Hurricane Health Woes Not Over

No calm after the storms for hard-hit public health workers

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By
HealthDay Reporter

TUESDAY, Sept. 21, 2004 (HealthDayNews) -- With their devastating triple punch, Charley, Frances and Ivan have left Florida and the Gulf Coast "the land of the soaked and the weary," said Miami-Dade County health department administrator Lillian Rivera.

Even as the gale-force winds have subsided, the dangers to public safety in the aftermath of these storms have remained -- from flooding to contaminated water and food to the special needs of the displaced sick and elderly.

Rivera knows firsthand how destructive hurricanes can be. "When Andrew hit a dozen years ago, I personally felt its fury," she said. "I and my family of five were left homeless. There's nothing like living through a hurricane to make you painfully aware of the need for preparations."

Luckily, lessons learned from Andrew, and even the events of Sept. 11, 2001, may have paid off, Rivera said in a special press teleconference held Tuesday by the National Association of County and City Health Officials (NACCHO). "With this recent onslaught of storms in Florida, we've had a chance to test our progress, and we're proud of what we've done," she said.

Joining the conference was Dr. Jeffrey Goldhagen, director of the Duval County (Fla.) health department, located in the Florida panhandle area that bore the brunt of Ivan's fury last week.

Goldhagen said teams from his office were already fanning out across the greater Jacksonville area, looking for ways to prevent or ease hurricane-linked threats to public health.

According to the experts, some of those threats include:

  • Flooding. "More people die from flooding post-storm than actually die from the storm," Goldhagen said. Those trapped in floodwaters tend to be unprepared, since they often live in areas downstream of the storm's center.
  • Carbon monoxide poisoning. As storms cut off electricity, people in poorly ventilated rooms too often turn to gas-powered generators that emit this odorless, silent killer. "We've had many, many deaths or people becoming very ill from carbon monoxide poisoning," Goldhagen said.
  • Disease outbreaks. Tainted food and water supplies, crowded shelters and overburdened sewage systems are breeding grounds for communicable illness. "We had a tuberculosis outbreak at one of our shelters that we had to deal with actively during Frances," Rivera said, while Goldhagen said his team fought a diarrhea outbreak at a local holding facility.
  • Mental health problems. Rates for suicide and posttraumatic stress disorder rise after every natural disaster; the U.S. Centers for Disease Control and Prevention reports that one Floridian took his own life during Hurricane Charley after witnessing a horrific event. According to Rivera, trained mental health professionals are now a standard part of the public health response, working to ease frayed nerves both in shelters and in the community after storms have passed.
  • Medically vulnerable populations. As each storm approaches, public health officials contact thousands of individuals with special needs -- sick or disabled individuals, or those requiring specific medications, oxygen or dialysis. "We make sure there are pharmacies open in communities," Goldhagen said, "and if dialysis centers aren't up and running, we make sure their clients have alternative sources for dialysis." And before special-needs patients are allowed to leave shelters, Duval County public health teams first inspect their homes to make sure electricity, water and other services are available for their safe return.

According to Rivera, the lessons of 1992's Hurricane Andrew created a shift in south Floridians' attitudes towards hurricane safety. When it comes to heeding public health warnings, "people are more obedient now," she said. "Before, many people just used to stay in their homes and say 'No, we'll ride out the storm.' But that's not the case anymore -- they do proceed to evacuate."

And the experts said another grim event, occurring much further north, has had a real impact on storm preparedness.

"For many of us, the wake-up call came on Sept. 11, 2001," said Dr. Michael Caldwell, NACCHO president. "After that, our work nationally to prepare for public health threats and emergencies ramped up dramatically."

Goldhagen agreed, noting that with increased federal and state funding, "we've established an infrastructure that otherwise, frankly, we wouldn't have had the monetary resources to put together."

Sept. 11 also led to increased cooperation between various public entities. "We're making stronger relationships with people who we probably didn't have partnerships with before," Rivera said -- "people like the FBI, that we didn't even have in the mix before. All of these dollars that are coming in are just going to make the public health system stronger -- for any type of event."

More information

For more about plans to protect the nation's health from hurricanes and other disasters, go to the Federal Emergency Management Agency.

SOURCES: Sept. 21, 2004, news conference, National Association of County and City Officials, with Lillian Rivera, R.N., M.S.N., administrator, Miami-Dade County Health Department, Fla.; Jeffrey Goldhagen, M.D., M.P.H., director, Duval County Health Department, Jacksonville, Fla.; Michael Caldwell, M.D., M.P.H., commissioner of health, Dutchess County, New York, and president, National Association of County and City Officials

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