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Wed Sep 3 16:19:42 BST 2008

For those who have been following Gustav

Recovery
Good morning. It is about 0230 as on write this on Wednesday morning
(9-03-08). 

As you know, there are 5 phases to disaster management. Some are shorter
than others depending on the disaster. They are Pre-planning,
Activation, Evacuation, Recovery and Restoration. Each part has
subparts. For example during Katrina the recovery phase was long. A
subpart was the backfill. Some of you were strong components of the
backfill as you sent or were a part of the folks that came to New
Orleans and Louisiana to supply people, vehicles and other resources
that we sorely needed. This time the Recovery will be very short as we
in New Orleans will not need much assistance, The Restoration will be
shorter as well. On the other hand Recovery in Baton Rouge will be much
longer. As of last night the decision had not be made as to the
necessary evacuation of all of the patients from all of the hospitals
because of no power and the potential of several days to weeks to get it
restored. I am sure that by now it has been made but since the cable
network does not work and I have not been to the EOC for 4 hours, I do
not know what is happening.

 Late yesterday afternoon the last of the feeder bands was providing us
with a lot of rain and some wind but certainly less than 36 hours
before. I was watching the American flag flying which is just outside of
my call room as the storm was approaching, it was laying flat against
the pole. As the winds picked it blew from east to west and in the
height it was standing at full and struggling hard to remain attached to
the pole. Part of the Louisiana flag was shredded. The rain was
horizontal. Not vertical. My second time to see this. The first was
Katrina. The wind were not >120 mph this time, just 75 mph. That makes a
lot of difference for those who have not been in both. Late in the
afternoon, I looked and the flag was blowing from West to east. The last
feeder band had passed. 

As I watched the flag, a Blackhawk landed on the parking lot (it was too
heavy to land on the helistop). The ED crew brought a stretcher to the
parking lot and the aircrew took it to the door of the chopper for a hot
offload of the patient. The patient was from Baton Rouge. We were now
the evacuation point from Baton Rouge not the reverse as with Katrina.
We had entered the recovery phase as we were able to take patients from
other facilities. We had recovered. We had changed phases.

In just a few hours from now, the three parishes around us, Jefferson,
St Barnard and Plaquemines will lift the evacuation order and the 'gen
pop' (general population in disasterspeak) will be allowed to return.
Tomorrow the same should happen in Orleans Parish. It may be a little
premature in both areas since many area have no power or water; many
streets are not passable and there is no infrastructure such as gas
stations, food stores, departments stores, building supply stores, etc.
On the other hand, I guess that these cannot open until the 'peops' come
back to staff them. It will be a mess for the next few days

Along with the gen pop will be the folks that get injured falling off
the roofs of their houses or ladders, getting cut with chainsaws (that
they do not know how to use) and hand injures from hammers and the like;
and yes the drug dealers will be back with the penetrating trauma (the
life blood of a trauma training program)

Myself, I plan to operate on the pussed out chest from a GSW prior to
'the Storm' (actually the transfer that came in on the Blackhawk)  and
then go home to start to cutting up the avocado tree in my back patio
the blew over from the winds. Unless Ike or the following storm changes
my plans, all will be readiness for HBR on Oct 25

Just another reason why New Orleans is different and if you stay here
you learn to love all of it peculiarities: Mardi Gras, Jazz Fest, the
food, the music and yes, the storms.

Thanks again for your thoughts and prayer

Norman

Norman McSwain Jr, MD FACS
Trauma Director Charity Hospital
Professor of Surgery
Tulane University School of Medicine
504 988 5111

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