With a population that swells to 250,000 on weekends, when many residents return to make repairs, the city is well short of the nearly 600 hospital beds it needs, said city health director Kevin Stephens.
Engineers hired by Louisiana State University, which manages the hospital, say "Big Charity" and University are not salvageable. With no revenue coming in, all but 250 of the hospital's 4,000 employees have been placed on leave without pay. Headhunters are swarming in, and several of the medical school's top researchers have warned that if they cannot resume work by year's end, they -- and their $7 million in grants -- will go elsewhere.
"We're out of cash," said Don Smithburg, chief executive of LSU's Health Care Services Division, after his fifth lobbying trip to Washington. Smithburg hopes to use hundreds of millions in federal disaster-recovery money to finally erect a hospital that has been on the drawing board for more than a decade. He contends it is an opportunity to provide more efficient, modern care.
Charity's supporters, including many of the doctors who have patrolled the wards for decades, counter that although it is dilapidated, the hospital Roosevelt helped build is needed today more than ever. Abandoning it would mean bidding farewell not just to an institution but to the region's only Level 1 trauma center -- capable of handling multiple life-threatening cases -- and the only major safety-net hospital in a city with high poverty and crime rates.
"From a structural point of view, it's totally sound," said Dave Rivard, a construction engineer and volunteer with the nonprofit relief group Airline Ambassadors. "The key to this whole story is that the decision to demolish this building certainly was not done after an exhaustive study. And it will take three to five years to build a new indigent hospital in New Orleans."
LSU officials are negotiating to lease space from Oschner Clinic Foundation for a temporary trauma center, Smithburg said. But he believes it would be a mistake to rehab "Big Charity."
"It's really not a good use of taxpayer dollars to renovate," he said, estimating that reconstruction would cost $250 million, compared with $350 million "for a more efficient, modern facility." Others, such as Rivard, dispute the cost estimates.
Regardless, much of the money will come from the Federal Emergency Management Agency, which provides funding for repairs to return public buildings to pre-storm condition. FEMA infrastructure chief David Fukutomi said federal rules also allow that money to be applied toward the cost of a new building. "This is a fantastic opportunity to implement a vision for the future," he said.
For decades, Charity and New York's Bellevue Hospital Center -- both opened in 1736 -- have squabbled over which is the longest-running public medical institution in the nation. What is indisputable is that through 270 years, a citywide fire, hurricanes, the Civil War, smallpox, yellow fever and AIDS, Charity has always been open to New Orleans' neediest patients. The prospect of that rich history coming to an end, in a city already reeling, is almost eerie to some here.
"The disaster is not over in New Orleans," said Oschner chief executive Warner Thomas. "The silent disaster will be when we get into wintertime with not enough personnel and not enough health care beds."
