Hurricane Katrina's Health Issues and Diseases - Literature review Example

Katrina’s Coughing Just a few days after Hurricane Katrina, perhaps the single worst natural disaster ever to ravage the United States, had struck it devastating blow, it was felt that the health effects of the storm were hard to gauge. It was projected that prolonged exposure to sewage-and chemicals-contaminated water and people's inability to perform normal hand-washing would cause a “jungle rot” of water-borne illnesses manifested by diarrhea, fever and skin rashes, and infections. The immediate aftermath of the storm was expected to bring deaths among the very young and old as well as the debilitated. The ensuing weeks and even months were expected to probably show us significant numbers of cases of hepatitis caused by viruses in the flood waters (Miller, Sept. 2005). It was known that especially at risk are those with previously existing health problems, including victims deprived of dialysis, oxygen-generating machines, and essential medications for illnesses such as epilepsy, heart and lung disease, thyroid deficiency, and diabetes. Many people in acute-care hospitals, and especially those in intensive-care units, were expected to deteriorate during transfer to facilities that storm and circumstance dictated had to be dozens or even hundreds of miles away. There was no doubt that many of them had already died, and more were to follow (Miller). It had become known already that the floodwaters had been extremely contaminated, and therefore access to sanitation and hygiene would be the most important things that the hurricane’s victims would have to face. If they did not have access to clean facilities, drinkable water, and edible food, then inevitably they would become ill. For those to whom drinkable water was not available, they were going to have to find a way to get to it or else run the high risk of contracting one or more of the several illnesses that are brought about by contaminated water (Waeckerle, Sept. 2005). Those who needed insulin were of great concern. Insulin is extremely important for one who needs it to be able to exist, and insulin for the most part has to be refrigerated. With the lack of electricity coupled to the lack of water and food, the insulin-needy were considered to be one of the first groups that should be targeted for rescue and taken to a better environment. “Rescuers are going to have to figure out how to identify or communicate with those people so they can somehow identify themselves, whether it's writing on the roof, making signs, using the cell phones, whatever. For the most part, after one or two days they will become sicker and will be in need of medical care”, said Dr. Joseph Waeckerle (2005). To begin with post-storm cleanup, perishable goods would have to be one of the very first things to be thrown out by those who were coming back to their homes because those foods would obviously be contaminated due to the fact that there was no electricity for refrigeration and related storage-damage issues. Next, returnees would need to proceed to removing all of their carpeting and furniture, because those things would not be able to be cleaned out quickly and would contain spore-breeding molds and a lot of residual contaminations from the floodwaters. They would also need to clean all of their floors, walls, and even ceilings. After that, they would have to clean all their utensils, pots and pans, and refrigerator with some kind of disinfectants which would be scarce for a period of time. At the same time they would need figure out how to maintain their personal hygiene. “They'll have enough concerns about what viruses and bacteria and infections and potential diseases are carried in the polluted waters and what's left over in the perishable foods and carcasses” without having to also endure contaminating each other because of poor hygiene, said Waeckerle (2005). “It's been well documented for a long time that the rescue people are very susceptible” to the same psychological scarring as the victims “and often become victims themselves. That's easily understood by the fact they care so much, they are there and by the very fact they care so much it makes them very sensitive. As a volunteer you must understand when you go in it's not like working in the emergency room, the operating department, or the clinic or repairing telephone lines in a city…Everything is chaos. Everything is devastated, and the way of life is in fact no way what we're used to in this country” (Waeckerle, 2005). Indeed, it was taken seriously that one of the impacts that would be difficult to quantify, but which is of the utmost importance, would be that on the mental health of the affected population. Depression, anxiety, and grief were projected to be among the mental health problems that might affect thousands of victims in New Orleans and other areas hit by the hurricane and subsequent flooding. Experts estimated that the effects of hurricane Katrina on public health will be enormous and long-term. Authorities in affected parts of the Gulf Coast declared that public health systems would now face huge problems caused by the difficulty of access to the area, lack of water, and the lack of electric power, telephone service, and other basic services essential to modern medicine (PAHO, Sept. 2005). Over three weeks after Katrina’s death-dealing swath had passed away, the Centers for Disease Control and Prevention (CDC) had teams in New Orleans consulting with local, state, and federal officials about issues related to the return of residents and business owners to New Orleans to explore critical health issues. Their primary concerns included housing safety and managing the flow of returning people to protect them from entering dangerous areas. “At this time, the city’s condition presents a number of potential health hazards to returning residents,” said the CDC. “Health and safety issues that should be considered include the following: an operational sewage system; clean water for drinking, cooking and bathing; debris and trash collection; widespread mold; and the capacity to be notified and evacuate should another emergency occur. In addition, greater health risks are faced by children, the elderly, and others with lowered immune systems who are more susceptible to disease. Those with asthma or other respiratory illnesses are at greater risk from mold exposure (CDC, Sept. 2005). About a month and a half after Katrina’s passage, the New England Journal of Medicine put forth that the single greatest health issue “was and will continue to be the inability of the displaced population to manage their chronic diseases. It remains uncertain how such a disruption of ongoing care will affect the long-term health of the population. Persons whose health depends on immediate medical care — hemodialysis, seizure