With the last of Hurricane Katrina’s (search) victims rescued from New Orleans’ toxic floodwaters, the public health disaster wrought by the storm continued to unfold Monday.
From overcrowded shelters running short on supplies and beds, to a growing mental health crisis that has already resulted in at least two suicides, health workers struggling to treat the tens of thousands of victims at emergency shelters and medical centers warned Monday that a severe public health crisis had yet to be contained.
At Riverside Shelter in Baton Rouge, La., (search) where between 5,000-6,000 victims were being housed and treated, Dr. Drew Dawson told FOX News that both crucial medications and available cots were running low.
“We need antibiotics for children, we desperately need tetanus,” Dawson said. “We have a lot of demand for tetanus, and we have none,” he said.
A volunteer from Arkansas, Dawson drove to Baton Rouge from Arkansas with a truckload of supplies and medications—high blood pressure medication, insulin and allergy and asthma drugs. He said the most serious problem at the shelters were those patients with chronic diseases like high blood pressure and diabetes who had been without their medication for days.
Dr. Steven Garner (search) of St. Vincent’s Catholic Medical Center in New York, a Fox News medical contributor, said a flare up of chronic illnesses was likely.
“Medications kept in heat and humidity begin to disintegrate,” Garner said. “You have people injecting themselves with insulin that is now like water, and you have people sharing medications, which is a no-no,” he said.
Infections from exposure to the floodwaters were also common among victims.
“Over the past few days, we’ve seen more infections in people who had been in the water,” Dr. Dawson said. “Those that had any open sores are now infected,” he said.
Many of the children at the shelters, Dr. Dawson said, were suffering from colds, coughs and ear infections, and among the younger children, a major concern is immunizations. Not only were the vaccinations not available, but the precise schedule with which immunizations are delivered has been interrupted.
On Sunday, Dr. Julie Gerberding (search), head of the federal Centers for Disease Control and Prevention, told The Associated Press in an interview at a triage center that her biggest concerns were tetanus (search) and childhood diseases.
"Tetanus is something we'd be especially concerned about," she said. Tetanus lives in soil and can enter the body easily through a scratch, and many flood survivors have endured filthy conditions.
Gerberding also raised the issue of childhood immunizations and urged health care workers in the growing multitude of refugee shelters to try to find out a child's shot history and, "If you can't establish that a child has been vaccinated, then vaccinate. We can't take chances."
The CDC chief, who traveled to Louisiana with Health and Human Services Secretary Michael Leavitt, Surgeon General Dr. Richard Carmona and other top health officials, spoke with the AP after visiting an impressive triage center on the basketball court at Pete Marovich Center at Louisiana State University.
Infectious Disease Threat
Health officials have been warning of the threat of infectious disease breakouts since the storm hit, and in Biloxi, Miss., a shelter had to be closed down Saturday after more than 20 residents became sick with dysentery, (search) and another 20 experienced vomiting and diarrhea, possibly from drinking contaminated water.
Biloxi police Cpl. Kayla Robert said she had no idea what caused the illnesses.
"Who knows what they swallowed before they got here," she said. "Half of them were swimming in stuff that we don't even know what it was."
But though health experts said diseases such as measles (search) and whooping cough (search) could rapidly spread in the cramped quarters thousands of flood victims are now sharing, an epidemic was unlikely.
Dr. Garner said that some of the diseases feared and mentioned in reports, such as typhoid (search) and cholera (search), were highly unlikely. The threat of hepatitis and dysentery, as well as mosquito born illnesses a few weeks from now, remained serious threats, though he said they would likely occur in small outbreaks, he said.
Mental Health Concerns
Reports of the suicides of a New Orleans police officer and, earlier in the week, a refugee inside the Superdome, foreshadowed the mental health crisis that loomed large in the concerns of most health experts observing the situation. The grief, stress, anxiety, loss and fear the victims were experiencing were being exacerbated, doctors said, by exhaustion and sleep deprivation.
“Sleeping has become a problem for people with anxiety and chronic back pain,” Dr. Dawson said. “It’s tough to get rest, it’s very loud [in the shelter]. We’re trying to take people to a quiet room to get some sleep,” he said.
Sleep deprivation, Dr. Garner said, can cause aberrant behavior and can be a factor in the kind of violence that has erupted within New Orleans. He said that suicide and major depression among the hurricane victims would become a growing concern.
Red Tape Strangles Relief Efforts
Meanwhile, in many cases, government bureaucracy and clogged communication channels remained an obstacle to alleviating the health crisis. In rural Mississippi, red tape is preventing 100 surgeons and paramedics in a state-of-the-art mobile hospital from North Carolina from reaching victims
"We have tried so hard to do the right thing. It took us 30 hours to get here," said one of the frustrated surgeons, Dr. Preston "Chip" Rich of the University of North Carolina at Chapel Hill, told the Associated Press. That government officials can't straighten out the mess and get them assigned to a relief effort now that they're just a few miles away "is just mind-boggling," he said in a phone interview.
The North Carolina mobile hospital offers impressive state-of-the-art medical care. It was developed with millions of tax dollars through the Office of Homeland Security after 9-11. With capacity for 113 beds, it is designed to handle disasters and mass casualties.
Equipment includes ultrasound, digital radiology, satellite Internet, and a full pharmacy, enabling doctors to do most types of surgery in the field, including open-chest and abdominal operations.
Other doctors also complained that their offers of help were turned away. A primary care physician from Ohio called and e-mailed the U.S. Department of Health and Human Services after seeing a notice on the American Medical Association's Web site about volunteer doctors being needed.
An e-mail reply told him to watch CNN that night where HHS Secretary Leavitt was to announce a Web address for doctors to enter their names in a database.
"How crazy is that?" he complained in an e-mail to his daughter.
Dr. Jeffrey Guy, a trauma surgeon at Vanderbilt University who has been in contact with the mobile hospital doctors, told The Associated Press in a telephone interview, "There are entire hospitals that are contacting me, saying, 'We need to take on patients,"' but they can't get through the bureaucracy.
"The crime of this story is, you've got millions of dollars in assets and it's not deployed," he said. "We mount a better response in a Third World country."
Dr. Bill Winkenwerder, assistant secretary of health affairs for the Defense Department, acknowledged there were problems and said it's a priority "to get the medical community at work and up and operating as soon as possible."
Many other doctors have been able to volunteer, and were arriving in large numbers Sunday in Baton Rouge. Several said they worked it out through Louisiana state officials.
In Miami, a trustee of a skilled nursing facility said he had been trying to offer 125 beds to the hurricane victims, but that no one has returned his calls.
Elliot Kalus, a trustee at Miami's Hebrew Homes Health Network (search), said he had been trying to reach officials since 3 a.m. Sunday. He has tried to call Florida Gov. Jeb Bush, President Bush, FEMA, the Red Cross and local health departments, and finally, the media to get his offer accepted. His calls have not been returned; his letters have gone unanswered. He says he can't even get a secretary on the phone at any organization.
"You cannot get anyone's attention," Kalus said. "We've seen people on the television screen sitting in a wheelchair or using a walker and needing help and we can just look at them. We're saying, 'Look, we have what you need,' but no one wants to hear it."
The 50-year-old Hebrew Homes Health Network has an 800-bed skilled nursing facility with 24-hour care. Kalus said the facility is equipped to house the patients "for however long they need." The care for those without health insurance could be covered by donations to the facility's foundation.
"It's heartbreaking. Our beds are still lying vacant," he said.
The Associated Press Contributed to this report.