Can Hospitals Afford NOT to Be Ready for Disaster?

Pendleton Memorial Methodist Hospital stands partially submerged in flood waters on Sept. 8, 2005, in east New Orleans, La., in the aftermath of Hurricane Katrina. (James Nielsen/AFP/Getty Images)

Pendleton Memorial Methodist Hospital stands partially submerged in flood waters on Sept. 8, 2005, in east New Orleans, La., in the aftermath of Hurricane Katrina. (James Nielsen/AFP/Getty Images)

Baton Rouge   The headline caught my eye. Sheri Fink, author of what has to be the definitive case study of a hospital in crisis post-Katrina, the award-winning Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital, had written an op-ed piece in the Times entitled, “Can Hospitals Afford to Be Ready for Disaster.” You can probably already see my head scratching. I had written a book about Katrina myself, The Battle for the Ninth Ward: ACORN, Rebuilding New Orleans, and the Lessons for Disaster. The one lesson I felt confident of was that we finally had a national, and certainly a community, consensus that we had to be ready for disaster, so for me the question was really, “Can Hospitals Afford NOT to be Ready for Disaster?”

The issue was an important one that is now lost in the bureaucratic maze. The Bush Administration started the wheels turning in 2007 post-Katrina and the Obama Administration proposed a draft for public comment in 2013. The language is stuck now in legal review at the Office of Management and Budget (OMB) on an extension of a 90-day legal review. The whole rule though is on a 3-year timetable, so if not finalized, we’re left with nothing.

You might say, “…but that can’t happen here.” We’ve had Katrina, Sandy Hook, Ebola, and now Zika all highlighting the need for disaster preparedness and, worse, proving over and over again how few health care facilities are ready and able. Please remember the Katrina situation involved nursing homes so unprepared for evacuation that many elderly were trapped and drowned. Memorial Hospital, the old Baptist facility, was in such a crisis mode as Fink has documented that “two desperate doctors later said that they hastened the death of patients who had waited days in the heat for rescue.” Reading the book, there was little doubt that many of these patients would have had years left to live had there been a different set of responses.

The rule would change much of those worries. It would affect 68,000 providers across the whole range of the health care industry and not just hospitals and nursing homes but kidney dialysis centers, mental health facilities, home health and the whole shebang.

So, this is a no-brainer, right? Well, it should be but you’ve already probably guessed that it would be if we had a public health system, but with a private dominated healthcare system if administrators can avoid spending the money, then emergency preparedness is at the bottom of the list. Fink even noted that there are 250 California hospitals that have still not been “retrofitted, replaced, or removed from service” 45 years after the Sylmar earthquake killed dozens at California hospitals. A professor in Maryland noted that an administrator was probably calculating that if they had to spend a couple of hundred thousand and they never had a disaster, then they lost revenue. This is topsy-turvy of course. You spend to prepare, while hoping you never have to meet a disaster. The same prof though noted that if the facility spent the money and faced a disaster and were ready, they would make a killing, but “how do you do a budget analysis on that?” Wow! The warped priorities here just takes your breath away, and where is Senator Charles Grassley from Iowa when we need him reminding so many of these facilities that they are tax exempt so why is “making a killing” a priority anyway!

We need this rule and probably a lot more. Time to Boy Scout up and get in touch with your Senators and Congressmen to reach out to the OMB and the Department of Health and Human Services and remind them that “Be Prepared” is not just a slogan, but a lifesaver!


Malcolm Gladwell’s Pop Science is Whitewashing Katrina Pain and People



New Orleans     President Obama here’s some advice before you come to New Orleans to commemorate the 10th anniversary of Katrina: no matter what happens please, please ignore every bit of advice you might possibly get from the author and The New Yorker writer, Malcolm Gladwell about what to say about New Orleans and Katrina, and probably any other advice he ever gives you any the future. Recently, Gladwell was cited as one of the wise and rich men and women that Obama was consulting about his future post-Pennsylvania Avenue.

