Southern Louisiana Area Health Education Center

Helen Caruso, a hospital librarian at the Southern Louisiana Area Health Education Center (AHEC) in Covington, Louisiana, discusses her Hurricane Katrina experience during August 2005.

Interview date: Friday June 1st, 2007

Questions:

(1.) What happened in your community (i.e., what was the disaster/emergency)?

On August 26, 2005, I was in New Orleans, manning the National Library of Medicine exhibit at a medical job fair. The television in my room didn’t work, so I had gone to bed Friday evening without hearing the weather report. The following morning I was blissfully unaware of the approaching hurricane. After a leisurely breakfast, I arrived at the exhibit hall to find exhibitors frantically dismantling their booths. Everyone was talking about the hurricane.

I wasn’t too worried. Frankly, I thought people were over-reacting. Hurricane warnings are summer constants in southern Louisiana; most of the time they don’t become serious. Since all the exhibitors and attendees were leaving, I decided to take the exhibit materials back to Louisiana State University Health Sciences Center (LSU-HSC) before driving home across the Lake Pontchartrain Causeway. When I got to the LSU-HSC library building, the doors were locked, and I had to bang on the doors for Security to let me in. They told me that the building was closed because of the storm. It took a good deal of persuasion for me to convince Security that the exhibit belonged to LSU-HSC. Finally I was escorted upstairs and allowed to deposit the exhibit in the library.

Meanwhile, it was becoming increasingly clear that many people were taking the situation very seriously. Someone had arrived to remove laboratory animals, and a policeman informed Security that the New Orleans Police Department was taking over the parking garage. As I began driving home, the Mayor was on the radio, telling everyone to “get out” of New Orleans. I realized I was only moments ahead of a mass exodus.

I live in a rural area, and my family decided to wait out the storm there. On Sunday, the hurricane winds and rain pounded the area for hours. (1) The electricity went out and the skies darkened. It became very scary when the tall pine trees started snapping. Over 100 pine trees blocked our road. It was several days before we could leave the property. Phone lines were down, and cell phones stopped working. Electricity was not restored for three and a half weeks!

After enough of the trees were removed from the road, we managed to drive to Baton Rouge for supplies-no stores in our area were open. Cell phones worked in Baton Rouge, but there was no news about St. Tammany Parish. No one knew how far the devastation went. On our way back from Baton Rouge, we drove past Lakeview Hospital (one of the sites where I work). There were a significant number of trees down, along with signs of wind damage, but there was no evidence of flooding. I couldn’t get into the institution however as security wouldn’t let us inside.

About ten days later, I was able to go to my other site, Slidell Memorial Hospital. The storm surge had brought the lake water up to less than half a mile from the hospital. The neighborhood suffered severe wind and water damage. Huge trees lay on crushed homes and flood soaked furniture was everywhere. The hospital had remained open through the hurricane, and was accepting emergency patients. More than half of the hospital employees lost their homes or could not live in them. Those who had livable homes shared them with other staff and family. Some staff and many rescue personnel ended up staying at the hospital.

My first day back at Slidell Memorial, I couldn’t go into the library at all. I was asked to assist in setting up day care services in the hospital so employees could return to work. But I didn’t mind in the least being at work (because the hospital, unlike my home, had electricity and running water). The library is located on the first floor next to medical records and rehab. Luckily, someone from rehab had thought to put plastic on the collection before the storm hit. It was a good thing, since the roof had leaked. There were trash cans and hastily gathered containers full of water standing on the library counters and desk. A restoration company arrived to remove the humidity from the air and prevent mold from growing. They dried out the whole hospital. I was surprised at the large containers of water that was “de-humidified’ from the library.