prophylaxis, medications for diabetes or cardiac disease, or treatment regimens for HIV infection or tuberculosis — were and are at risk for potentially lethal exacerbations of disease. Those with special needs — hospice patients, the mentally and physically disabled, the elderly, and persons in detox programs” — continue to have to face down life-or-death situations “beyond that of evacuation. Planning agencies are already struggling to build the sustainable procurement and distribution apparatus to address such long-term needs” (Greenough and Kirsch, Oct. 2005). The life-and-health threatening circumstances are complex and compounded. Among some there is concern the chemical plants and refineries in the area could have released pollutants into the floodwaters, adding to their contaminants. Those who suffer from asthma, severe allergies, or other lung or respiratory ailments have developed what some health officials have dubbed “Katrina Cough”. In Gulfport, Mississippi, several hundred tons of chicken and uncooked shrimp were washed out of their containers at the nearby harbor and could have contaminated the water table. In early September, it was reported that Escherichia coli (E. coli) had been detected at unsafe levels in the waters that flooded New Orleans. The CDC reported at the same time that five people had died of bacterial infection from drinking water contaminated with Vibrio vulnificus, a bacterium from the Gulf of Mexico (Wikipedia, 2005). But as one research scientist sagely informed us, “It’s clear that wealth equals health and safety” (Glassman, 2005). The New England Journal of Medicine states that “the economically disadvantaged often have multiple medical conditions that may be in advanced stages. For the largely black population of New Orleans whose access to health care was limited before Katrina and who already bear a comparatively heavy burden of chronic disease, the situation is especially critical. As we have learned from previous disasters, a strong infrastructure is required to withstand such an onslaught. Katrina disproportionately affected the poorest residents of New Orleans, who did not have the health reserve or the access to care needed to absorb the blow of a breakdown of the local public health system. In the long run, the destruction of the public health and medical care infrastructure has the potential to be more devastating to the health of the population than the event itself” (Greenough and Kirsch). Over three months after Katrina has come and gone in New Orleans, a major health crisis is in fact arising as residents struggle with the tainted air quality, the mold-riddled houses, and the mind-numbing psychological stress that had largely been predicted. Even across Mississippi and Louisiana, people are afflicted with coughs, infections, rashes, and broken limbs. People are jittery, tired, depressed, and prone to bizarre outbursts (Borenstein and Adams, Dec. 2005). Burning debris strewn by the storm, increased diesel exhaust, runaway mold, and the fumes from industrial glue and plywood in new trailers are irritating people's lungs and nasal passages. Psyches are fractured as much as, or perhaps even more than, the physical bodies. “It's a cumulative effect here,” said Claire Gilbert, a New Orleans surgical technician. “You get a little cough. You get a nose that runs. You get eye irritation. Then you get falls. And you've got the stress. It's not just little things. It's how they all add up” (Borenstein and Adams). While initially, area health officials worried about a “toxic gumbo” of industrial chemicals that might flood the area along with the rapid spread of infectious diseases, a more subtle health problem has instead developed, says Dr. Howard Frumkin, director of the National Center for Environmental Health, a division of the CDC based in Atlanta. “In many ways, this is the major environmental health disaster of our lifetime. It's a very complicated set of risk factors people face…This is a huge set” of stresses on the environment. Frumkin tells of several irritants and carcinogens emitted from the burning of Katrina's flotsam and from traffic emissions in the wake of all the returnees and emergency vehicles, including acrolein and formaldehyde. Those two chemicals trigger coughs and bad congestion in the short term and are linked to cancer after prolonged exposure. Indeed, measurements from Mississippi air monitors at the time of this writing show that increases in the chemicals are much higher than what federal standards allow. In October, acrolein levels measured up to 155 times higher than federal standards and formaldehyde levels were between five and seven times higher than what the EPA deems healthy (Borenstein and Adams). But, most painful of all, and adding scarring insult to the injury of all else, is the stress. “Stress isn't a strong enough word. I'd call it anguish,” Frumkin tells us. “The level of grief and anguish there is palpable” (Borenstein and Adams). People cannot sleep, and often don’t know or can’t remember what day it is as one slouches into the next with the same sturm und drang. William Gasparrini, a Biloxi clinical psychologist, calls it “Post Katrina Stress Disorder”, in which residents suffer bouts of grief, shock, rapid mood shifts, confusion, anger, marital discord, guilt, escape fantasies, and substance abuse. “The effects are lasting longer than I suspected,” Gasparrini said. “I thought everything would be back to normal in three to four weeks. Now, three months later, it looks like it'll be one to two years—if we are lucky. There are a lot of people in pain—a lot of people who cry every day.” Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, has spent time in New Orleans and Mississippi since the storm (Borenstein and Adams). He says, “Because the sheer size of the impact was so large, I think there is a greater sense of despair and loss that people are experiencing. This experience of dramatic, prolonged displacement will” be taking its toll long into the future. Works Cited Borenstein, Seth and Adams, Chris. “Katrina’s Anguish Won’t Relent”. “Detroit Free Press”: Dec. 1, 2005. . Centers for Disease Control and Prevention. “PM Update, September 21, 2005”. Retrieved Dec. 1, 2005. . Greenough, P. Gregg, MD, MPH, and Kirsch, Thomas D., MD, MPH. “Public Health Response—Assessing Needs”. The New England Journal of Medicine: Issue 15, Volume 353, pp. 1534-1536. Oct. 13, 2005. . Miller, Henry I., MD. “Another ‘Gulf War’”. Tech Central Station. Sept. 1, 2005. . Glassman, James K. Interview with Dr. Roy Spencer. Tech Central Station. Retrieved Dec. 1, 2005. . Pan American Health Organization. “Katrina Raises Health Concerns”. Sept. 1, 2005. . Waeckerle, Joseph, MD. “Hurricane Katrina: Health Issues in the Aftermath”. WebMD (Interview). Sept. 1, 2005. . Wikipedia. “Hurricane Katrina”. Retrieved Dec. 1, 2005. . Read More