Online NewsHour: Report | Gulf Coast Doctors Still Strained | March 20, 2007

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REGION: North America

TOPIC: Health

Online NewsHour

Originally Aired: March 20, 2007


	Doctors Provide Temporary Health Care Solutions for Katrina Victims

	Almost 18 months after Hurricane Katrina devastated the Gulf Coast, thousands of its victims are still without health care. In the first of a two-part report, NewsHour health correspondent Susan Dentzer looks at how doctors are providing some temporary relief.

SUSAN DENTZER, NewsHour Health Correspondent: Dr. Joseph Smiddy is a lung specialist who hails from Tennessee, but recently he was working in an unusual space: in the back of a tractor-trailer in New Orleans.

DR. JOSEPH SMIDDY, Lung Specialist: So our diagnosis would say normal heart size, normal bones...

SUSAN DENTZER: He'd converted the truck into a portable X-ray unit last year. He and other doctors have seen a need for such a unit when they came to New Orleans to treat victims of Hurricane Katrina.

DR. JOSEPH SMIDDY: We knew we would be coming back to New Orleans, and we raised the money for a tractor-trailer lid-lined with X-ray to be able to take not just an X-ray, but a high-quality diagnostic X-ray that would enable us to come back here and meet this need that we identified when we were here before. This is the equivalent of a hospital chest X-ray unit on the road.

SUSAN DENTZER: He even went to truck driving school so he could pilot the trailer here himself. Smiddy was one of several hundred health care providers from around the country who headed back to New Orleans recently for what was billed as medical recovery week. It was a health fair on the grounds of Joe Brown Park in a still-distressed part of east New Orleans.

This is the second free health fair New Orleans has held in the past year. Almost 18 months after Hurricane Katrina, thousands of people here are still jobless or without health insurance, and they lack access to everything from chronic disease treatment to mental health care.

To make matters worse, fewer than a third of the city's health care providers have returned. So the international relief groups Operation Blessing and Remote Area Medical Volunteer Corps, or RAM, came together to organize this year's fair. RAM's founder is Stan Brock.

STAN BROCK, Remote Area Medical Volunteer Corps: I got a call from Dr. Kevin Stephens, the director of the city health department, asking us if we would come down. He said, oh, we've got a lot of needs in dental and we've got a lot of needs in vision.

And, of course, the other run-of-the-mill medical problems that just indicate that the services really aren't back up to speed here yet, even after all this time.

Receiving free medical service

SUSAN DENTZER: Bill Horan is Operation Blessing's president.

BILL HORAN, Operation Blessing: The average number of deaths per month has increased almost 50 percent since Katrina, while at the same time the population has diminished by almost 50 percent. So that's why people are lined up here at 4 and 5 in the morning for free medical service.

SUSAN DENTZER: One of the nearly 4,000 patients who came that week was 38-year-old Julia [last name withheld]. She contracted tuberculosis from living in a homeless shelter before Hurricane Katrina. But the storm cut short her months-long course of treatment for T.B., when it shut down the city's charity clinics for the uninsured.

JULIA, Hurricane Katrina Victim: I couldn't go back to charity because there was no more charity. So I didn't know where to go. I mean, I didn't know who to call. I didn't know what to do.

SUSAN DENTZER: Smiddy pointed out tell-tale signs of the old tuberculosis on [Julia's] chest X-ray. He told us gaps in treatment like the one she experienced can lead to deadly drug-resistant strains of T.B.

DR. JOSEPH SMIDDY: This creates an environment for resistant tuberculosis to have intermittent treatment, so it's a serious problem. And that's part of why we're here, is to help identify those patients.

SUSAN DENTZER: Another doctor then gave [Julia] a referral to New Orleans' Public Health Department, where she'd get special antibiotics to start another nine-month course of T.B. treatment.

JULIA: That's great.

SUSAN DENTZER: Also at the fair was 71-year-old Mary Henry, who had just returned to New Orleans after 18 months up north.

