August 29, 2005 changed my life. It unambiguously divided my existence on this earth into two very specific categories: pre-Katrina and post-Katrina. I had the dubious privilege of practicing medicine in New Orleans for the entirety of the natural disaster known as Hurricane Katrina and through that horrific ordeal, I witnessed the most vile atrocities and true suffering that I've ever seen in my life. I don't think I'll ever recover.
My office was only shuttered for a few days and I returned to seeing patients a short time after the floodwaters receded. New Orleans was basically a M.A.S.H. unit for months. It's hard to imagine but there were yachts in the middle of major highways, cars overturned, trees uprooted, and dead, waterlogged bodies in the middle of the street. This was a daily sight in the immediate aftermath of Katrina. More than 1,800 people died.
Although it's been more than 4,380 days since the storm, the horrors are etched into my mind, both as a doctor and as a human being. Texans will be facing the aftermath of Hurricane Harvey for many years to come, but in this acute phase of their ordeal, there are some issues that need to be addressed to protect not only their physical health but also their long-term mental health.
It's being reported that Harvey has produced floating mounds of fire ants, snakes and alligators in the floodwater, and there will likely be toxic mold growing in thousands of homes, which is dangerous for more than just people with allergies and asthma. If there's a lot of standing water once the floodwater recedes, mosquitoes that spread West Nile virus and Zika will have ample breeding grounds. These issues will cause Texans to suffer for a long time to come.
I'm hoping the lessons from my Katrina experience might benefit Texans. Here are a few things that may not be what the media focuses on while first responders are still in search-and-rescue mode.
There are a lot of hazards that must be addressed when confronted with a hurricane's floodwaters. Notwithstanding the obvious possibility of drowning, most people don't think of another major danger of wading through the murky water: If you get a large laceration or even a minor cut from hidden debris, you could die of a tetanus infection or any one of a myriad of bacterial infections, which spread very rapidly. At this time it's still unknown, but I would venture to say that hundreds of people who perished in Hurricane Katrina died from skin infections that spread to the bloodstream. Floodwaters are a cesspool of harmful bacteria and toxic chemicals. I would implore all people who got wounds from walking through the water in the Houston area to wash them with soap and water. If the wounds get warm, red, or start oozing, it's a sign of infection and you should seek medical attention; your life may depend on it.
Yes, tetanus is rare, but if you do contract it and you don't have a tetanus shot that's up to date, the infection can be fatal within days. If one person dies of a preventable disease, it's too many. I encourage everyone to keep their tetanus vaccination updated because you never know when a natural disaster will come your way; invariably one will. On that note, if you take a medicine daily to survive, you should get backups if a disaster is predicted. For people on medicine that has to be refrigerated, if there's a chance you'll lose power, the meds could be rendered useless. That should factor into your decision of whether to evacuate. And people taking any kind of medicine will need to prevent it from coming into contact with the floodwater.
If you are staying in a shelter, you should wash your hands frequently with soap and water, as viruses can spread quickly in crowded quarters. If you can't wash, use alcohol-based hand sanitizer but know that hand-washing is definitely the better option, since hand sanitizers don't kill all viruses, including the highly contagious stomach bug norovirus. Sanitizer is more like a backup until you can wash with soap and water. Lastly, you have to protect your mind. You must see a mental-health professional if you start having even the slightest feelings of hopelessness or despair. The Department of Health and Human Services has a Disaster Distress Helpline where you can talk to a trained crisis counselor right away by calling 1-800-985-5990 or texting TalkWithUs to 66746. There are usually centers set up for counseling after natural disasters, but these buildings may be flooded as well, so it's a good idea to contact their local municipality for information. Post-traumatic stress disorder (PTSD) will be rampant following Hurricane Harvey. Texans will be so busy trying to survive that they won't allow themselves to grieve. Many New Orleanians are still grappling with Katrina PTSD because they never allowed themselves to step back and evaluate the severe trauma they experienced. Trust me, it will sneak up on you in a year or two when you can't focus and your life is starting to unravel.
In post-Katrina New Orleans, some patients would have panic attacks every time it rained. This level of illness happened to my young patients as well as my older ones. They would come to my clinic and I would have to give them injections of anti-anxiety medicine just for them to get through the day. Some of the more severe patients were actually scared to take baths and showers because they were traumatized by having been stranded in floodwater for days.
I gave a medical lecture in New York six months after Hurricane Katrina, and the folks that attended kept asking me "why do you live in New Orleans?" and "why would they rebuild New Orleans—it's just going to flood again." Many of them had no sympathy, and definitely no empathy. They never thought it would happen to them. It was only a few short years later for them to truly feel empathy, when in 2012 Hurricane Sandy descended upon them. Sandy illustrated the reasons why you should aIways be prepared. It also illustrated to those unsuspecting lecture attendees why I wanted to rebuild my great city. They have now rebuilt the New York and New Jersey area and Texas will rebuild as well.
I don't wish this type of natural disaster on my worst enemy. But as climate change is warming our planet and concrete sprawl is not allowing our natural soil to drain the rainwaters, so these events are going to become only more common. Texans, be strong. Remember your state motto: Even Harvey can't mess with Texas. Please take care of yourselves and prepare for next time, as preparation is the only way to ensure your safety for the next hurricane, which inevitably will come sooner than you think.
Corey Hebert, MD, is a medical broadcast journalist, pediatrician, and emergency medicine physician in New Orleans. Hebert is a clinical assistant professor of pediatrics at LSU Health New Orleans School of Medicine and an assistant professor of pediatrics at the Tulane School of Medicine.
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