I was allowed back at Lakeview Regional Medical Center after about two weeks. During this time I hadn’t heard from other SEL-AHEC (Southeast Louisiana Area Health Education Center) co-workers, or even my library assistant. I tried to call other library contacts, but couldn’t reach anyone. One of the first calls I received was from Greg Bodin from the National Network of Libraries of Medicine/South Central Region (NN/LM SCR) in Houston. Ethel Madden from Oschsner called the following week and related all the New Orleans news. The pair of us concluded that as far as medical library services in Southeast Louisiana-we were “it.”

Ethel and I began to coordinate our efforts toward recovery. Neither of us lost our homes (although we did host displaced family members). Since our energies weren’t consumed with simply trying to survive, we were able to work and try to help.

The harrowing after-affects of Hurricane Katrina are far from over. I recently traveled through Gulfport, Mississippi, where the Highway 90 Bay Bridge at Bay St. Louis had only just re- opened. (2) What I saw along the highway was truly devastating. It will take a long time for the gulf coast to recover. No one knows the full health effects from the aftermath. Respiratory illness and unusual rashes are common, even though epidemiologists found no lasting effect on the air quality. (3)

(1) For a chilling official report on Hurricane Katrina, see: Knabb, R.D., J.R. Rhome, and D.P. Brown. 2005. Tropical Cyclone Report: Hurricane Katrina, 23-30 August 2005. Miami: National Hurricane Center. http://www.nhc.noaa.gov/pdf/TCR-AL122005_Katrina.pdf accessed 7/6/2007.

(2) For more about the bridge, see: Nossiter, A. May 29, 2007. A Bridge Restores a Lifeline to a Battered Town. New York Times. http://www.nytimes.com/2007/05/29/us/nationalspecial/29bridge.html?ex=1338091200&en=24a98c1c1216af01&ei=5088&partner=rssnyt&emc=rss accessed 7/17/2007.

(3) This article seems to convey the ambiguity of the health situation: Wilson, Jennifer F..Health and the Environment after Hurricane Katrina. Annals of Internal Medicine 17 Jan 2006; 144(2):153-156. http://www.annals.org/cgi/content/full/144/2/153 accessed 7/6/07.

(2.) How did the library respond? How did the librarian respond? Were there non-traditional (unusual) roles that the librarian performed?

The first real day back at work (once the library was accessible again), I helped set up a daycare for the hospital employees’ children. It wasn’t a traditional library job, but it was something I could do to help the hospital The daycare was in operation until the schools started up again in October.

I worked with Ethel Madden. We talked about what was needed for the area and what we could do. We identified information access as the biggest need. Perhaps even more than health concerns, people needed telephones and an internet connection to begin reconnecting their families and restoring their homes. We appealed for assistance from the outside once people were allowed into the area to help. The South Central Region (SCR) of the NN/LM started to send out information about disaster recovery, health vulnerabilities, food storage, etc. which was then dispersed through the hospital library. I don’t know if the information was used, but it was gladly accepted by areas like the infection control, emergency room and the immunization center.

By the third week, the hospital internet was operational. I started to send hospital staff links to useful items. I also printed them out and distributed the articles. The library began offering computer access to displaced health providers and the public. Most of my actions were self-initiated or agreed upon with Ethel Madden. At first, the two of us were out of contact with the professional community. So we made the decision to go it alone. The situation was totally outside of anything that we had ever experienced, so we ended up doing many things that were out of the ordinary.

Even though the immediate financial future was uncertain, SEL-AHEC asked me to go to the SCC/MLA conference. There, I talked to other librarians and learned what they were doing. I came away with these pieces of advice for professionals in a disaster situation:

Ø Go in person to the areas where help is needed

Ø Talk to people

Ø Don’t wait for an invitation

The Medical Library Recovery Project was inspired by Ethel with input from Jenny Dagate and me, and funded by NLM and the SCR. We determined what was needed: computers, internet access and training. While we were working on the proposal, Hurricane Rita hit the region. Luckily, it didn’t affect us like Katrina did. We kept working. The proposal went to Renee Bougard and by January we were visiting the sites. We finalized the contact people and made agreements very quickly. By February, we started getting the computers. We hired a soon-to-graduate library school student to teach the classes and began the project. It continued until March 2007.

