As Hurricane Katrina brewed in the Gulf of Mexico during the final days of August, more than a million people fled the New Orleans area. Hundreds of thousands found shelter in my community of Baton Rouge, La., just 50 miles northwest of the devastated Crescent City. In the days after Katrina's landfall, Baton Rouge was overwhelmed as tens of thousands more people were evacuated, including critically ill patients in desperate need of medical care.
In the blink of an eye, everything changed for Baton Rouge, including the long-term future of our healthcare system. Immediately our community became the front line of defense in the first ever evacuation of a major U.S. city. With other evacuation routes closed, the only escape route would bring every evacuee through our city, many in need of medical attention.
Several years ago, hospitals in our community began working together to develop a stronger emergency response system. We were fortunate to participate in several extensive training programs involving all response organizations within East Baton Rouge Parish. In fact, Baton Rouge was one of three communities in the country selected to participate in an offsite community-wide disaster-response simulation. I can't think of any experience that could have better prepared us for something of Katrina's magnitude.
At Baton Rouge General, the most intense moment was when we first heard news that the levee in New Orleans had been breached. An eerie silence fell over our hospital's Command Center; we understood the ramifications of a catastrophic failure. In the days to come, it would be our hospital's deep-rooted commitment to caring for our neighbors that sustained us as our energy drained, staff was pushed to the limit and the situation seemed to deteriorate by the hour.
The first week after the levee failure was an experience I pray our country never faces again. It exhausted the staff physically and emotionally. But we did our jobs well and took care of the patients. Hospitals in the community collaborated, and physicians volunteered at triage areas within the community and at hospitals. We graciously accepted offers of volunteer assistance from around the country and we cared for every patient who came through our doors.
The next week held no reprieve. The New Orleans evacuation was completed, but Baton Rouge was still in crisis. Two hundred thousand evacuees remained in our city. For many, the only resource for medical care was Baton Rouge's emergency rooms. As the evacuee triage areas closed, the emergency rooms were again overwhelmed. Staff members who were near exhaustion after caring for patients during the weeklong rescues were now faced with a deluge of new patients coming from area shelters. Many of these patients needed only prescriptions, medication or minor first aid, but those basic resources were not in place.
As we continue in the post-Katrina era, we recognize the profound and permanent changes to our region. No one knows how long residents will be displaced or how many will make permanent homes in their new communities. Here in Baton Rouge, officials project that the city is now home to 200,000 to 250,000 new residents. No community our size has the infrastructure in place to respond to such rapid growth. Our hospital's challenges are daily and vast: housing, transportation, supplies, staff, space for all the patients and equipment for their care.
I recently joined with representatives of other Baton Rouge-area healthcare organizations in a meeting with HHS Secretary Mike Leavitt. We discussed some of the challenges facing our region:
We estimate we need to hire 400 new nurses for area hospitals, along with additional allied health professionals and nonclinical employees. We must find them housing and transportation as the community struggles with our "new normal" size and infrastructure limitations.
The Baton Rouge community must respond with an increased level of acuity for our program, establishing trauma and transplantation programs for the larger population and region we now serve.
However, our biggest challenge is the future uncertainty and fallout of the disaster. What are we preparing for? How many people will we serve? We may not have enough licensed hospital beds in our community to meet the new demand. Certainly, we will require more equipment and technology, but it is impossible to plan wisely given the fundamental questions that remain unanswered, especially what our new population will be. We worry that state Medicaid dollars could be cut as the state struggles to manage the cost of recovery.
Just nine months ago, Baton Rouge General began construction on a major expansion project. However, those plans were based on a needs assessment that is irrelevant in our post-Katrina community. The new projections are uncertain.
It is obvious that many challenges await Baton Rouge General, other Louisiana healthcare providers, and our state and country in the aftermath of Katrina. One thing is certain-life in Baton Rouge will never return to the pre-Katrina days. In just hours, Katrina forever changed life in Louisiana. We will need help from every sector to restructure, rebuild and respond. It won't be easy, but nothing in healthcare ever is.
William Holman is president and chief executive officer of Baton Rouge (La.) General Hospital.