MARY HENRY, Hurricane Katrina Victim: I haven't seen a doctor in maybe about three weeks or a month in Detroit. And I'm going to be here for a little while trying to get my house repaired.

SUSAN DENTZER: Like thousands now back in the city, Henry suffers from diabetes and high blood pressure and had a dizzy spell as she arrived at the fair. Henry quickly saw Dr. Steven Smith of the famed Mayo Clinic in Minnesota.

DR. STEVEN SMITH, Mayo Clinic: You know that measurement called an A1c? It's an average of how your blood sugar has been for, like, the last two months. It says on the average your blood sugar has been about 300, I would say. So it's been kind of high.

MARY HENRY: Also, when my sugar is high, I get real sleepy. And my finger tips, my finger tips feel like burning.

DR. STEVEN SMITH: All this blood sugar is running around your bloodstream; it's not getting to your body where it needs to be.

SUSAN DENTZER: Smith wrote her a raft of prescriptions, including one for a blood sugar monitor, all to be filled for free at the health fair's pharmacy.

DR. STEVEN SMITH: So, you know, diabetes is not just a blood sugar illness. It's a blood vessel illness for heart attack and strokes. So that's why treatment of your blood pressure, you know, treatment of the cholesterol is all very, very important. So that's unfortunately why you end up on so many medicines.

SUSAN DENTZER: The doctors told us Henry's best hope for getting her medicines in the future would be through one of the local clinics set up post-Katrina. This one is run by Operation Blessing adjacent to the health fair grounds.

'The neatest thing'

Jim Kleinatland, who's 48, explained why he was wearing a cut-off sweatshirt hood. He'd contracted a virulent parasitic skin infection, highly sensitive to the sun, while helping to rescue people in noxious waters after the hurricane.

JIM KLEINATLAND, Injured During Hurricane Katrina Rescue: It travels under the skin. It's bad stuff.

SUSAN DENTZER: A legal researcher before Katrina, Kleinatland, is now jobless. To top it off, he now suffers from post-traumatic stress disorder stemming from his rescue work.

JIM KLEINATLAND: I saw a lot of people that died. I saw a lot of people in the water. I have a lot of flashbacks of seeing the actual things, so it's almost like I'm there smelling -- the smell that you smelled in the days after the storm, for days, it was almost a sewer-rotten smell. That comes back to me all the time.

SUSAN DENTZER: Although he came to the fair seeking help with the PTSD, the fair sponsors have been unable to recruit any mental health professionals, so he only got a referral to a local mental health clinic. Even so, Kleinatland, was surprisingly upbeat.

JIM KLEINATLAND: I think this is just about the neatest thing the city of New Orleans has ever seen. And I'll tell you why: There's a lot of things in the community you can live without. You can live without the fast food restaurants. You can live without the movie theater. But when you go without your medical help, you've got a problem.

Lack of mental health specialists

SUSAN DENTZER: City Health Department Director Kevin Stephens told us the absence of mental health providers was one of the city's worst problems, including a dire shortage of psychiatric beds in the area's hospitals.

DR. KEVIN STEPHENS, Director, New Orleans Health Department: We have a lot of post-traumatic stress. We have a lot of depression. We have a lot of suicides. We have a lot of challenges in terms of mental health. And, in fact, a lot of people self-medicate by using alcohol and other drugs.

We have like 10 percent of the psychiatrists we had before. So we have a lot of problems in terms of mental health. And it's a hard row.

SUSAN DENTZER: Smiddy told us these types of problems permeate the system.

DR. JOSEPH SMIDDY: The world really needs to know that New Orleans is still in a great crisis. The system in New Orleans is totally broken. The health care system is broken. Patients cannot get into the system, even with insurance and money. It's very limited and a very broken system for the indigent and the underserved.

SUSAN DENTZER: And as federal and state officials continue prolonged discussions on fixes, Band-Aids, like the health fair, are apparently about as good as things get.

JIM LEHRER: In her next report from New Orleans, Susan will look at the health care system's larger problems.