Katrina medical help held up by red tape
Doctors waiting to treat victims in tax-funded, state-of-the-art unit
Sunday, September 4, 2005; Posted: 5:36 p.m. EDT (21:36 GMT)
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.
Military Expresses Frustration Over Red Tape
BY DAVID WOOD
c.2005 Newhouse News Service
More Stories by David Wood
CAMP SHELBY, Miss. -- Only a tiny fraction of the active duty U.S. military is engaged in rescue and relief efforts in the aftermath of Hurricane Katrina, a situation that frustrated senior military officers are attributing in part to complex relationships with the Federal Emergency Management Agency.
"We are in support of FEMA; we are not running our own operation," said Maj. Gen. Dan Colglazier, deputy commanding general of the First U.S. Army, which coordinates all military involvement in hurricane rescue and relief.
"That's one of the hazards" of a complex situation involving dozens of local, state and federal agencies, Colglazier said.
But a difficult command structure inside the military seemed equally cumbersome as officers wrestled Friday with having to coordinate any movement of forces with dozens of supervising commands and agencies.
At the Pentagon's sweltering forward command post here, a television running on intermittent power showed scenes of utter devastation in New Orleans, with bloated corpses, burning buildings and throngs of desperate refugees.
Military action officers -- who have at their fingertips thousands of heavy-lift cargo planes, medical evacuation helicopters, warships, quick-reaction battalions of infantry and military police, as well as fleets of trucks and armored personnel carriers -- watched the chaos while monitoring computer screens and answering the occasional phone call.
Lt. Gen. Russel L. Honore, commander of First U.S. Army, flew into New Orleans Friday to kick the military effort into higher gear, and thousands of National Guard troops began delivering food, water and ice to refugees stranded in the city.
But officers said no military assets can be touched without an official request from FEMA.
That request -- say, water delivered for a thousand people a day, or a dozen emergency generators and fuel at the New Orleans airport -- must come through a defense coordinating officer in Baton Rouge, La., or Jackson, Miss.
Then it is forwarded to the operations center here, which ensures the military can meet it.
Next, it is forwarded to Peterson Air Force Base in Colorado Springs, Colo., where officials of Northern Command -- which oversees all active-duty military operations inside the United States -- match it with specific units.
The package finally goes to the Pentagon to await the signature of Defense Secretary Donald Rumsfeld. Only then can the unit be deployed, whether a squadron of helicopters or a dozen dump trucks.
So far, according to officers here, the military has managed through this system to deploy 68 Army, Navy and Marine Corps helicopters and four ships including the USS Bataan, an amphibious carrier; the aircraft carrier Truman; the Iwo Jima, a second amphibious ship; and the USS Comfort, a hospital ship.
Getting soldiers to the disaster zone was slow.
As of Friday morning, according to officers here, only 12,000 Guardsmen from all contributing states were on station in Lousiana and Mississippi. That's less than half the 30,000 National Guard troops available for deployment from the immediate region -- Louisiana, Mississippi, Alabama and Florida -- according to officials at the National Guard Bureau in Arlington, Va.
"There is a tremendous amount of frustration here, that we have assets stacked up ready to go and we don't have the requests for them," said an officer who asked not to be identified. "All we can do is nudge the folks at FEMA and say, `How about if we do this or that?"'
FEMA spokeswoman Natalie Rule defended her agency's coordination efforts with the Pentagon.
"The military has been joined at the hip (with FEMA) since this storm was approaching Florida," Rule said. "We were working all together on the national coordination response in Washington as well as at the regional level 24 hours a day, seven days a week."
Rule said FEMA responds to disaster relief requests from states that involve use of the military.
"We work with the state and look to the state as to what they need," she said. "If (a state request) has something to do with military assets, we would tap into those."
The maddening delays in delivering help also stem from the extraordinary, complex nature of the disaster itself. The major focus in New Orleans has swung from simple storm relief to desperate flood relief to security to emergency delivery of food and water as the week stretched on.
"This is tough because there are so many people who want to help, and sometimes you just have to hold them off until you see how they can be used," said Air National Guard Maj. Gen. Hank Morrow, the air liaison officer with Northern Command.