Gladwell has been on a bit of a roll the last number of years as the highly popular author of a number of books that might be characterized as “applied pop psychology” books including The Tipping Point, The Outliers, and others. Don’t tell me you haven’t read anything he’s written or I’ll ask you to give me the address of your cave. I’ve certainly read several. He specializes in pseudo-science stories that act like brain candy. You can’t read them quickly enough and they all seem smooth and sweet until you make the mistake of actually thinking about them and then you’re not sure. Whatever? It’s candy, so what might be the harm, right? Well, having just finished reading his most recent piece, “Starting Over” in The New Yorker labeled “Dept. of Social Studies,” which goes past candy, approaches unmitigated drivel, and then swerves into just plain dangerous, I’m convinced we need to get a petition together to the Secret Service to keep Gladwell as far away from the President as possible. Who knew Canadians could be so diabolical!

The thin reed Gladwell tries to grasp starts by trying to look at Katrina as a social experiment that might measure the impact of mobility on survivor families torn away from their homes by the devastation of Katrina, who were dropped or came to shore in other communities, and how they fared. Ok, that might be interesting, but then he tries to expropriate a seminal study done by economists indicting the United States at large for decades of abandoning urban America and perpetuating inequality by pretending the only thing under that shell was the issue of mobility, rather than disinvestment, racism, a deteriorated and mean-spirited social safety net, deindustrialization, and tax policies that have stagnated most of us while creating the super-rich. I could go on.

And, Gladwell knows he’s treading on dangerous ground throughout the piece. He tries to act like Katrina was bad news and that he would not have been riding with the business interests and social elites who were avowedly trying to whitewash the city, but unfortunately he wears his neo-conservative, neo-liberal biases on his sleeves. Implicitly, he totally supports every effort to prevent families from being able to return home from closing the schools to denying rebuilding funds to providing no healthcare. He pretty much sees the economy and population of New Orleans as a horror. He rationalizes this with a pseudo-science argument that the odds of lower income families “moving on up” are better in Houston, which he insults by calling it the “Salt Lake City” of the south, because the odds are slightly better that someone might crawl out of poverty, so darned are they lucky they were in a hurricane, surrounded by water and dead bodies, separated from family, friends, community and culture so they have a little teeny bit better chance in an economically stratified country to make it out. Spoiler alert: Please remember that there was no real way to read the study as arguing anything other than the odds were almost impossibly low for upward mobility anywhere!


How do you unravel this preposterous pretzel of an argument? We need public policies for cities and their population which create equity, not that forcibly relocate people on buses, planes, and trains. And, those policies need to be applied to every city. If Gladwell, wants to pretend to look at the impact of mobility and social science, it is interesting that nowhere in the article is there mention of Canadaville, a post-Katrina project of his fellow Canadian, the huge auto parts gazillionaire Frank Stronach from Magma International and his 300-family relocation project of lower income families to Simmesport, Louisiana several parishes up the river. Perhaps he avoided that because it is universally seen as a disaster and was abandoned by Magma and Stronach.

Gladwell finally ends his piece saying with this monument to sophistry:

In the past ten years, much has been said, rightly, about the resilience and spirit of those who chose to rebuild the neighborhoods they had lost. It is time to appreciate as well the courage of those who, faced with the same disaster, decided to make a fresh start.


Courage is triggered by choice, not a combination of disaster and coercion that for many families continues to this day. The overwhelming number of families still not able to return home are African-American. Where there was choice – and resources – in higher income white families, as has been well documented and even Gladwell seems to acknowledge, people overwhelming came home. On one count after another for lower income families Katrina was a pure and simple devastation that continues to this day. Gladwell would undoubtedly line up in favor of putting the Cherokees on the Trail of Tears, supporting pogroms forcing Jews to flee, and any number of outrages in the name of a few percentage points of progress in the by and by, rather than hunkering down and doing what’s right to support widespread progress for all the people where they live, including in urban areas like New Orleans.

Mr. President, don’t listen to Malcolm Gladwell. He may sell books, but that doesn’t change the fact that he’s a sycophantic apologist for the rich and, sadly, turns out to be a fool.

one of the homes at Canadaville

one of the homes in Canadaville


The Storm Next Time: How Safe is New Orleans?

120828073556-katrina-ann-01-horizontal-large-galleryNew Orleans   President Obama announced that he is visiting New Orleans on the eve of the 10th anniversary of Hurricane Katrina. Reportedly he wants to use the event to underline his climate change initiatives. The local papers are full of discussion about what needs to be done with many reviving the original President George W. Bush promise for 500-year storm protection. The cost is guesstimated at $100 billion. New Orleans Mayor Mitch Landrieu says “let’s go!” Congress has repeatedly said, “no go!”

