September 6, 2005
On Friday, September 2, a Doctors Without Borders/Médecins Sans Frontières (MSF) team made up of two physicians, a nurse, and two logisticians headed to the Gulf Coast region of the United States to directly assess the unmet emergency medical needs following the disaster. Dr. Darin Portnoy, MSF-USA president, was part of the assessment team that traveled to Louisiana. He describes what the team saw and why, for the time being, MSF has decided not to begin relief operations in the region.
Why did MSF decide to do an assessment of the Hurricane Katrina-affected region?
MSF works primarily in the developing world providing assistance to people affected by war and disease, as well as natural disasters. Other than a modest psychosocial support program for first-responders after 9/11, we've never worked in the United States and therefore have limited logistical capacity and expertise here. Given the resources and response capacity in the United States, we initially did not anticipate that there would be a need for the limited role we could play in responding to unmet emergency medical needs. Nevertheless, after watching the horrible impact of Hurricane Katrina and the relief response unfold, we decided to carry out an assessment mission in the state of Louisiana, and particularly in New Orleans.
We had been in touch with many official and personal contacts as well as several former MSF volunteers who were already volunteering in the relief effort in the region, and based on these conversations, we thought we ought to go there and do our own independent assessment of the situation. We were aware of the large mobilization to offer shelter to the people directly affected and the ongoing massive evacuation, but we were particularly concerned about people still stranded in New Orleans and who may require emergency assistance.
What kind of a team did MSF assemble?
We quickly put together a team of five — two physicians, one nurse, and two logisticians — all of whom have considerable expertise in emergency relief work. Team members had worked in the aftermath of Tropical Storm Mitch, floods in Mexico and Venezuela, as well as the earthquakes in Turkey. In addition, two of us had ties to Louisiana. One of our logisticians is a native of New Orleans, whose brother and parents were evacuated from the city. And I had spent eight years in New Orleans completing my medical training. In addition to personnel, we also brought along water, food and basic medical supplies in case they were needed.
Where did you travel first and what were your impressions?
When we first arrived, we went straight to Baton Rouge where much of the disaster relief for the entire state is being coordinated. We met with Red Cross and other officials and visited one of the largest shelters in Baton Rouge. We assessed the medical services and talked to the health care workers in this shelter and several others around the city.
You don't see the evidence of the storm damage in Baton Rouge, but we were really struck by the sheer number of individuals who had been displaced â€“ we heard that the population of Baton Rouge had doubled.
And then there was this amazing response mechanism of volunteer and local assistance that had been mobilized. We were impressed by their efforts to assist those in need. We were also glad to see that well-established national and local relief organizations were also providing assistance. There were huge numbers of people responding. We could also see this as we came into the city passing many convoys of goods, relief workers, and military coming into the area.
Relief workers in Baton Rouge told us that there may be unmet medical needs in the eastern part of the state, so we headed up to visit the hospitals and shelters in those areas.
We really got a sense of the scale of the damage that the hurricane and flooding had wrought when we began our drive towards that part of the state. It was already late in the day on Saturday when we arrived, but we could still see the horrific damage that the region had suffered. There was wind damage, power lines down, homes damaged, and people displaced and living in shelters. We took a big loop along the Mississippi border and along the eastern edge of Louisiana arriving back in Baton Rouge very early on Sunday morning.
We spoke to many people and visited many shelters and a hospital along the way. We found that resources had been mobilized and people were responding to the needs. The vast majority of evacuees had already been redirected to larger centers and shelters in the main cities of Louisiana and neighboring states and many residents in unaffected areas were taking people into their homes. There were still great difficulties â€“ electricity and water were still lacking â€“ but medical and other volunteer staff were doing a good job. We could see that people were really coming together to help provide medical care, food, and water to those affected. They certainly needed some things, but under the circumstances, the local response was impressive.
What did you find when you went into New Orleans?
In New Orleans we managed to cover a huge swath of the city — at least those parts that were not under water — in order to get a sense of what the distinct needs could be that MSF might be able to help with. We were especially interested in seeing if there were people left behind in the city who might be especially isolated and in need of assistance.
The first impression we had of the city was the absolutely complete, extreme, and extensive devastation. We saw incredible wind damage, tress uprooted, and tree limbs and utility lines down everywhere. But they had already done a good job of making many of the roads passable for emergency vehicles to travel on, so we were able to get around fairly easily.
We went through areas of the city that I knew very well and there was hardly anything that was untouched. But the city was almost empty as it seemed that most people had now left or been evacuated from the city. We did meet and speak with people who had weathered the storm and talked to them about their experience, what the past days were like for them, what their plans were, and what urgent needs they had.
From everything we saw and from what everyone we spoke to said, the situation in New Orleans had improved considerably from Friday to Saturday, September 2 to September 3, with improvements in availability of food and water, search and rescue efforts, evacuation, and security.
Who did you meet with while you were in New Orleans?
We were able to travel in many areas around the city and spoke with remaining residents and displaced people, as well as police and relief personnel.
For example, we spoke to a 65 year-old gentleman, a long-time resident of New Orleans, who had been working in the Convention Center. He was ready to leave the city as well and we took him with us to Baton Rouge at the end of the day. He told us of the worsening and desperate conditions in the center. He spoke of considerable delays in getting food, water, and medical care to the people there and as well delays in their evacuation. The Convention Center had finally been completely evacuated by the time we got there.
We spoke to a 76 year-old woman with multiple, chronic medical problems who was concerned about how to get medication refills and further care which was a problem voiced by others remaining as well.
We had brought in water and some food and medical supplies in case they were needed, but by Sunday, most people we met had some supply of food and water and there was a capacity to evacuate people in urgent need of medical care, so there was not a great need for our help.
Will MSF provide assistance in the Gulf Coast?
At this point, it does not look like MSF has a role to play in providing assistance to the victims of Hurricane Katrina. Everyone on our team was and remains deeply affected by what we saw and what we heard from those who had endured such suffering. But, as we've seen in other natural disasters, the initial acute emergency phase — when MSF medical teams might really be able to help — is almost always over in the first few days, perhaps weeks, following a disaster. We weren't on the spot in New Orleans when the disaster happened, but from what we saw and heard during our time in the region, we really felt that by Friday and Saturday, the established local and national efforts were beginning to meet the immediate medical and humanitarian needs of the victims of this tragedy, particularly in the shelters and reception areas for the hundreds of thousands of evacuees from the worst-affected areas. We have concerns for those remaining in New Orleans, but there are few people left following the large-scale evacuation that has been carried out and there is capacity to respond to their needs. The displaced and those who have been evacuated will also continue to require assistance, but the number of volunteers and organizations arriving to help them is impressive. There are now significant resources being devoted to helping people and the situation is improving.
MSF will continue to be in touch with colleagues, especially the former MSF volunteers who are donating their time very effectively through local or national relief organizations working directly on the relief effort, as well as aid agencies and officials in the region to monitor the situation.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)