The city looked like it had been bombed. But in fact, it was an act of nature that had caused such devastation–more specifically, the force of Hurricane Katrina. Never before had I seen such destruction and total wreckage of what had once been a treasured city. Never had I evidenced people so distraught over missing family members, not knowing whether their loved ones were alive or dead. As we drove through the streets of the famed city of New Orleans, I wondered how long it would take to rebuild, how long it would take before the city would be bubbling with life and excitement once again.

I had visited New Orleans about 10 years ago and I remembered its lively downtown, busy with people and vehicles crisscrossing. Judging from the destruction I now saw before me, it would be very costly and time-consuming to rebuild all these ruined homes, businesses and lives. Questions and thoughts ran through my mind as I looked at the damage everywhere, too stunned at first to photograph it, eventually taking a few pictures when I had returned to my senses. Would New Orleans ever be normal again?

Relief workers assist the effort.Relief workers assist the effort.

On August 29, the day Katrina first struck the Central Gulf Coast, I received notification that I was to be deployed to the South. Hurricane Katrina was increasing in strength and power. Initially it was feared to be a Category 5 hurricane, but as it hit landfall it had lessened to a Category 4. According to the Federal Emergency Management Agency (FEMA), a Category 1 is a hurricane with winds between 74 and 95 miles per hour while a Category 5 has winds greater than 155 mph. As it slammed into the Gulf Coast, the deadly Katrina had destroyed everything in its path. I saw roofs, building structures, cars and boats positioned as if tossed around aimlessly. In the wake of the hurricane, a powerful storm surge and broken levees had caused major flooding in New Orleans, wreaking further havoc.

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On September 4, after waiting for the call, I received an email instead. I was off on a mission. As a U.S. Public Health Service (USPHS) Commissioned Officer and a nurse, I was finally on the roster and on standby to deploy, having just completed my graduate studies in nursing. I had my deployment bag still packed from my military days; I had served in the Air Force as a flight nurse and clinical nurse from 1995 to 2001. I went through the bag quickly and repacked it with fresh items.

The email stated that the conditions at the deployment destination would be austere and to be prepared. We would be using porta-potties, consuming Meals Ready-to-Eat (MREs) and sleeping on cots–if we were lucky. To me, this sounded all too familiar: I was born and raised on the Navajo Reservation. I had also experienced similar conditions at the Prince Sultan Air Base in Saudi Arabia, where I flew many times to evacuate or return soldiers.

Missions, Medicine and Mosquitoes

I arrived in Alexandria, La., on a hot, humid afternoon. First stop: England Air Park, where an old Air Force hangar would be home for the next two days. We worked in the hot sun, dripping with sweat, unloading supplies, setting up and getting ready for the swarms of evacuees who were expected the next day. Then came the task of dismantling the medical equipment, cots, etc. and packing them up only to move down further south.

LCDR Ruth Kawano, MSN, RNLCDR Ruth Kawano, MSN, RN

Those first few days, the humidity seemed unbearable. For me and 75 other relief workers, our nights were spent on cots, with mosquitoes biting every exposed area. The hangar was full of dust and small creatures unknown to me. Our next journey would take us to Camp Port Allen–or Camp Mosquito as it soon became known–in Baton Rouge.

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Upon our arrival in Baton Rouge, the humidity became extremely unpleasant. But by then, I had gotten used to it. We rolled up our sleeves. The first order of that afternoon was to haul luggage and medical supplies from a truck to our tent, then find our cots and get an orientation on our next missions. In addition to USPHS nurses and physicians, there were many firefighters, Disaster Management Assistance Teams (DMATs) and other volunteers who had traveled from many parts of the country to help out in this emergency.

Many people who had been displaced by the hurricane and flooding were now in shelters throughout Louisiana. Some people who needed medical care were placed in the Special Needs Shelters, a type of makeshift hospital. Others were staying in churches, Red Cross shelters or in private homes. Still others were trapped in New Orleans, unable to get out of the flooded areas, or had perished.

