By Debbie Blanchard, MSW, LCSW
In the months since New Orleans was devastated by Hurricane Katrina, I have learned not only what it means to––as the song goes––miss New Orleans, but I also got some pointed instruction about a lot of other stuff that I wish I never had to learn. Then again, maybe they were lessons I needed to learn. But I can think of about a million other ways that I could have gone about it. Katrina was one of the worst things I have ever experienced—and that includes the twelve surgeries I have endured in my lifetime.
My story actually begins on Friday, August 26, 2005. We had received an e-mail that afternoon that we were on high alert because—despite the fact that it looked like Katrina was headed for Florida—forecasters were predicting that the storm would turn toward New Orleans and the mouth of the Mississippi River and, that if this happened, the city would take a direct hit. Most of us, however, paid little attention to the warning since the storm had just passed over the Florida Keys and was headed straight for the panhandle. Nonetheless, by the time I got home from work, Katrina was, indeed, turning and was probably going to head straight for us. I sort of began to pay attention at that point, but I didn't get alarmed. I went on with my rather boring Friday night as usual. But when I woke up on Saturday, the president of Jefferson Parish (parishes are like counties in other parts of the United States) where I live and which is the parish right next to Orleans Parish, was declaring a mandatory evacuation for the lowest lying areas, and a voluntary evacuation for everyone else. I still decided to just wait and watch. In the 15 years that I have lived in New Orleans, I've always stayed and nothing really horrible had ever happened. If this was just another one of those times, I wasn't going anywhere.
The reason that I didn't want to leave is because—for me and all other persons with special health care needs—evacuating is more than just a pain in the *#$%, it's downright difficult—especially if you live alone and are the proud owner of two very spoiled, geriatric cats that don't travel well. So packing up body and soul and shoving Chrissy and Bucky into carriers (I tried convincing them that the carriers were brand new kitty beds, but they didn't fall for it) and, driving 55 miles to my mother's house in a contra flow––where all lanes, on both sides of the Interstate, flow in the same direction––that was going at a snail's pace while Chrissy and Bucky howled the whole way was not my idea of a good time and definitely not the way I wanted to spend my weekend. After all, aren't we supposed to relax on the weekend?
To add insult to injury, I knew that somewhere along the way I was going to have to go to the bathroom. And with rain beating down on the roof of my car. . . need I say more? Consequently, I decided to watch the weather reports on Saturday and if it still looked like Katrina was coming and if it remained anything above a Category 2 hurricane, I'd leave on Sunday.
So I spent Saturday making lists of things that I needed just in case I had to evacuate while keeping a close eye on the weather reports. When it was announced that the contra flow for Interstate 10 out of the city would begin at 4:00 Saturday afternoon and would be in effect for the next 24 hours, I began to think that this might just be THE ONE. But, I still wasn't getting too alarmed. Afterall, New Orleans' Mayor Ray Nagin was only calling for a voluntary evacuation. Maybe this was "much ado about nothing" once again. The fact that the leaders of every other parish in the metropolitan area were calling for a mandatory evacuation should have told me that this was serious. By 8:30 Saturday night, I made my decision to leave on Sunday.
I awoke bright and early Sunday morning to learn that we would surely get the storm, and it would probably be a direct hit. As you know, most of New Orleans is below sea level. So, if Katrina came up the mouth of the river as predicted, New Orleans could expect an 18 foot storm surge. Denial, however, is a wonderful tool and, using my tool, I proceeded to pack five days worth of clothing, as well as anything else I thought I might need for five days and––in a stroke of insight––I grabbed the good jewelry and the important papers just in case, and took off with two screaming cats in tow.
When I awoke Monday morning, August 29, we thought New Orleans had dodged the bullet. It seems the eye of the storm had gone just east of the city. Parts of southeast Louisiana, however––the area around Slidell and the Mississippi Gulf Coast–– had been hit hard. The few photographs I saw reminded me of pictures taken following Camille in 1969. But New Orleans was in fairly good shape, so I figured I'd be able to go back home in a day or two.
I figured wrong. At about 9:30 Monday morning we lost power in Hammond, where I grew up, which is about 50 miles north of New Orleans and about half-way between New Orleans and southwest Mississippi. It turned out that Katrina was a huge storm and Hammond and the surrounding areas had sustained monumental wind damage. When you live in south Louisiana, however, where tropical storms and hurricanes are common occurrences, you have "battery-operated Everything." I dug out my battery- operated television set, but the blasted thing didn't work, so I had to resort to the radio. I learned there had been a breach in the 17th Street Canal levee and parts of New Orleans were beginning to flood. Then the announcement came that the London Avenue Canal levee had breached and, possibly, the Industrial Canal levee, as well. It didn't take a rocket scientist to know that New Orleans was in real trouble and, before long, the city was under six feet of water. St. Bernard, Plaquemines Parish, and parts of Jefferson were under water, and it was getting deeper by the minute.
By late afternoon and early evening, there were reports of neighbors rescuing neighbors in boats and people breaking out of their attics where they had climbed, trying to escape the flood waters. For days, as the flood waters continued to rise from the levee breaches, first responders and others worked around the clock to rescue as many people as possible from the hardest hit areas of the city––all the while waiting for FEMA, but that's another article.