The question continues to be “How Safe is New Orleans?” The New Orleans on-line news service, The Lens, convened a question and answer session with Dr. Paul Kemp, a geologist and oceanographer connected to Louisiana State University who was involved in the inspection of the levees after the storm, the now-closed Hurricane Center at LSU, and a controversial commissioner on the Southeast Louisiana Flood Protection Authority, moderated by award winning reporter, Bob Marshall. To summarize the answer in one word from the experts: maybe.

This was not a crowd pleasing response, partially due to all of the “ifs, ands, and buts”, but let’s look at what Dr. Kemp offered. The levee system and the new gates leave the city better protected than it was at the storm. Kemp minced no words, saying that at the storm, there was “no system,” but an unfinished dirt patchwork. Now, he claims the pieces are put together, “armor,” meaning plastic sealing both sides of the levee is being added, and there’s an understanding that there has to be progress every day to maintain and advance the system.

Many were not assured. Saying something requires daily attention in the city “that care forgot” is a stretch. And, so is money in this broke ass community. St. Bernard Parish below New Orleans is already trying to scrimp on their share and they are often the first place on a storm’s path. Kemp under questioning said a minimum maintenance budget is $15 million, but no one really knows what the real costs are to maintain a multi-billion dollar system. Furthermore Kemp was clear that budget was not in hand, and repeated the need to keep improving daily or protection would be eroding.

Marshall’s questions were tinged with skepticism. In his introductory remarks he was clear that the minimal requirements to qualify homeowners for the national flood insurance program drove the levee protection plan, not the future safety of the residents. Metaphor mayhem broke out. Homeowners were reminded that they had fire insurance not to stop a fire, but to rebuild what they could after a fire and that this situation was similarly not about prevention, but potentially rebuilding. We needed a well-built third story house for protection and what we had might have is a decent one story dwelling.

Kemp on the other hand was more scientist than advocate or politician which was reassuring. Unfortunately most of the science and technology is rapidly developing and unsteady so there’s no solid ground there. He clarified the misconceptions on storm surge articulately as not one 20-foot wall of water but a bulge that rose to a level and then fell with the task being to prevent the highest crest from hitting the levee protection.

Bottom line Kemp argued that no matter the storm, if it were just a matter of over-topping the levees whether five feet or whatever, the city would survive. There would be water in the streets and low lying areas but it would run in and out, and be similar to terrible New Orleans thunderstorms. There was a big “if” though constantly repeated: if the levees are not breached.

The real battle of New Orleans is being fought now on whether or not everything is being done to prevent the levees from being breached and identifying the most vulnerable spots and gaps, then shoring and closing them. There lies the answer to the question, “is New Orleans safe?”


Please enjoy Widespread Panic’s Steven’s Cat.


Thinking about Cascadia on the 10th Anniversary of Katrina

DSCN0401 (1)New Orleans   As the final countdown begins on the 10th anniversary of the August 29, 2005 landfall of Hurricane Katrina, the devastation it wrought, and the recovery still in progress, A Community Voice, formerly Louisiana ACORN, and an affiliate of ACORN International, held a “Katrina Heroes” event that was quite moving. Members, leaders, friends, and allies were often hardly able to restrain tears as they got up to speak, received recognition, or helped themselves to a plate of food. They have built a great community through their struggle.

Katrina was a 400-year flood event. The protection at considerable expense in the new levee system for New Orleans is a long way from that level. An op-ed in the New York Times laid out the price for a 500-year protection system. One-hundred billion or so, if done now, with about a quarter of it protecting New Orleans. It almost seems cheap at the price, but do we ever learn?

That question has been plaguing me especially since reading “The Really Big One” in The New Yorker about the impact of the disaster on the Pacific Northwest coast and its population when the Cascadia subduction zone erupts over a 700 mile expanse with impacts from roughly Vancouver down to northern California around Mendocino. The North American tectonic plate is inexorably moving to confront the 90000 square mile oceanic plate called Juan de Fuca, which is building up heat and pressure to slip underneath. The earthquake that will follow will be between 8.0 and 8.6 on the Richter scale on the low end to 8.7 to 9.2 on the scale on the high end, and because the scale is logarithmic the magnitude is almost incomprehensible. As reporter Kathryn Schultz writes, “…the northwest edge of the continent, from California to Canada, will drop by as much as six feet and rebound thirty to a hundred feet to the west – losing, within minutes, all the elevation and compression it has gained over centuries.” Holy-moly!


