Hurricane Katrina hospital disasters

Hospitals and other health care facilities may further classify disasters as either internal or external. External disasters are those that do not affect the hospital infrastructure but do tax hospital resources due to numbers of patients or types of injuries (Cans, 2001). For example, a tornado that produced numerous injuries and deaths in a community would be considered an external disaster. Internal disasters cause disruption of normal hospital function due to injuries or deaths of hospital personnel or damage to the physical plant, as with a hospital fire, power failure, or chemical spill (Aghababian, Lewis, Cans, Curley, 1994). Unfortunately, one type of hospital disaster does not necessarily preclude the other, and features of both internal and external disasters may be present if a natural phenomenon affects both the community and the hospital. This was the case with Hurricane Andrew (1992), which caused significant destruction in hospitals, in clinics, and in the surrounding community when it struck south Florida (Sabatino, 1992), and Hurricane Katrina (2005) when it impacted the Gulf Coast, rupturing the levee in New Orleans (Berggren, 2005). 

Disaster planning must include a community mutual aid plan in the event that the hospital (s), nursing home(s), or other residential health care facility needs to be evacuated. Plans for evacuation of health care facilities must be realistic and achievable, and contain sufficient specific detail as to where patients will be relocated to and who will be there to care for them. Patient evacuation was a major challenge to disaster response efforts following Hurricane Katrina, and was hampered by the destruction of all major transportation routes in and out of the city. Pre-planning for the possibility of the need to evacuate entire health care facilities must address alternative modes of transportation and include adequate security measures (see Figure 1.4). 

The Joint Commission on Accreditation of Healthcare Organizations also defines a third level of crisis—a catastrophe. A catastrophe is considered a disaster in which the community and hospital are overwhelmed and isolated for 3 or more days. This is exemplified by the Sumatra tsunami in 2004 and by Hurricane Katrina in New Orleans in 2005 (Berger, 2006). For our purposes, this category will be considered a disaster. 

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