As people were rescued, they were brought to the Louisiana Superdome, which was the shelter of last resort as well as the Special Needs Shelter for New Orleans. Finally, when the dome could hold no more, the overflow was taken to the New Orleans Convention Center. To say that the conditions in either of these buildings were less than adequate is a gross understatement—particularly for people with special health care needs. There was no electricity, no running water, and because the roof of the Dome was damaged early on Monday morning, there were leaks everywhere. Needless to say, it became very difficult to care for people with special needs under those conditions. We are just lucky that nobody died—although we did have some traumatized doctors and nurses who worked around the clock to care for the people who were there. All one of these doctors would say shortly after Katrina was that it was "horrible."
It is estimated that approximately 10,000 people did not evacuate during Katrina. It's easy for us to say what they "woulda, shoulda, coulda" done and, granted, some people are just plain stubborn, but, other people did not have the means to evacuate. New Orleans is made up of people of all socioeconomic levels and 28% of our citizens live at, or below, the poverty line. Many do not own a car; they couldn't just load up the SUV and get out. Of those 28% at the poverty line, there is a fairly large spinal cord injured (SCI) population because gun violence has been a common occurrence.
Most of these are young men from the inner city with no education and no work history prior to getting shot and now surviving on Social Secuirty checks. It became one of my daily rituals to access the New Orleans newspaper on my computer to see how many people I knew from my years at Charity Hospital were pictured, or whose names appeared on the lists of known dead. It was not uncommon to see at least one every day. This added, not only to my grief, but to my survivor guilt. Many of these people did not own an automobile and unless someone came to get them, they had no means of getting out.
As a result, the death toll in New Orleans from Katrina is was 1,000 and counting. Because some areas were completely destroyed and contain structures that were deemed unstable, these areas were being bulldozed. Before they are destroyed, however, search and rescue teams with cadaver dogs continued to find bodies.
What lessons have we learned from the biggest natural disaster in US history? Frankly, I'm not sure. I'm embarrassed to say that the federal, state, and local governments can't stop blaming each other long enough to find out and the mayor seems to be too busy running for re-election. The Army Corps of Engineers can't agree on how to fix the levees so that we can have, at the least, Category III protection. Of course, they didn't admit until very recently that there was, indeed, a design flaw in the original levees and it was this design flaw that caused the breach in the first place.
But I can tell you the lessons that they should have learned. First and foremost is the fact that a shelter located below Interstate 10 is illadvised. Almost all of that area is at, or below, sea level. Spend whatever money it takes to open the shelter of last resort at the Superdome and bus folks out of there. You'll kill two birds with one stone. You'll save lives and you won't have to sell flooded-out buses on E-bay.
Second, make provisions for the population with special health care needs. In many parts of the state, the Office of Public Health coordinated Special Needs Shelters. I'm happy to say that these ran very smoothly in every part of the state except New Orleans. But I can honestly say that this was not the fault of the Office of Public Health. The Special Needs Shelter was in the Superdome where nothing ran smoothly. But when you and 30,000 of your closest friends are in there with no electricity and no running water. . . Need I say more?
Third, have evacuation plans for hospitals and nursing homes and make sure they are properly executed. The hospitals in New Orleans did things according to plans they had filed with the Department of Health and Hospitals. I worked in hospitals long enough to be familiar with those plans. In a situation such as Katrina, those plans were simply inadequate. Once again, there was no electricity and no running water, and because this went on for so long, generator power was giving out. There were many reports of hospital personnel bagging patients for respiration for hours. And regarding reports of euthanasia––I don't know and I don't want to know. I do know, however, that there were lots of heroes in the hospitals of New Orleans. But patients in hospitals below Interstate 10 needed to be evacuated sooner rather than later. Unfortunately, several New Orleans nursing homes did not evacuate patients in accordance with the evacuation plans which they, themselves, had established. Because of this, many vulnerable elderly people and persons with disabilities lost their lives. Fortunately, there are several bills that have been pre-filed for the present legislative session providing for the evacuation of patients in hospitals and nursing homes.
Fourth, there needs to be an established protocol for people for whom the Special Needs Shelters are not appropriate. This includes people who have latex allergies and severe mental illness, among other issues. Many of the area's most vulnerable patients, whose needs cannot be met in the Special Needs Shelters, do go to area hospitals. But if a person has spina bifida and a severe latex allergy, but is otherwise healthy, neither option is appropriate. They don't need hospital care, but they could die from anaphylaxis in a shelter—even a Special Needs Shelter. So unless these people have family or friends outside of the city, they have no choice but to take their chances at home. And, frankly, I don't consider that to be a viable option in a severe storm
There are many other lessons that came out of the Katrina debacle. Parts of New Orleans look exactly as they did months ago. Jefferson Parish is up and running for the most part, as are parts of uptown, downtown, and the French Quarter. No longer do you see sign after sign for workers being offered $1,200 sign-on bonuses for Wendy's and Burger King, although there are still "blue roofs" and piles of debris everywhere. The Corps of Engineers continue to work on shoring up the levees. My only hope is that the next time this happens, we will take the lessons that we have learned the hard way and apply them.