For the next few days, our missions ended and new ones evolved. For three days, we traveled all over Louisiana preparing Shelter Needs Assessments. These assessments were crucial in evaluating the needs of the evacuee shelters. We augmented the American Red Cross, the Centers for Disease Control and Prevention, and the Louisiana Department of Health & Hospitals to complete the assessments. We worked in teams of three or four people, consisting of a medical provider, a nurse and an environmental health officer. We assessed the environmental needs and in some areas evaluated the care of the evacuees. We made recommendations to all the shelter staff depending on their needs. Each day, we went to different parishes in the state. (A parish in Louisiana is equivalent to a county in other states.)

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I also had a chance to use my nursing skills in Lafayette, La., where a Special Needs Shelter had over 65 patients. I got to meet, talk with and care for many displaced, depressed and frustrated evacuees. There I relearned how to set up a temporary hospital, much like I had done in the military.

Then, for the next few days, I was part of a group who worked with the FEMA-sponsored Find Family National Call Center, answering telephone calls from people who were trying to locate lost relatives. Over the course of several days, we worked to track down more than 3,500 people who were missing or may have perished in the disaster. By September 15, about 230 people had been located! It was amazing to have been a part of that mission and to be able to help those in need.

Other volunteers got a chance to work with the Louisiana State University evacuee Special Needs Shelters and the animal shelters in Baton Rouge, the Cajun Dome shelter in Lafayette and the shelters in Alexandria.

Into the Flood Zone

Two days before the end of my deployment, I had the chance to go into the flood-ravaged areas only a few could enter. There, in the heart of New Orleans, accompanied by LCDR Michael Truesdell–a fellow USPHS Commissioned Officer who is a physician at the Tuba City Regional Health Care Corporation in Tuba City, Ariz.–I met people who had returned to their devastated communities now that the floodwaters had receded. Some had a look of sadness; others were excited and ready to rebuild. Some people with health problems had run out of their medications and had not seen any health care providers for a while. We were able to assess some of their immediate needs; even just taking their blood pressure made them happy.

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Destruction was everywhere around me. I saw buildings streaked with darkened lines of demarcation from the floodwaters and smelled the stench of garbage and decay. Cars and boats were overturned; some buildings were completely destroyed, reduced to piles of debris on the ground. The hurricane’s fierce winds had caused many trees and vehicles to plunge through houses, and debris was everywhere. The once-populated hospitals and medical centers were empty and the streets were void of the living. The famed Interstate 10 was strewn with garbage, making it unsafe to drive through. It was as if I was in a bombed-out war zone, like the images I had seen of Iraq and other foreign countries on television.

This deployment has definitely opened my eyes to what a city and its populace can experience from a powerful, ruinous force of nature. Overall, it seemed to me that there is much room for improvement in the way the federal and local government–including the mayor of New Orleans, state officials, FEMA and the President of the United States–responded to the hurricane and its aftermath. It seemed that the nation was completely unprepared because we had never had to deal with a disaster this monstrous before Katrina. Now that we have had this experience, I think the government will be able to learn from what happened and do a better job of responding in the future.

Based on my personal experience, it also seemed that some better planning may have been needed in the way the Division of Commissioned Personnel (DCP) reacted in the initial stage of our USPHS deployment. For our first few days after arriving in Louisiana, we found ourselves sitting there with equipment and supplies but not much to do until days later. I also feel that the DCP needs to provide disaster training for its Commissioned Corps officers. Not all of us are disaster-trained like the DMATs. In the Air Force I had Survival Training, Basic Field Nurse Training and yearly Survival reviews. In the civil service, however, we don’t get that type of training.

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Although it was sometimes a physically and emotionally challenging experience, answering Katrina’s call has truly given me the opportunity to carry out the USPHS mission of promoting the “health of the nation [and] deliver[ing] health expertise in time of war or other national or international emergencies.” I hope and pray for the thousands of homeless, dispossessed and lost people whose lives continue to be affected by the devastation of Katrina.

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