Hurricane Katrina: Public Health

Dr. Georges Benjamin , executive director of the American Public Health Association, was online Friday, Sept. 2 at 11:30 a.m. ET to discuss public health concerns in the aftermath of Hurricane Katrina.

The transcript follows.

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Baltimore, Md.: Could you discuss some of the mental health implications of this disaster? I'm thinking mostly about people who were on meds prior to the disaster who have not been able to continue taking them.

Dr. Georges Benjamin: The mental health of the people and rescue workers in the affected regions are on concern and must be addressed. While initially, people may appear able to handle the stress. They will over time require additional support.

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Philadelphia, Pa.: Is there any talk about immunization against certain diseases or illnesses? What procedure would you take if an outbreak were to occur?There is no definite way to quarantine or box in people....isn't this correct!? Thank you

Dr. Georges Benjamin: There is always concern about tetanus. So workers should ensure they have a tetanus shot. Also people who get injured will also need a tetanus shot if they have not had one within 10 years.

Should an outbreak of disease occur. Public health officials will need to investigate promptly to determine the cause. If a vaccine preventable disease, then vaccinations will need to be done as appropriate.

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Washington, D.C.: State and local public health departments have been putting together emergency preparedness plans for more than 3 years. DHS and DHHS have put tens of millions of dollars in updating communication systems alone. How could these plans and communication systems have failed so utterly?

Dr. Georges Benjamin: This is an emergency response vastly above and beyond the systems put in place for bioterrorism. This demonstrates the need for integrated planning at all levels. The public health response will be needed now as the issues of clean water and safe food become more pressing.

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Germantown, Md.: It seems to me -not understating the devastation/other problems] that the biggest problem down on the Gulf Coast, and in New Orleans specifically, are public health problems. I can think of five or six diseases right off the bat that are going to be a problem there, without even thinking about it much. Add to that the toxic waste and other poisons floating around, is it even a good idea to repopulate New Orleans?

Dr. Georges Benjamin: I think we should plan to rebuild New Orleans and support the people there. We should do what ever is necessary as a Nation to do so.

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Miami, Fla.: Dr. Benjamin,

How could public health students, like myself, get involved to assist in this disaster?

Dr. Georges Benjamin: Contact the Red Cross or other official aid agencies in your community. Monetary contributions are usually the first need from you and me. Followed by direct involvement when possible. Needs to be done through people/organizations that do this professionally for safety and security reasons.

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Bethesda, Md.: Dr. Benjamin, thanks for sitting down to talk with us. I realize this is an extremely difficult time for Americans and also for the APHA, with your annual conference having been scheduled to be in New Orleans.

As a recent MPH graduate, I have been watching the situation in New Orleans with unease because of the continuously degenerating health conditions in the city. Is there a large concern that epidemics of waterborne diseases and possibly even malaria will arise in the city if preventive measures are not put into place?

Dr. Georges Benjamin: I have been pushing the concept of prevention in every discussion I have had on this problem. It is good to hear you state the need for this as well.

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Silver Spring, Md.: Thank you for taking our questions. I remember in past with earthquake catastrophes in California, there was not as much concern over disease spread (typhoid and cholera). Does the fact that there is so much standing water on the ground in NO make this a different case? If so, how does the water obtain these germs and then spread them?

Dr. Georges Benjamin: The biggest problem is people drinking water which is contaminated or food which is spoiled. Numerous opportunities for this to happen since it is hot and with the loss of power. Often food that looks good isn't and water that looks safe has high bacteria counts. This is one of their biggest challenges

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Arlington, Va.: Isn't an epidemic of dysentery imminent in New Orleans ? Will typhoid appear ?

Dr. Georges Benjamin: We should talk about risks versus guessing what will happen. Ensuring the provisions of basic hygiene, will go a long way to preventing infectious outbreaks/ handwashing, clean water and safe food.

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Washington, D.C.: I have been hearing that money is needed first and foremost instead of basic supplies, to those affected by Katrina. If we are willing to help, should we send money-where and to whom? Or should we send supplies?

Dr. Georges Benjamin: You should check the list at fema.gov for a list of aid organizations. Always watch out for scam artists.

