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    Saturday, September 03, 2005

    Hurricane Katrina: There's a lot of angry blame casting going on in the wake of the hurricane. It's a little cruel and heartless to criticize people in the midst of a disaster of the proportion of Hurrican Katrina, but I've been reading the newspaper coverage, and my husband has NPR on in the kitchen, and think I've been infected by the blame bug. Reading the news reports of hospitals and nursing homes that seemed to have been caught off-guard by the hurricane leaves me wondering whether they had any contingency plans in place for an emergency evacuation. Anyone who has ever worked in a hospital or doctor's office knows that OSHA requires emergency preparedness plans. If a facility was in a hurricane zone and below sea level at that, you would think they would be required to have plans for flood and hurricane evacuation, wouldn't you? Turns out they were. From the City of New Orleans policy for emergency preparedness:

    Nursing Facilities Hurricane Plan

    Evacuation Host Facility: This designates arrangements with a host facility outside the risk area where nursing facility clients and staff will shelter during a hurricane evacuation. This facility must be outside the risk area, and signed agreements must be current.

    Patient Transport Company: The transportation method that will be used to transport patients and staff to the out-of-town facility in case of evacuation. Signed and current contracts are necessary to fulfill these criteria.

    Supply Transport Company: The supply transport is the method by which the supplies will be taken to the out-of-town host facility. A signed and current contract is required or an addendum saying that patient and supply transportation is the same.

    Supply Listing: A complete list of the a) Supplies being transported to host site; b) Supplies to be delivered to host site; c) Supplies host facility will provide.

    Vendor Agreements: Vendor agreements are necessary to ensure delivery of emergency supplies, food provisions, nursing equipment and laundry needs to host site. These agreements must be current and must include all supplies that might be needed.

    Emergency Generator Testing: The number of hours the facility's generator can operate.
    Accurate Emergency Telephone Numbers: A complete and accurate list of emergency phone numbers which includes the City of New Orleans Office of Emergency Preparedness number and fax number.

    Did anyone ever enforce these requirements, or did they just exist on paper?

    The city also had a detailed plan for emergency sheltering of those living at home with special medical needs who were unable to get out of the city in time. That's the kind of shelter the Superdome became, but again, the city doesn't seem to have followed their plans. Note point #7 under getting the facility ready:

    7. Port-o-lets must be on site in the event of rest room failures or disruption.

    So, what happened to the port-o-lets?

    The bathrooms, clogged and overflowing since Monday, announced the second level of hell, the walkway ringing the entrance level. In the men's, the urinal troughs were overflowing. In the women's, the bowls were to the brim. A slime of excrement and urine made the walkway slick. 'You don't even go there anymore,' said Dee Ford, 37, who was pushed in a wading pool from her flooded house to the shelter. 'You just go somewhere in a corner where you can. In the dark, you are going to step in poo anyway.

    Maybe they had them, but no one used them. Or maybe they underplanned. But the presence of port-o-lets would have eliminated scenes like that described above. Granted, no one could come and clean them or haul them away in the middle of a flood for clean-up, but their contents could certainly be emptied into the raw sewage of flood water, couldn't they?

    This is a natural disaster of incredibly heart-breaking scope. No response is going to be perfect or without problems given the level of destruction. Sometimes, events overtake us. But there is such a disparity between actual events and the hurricane evacuation plan, one has to wonder if anyone in the city's government actually read the thing.

    UPDATE: Looks like the New Orleans authorities should be asking themselves some hard questions.

    UPDATE II: And Mickey Kaus has a synopsis of pre-hurricane New Orleans authority criticism from Brendan Loy's blog. Most damaging:

    I can't emphasize enough what a bad decision I think it is for New Orleans Mayor Ray Nagin to delay the mandatory evacuation order until tomorrow morning.

    and a bit later that day:

    Okay, so let me get this straight: the governor calls the mayor during dinner, and basically says "HEY, IDIOT, CALL THE F***IN' HURRICANE CENTER!" It took a phone call from the governor to convince him to make this call?!? Well anyway, the mayor calls the NHC, and they basically tell him, "GET EVERYONE OUT OF YOUR CITY NOW!!!" So now, finally, the mayor is apparently planning to order first mandatory evacuation in city history tomorrow morning. About damn time.

    UPDATE III: And Brendan Loy also explains why the nursing homes didn't evacuate - not enough notice:

    Fellow blogger Matt Drachenberg of Overtaken by Events is deeply worried about his mother-in-law, who is trapped in a nursing home just west of New Orleans. He writes:

    I just had a very frank conversation with the administrator of Jefferson Healthcare, (where my mother-in-law is trapped). They were forced to make a decision yesterday as far as evacuation. Mr. Ray was honest enough to tell me that, had he had all of the information, he would have made a different decision, but as it stands, my wife's mother will be riding out Katrina in a one-story bulding, with a broken pelvis, requiring a serious regimen of prescription medication.

    I really wanted to get angry about this conversation. However, once I realized that, should my wife lose her mother, Mr. Ray would also be dead, I found it impossible to be upset. I thanked him for his service and his commitment and said that he'd be in our prayers. There are people in that facility that make less in a year than a lot of people make in a week of Blogads, but they're staying with the patients to which they've made a commitment.

    Read that again -- they made their decision yesterday, and would have decided differently if they had better information -- and explain to me again how the mayor of New Orleans didn't completely f**k this up. Does anyone doubt that, if he had ordered a mandatory evacuation yesterday morning, the nursing home would have made a different decision, and Matt's mother-in-law would be safe now?

    You know, there's more to being a mayor than eating at fancy restaurants and getting special parking privileges.

    posted by Sydney on 9/03/2005 04:49:00 PM 0 comments


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