Also frustrating was the shortage of information. Nowhere, for instance, did officers have access to the kind of overhead pictures routinely provided by Predator drone aircraft in Iraq, for example.
Air Force Col. William Duckett, an air liaison officer here, said there had been discussion of asking for Predators from their chief base at Nevada's Creech Air Force Base, but no decision had been made.
Moreover, "you have got to know a problem exists before you can solve it. We rely on local people for that," Colglazier said. The staggeringly desperate situation at the New Orleans convention center, appearing all day Thursday on cable news television screens, "wasn't anybody's priority until this morning," Colglazier said Friday.
Once they are thrown into a difficult situation, however, military personnel often find ways to cut through bureaucratic tangles to get things done.
This week, for example, air officers aboard the USS Truman waived the normal requirements that Army helicopter pilots train and qualify to land on an aircraft carrier.
"There was no time for that," Duckett said. Given the desperate need to bring refugees out to the ships and return with food, water and ice, "They just said, `Come on and land,' and they're going like madmen out there."
Sept. 3, 2005
(David Wood can be contacted at [email]firstname.lastname@example.org[/email])
Cut the red tape, Lott says
Criticizes FEMA for holding up 20,000 trailers 'sitting in Atlanta'
Monday, September 5, 2005; Posted: 9:12 p.m. EDT (01:12 GMT)
POPLARVILLE, Mississippi (CNN) -- Sen. Trent Lott berated both the Federal Emergency Management Agency and his own state's emergency management, MEMA, for being mired in red tape at a time of urgent need given the devastation left by Hurricane Katrina.
Lott said he has been trying to get FEMA to send 20,000 trailers "sitting in Atlanta" to the Mississippi coast, and he urged President Bush during a meeting Monday to intervene. He said FEMA has refused to ship the trailers until contracts are secured.
"FEMA and MEMA need to be saying, 'Yes' to Mississippi's needs, not, 'No.," the former majority leader said in a written statement.
"Mississippians are homeless, hungry and hurting."
Similar stories of governmental red tape have been reported elsewhere, including a case of 100 surgeons and paramedics hindered from caring for hurricane victims in rural Mississippi. (Full story)
"This is an emergency situation without peer, like nothing our generation has ever encountered," Lott said. "If suffering people along the Gulf Coast, from Mobile to New Orleans, are going to recover as soon as possible, we'll need an unprecedented public and private effort that can't be hampered by a process geared toward much lesser disasters."
His own home, in Pascagoula, was among the thousands destroyed in the storm. (Full storm)
Bush visited Poplarville, Mississippi during a tour of the region Monday. He told a group of community workers assisting in relief efforts that the region will be rebuilt.
"I understand the damage, I understand the devastation, I understand the destruction, I understand how long it's going to take. And we're with you," Bush said. (Full story on his Gulf Coast visit)
Lott said he appreciated Bush's visit, but stressed to the president the need to cut through the bureaucracy.
Earlier in the day, former President Bill Clinton told CNN the government "failed" the people in the coastal communities in the immediate aftermath of the hurricane. He called for a federal investigation into the handling of the disaster in the weeks ahead. (Watch interview -- 2:32)
In a reprise of their fund-raising efforts during the Asian tsunami, Clinton and former President George H. W. Bush have launched the Bush-Clinton Katrina Fund to raise money for the people Katrina left homeless. (Full story)
Although officials have not put a price tag for the damage in Mississippi, it's expected to be in the billions.
``It's not any one person's fault, but the system failed,'' she said.
Hospitals around the country were standing by with empty beds, staff, triage centers and air transportation to fetch patients, she said. But they couldn't launch the rescue flights without requests for help, and those requests never came.
``These victims could have been here a week ago, and now they're spending a lot of time and money making triage centers? In situations like this every minute counts, not every day counts. Why not get them to these open beds?'' she said.
Frank Russo of the Chicago Ambulance Alliance said his organization was ready to send help immediately. But the request didn't come until Thursday, three days after the hurricane struck.