FEMA estimates that “everything west of Interstate 5 will be toast” on the west side of the volcanic range of the Cascade Mountain range. They estimate that 13,000 people will die, dwarfing Katrina and every other US-disaster. Another 27,000 will be hurt. One-million will be displaced and FEMA will have to provide food and water for another two-and-a-half million. Been there, done that, and we all know they are unable to handle anything near that. Seattle’s emergency office estimates that there will be 30,000 landslides in that city alone. If you didn’t drop down a hole to middle earth, the tsunami will be the most frightening catastrophe to hit next, and it will move within four minutes of the earthquake and the height could range between 50 and 100 feet. There are 70000 people estimated to live in the inundation zone and they will have between 10 and 30 minutes, depending on where they are, literally in the words of one Oregon official to “run for your life.”

There is a one in three chance that this earthquake will occur within the next 50 years. Those are bad odds. That is like, tomorrow! I can remember reading articles in the years before Katrina about what might happen to New Orleans in a worst case scenario. We did little to nothing to prepare for it. It was every man for themselves. I lived on higher ground. That was not enough for a community or all of the people lost forever or with their lives and families irreparably damaged.

What are we doing to prepare in the Northwest or nationally for a catastrophe that will absolutely happen and won’t be a matter of bad construction by the Corps of Engineers, but part of natural earth movements verified by meticulous science? Very, very little it seems, other than talk about it, and the not even that much talk really.

This is the fire and flood next time. It would seem to me that we would learn some of the lessons of Katrina not only by protecting New Orleans and the Gulf Coast, but preparing the Pacific Northwest to survive the Cascadia subduction when it erupts.

This can’t just be me saying this.





Nine Years after Katrina

Lower 9th Ward before and after

Lower 9th Ward before and after, credit to Ted Jackson at

Little Rock       Perhaps the best news in the nine years since Katrina has been that we have not faced another devastating hurricane, as the city continues to struggle to rebuild.  We had a bit of problem a couple of years ago in 2012, but not so severe that it forced widespread evacuation or extensive damage.  Every year that we can get past Katrina is another gift.

            Surveying the changes over nine years isn’t easy.  Many of the positives come with big, fat “buts.”

            Like the fact that population in the metro area is now 93% of what it was before the storm, but in the city itself we are only 78% of where we were before Katrina.  The Census Bureau estimates New Orleans’ population at 378,715 compared to the 2000 Census population of 484,674.  That’s still 100 grand down, and that’s not good.

            We’re growing, yes, but people still can’t find their way home, especially African-Americans.

The Census Bureau estimated 99,650 fewer African Americans in 2013 compared to 2000, but also 11,494 fewer whites and 6,023 more Hispanics. African-Americans still represent the majority of the city’s population at 59 percent, down from 67 percent in 2000.

All of which means we are becoming more diverse, even while we have so many “missing New Orleans.”  We gained 44,281 Hispanics and 6,564 additional Asian residents. The Hispanic population in the metro spiked 76 percent between 2000 and 2013, a rate greater than the nation’s 53 percent growth.

            So the city fathers that wanted a “whiter” city, didn’t get their wishes, even though their policies barred return for so many.  They also didn’t get a richer city because of their continued programs.

            According to The Data Center’s figures:

While the poverty rate in the New Orleans metro declined from 18 percent in 1999 to 15 percent in 2007, it then increased to 19 percent in 2012, such that it is now statistically unchanged since 1999. In New Orleans itself, the 2012 poverty rate of 29 percent is also statistically the same as 1999 after falling to 21 percent in 2007.   Like the overall poverty rate, child poverty in Orleans Parish and the metro area dropped in 2007 but has since increased to its 1999 levels. In 2012, the child poverty rate was 41 percent in the city and 28 percent in the metropolitan area, both higher than the U.S. rate of 23 percent.

