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Christopher Fleming
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Two Years After Katrina, Are We Ready To Do Better When The Next Disaster Hits? No, Says One Gulf-Area Health Care Safety-Net Provider

BETHESDA, MD -- The nation has squandered the opportunity to learn important disaster-planning lessons from Hurricane Katrina and its aftermath, says Joe Dawsey, executive director of the Coastal Family Health Center, in a conversation published today -- the second anniversary of Katrina -- on the Health Affairs Web site. Katrina virtually destroyed Coastal’s network of nine community health clinics in the Biloxi, Mississippi, area. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.5.w644

“If Katrina happened tomorrow, I honestly don’t believe we’d be better off,” Dawsey tells Tom Bearden, a correspondent with the NewsHour with Jim Lehrer who has reported extensively on post-Katrina recovery efforts. Dawsey and Bearden are joined in their conversation by David Campbell, executive director of Hands On Disaster Response, who coordinated a team of volunteer planners, architects, and other professionals aiding Coastal’s recovery effort; and Kris Cyr, executive director of Ceiling and Visibility Unlimited (CAVU), who assisted in bringing external funding and support to Coastal.

Dawsey, Campbell, and Cyr describe a post-Katrina recovery process that was problematic on both the public and private sides of the equation. For example, on the public side, Dawsey says that early-stage recovery efforts “were all very chaotic.” The Federal Emergency Management Agency “had a good response plan. They just didn’t follow through with it. . . . They had Disaster Response Teams come in, and we’d spend hours making detailed plans, and then that team would rotate out and a whole new group would show up. And we’d have to start from the beginning with the new group.”

Problems persisted as the recovery process continued. To obtain needed funds from the federal and state governments, Coastal had to rely on pressure from Cyr and Brad Prewitt, an attorney who had worked on the staff of Sen. Thad Cochran (R-MS). “I’m elated that it worked, but it’s absolutely inappropriate that that’s what was required,” Campbell states.

According to Dawsey, Campbell, and Cyr, innovative planning also fell victim to political requirements on how money should be distributed. For instance, Dawsey relates that Mississippi asked Congress for $2 million for disaster communications; Congress eventually appropriated about $4 million but spread it among the primary care associations in six states. “The bottom line is, we haven’t received any of it,” he notes ruefully. Cyr adds: “The emergency communications plan that was originally put forward really was very smart” and “could have been a national model, but it was twisted and turned and picked apart until it was completely ineffective . . . . By the time the carcass gets to Coastal -- the people who need to implement this -- there’s nothing left.”

On the private side, “most of the people who donate want to tell you where to put their donation,” Dawsey says. “They want something specific, something they put their name on. Nobody wants to give you money for general operations.” Campbell adds: “It’s amazing that the donors frankly don’t listen a little more. So it’s nice when someone says, here’s a mobile clinic, but maybe at that point in time, what you really needed was some money so somebody could start sketching out what all the projects are that you need to start.”

Despite the problems that have plagued the Katrina recovery, Dawsey says that he has seen no evidence of efforts by the federal government to apply lessons from Katrina toward more effective planning for the next disaster. Asked by Bearden “who needs to fix this,”  Dawsey answers: “I think the health care piece would have to be [the federal Department of Health and Human Services] and [the National Association of Community Health Centers]  working with local organizations to provide some national coordination. I don’t think FEMA can fix it unless it changes, unless it can have a separate health care branch -- which I think would be unnecessary.”

Cyr warns that, in fact, the nation may already be facing its next crisis in “the mental health status of people in all of the hurricane-affected areas.” He cautions that problems such as post-traumatic stress disorder can take eighteen months or more after a disaster to fully manifest. “We’re talking about a disaster after a disaster, and frankly a lot of the mental health money that came in originally has been pulled back out even before it was fully spent.”

ABOUT HEALTH AFFAIRS:

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.

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©2007 Project HOPE–The People-to-People Health Foundation, Inc.