Days after the storm, survivors at the New Orleans Convention Center , denied food, water, medical assistance or help of any kind try desperately to keep 89-year-old Dorothy Divic alive.

When the hurricane struck in 2005, racist and incompetent government agencies failed to provide people in the Superdome with water, food or sanitation. According to a report published in June 2007 in the new journal, Disaster Medicine and Public Health Preparedness, the sequel to the Superdome disaster is an ongoing toll of almost 400 excess deaths a month.

Dr. K.U. Stephens, head of the New Orleans Public Health Department, led the team of experts who produced the study documenting the rise in death rates. The authors cite the collapse of the public health infrastructure as a major cause of this increase.

The report notes that "only 15 of 22 area hospitals have reopened, with less than half the number of pre-storm beds. A significant portion of the population is still living in substandard conditions, contributing to the reported pervasive, unmitigated stress among residents."

New Orleans' public hospital - named Charity - which provided care to many of the poor and uninsured, including the majority of the mentally ill, has been closed. More than 4,000 doctors have left the city. Rates of depression, post traumatic stress disorder and other psychiatric problems have soared.

The lack of medical resources has been made worse by the inability of health officials to accurately track, monitor or report conditions that require urgent intervention. The report concludes that "a destroyed or poorly recovered public health infrastructure, which normally would be able to identify health problems and protect the health of a population, has in fact contributed to excess mortality."

The study used paid death notices published in the New Orleans Times-Picayune, the major daily newspaper, to obtain numbers of deaths occurring in the greater New Orleans area from January to June 2006. Official death certificate data is unavailable due to understaffing and other problems in the city's health statistics bureau. A comparison of average monthly mortality rates for 2002 to 2003 showed that the death notices in the Times-Picayune and official Louisiana state data were closely comparable.
An average of 1,317 people died each month during the study period. This compares with 924 before the storm - when the population of New Orleans was much bigger. The number of excess deaths was more than 2,300 in the course of the six month study period - about twice the number who died during the storm. The mortality rate in the first six months of 2006 was 91 per 100,000 people, up from 62 per 100,000 before Katrina, an increase of 47 percent.

People throughout the world exposed to catastrophic public health emergencies die from indirect causes for many years afterward. These deaths affect the most vulnerable people in society and are 90 percent preventable, according to the editors of the new public health journal.
Beyond the report

The report did not address issues of age, race, gender or cause of death. Racism results in wide gaps in health status between whites and African-Americans. Studies of health disparities show this in everything from infant mortality to HIV, treatments for heart disease and cancer - even when insurance status is equal. A similar pattern would be expected in the post-Katrina deaths.

Another important health issue following Hurricane Katrina concerns questions about exposure to mold and to toxic substances in the floodwaters. Tracking these outcomes will require long-term follow-up studies.

Deaths among survivors who were unable to return to New Orleans were not included in the report. These evacuees face the trauma and stress of having lost their homes, possessions and social networks. Accessing health care in their new locations is just one of the multiple problems and stresses they face.

"We can get hung up on the numbers, but the bottom line is that people are dying at a faster rate here post-Katrina," says Jullette Saussy, director of New Orleans EMS in a June 21 interview in USA Today.

"The lack of primary care, of mental health care and the long waits in emergency rooms all have [worsened] people's normally controllable chronic diseases," she says.

"Diabetes, respiratory disease and hypertension all are killers, especially when they're not dealt with."
This article originally appeared on workers.org. Ellen Catalinotto was a volunteer nurse at the Common Ground Health Clinic in New Orleans in December 2005.

Tag it:

?