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Specialists warn of health disaster

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Sep. 2--Louisiana and Mississippi are facing what could be the nation's worst public health disaster in many decades in the aftermath of Hurricane Katrina, health specialists said yesterday, as a region already known for poverty and chronic health problems braces for an extended period with limited access to water, food, power, and even essential medicines like asthma inhalers. And, just as the need for medical care is at a high, most of the hospitals in New Orleans are being evacuated.

Sniper fire in New Orleans yesterday forced the suspension of helicopter evacuations of the remaining 350 patients at Charity Hospital, despite the waist-deep water outside. A few blocks away, Mayor Ray Nagin pleaded for buses to get 15,000 refugees out of the increasingly unsanitary convention center, outside of which at least seven corpses were scattered. Meanwhile, an untold number of people remained stranded without electricity in the summer heat.

But public health specialists warned that the worst may be yet to come as increasingly desperate people, marooned in flooded houses or homeless on the streets, grow dehydrated, hungry, and restless. Children, the elderly, and the sick are especially vulnerable and could succumb to injuries, exposure, or disease.

To minimize the death toll, a Harvard School of Public Health professor said, looting and lawlessness have to be stopped so that emergency personnel can do their jobs.

"This whole disaster is becoming what we in the humanitarian community call a complex humanitarian emergency where . . . the people who are trying to help face new jeopardy," said Jennifer Leaning, a Harvard School of Public Health professor helping the American Red Cross with Katrina's aftermath. "It is compounded by the fact that all the people on the ground are having a terrible time communicating and getting around. . . . In some ways, this resembles an overseas international disaster" in a less developed nation, Leaning said.

Because of the chaos and continued flooding, emergency officials have not been able to estimate the number of dead and injured, or even the number of people who remain in the New Orleans disaster zone. But there were reports of hundreds of bodies in the region, including 30 people who died at one nursing home in St. Bernard Parish, according to Lieutenant Governor Mitch Landrieu. The number of deaths could be far greater if infectious diseases spread among the survivors, medical officials said.

"We have the opportunity for things we haven't seen in many years -- cholera, typhoid, tetanus . . . malaria," said Dr. Marshall Bouldin IV, director of diabetes and metabolism at the University of Mississippi Medical Center in Jackson, the state's only major teaching hospital. "We haven't seen health conditions like these in 50 years. . . . People are crowded together and they're wading through sewage."

The magnitude of the suffering will depend on how quickly government agencies can get supplies to desperate people, said Gerald Keusch, assistant provost for global health at the Boston University School of Public Health. He said a disease such as cholera, which spreads through contaminated drinking water, can infect large numbers only if authorities don't distribute clean water. "If there were an outbreak of cholera, it would be an indictment of the response system in this country," he said.

By most measures, Louisiana and Mississippi were two of the nation's most unhealthy states to begin with, leading the nation in rates of obesity and other chronic illnesses while trailing most states in availability of healthcare.

Homeland Security Secretary Michael Chertoff said at a Washington news conference yesterday that the Bush administration is doing everything possible to head off a health calamity. He said the federal government has sent 5.6 million meals, massive quantities of water, 50 disaster medical teams, and 28 search and rescue teams to the region, but it was unclear yesterday how much of these supplies had reached the victims.

Patients from most of the city's hospitals have been evacuated, most to out-of-state hospitals, but doctors at Charity Hospital and nearby University Hospital, which serve many of the city's poorest residents, issued a desperate appeal, calling The Associated Press yesterday morning to say they were nearly out of food and power and had been forced to move patients to higher floors to get away from the looters.

Material from The Associated Press was used in this report.


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