30 September 2005

TO:             All Commissioned Corps Officers

FROM:   United States Surgeon General

Subject:        Update on Hurricanes Katrina and Rita Response

We are in a time of unprecedented recovery efforts in the aftermath of Hurricanes Katrina and Rita. The Commissioned Corps has demonstrated its flexibility, dedication and energy in rising to the challenges incurred by these catastrophic storms in Texas, Louisiana and Mississippi. Our presence, working alongside federal, state and local agencies and a large, diverse cadre of volunteers displays a profound commitment to helping the people of the Gulf States Region rebuild and return to their quality of life.  Whether in deployment status, or at normal post, Corps members continue to bring forth their empathy and public health expertise.

The Corps has accomplished much in recent weeks.  Following are a brief description of current Corps endeavors.

In Texas, a Secretary's Emergency Response Team (SERT), led by RADM Mary Pat Couig from FDA, is staffed by 39 officers as part of the Joint Field Operations.   Field operations continue in San Antonio, Houston, Dallas, and in many areas in the heavily impacted 17 counties of southeastern Texas.   Here are a few excerpts from their daily reports:

The PHS team, led by CAPT Henry Lopez from HRSA, is working with civilian CDC and SAMHSA staff.  There have been 13,000 Rita evacuees, including more than 800 special needs patients.  The special needs population has been relocated to shelters in Waco, Texas and determination of ongoing services is underway.  Transition to community-based medical services and rumor control efforts through health education of organization supervisors and team leaders continues.

In Houston, the PHS officers, led by CAPT Gene Migliaccio from HRSA/INS, have worked closely with the mayor and his municipal leadership. The team reports that they are working with the hospitals to address high census counts and limited availability of facilities for discharging nursing home patients.  The Convention Center is being used as a special needs shelter for Rita evacuees. A 20-member team from Kaiser Health has been federalized to help support reopening of area clinics.

From North Texas (Dallas/Fort Worth) PHS reports 8,500 people have been triaged to community agencies. Hundreds of evacuees remain in shelters across the region.  The PHS Corps is working with the American Red Cross to coordinate all efforts. HHS Regional Director Linda Penn is working with local, state and federal officials to establish a task force to address continuing medical and social service needs of evacuees in the Dallas area.

In Louisiana, RADM Craig Vanderwagen from IHS and RADM Sam Shekar from HRSA, lead 22 ongoing missions supported by the USPHS and staffed by 205 PHS officers, 103 federalized employees and representatives from CDC and FDA. Eight medical strike teams are now onsite to assist with shelter staffing and to provide relief for those who have been serving nonstop for nearly a month.  A few of the missions include:

The PHS team, in conjunction with a SAMHSA contingency, in the New Orleans area has been extremely busy. Of the sixty hospitals in fifteen parishes that were affected by Hurricane Rita, phone assessments have been conducted in fifty-five and direct assessments have been conducted on thirty. Thirty-eight hospitals are currently fully restored, eight are partially restored and fourteen are not restored. Utilities and sanitation are the primary reasons for closure of the hospitals.  The Veterans Administration has offered their facility and staff to assist with special needs population. The USNS Comfort has arrived in the Port of New Orleans, fully staffed for 250 beds and is scheduled to remain in port for two weeks to provide an enhanced trauma capacity for the city.

Special needs shelters, with PHS officers staffing, remain active in Alexandria, Baton Rouge, Bossier City, Lake Charles, Lafayette, Monroe, Napoleonville, and Hammond, Louisiana.  Medical Reserve Corps volunteers are also serving at several of the sites.  Triage, assessment, and care of more than 400 patients (adults and children) continue.  Work has begun on transition plans and preparation.

PHS officers are working with SAMHSA to provide ongoing mental health services across the state in collaboration with the state mental health authorities. The issue of providing services to families and children in prolonged alternate living communities and psychiatric facilities is being addressed.

Corps officers are assisting Disaster Mortuary Operation Response Teams. The importance of dignity and respect in all aspects of this effort is being emphasized. Development of a Family Assistance Center to help those who have lost loved ones is proceeding.  The Army Corps of Engineers expects to complete their pumping work in early October which will allow for continued recovery efforts.  By aerial observation, there are at least 30 cemeteries with damage and a minimum of 500 disinterred crypts and vaults.   Federalized chaplains continue to work with the human remains recovery teams, at the morgue and the family call-in center.

USPHS veterinary officers are supporting pet shelters in Gonzales and at Louisiana State University.  Most recently, the PHS veterinary team assisted in the loading and transfer of approximately 115 dogs for air transport to the Humane Society of San Diego.  Medical records on animal bites that were lost after Hurricane Rita were found by the PHS teams.  PHS medical providers are also providing clinical care for the veterinarians and pet handlers

.

In Mississippi, a team of 57 PHS officers and 113 volunteer staff led by RADM Brenda Holman from FDA are supporting the Nevada 1 Clinic in Gulfport. Security is in place, a dental clinic has been set up and a laboratory contract awarded.  PHS is also staffing a community health center in Biloxi and a cruise ship clinic in Mobile with 1000 patients plus responders on board.  PHS engineers are working with the local counties on water and waste water issues. Assessment continues for staffing issues at shelters and the various clinic venues.  PHS team leaders will meet with state officials to evaluate continuing operations and demobilization strategies.

Individuals and communities in the storm-ravaged areas will need help for many days to come and PHS Corps members will be sought to support these efforts. As time goes on, we will strive to include the Medical Reserve Corps volunteers and other unpaid, temporary federal employees in appropriate deployments but the Corps will remain essential to the response. We appreciate and need your assistance in the ongoing work to protect the public health of the people in Texas, Louisiana and Mississippi.

I also want to remember the families of those who have deployed.  We must not forget the sacrifices made by spouses, children, and parents so that our Corps can help those with greater need.  We are proud and privileged to have our "support team" behind us each and every day - a hearty HooAAH to all of you!

We must continue to work together to provide relief, public health and medical care to those living in the Gulf States Region. The work is challenging, the rewards are boundless. Join with us to make our mission complete.

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