The Medical Library Recovery Project was so well received that we were invited to organize more classes. After The Medical Library Recovery Project funded a full year of high speed internet access and provided two MedlinePlus classes for The Community Resource Center at Miller Memorial Library in Hammond, they asked for more classes during 2007.

I served the North Shore and Ethel and the Ochsner staff covered the South Shore. They opened two libraries – one in the former Memorial Hospital, newly acquired by Ochsner, and one in Raceland at St. Anne’s. Some of our outreach efforts changed as we determined different needs along the way. Luckily, NN/LM SCR and NLM were very flexible, allowing leeway to revise the plans when needed.

(3.) How has the library (or the services provided) changed as a result of these events?

In general, I am more proactive. The Medical Library Recovery Project was a foot in the door for the library. It opened many places to library services that had never worked with a librarian before. The work enabled me to be more willing to approach hospital/clinic administration. And I was able to include patients and their families more in library services.

I am still working to make contacts with emergency responders. Individuals that worked for emergency agencies and groups passed through the hospital quickly. The relief workers used the computers, but that was about all the contact they had with the library. I later attended a community outreach exhibit in Hammond that included representatives from Red Cross and FEMA. I went to talk to them and handed out brochures with information about NLM’s environmental resources, MedlinePlus, and WISER.

I recently wrote another proposal (which was funded) to conduct outreach to emergency responders.

I received help from other library professionals, including my EBSCO agent Pat Pauletti. Pat provided essential aid by helping us stay connected, find missing issues (mail service was particularly bad during the aftermath). Because of Pat, my libraries are missing only a few issues.

I also received help from several libraries, including the medical library at Harvard Medical School. They had sent new, useful books for use in the emergency shelters. The leftover books made it into hospital libraries that didn’t have much funding for collections.

A hospital in Cambridge, Maryland (part of the Shore Health System) adopted Slidell Memorial Hospital. They sent truckloads of household and personal supplies and even sent people down to help out. The two institutions continue to maintain a relationship.

I spent a lot of time helping displaced health providers. Both hospitals had lots of extra people. Many displaced doctors, medical students, and nursing students needed library reference, computer access and help continuing their studies. Through The Medical Library Recovery Project, I helped put a workstation in the library as a convenient location for these individuals.

I remember a fire in 2000 at the SEL-AHEC headquarters. The library lost everything but the card catalog. At the time, it was the worst thing that could have happened to them us. Katrina was a different kind of loss entirely. The library gained much more in the long run and became more effective. It certainly doesn’t mean that Katrina was a good thing – the entire area still has devastation two years later – but I was able to help in a positive way and to increase the reach of the library. It made a difference to the kinds of services that I could provide and doors opened as a result.

(4.) What, in your opinion, are the roles for libraries (and librarians) in disaster planning, response and recovery efforts?

There are three major roles that librarians can take: conducting outreach, training, and proposal writing. They can appeal for needed help through their networks and professional connections. I knows from experience that the outreach grants from NLM have made a significant difference, especially by providing opportunities to network with local health providers, hospitals and clinics, By getting to know them, I was better able to predict their needs following this disaster .

Librarians also know which information resources have accurate and reliable sources. And they know the community. As a result, they can accurately decide what is needed and provide it quickly.

In thinking ahead for another hurricane season, I advise other professionals to make sure they have accurate contact information – “real” contact information, which includes relatives and friends and cell phone numbers. The contacts should also include hospital administrators and staff. I also think it is a good idea for hospitals and organizations to set up websites hosted from an outside location and toll-free numbers to provide up to date information for employees.

Here are some pictures submitted by Helen Caruso and Kathy Duplechien, SWLAHEC Librarian, that illustrate the extent of the destruction in Slidell, Louisiana.

Destruction in Slidell, Louisiana

Destruction in Slidell, Louisiana

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