No small reason for the continued poverty and stalled return continues to rest on the problem of inadequate and unaffordable housing, because of the double whammy of first the storm and then the recession which rolled back credit availability and made home reconstruction unaffordable for many low-and-moderate income families.  Rents soared after the storm and continue to be sky high.  The Data Center finds that “36 percent of renters in the city paying more than 50 percent of their pre-tax income on rent and utilities in 2012, up from 24 percent of renters in 2004.”

The beat goes on like that.

We did better on jobs and jobs on recovery after the storm than many cities in the recession, but the jobs didn’t pay diddling, especially when so much of the income went for housing.  Higher education is lagging, especially for African-American men, and the charter school experiment has not moved the needle on failing schools.  New businesses are up, but so are sales tax revenues and other taxes servicing a smaller population, so many of these businesses are marginal.  We have more bike lanes and bike trails but can’t seem to fix the potholes in the streets.

Here’s the story in New Orleans.  We’re going to make it, but every day is still going to mean a struggle over a bumpy road.  We’re going to come back somehow and we’ll welcome all the new people, but we can’t escape the heartache for people we miss, who still can’t make it home.



Going Old School with the Teachers’ Union

indexNew Orleans    I have hugely mixed feeling about my old high school in New Orleans, but finally I found myself in a situation, sitting next to another alum, my daughter, Dine’, where I found that I had never been prouder of the teachers at Benjamin Franklin High School than on that night in that auditorium.   In the long and bitter post-Katrina story, these were real heroes as 85% of the faculty had stepped forward and stood up by organizing the United Teachers of Franklin affiliated with the United Teachers of New Orleans, a local of the American Federation of Teachers.

Few will forget that one of the most ignominious stories of the aftermath of hurricane was the “never waste a crisis” mentality that found the school board terminating more than 5000 teachers and school employees and not reopening the schools in the fall of 2005, allowing the state and those trying to take over the system to seize most of the schools through the so-called Recovery School District and launch what continues to be the largest charter school pilot in the country.  Part of the collateral damage of course was also the devastation of UTNO, the largest, and arguably the strongest, union in New Orleans and voiding of all collective bargaining agreements.  Successful lawsuits filed at that time for the termination and rehiring proved breeches of the contract and though they are still pending should add up to billions, if there was justice in any settlement.

The Franklin story was one of the travesties of that time, since not only was it universally seen as the best public high school in the city and state, but it was also ranked annually as one of the top schools in the country.  The charterization of the school was little more than unaccountable and unconscionable re-purposing of a huge public asset by an insider group wanting less interference from the elected school board, read African-American, leadership in the overall supervision of the school.  Sitting at the public hearing called by the board on the question of whether to recognize the Franklin teachers’ union, no one commented on the fact that in this majority African-American city the board sitting in the front rows lacked any African-American representation, but that’s another story.

The teachers were eloquent in making their presentation.  They wanted equity, rather than a wildly arbitrary pay scale benefiting “picks and chooses” of the principal, now being paid $172,000 according to the on-line Lens report, they wanted job security rather than an annual application process, and they wanted a voice in educational policy from their position in the classroom rather than lectures from lawyers and accountants.  Who could disagree?  As it turned out almost no one.  Parents and students spoke in support of the teachers.  A couple of alums demonstrated their anti-union animus in one case offending the teachers by calling them “amateurs” in a misplaced point about Latin roots, and in another case just sort of whining about the surprise to hear of a union and the wishing it would all go away.

I had my 2-minutes to express solidarity in behalf of our family.   It was easy to punch holes in the notion of “collaboration” when collective bargaining better expressed – and guaranteed – such a voice.  It was easy to remind everyone there that it was teachers and students that every study and all personal experience proved made education work and not “bricks and sticks.”   It was even easy to remind the crowd that the values of the school itself spoke to allowing these special teachers to have a special voice.  Finally, as an organizer of a union, I was able to remind them that the teachers already had built a union, now they had to get used to it.

Larry Carter, the head of UTNO, spoke shortly after I did and reminded them that UTNO was no longer the old UTNO and that the teachers at Franklin now had their own, almost autonomous union chapter.  He didn’t say that it was all different now because if the Franklin teachers are able to win a contract, they will be the only teachers in New Orleans to have organized independently and done so and won a contract on their own.  The anti’s were at best fighting ghosts.  The teachers were fighting for the future.

That’s the true Franklin spirit, and as proud as I was of the teachers, for a change I was even proud to say that I was a Franklin graduate.