Many of us have been working with several organizations on behalf of people with special health care needs. Loss of durable medical equipment (DME) has been a major issue and getting them replaced, either through either insurance or Medicaid, takes forever. Getting things replaced requires a prescription and if your doctor has evacuated and not come back yet, it makes things all the more difficult. We have also had to figure out ways to get equipment and supplies to people who are now temporarily residing in other states and who have Louisiana Medicaid, but whose doctors are nowhere to be found. This has taken lots of coordination but, thankfully, many organizations have stepped up to the plate and purchased things for people who lost equipment in the storms.
In addition, many, many people need information and referrals for post traumatic stress disorders, depression, and anxiety. Sadly, a large number of these people do not have insurance, either because they never did, or because it evaporated when they lost their jobs due to the storm, nor do they have the funds to pay for needed treatment. As a result, we have had to come up with innovative ways to get their needs met through grants and/or faith-based organizations.
One of the major lessons we have learned was how woefully inadequate our planning was for our special needs shelters. Instead of having a special needs shelter anywhere in New Orleans, plans are being made to have shelters in another part of the state so that people with special health care needs will not need to stay in a facility such as the Superdome until it becomes unbearable and, then, be shipped out to another facility. Happily, more organizations outside the Office of Public Health, are beginning to pay attention to the needs of people with disabilities and special health care requirements during natural disasters.
Prior to Katrina, this was a largely forgotten population. Because of the high death toll, however, people are beginning to pay attention. There has been a three-day conference in Baton Rouge of people involved in emergency preparedness planning that I was supposed to attend, but had to cancel at the last minute. My reason for wanting to go was to ensure that these emergency preparedness folks addressed the special needs of people with disabilities during the next disaster much more effectively than they did this time. Conference coordinators assured me that this was a large part of the conference.
Katrina has affected all of us in many different ways. For me, personally, even though I suffered no material losses, I've had to deal with my feelings about being a person with a disability who had been affected by Katrina. And, being your typical "Type A" personality, that's something I do not like to dwell on.
To begin with, even though my New Orleans apartment was perfectly intact, I couldn't go home because there was no infrastructure—not even a 911 system. One of the three hospitals in the metropolitan area that were up and running was the one that I use, but if I'd had a shunt failure, for example, and could not drive and needed ambulance transfer, I was out of luck. Also, the things that make my life easier by preserving energy, like drive-up windows, weren't available. We were also back to the days when grocery stores and drug stores closed at 6:00 due to lack of staff, or were not open at all. Consequently, many of our basic needs either were not met or were more difficult to get.
I also had to deal with a great deal of guilt over being exempt from working with my colleagues at the special needs shelters. But they had all the work they could say grace over, and they didn't need an extra person that might, herself, need some help. Yet, because they needed some of the skills that I had, I had a really tough time with the emotions that came from my non-participation. Katrina has also left me with a fear that I've never had until this disaster––as I said earlier, I'd never evacuated before. I would just hunker down with my feline buddies in my room with a battery-operated television, radio, clock, the trusty Maglite™, Coleman™ lamp, my laptop, a good book, and my emergency jar of peanut butter. But next time anyone mentions hurricane, I'm heading north. One more storm like this and I'm out of here. I'll commute to work for the next six years or until I can find another job.
Nonetheless, after seven months I have finally been able to return to my apartment. My office building downtown, however, was destroyed. Because so many office buildings were lost, office space that is still intact, or that is in Jefferson Parish, is scarce and rents are through the roof. So, for awhile, with no office in New Orleans, I was lucky enough to be able to work out of the office of one of our contractors in Hammond and continue to live at my mom's house. But I am finally at home where I no longer have to remind someone that I am a fully independent adult who is quite capable of making her own decisions.
Before I close this article, I'd like to take this opportunity to thank each and every one of you who contributed the funds to help the people affected by Hurricanes Katrina and Rita. The outpouring of generosity was overwhelming and I appreciate it more than you know. Many, many people down here lost absolutely everything they owned—and many are still fighting with their insurance companies over who's going to pay for the damage. Plus, FEMA recently provided us with the new flood maps that they promised long ago––people have not been able to re-build because they don't want to spend thousands of dollars on construction, only to learn that they have to raise their houses eight feet off the ground. Consequently, it has been difficult to begin to heal from the trauma and we are seeing increasing numbers of people with depression, anxiety, and post traumatic stress disorder.
Thankfully, many mental health organizations have offered assistance. Also, there are several bills that have been pre-filed in the legislative session regarding mental health services for hurricane victims. The legislature, however, has to approve the bills first, so let's just hope that they show better judgment than they have in the past and appropriate the necessary funds. Let's also hope that we have another 40-year gap between Katrina and the next hurricane like we did between Betsy and Katrina. Unfortunately, since the powers that be have predicted more active hurricane seasions in the future, I'm less than optimistic. But one can hope.