Last September, the world watched as one of the oldest cities in the United States was decimated and nearly drowned by a hurricane of disastrous proportions. Although Hurricane Katrina narrowly missed New Orleans, the storm caused the waters of Lake Pontchartrain to breach the levees that protected the city, turning it into a network of rivers and canals.
Four weeks after Katrina I drove across the 38-kilometre bridge spanning Lake Pontchartrain, its waves less than a metre below our car, hours before Hurricane Rita hit the region. I was due to begin my clinical rotations in New Orleans.
News reports and film couldn’t have prepared me for the destruction Katrina had wrought on the city of New Orleans. Entire section of highway had fallen through, diverting traffic miles out of the way as residents of Louisiana yet again evacuated their homes. We drove past homes that seemed to have vomited their contents into the streets, past abandoned cars on the roadside, past people who were trying to salvage what they could from their homes and properties before yet another force of nature overturned their homes, and their lives.
Six months on, New Orleans is recovering. Businesses are slowly re-opening; residents are returning home. Yet entire parishes are still devoid of inhabitants, where waters have receded but destruction remains. Nowhere is this emptiness more obvious than at Charity Hospital in downtown New Orleans.
Charity Hospital, built in 1736, is the cornerstone of the charity healthcare system that treats the uninsured population of New Orleans. Nearly one quarter of Louisiana residents are without any type of medical insurance and rely on the charity network of hospitals for their healthcare. When the levees broke, the hospital was flooded in nearly two metres of water, trapping both patients and staff inside.
Stories emerged of medical residents and staff taking turns ventilating patients manually with ambu-bags in shifts once the power failed, of bodies piling up in stairwells as the morgue flooded, and of shots being fired by armed citizens as doctors attempted to ferry patients across the street to be airlifted to safety.
Many doctors who once staffed the city’s hospitals have been displaced around the state to other facilities. Others simply left. Dr. Jorge Martinez, of Louisiana State University, estimates at least half the city’s 4,800 physicians have not returned post-Katrina.
Of the nearly twenty hospitals in New Orleans proper, only six are fully functional. Medical services are still being offered out of the “tent hospital” in New Orleans. “We cannot convince people to come back to the city if there is no place to put them and no city-wide health care system,” says Martinez.
Tulane Medical School is temporarily based out of Texas, while Louisiana State University’s Medical School has moved its entire campus to Baton Rouge. Students were displaced and classes disrupted, and while things are slowly returning to normal in Louisiana, students still feel uncertainty regarding the future of their schools.
Renee Chauvin and Jamie Hutchinson, third-year medical students at LSU, were displaced from their clinical rotations at ‘Big” Charity to a smaller state hospital in Houma, a smaller city about 45 miles away from New Orleans, where they grew up. They speak of students who have been moved four hours from home, have had to fend for themselves in finding housing in cities overflowing with hurricane evacuees, and some of whom have left Louisiana altogether, by transferring to other institutions.
Last month, Chauvin didn’t know where her next rotation was, though it began in a week. She had not been able to contact anyone in administration for help. Hutchinson, who is married with children, was told no housing would be provided for his family during one of his rotations and he should “consider dropping out” if he wasn’t able to make the rotation.
Yet, both maintain a positive outlook. “The hurricane may have actually made things turn out better-not only do we have more autonomy (as students), but we are more spread out, and get to experience different things, while getting the same education,” says Hutchinson.
The faculty of medicine at LSU made program adjustments as a result of the storms. Some residency programs are on hiatus. Others have cut their numbers.
As Martinez explains, it comes down to funding and decreased patient load, as all the inhabitants of New Orleans have not yet returned: “There are not enough hospitals, or a patient base at this time to support the previous level of residency positions.”
And how did I fare, in storm-ravaged Louisiana? I have helped treat patients who have watched their homes flood with water as they sat in a boat not ten feet away, and seen patients come in with a leg swollen from ankle to knee, infected from a microbe acquired while wading in flood waters. People always ask me: Where I was during the storms? What I was doing? How did I fare?
Less than six months from now, Louisiana will be in the midst of another record-setting hurricane season. Residents hope that if the city can weather this round of storms, it will be a sign for others to return and rebuild. The fate of Charity far from optimistic, though. Martinez speculates that services offered there will be redistributed to nearby hospitals, and that Charity proper will not re-open. He does, however, hope that that spirit of Charity will live on in New Orleans, as the city rebuilds.