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Harrisburg, Pa.: The CDC and State Health Departments are developing a list of public health volunteers. The Miami public health student should contact his/her state health department if s/he's interested in volunteering.

Dr. Georges Benjamin: This is a good point. The state health departments have been asked by CDC to identify people who want to help. Also the American Hospital Association, American Medical Association and many professional societies are looking for ways to help as well. If you are a member of an organization please check to see what they may be doing.

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Bronx, N.Y.: How do you think the costs of treating the survivors of the storm will be covered? Especially when such a public health threat exists and most of the victims in New Orleans and Mississippi are poor?

Dr. Georges Benjamin: Always a good question. But, I believe we should save lives, treat the needy and worry about who pays in due course. Sure, we must be fiscally responsible as a part of this. I understand Congress is moving a fiscal package through as we speak.

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Burke, Va.: Hello, I am reading about all the chemicals, bacteria, and bodies in the water. Once the water is drained, much of this will seep into the ground. What are the long term health issues concerning rebuilding on heavily contaminated ground?

Dr. Georges Benjamin: Sure, stuff will leach/leak into the ground. This will need to addressed as a part of the environmental clean up.

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Washington, D.C.: Dr. Benjamin,

To say the least, the state of Louisiana has failed this once great city. I realize that you speak on the public health core component, but in what way has the state/federal government taken steps to deal with the public mental health concerns. Issues of traumatization, re-traumatization and mental health consumers that have not taken medications etc.?

Dr. Georges Benjamin: I am aware that the Department of Health & Human Services is addressing this.

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Gaithersburg, Md.: Can you comment on how the crumbling public health infrastructure may have contributed to the disaster, or could be compounding the effect of this disaster? It has long been recognized that public health is under-funded. Thanks.

Dr. Georges Benjamin: Public health is underfunded and has been so for decades. This problem was caused by a hurricane. Public health is part of the solution. Important to note, their infrastructure was taken out as part of this event as well.

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Cary, N.C.: Do you think that this is a time for Public Health professionals to team up with emergency management/response teams to assist with educating the public about the need for evacuation? Also planning to assist people who have barriers to accomplishing this (such as having no money, transportation, place to go)? Prevention before the disaster?

Dr. Georges Benjamin: Yes, they are engaged in the process. They need to be arm and arm with the other response professionals.

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Greenbelt, Md.: It sounds like drinking water is of short supply and needed. What are all the bottled water companies doing to address this need?

Dr. Georges Benjamin: Don't know but what a great idea.

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Washington, D.C.: Do you have any information about what is happening in New Orleans's hospitals? I can hardly fathom how the ill and dying are dealing with the lack of electricity and water. Were any of the hospitals evacuated before the storm?

Dr. Georges Benjamin: I see and hear the same news stories you do. Looks like the hospital folks are heroic in their efforts.

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Washington, D.C.: Do you believe that public health communication has improved since 9/11 (post anthrax scares, post-bio-terrorism program activities, etc) between federal, state and local public health agencies?

Dr. Georges Benjamin: Yes. This is more than public health communication. Also, I understand communication as it is in most disasters was a challenge.

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New York City, N.Y.: Hello Dr. Benjamin -

I am at Columbia University's Mailman School of Public Health, and I am just heartbroken about the situation in the Gulf Coast. I'm curious as to how long it would take to eradicate the diseases in those areas. In other words, when will it be TRULY safe for people to return for long periods of time without fear of disease or death?

Thank you for your hard work and leadership during this time.

Dr. Georges Benjamin: The best approach to this is to practice sound public health principles. If disease strikes, we will have to aggressively address it as well.

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Washington, D.C.: Can you verify the following information for physicians and nurses?

"the governor has waived malpractice coverage requirement and to practice in LA you are asked to bring the license from the State in which you practice and your drivers license or similar proof of identity. And to bring the "tools of your trade."

Katherine Kirkland, Assn. of Occupational and Environmental Clinics

Dr. Georges Benjamin: I can not verify this. I believe health professionals should contact their professional societies and state health departments to get up to date information on how to help and what the criteria are for doing so.

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Dr. Georges Benjamin: Thanks for joining me today

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