New Orleans — Four Years After the Flood Waters Receded

By Marc J. Kahn, MD, Tulane University School of Medicine, New Orleans, LA

On the evening of August 26, 2005, most New Orleanians relaxed after what seemed like a normal Friday workday. But during the night, it became apparent that a storm that had formed off the West Coast of Florida was likely to enter the Gulf.  By Saturday morning, it became clear that New Orleans was in the “cone of possibility” for a hurricane strike. By Monday, it was certain that New Orleans would be changed forever when Hurricane Katrina made landfall, and the resultant levee breaches over the next 48 hours flooded more than 80 percent of the city.

No resident of New Orleans will ever forget the events that played out in the days and weeks following Katrina’s arrival. Despite difficulties in evacuation made famous by CNN and other news media as they reported from the Superdome and convention center, within a week evacuation of the entire city of New Orleans reduced the population from more than 600,000 to virtually zero. Families were separated, homes and businesses were destroyed, property was lost, lives were taken, and daily routines were upended. Many New Orleans residents, including my family, evacuated to Houston, TX — an unfamiliar city 350 miles from home.

As has been reported elsewhere, following Katrina, Tulane University School of Medicine moved its students and educational programs to facilities on the Baylor College of Medicine Campus. Louisiana State University School of Medicine (LSU) relocated most of its programs to Baton Rouge, and Charity Hospital, the safety-net hospital for the New Orleans region, closed indefinitely. Organized health care virtually ceased to exist as a result of the storm.

It is now four years later. Charity Hospital remains closed, but both Tulane and LSU have come back to New Orleans. Medical care in the city remains fragmented, especially for the poor. Mental health facilities are lacking, and large parts of the city have not yet been rebuilt. The city’s economy is stagnant.

In spite of the challenges that face New Orleans in the post-Katrina era, there have been reasons for optimism. Tourism has long been a major part of the local economy; this year’s ASH meeting is evidence that conventions and tourists are coming back to New Orleans. Mardi Gras is as crazy as ever; Jazz Fest continues to provide musical delights. The city is said to have more restaurants now than prior to the storm. Liquor continues to flow in the French Quarter.

More importantly, the storm and its aftermath have given New Orleans a chance to rethink the status quo. Our public schools have improved with the creation of one of the largest charter school systems in the country. We have had an unprecedented influx of young people committed to rebuilding a great American city; programs such as Teach for America and Americorps flourish. Colleges and universities in Louisiana are receiving record numbers of applications, including more than 9,500 applicants for Tulane School of Medicine last year. Health care is being redesigned through the creation of neighborhood health centers that provide primary care for communities, within the communities. Flood protection, architectural design, and city planning have changed the way we do business. Residents have removed generators from basements and are now building homes upon elevated foundations. Hurricane Gustav made landfall as a Category 2 storm near New Orleans last summer and allowed all of us to “get back on the bicycle” and show that the city and its levees could survive hurricane force winds. The fact that the hurricane and evacuation were for the most part uneventful allowed the entire city to breathe a collective sigh of relief.

August 29, 2005, and its aftermath changed our lives forever. We no longer care so much about material goods — a house is just bricks and mortar, a car merely bolts and metal. We recognize the temporary nature of our situations. We have learned to appreciate what really matters: family, friends, health, and community. We are a resourceful people in New Orleans, residents of a city that has not forgotten how to care.

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