Soon after Hurricane Katrina devastated thousands of miles of the Gulf Coast of Louisiana and Mississippi, The Children's Health Fund (CHF) responded to the urgent public health needs by establishing Operation Assist (OA), in collaboration with the National Center for Disaster Preparedness (NCDP) at the Mailman School of Public Health at Columbia University. OA provides acute care and mental health services using Mobile Medical Units (MMUs) in Mississippi and southeastern Louisiana, ensuring access to health care for displaced children and families. OA’s six mobile teams also provide public health assessments and management. OA is overseen by Irwin Redlener, MD, president and co-founder, along with singer-songwriter Paul Simon of the CHF. He also directs the NCDP. OA has been working closely with senior disaster response officials, local health care resources and community leaders, to coordinate with other efforts, determine where services should be dispatched, and assess the situation. New MMUs have been ordered and permanent clinical and public health teams are being hired. In September and October, OA saw more than 10,000 patient encounters at more than 35 sites, which includes 3,400 in Mississippi and Louisiana and an additional 6,600 in Texas and New York. The initial patient need was extreme, with much of the care being related to injuries from the disaster or acute medical problems. CHF teams were treating infected wounds, providing critical vaccinations, dealing with exacerbated chronic health conditions, and managing severe psychological stress.

Gulf Coast Community Support and Resilience Program. Spearheaded by Paula Madrid, PsyD, this program will provide mental heath support, interventions, and education to all impacted psychologically by hurricane Katrina. Madrid has met with evacuees, teachers, nurses, and directors of school-based health programs to assess the needs and new and existing mental health services. A specially designed mobile unit has been ordered to provide services, including individual and group therapy consistently. Case management, community education, and staff training will also be provided. Similarly, the program aims to help strengthen mental health infrastructure of impacted communities by connecting individuals with existing resources as well as to provide training to caretakers in order to increase their ability to serve their client populations. The Program will take a community-based approach in the Biloxi-gulf-port area, providing direct mental health services, case management and referrals to impacted individuals. In addition, the program will conduct mental health community education presentations, and offer staff training to schools and community organizations that work directly with children. The program will provide services aboard mobile medical units as well as on-site in schools or school-based health centers.

Public health assessment and intervention. By collaborating with the NCDP, OA is bringing significant public health expertise to the field. An official partnership with Tulane University is also being explored. Activities under way include a survey of Louisiana schools looking at health, mental health, environmental and educational issues. In Mississippi, our public health team is conducting environmental health assessments on the Turkey Creek community in Biloxi, which is bordered by two waterways, each of which is used by hazardous industries. Threats from industrial waste represent both short- and long-term hazards. Throughout the Gulf Coast region, the impact of black mold infestation occurring in flooded buildings on residents with respiratory conditions will also be monitored. To gauge the safety of individual homes and communities, the project will conduct environmental health assessments and field testing.

Policy/Advocacy. Redlener has met and spoken extensively with national, regional and local officials regarding the opportunities and promise of reconstruction, and has been invited to bring OA staff expertise to represent medically-disadvantaged children, families and communities. Several CHF Board Members met with officials at an Emergency Operation Center and visited a service site. A highlight of the visit was the town hall meeting where a range of medical and public health issues were discussed, providing an platform for future advocacy. We plan to convene field hearings in Louisiana and Mississippi, and CHF will lend its voice to the long-term recovery process. Ensuring that survivors, especially children, are linked to medical homes and that individuals are seamlessly transitioned from emergency Medicaid programs to permanent ones is a critical goal. The successful restoration of the public health care infrastructure also hinges on increasing the medical personnel workforce and overcoming transportation barriers that impede access to health care.