1/23/2015
Lessons Learned from Hurricane Katrina
LTG. RET. Russel L. Honoré
CDR JTF‐Katrina
Search and Rescue
RELIEF OPERATIONS SUMMARY
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Search and Rescue: 41,789 Saves
Civilian personnel treated: 13,612 DOD forces treated: 4,784
Civilian patients evacuated: 2,750
Food inspections: 715,081 lbs
Water inspections: 275,024
Meals: 164, 874
Animals treated: 1,120
Immunizations administered: 23,329
Aerial Insecticide Spraying: 2.8 mil acres
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1/23/2015
Heroes Rise
Dr. Juliette Saussy, Director of Emergency Services for
the City of New Orleans, supervised the medical triage
efforts at the Convention Center, evacuating over 19,000
patients in one day
HEALTHCARE IN LOUISIANA
Damage and Destruction of Health System Capacity (1 of 2)
23 - Number of hospitals in Orleans Parish before Katrina with 3,679 beds
1 - Number of hospitals operating in Orleans Parish after Katrina – the temporary US
Comfort medical ship with 270 beds
54% - Percent of total charges for uninsured patients served at Charity / University
Hospital in New Orleans; Charity Hospital is no longer open
11 - Number of hospitals in Jefferson Parish before Katrina with 2,108 beds
5 - Number of hospitals operating in Jefferson Parish after Katrina with 1,068 beds
53 - Number of nursing homes operating in Jefferson, Orleans, Plaquemines, and St.
Bernard Parishes before Katrina
6 - Number of nursing homes operating in Jefferson, Orleans, Plaquemines, and St.
Bernard Parishes after Katrina
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HEALTHCARE IN LOUISIANA
Need for Health Care and Health Coverage
50th - Ranking on health of population prior to Katrina
5th - Ranking on rate of uninsured prior to Katrina
17th - Ranking on proportion of low-income uninsured children prior to Katrina
761,000 - Number of uninsured people in Louisiana prior to Katrina
71% - Percent of low-income (< 200% of poverty) Louisianans who have Medicaid
coverage or who are uninsured
653,175 - Number of Medicaid beneficiaries in affected parishes prior to Katrina
40% - Percent of individuals denied Medicaid coverage in Baton Rouge since Katrina
who meet income rules but not other eligibility rules
22% - Percent of Louisianans living in poverty
1.1 million - Number of people in Louisiana displaced by Katrina
39,000 - Number of people in Louisiana in shelters as of 10/4
52% - Percent of Houston Astrodome evacuees who were uninsured
33% - Percent of Houston Astrodome evacuees hurt or ill due to Katrina
41% - Percent of Houston Astrodome evacuees with some chronic health problems
HEALTHCARE IN LOUISIANA
Damage and Destruction of Health System Capacity (2 of 2)
1,850 - Annual number of mental health acute unit admissions at Medical Center of
Louisiana at New Orleans, which no longer is open
1,974 - Annual number of mental health outpatient clinic visits in New Orleans at clinics
that are no longer open
6,821 - Annual number of individuals served in New Orleans outpatient substance
abuse programs that are no longer open
16,488 - Number of basic health care providers in Jefferson, Orleans, Plaquemines,
and St. Bernard Parishes prior to Katrina, many of whom are no longer there,
including:
• 1,479 primary care doctors
• 9,442 licensed nurses
• 1,105 pharmacists
• 3,047 emergency medical technicians
• 1,415 mental health workers (psychiatrists and social workers)
DISASTER CONDITIONS –
RIPE FOR SPREAD OF DISEASE
• Heat, high humidity, standing water
• Perfect breeding conditions for mosquitoes
• Numerous bio-hazards in water people waded through
• Close quarters for evacuees
• Reduced immune systems due to fatigue, stress, dehydration
• New Orleans has a history with yellow fever (41,000 deaths
and 1905 – 7,849 in 1853)
between 1815
• West Nile Virus (117 cases in LA in 2005) and encephalitis (Missouri outbreak
1975) also possible concerns
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1/23/2015
FEDERAL RECOMMENDATIONS FOR FUTURE PUBLIC HEALTH CRISES
• Develop a comprehensive plan to ID, deploy, track Federal public health and medical assets
• Propose legislation to transfer National Defense Medical System from DHS to HHS • Train, equip and roster preconfigured, deployable healthcare teams
• HHS oversight and coordination of emergency, bioterrorism, and public health preparedness needs
• Communicate public health and individual/community preparedness guidance to the American people
• Create and maintain dedicated/deployable teams of commissioned U.S. Public Health Service officers to provide on‐site expertise • Assist local and state health infrastructures to increase capacity
• Foster widespread use of interoperable electronic health records (HER) systems to support emergency responders
Washington’s Crossing of the Delaware
- At the Battle of Trenton, during the Christmas of
1776, the Continental Army composed of 2,400
volunteers captured or killed over 900 British and
Hessian Soldiers keeping the American Revolution
alive
Emanuel Gottlieb Leutze, American, 1816-1868
George Washington Crossing the Delaware, 1851
Oil on Canvas; 12 2/5 x 21 1/4 in
To be Born
FREE
is an ACCIDENT
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1/23/2015
To Live FREE
is a PRIVILEGE
To Die FREE
is a Responsibility
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1/23/2015
US Population Concentrations
60%
54%
42%
42% of US Population Lives within 20 miles of Ocean Coastline, Mississippi River & Great Lakes – a “target rich”
environment!
