason to pay attention to the lessons the history of the past century of human market failure and war might have to teach us.

A country of people too self-involved to summon the collective will to demand that its government insure the health and well-being of ALL its citizens can hardly serve as a good model of democracy to the rest of the world. Such a country has only a poor future ahead of it. The future we help (or do not help) to build in the Gulf Coast will mirror the future we are building (or not) for the rest of the country. Perhaps the best way we can begin, as a people, to earn back the respect of the rest of the world for this country is to show that we can insure the well-being of our own fellow citizens, beginning with those on the Gulf Coast.