12 October 2005

TO: All Commissioned Corps Officers

FROM: United States Surgeon General

Subject: Update on Hurricanes Katrina and Rita Response

I could not be more proud of the continued efforts of our Commissioned Officers who are, and have been, deployed to the Gulf States Region. They are carefully tending to the needs of many who are filled with despair and yet struggling mightily to rebuild their lives. Each day I’m touched by the countless stories I hear of our officers who, with great humility and self-sacrifice, attempt to lift up the spirits of those they are serving.

Typical of the notes we receive in the Office of the Surgeon General is this one from CAPT David Racine of FDA:

“I realize you are very busy, but I just wanted to briefly express my thoughts on my recent deployment.  To be honest, when I left, I was apprehensive, wondering if I would be able to come through for PHS and be able to perform any duties that I was assigned.

Sir, those two weeks were some of the most rewarding I have spent in my career.  I was fortunate enough to be assigned to an immunization team under a great team leader.  Everywhere we went in the state, we were greeted with open arms.  The people were so grateful for us to be there. (well, maybe a few of the pediatric patients were not so happy to get a shot).  Many of the shelters we visited offered to feed us and even offered to put us up in their spare rooms if the drive back to Baton Rouge was too long.  I was able to work on my team with a dedicated group of health professionals, all of whom made me proud.

It was with much pride that I was able to say over and over in the State while pointing to the letters on my BDU's "I'm with the United States Public Health Service"

We can all see CAPT Racine’s face beaming as he talked about his service in the PHS with those he met. His efforts and self-effacing manner are typical of the almost 2,000 officers who have been a part of this deployment.

Our PHS colleagues assigned to the Coast Guard have also been active in Texas, Louisiana, and Mississippi. Although not deployed by OFRD, they have provided direct mission support to Coast Guard operations, which increased dramatically at all duty locations. While we viewed the televised images of the Coast Guard’s dramatic rescue of people from rooftops and raging waters, PHS medical officers with special flight training were behind the scenes keeping the pilots and air crews safe, in action and at rest.

We should not overlook the CG/PHS officer support to the hurricane response at the local unit level. Port security and air station units across the country were ramped up to go. Medical, dental and pharmacy PHS officers underwent the appropriate screening and prepared for potential needs in aviation medicine, shipboard medicine and immunization programs. When the call came, they all stood tall and said “send us, tell us where to go.”

The entire Commissioned Corps continues to remedy situations in the hurricane-devastated multi-state region. We support and applaud these efforts. The following items describe several of the ongoing activities.

PHS officers are working closely with the Louisiana Department of Education implementing the “Mercy Mental Health Program.” The Mercy program was developed during the tsunami response to Indonesia and provides tools to understand behaviors in children who have experienced great distress and offers intervention techniques. Eight school systems were directly affected by the hurricanes resulting in the displacement of nearly 225,000 students and 6,000 teachers. This displacement has affected all school districts in the state and their ability to cope with the situation. The overarching strategy is to assist Louisiana state agencies in creating an integrated population-based behavioral health plan and program. In concert with the Louisiana Governor’s health policy team PHS has created a list of recommendations identifying five community anchors (schools, faith-based organizations, healthcare, recreation, and support services) to be used as foundations for developing and sustaining a functional and productive community.

Concern for the psychosocial needs of returning children and families is ongoing. PHS officers are working with SAMHSA to address this issue. There are 64 SAMHSA-contracted mental health providers currently in more than a dozen cities across the affected region. Ten-thousand public information packets have been distributed to disaster recovery centers and shelters. Plans are being made to reach out to those individuals displaced to greater distances.

Team Orleans (Orleans Parish) is addressing re-establishment of hospital capabilities with site visits underway. Ambulatory clinic capabilities are also being re-established including pharmaceuticals and other supplies. The free supply of prescription medications available to patients deemed “Shelter Eligible” expires at the end of October and there is discussion about extending this program. Charity hospital was the only Level 1 trauma center (highest level that handles even the most complex trauma cases) in Louisiana and it has been down since Hurricane Katrina. Children’s Hospital is scheduled to open fully on Monday.

The DOD expeditionary field hospital is operational. Louisiana State University (LSU) and local health officials are training with military medics and the facility is expected to begin seeing patients this week. FDA has inspected 104 food service facilities in Orleans and Jefferson Parishes, 17 day care centers, and 16 residential special needs facilities. Retail businesses (restaurants, stores, hotels, pharmacies) across the area are being inspected and reopened. The boil order for drinking water usage has been rescinded for Orleans Parish.

PHS activities across Texas are stabilizing. Officers in Houston continue ongoing collaboration with leadership representatives from the Mayor’s office. Plans are being readied for exit strategy of HHS entities. In Austin, we continue assessment and discharge planning of special needs patients in Texas shelters as well as participating in strategic planning with state and federal partners to address repatriation, special needs shelters, and staff relief of medical personnel. The North Texas region (Dallas-Fort Worth) reports there are no evacuees in shelters in the Dallas area and less than 300 people in shelters in the Fort Worth area. There are no health threats or unaddressed medical issues in any of these facilities.

In Mississippi, a total of 30 PHS mission assignments and 40 PHS officers, NIH security personnel and 113 federalized employees are led by CAPT Christopher Jones of OS/OPHEP. SERT Mississippi is helping the State of Mississippi ready a plan for dental care and staffing of medical facilities/resources. The teams are also participating in preparation of a 12-18 month transition and recovery plan for the State of Mississippi.

The Commissioned Corps’ enterprise of preparedness must always be one of protecting, promoting and advancing the health and safety of the nation. As evidenced by the frequent occurrence of natural disasters, domestically and abroad, this remains our top priority. Have no doubt your efforts as a PHS officer are recognized and appreciated with great gratitude by the individuals whose lives you touch. Once again, I commend you all for your actions in our mission of helping others.

Richard H. Carmona, M.D., M.P.H., F.A.C.S.

VADM, USPHS