Data based on 2003 US Census Data
[email protected]
Decision Superiority
See First
Understand First
Act First
Russel L. Honoré, LTG, U.S. Army
[email protected]
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Who
ELSE
Needs to Know?
Russel L. Honoré, LTG, U.S. Army
[email protected]
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1/23/2015
Creating a Culture of Preparedness
LEFT
Recover
RIGHT
Prepared?
Respond
Mitigate?
Money
Spent on Preparedness
Presidential Declaration
WHAT IT SHOULD BE
Disaster
Strikes
WHAT IT IS
POLITICAL
HEALTH
EDUCATION
ECONOMIC
STAFFORD
ACT
LOCAL
GOVERNMENT
GOVERNANCE
FEDERAL
HOME
STATE
DIPLOMATIC
National Preparedness Plan? (NPP)
ECONOMY
ACT
National Response Framework
[email protected]
Russel L. Honoré, LTG, U.S. Army
Battle Drill: React to MEDIA Contact
Leadership During Disaster
Russel L. Honore’
Russel L. Honore’
LTG, USA (Retired)
[email protected]
LTG, USA (Retired)
[email protected]
1. Don’t lie. Tell the truth.
2. If you don’t want to hear it or read it, don’t say it or do it.
3. Give media access 0500‐2400. Set aside at least 20‐30 minutes a day for interviews. Be prepared for unexpected.
4. Purpose: To provide information to the public. The American people have a right to know.
5. Talk about what you KNOW, not about what you THINK.
6. Don’t answer “How do you feel about…?” questions. Focus on mission. Think about answers.
7. Interject humor with caution. Watch timing based on situation.
8. It’s about “US” not “ME.”
9. The Army is an outdoor sport. Do interviews outside in an operational environment.
10. Have your public affairs officer keep you posted on your boss’s and your boss’s boss’s quotes.
11. Figure out your daily top 3 priorities of work and talk about them.
12. Get satellite radio and listen to national news a few times a day.
13. Don’t be part of a public investigation. Don’t let reporters act like prosecutors.
14. Build business relationships with reporters. Drink coffee, eat with them, let them get to know you.
15. Be yourself.
16. Don’t read any damn prepared remarks.
17. Don’t do politics – focus on your mission. Don’t compliment or criticize political leaders.
18. Use your staff to see first, understand first, act first
HELMSBIDEN ACT
1. Arriving on the scene of a disaster – you must be the calm in the storm.
2. Work through the chaos and confusion – don’t add to it.
3. Can’t do everything at once – establish a Priority of Work.
4. Look for quick wins.
5. In a disaster, you are the priority – if you ask for it, you’ll get it.
6. Need decision superiority – See first, Understand first, Act first.
7. Collaboration is key – everyone has a boss – unity of effort, not unity of command.
8. Who else needs to know?
9. Public information critical in a disaster situation – poor communications.
10. Must give the media access – if you’re not speaking, someone else will speak for you.
11. Stay connected with those responsible – Mayor, Governor,
President, Military Leadership.
12. Track what the key leaders are saying so there are no contradictions.
13. Deal with the misinformation put out by others.
14. Real art of leadership is getting people to follow you willingly.
15. Your audio and video have to match, do what you say
16. Leaders cannot be observers, you must be a player.
17. Leader takes responsibility for what happens – good, bad, or ugly.
18. Don’t play the blame game.
19. Do not allow the media to interrogate you.
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1/23/2015
Prayer of Saint Francis
Lord, make me an instrument of Your peace.
Where there is hatred, let me sow love;
where there is injury, pardon;
where there is doubt, faith;
where there is despair, hope;
where there is darkness, light;
and where there is sadness, joy.
O, Divine Master, grant that I may not so much seek to be consoled as to console;
to be understood as to understand;
to be loved as to love;
for it is in giving that we receive;
it is in pardoning that we are pardoned; and it is in dying that we are born to eternal life.
Russel L. Honore’
LTG, USA (Retired)
@ltgrusselhonore
The Sunshine Patriot
THESE are the times that try men’s souls.
The summer soldier and the sunshine patriot
will, in this crisis, shrink from the service of
their country; but he that stands it now, deserves the
love and thanks of man and woman.
Tyranny, like hell, is not easily conquered; yet we have
this consolation with us, that the harder the conflict, the
more glorious the triumph.
What we obtain too cheap, we esteem too lightly: it is
dearness only that gives every thing its value.
Heaven knows how to put a proper price upon its
goods; and it would be strange indeed if so celestial an
article as FREEDOM should not be highly rated.
Top Five Challenges for 2014
Thomas Paine
December 23, 1776
1. Poverty/Hunger in less developed nations
2. Dependence on fossil fuels
3. Protect the environment and preserve our natural resources
4. Infectious Diseases (HIV/AIDS, Avian Flu, Mad Cow, etc.)
5. Religious, Political & Ethnic intolerance throughout the world
Leadership: Lessons from Geese
Leadership: Lessons from Geese
Observers of geese say that the lessons they have learned by watching these birds are useful for foster parents and others who work with and rely on others.
MODEL OF EXCELLENCE
TEAM
DISCIPLINE
Competence (skill, knowledge, and ability) gives Soldiers
confidence to be great Warriors, based on solid individual,
leader and unit discipline. Creates high unit morale and Esprit
de Corps.
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1/23/2015
Lessons Learned from Hurricane Katrina
LTG. RET. Russel L. Honoré
CDR JTF‐Katrina
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1/23/2015
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