Introduction
According to Falk (2004), Hurricane Katrina struck the American Gulf Coast in August 2005, causing devastating effects on the infrastructure and livelihoods of the people living around the region. Hurricane Katrina particularly led to massive flooding of the city of New Orleans and further caused severe damage to the Gulf coasts of Alabama, Mississippi, and Louisiana (Frey, Audrey & David 2007). Because of its devastating effects, Hurricane Katrina is the most severe in American history due to the massive relocations of people and damage caused to the infrastructure. In the aftermath of the storm, some of the evacuees managed to return and rebuild their homes while others preferred to set up new residences in new regions away from the volatile area.
Decisions made by evacuees in the aftermath of the storm, as far as reconstruction efforts were concerned, had far-reaching implications on their general wellbeing as well as the economy of the affected regions(Dolfman, Solidelle& Bruce, 2007). Evacuees who preferred never to return to their previous homes but instead started life in new areas encountered the challenges of new labor markets and economic conditions. On the other hand, regions, which lost important employees, suffered from declining human resources and economic slowdown. Relative return of evacuees also led to a drastic change in the demographic patterns of affected regions, particularly in economic and cultural dimensions. Individuals who may not have lived in the affected areas might as well decide to migrate and live there. The in-migrations have a major impact on the economic, social, and cultural priorities of the affected regions. For instance, decisions made as far as reconstruction efforts are concerned must factor in the in-migrations component (Falk, Matthew& Larry, 2006).
Social and health amenities contribute largely to the quality and welfare of life of inhabitants of a place. Hospitals are one of the most important facilities in society. The damage caused by Hurricane Katrina on hospital infrastructure was equally devastating since the cost of rehabilitating and setting up similar facilities is quite an expensive venture.
The situation
For instance, the hurricane forced us to evacuate New Orleans hospital to Baton Rouge. The entire hospital staff comprised of 40 workers who assisted me in the reconstruction efforts particularly the cleaning up of the debris and setting up new facilities and equipment for the hospital. I worked as an industrial hygienist at the hospital. As such, I was obliged to evaluate, plan and organize the recovery efforts for the hospital taking care of basic medical needs. The hospital team working on the reconstruction efforts comprised of the current Safety supervisor (programs and training), the environmental Manager (Physical plant, wastes, and regulatory issues), and two technicians, (versed in IH and environmental sample collection and testing). The entire team was answerable to the hospital Incident Commander (Baker, et al 2008).
We temporarily housed the team on the new site in FEMA trailers supported by standby power generators. The place is congested and filthy due to the accumulation of mud and debris all over the place. The surgical site and the pharmacy section are also dirty. Generally, the entire New Orleans hospital is contaminated with substances that are toxic enough to cause further disease transmission to patients and hospital workers. The level of exposure to pathogenic compounds is equally high since the accumulation of debris and dirt surpasses acceptable levels of toxicity (Dolfman, Solidelle& Bruce, 2007). Reports indicate that foreign materials are causing negative effects such as irritation, watering of the eyes, and coughing among patients.
Hospital workers have also complained of tremendous itching and irritation among other potentially harmful effects from exposure to these foreign substances. The occupational health and safety of the hospital workers and patients are paramount towards achieving organizational goals and objectives. The development of healthcare facilities, therefore, goes in line with safe working conditions. Disease development is associated with trigger substances such as the pathogenic materials exposed to the hospital environment (Falk, Matthew& Larry, 2006). Some of the materials were toxic enough to be carcinogenic such as phosphate gas.
Ventilation
The makeshift trailer containers require a proper ventilation for purposes of contamination control as well as provision of fresh air to both patients and hospital workers. Ventilation also provides for heat control systems especially in laboratory areas and the power room. The type of systems used is either general-purpose ventilation or for local exhaust where exhausted air is released (Dolfman, Solidelle& Bruce, 2007). Selection of system types follows a criterion where various parameters apply, which includes:
- Properties of air- density, and effects of heat, pressure and moisture
- Basic ventilation formulas- perfect gas flow and density factors
- Energy and pressure in a system
Hazardous Exposures
Primarily, recognition of hazardous substances within the hospital environment is of utmost importance. The degree of exposure to dangerous chemicals and other foreign substances at the hospital facility calls for urgent remedy. It is highly recommended that control measures should be in place using appropriate design systems and ventilation schemes, which are implementable (Baker, et al 2008). Parameters used to determine whether there are potential, hazardous exposures at the hospital include:
- Health hazards
- Flammability, deflagration and explosion potential (NFPA)
- Physical Hazards-noise, heat sources, excessive moisture
- Regulatory Issues (OSHA, EPA)
Types of human effects associated with contamination can be classified as either acute (for serious overdose) and chronic where continuous exposure to increasing doses of contaminants over a long period of time leads to harmful effects on the human body. When evaluating exposures, three parameters are involved:
- Route of exposure
- Dose-quantity and duration of exposure to pathogenic substances
- Severity- Whether it is acute or chronic.
The following outcomes are identified as the potentially harmful effects resulting from inhalation of dangerous chemicals and substances.
- Lung disease-fibrosis, pneumoconiosis
- Systemic reactions resulting from exposure to lead, hex chrome, pesticides, radionuclide
- Metal fume fever
- Allergic/ sensitization reactions
- Bacterial/ Fungal infections
- Damage/ Irritation to the mucus membrane
Team structure and organization
The hospital’s current safety supervisor should be in charge of training the hospital staff on all aspects to do with environmental health and safety including occupational health concerns (Dolfman, Solidelle& Bruce, 2007). Secondly, the Environmental Manager should organize the process of inspecting the hospital physical plant to eliminate wastes and clean up the debris within the premises. He should therefore liaise with the Industrial hygienist in coordinating workers towards environmental sanitation and clean-up campaigns regularly to the expected standards of hygiene. The two technicians should come in handy in the collection and testing of foreign substances at the hospital. Continuous laboratory testing is necessary to ensure that pharmaceutical drugs and laboratory supplies are free from any contamination before being prescribed to patients or otherwise during therapeutic interventions (Falk, Matthew& Larry, 2006). Best medical practices demand that cleaning begins from the upper stairs downwards and sanitized cabinets safely locked.
A total makeover of the pharmacy section is required where prescription drugs need proper rearrangement in sanitized cabinets. Organizing office furniture and electronics within accessible and stable compartments is necessary. Telecommunication infrastructure, severely damaged by Hurricane Katrina requires reinstallation within three weeks. In the meantime, face-to-face communication between hospital workers and patients is sustainable through facilitated training and education.
PPE Equipment
The need for personal protective equipment cannot be overemphasized. Professional ethics demand that hospital workers towards eliminating chances for cross-transmissions and infections use appropriate attire and equipment. Such PPE’s include gloves, lab coats, and proper sterilization techniques of laboratory equipment. In addition, proper use of injection needles and other aseptic techniques is essential (Baker, et al 2008). The dress code for hospital operations is standardized and directed towards upholding the highest standards of medical professionalism. The task of removing unwanted substances and materials from the hospital premises demands that workers are effectively equipped with necessary PPE’s at their place of work. PPE’s should be sanitized according to and on a regular basis to avoid skin infections and transmission of disease from patients to workers and vice versa. A functional first aid kit should be installed at the right locations and workers appropriately trained on how to use them. Dangerous chemical and pharmaceutical preparations should be stored in a cool and dry place away from unauthorized persons.
Even though situated on trailer metal premises temporarily, New Orleans hospital is capable of serving its neighborhood to the expected within these guidelines. Regular training of hospital employees on matters of industrial hygiene, aseptic techniques, and first aid among other precautionary measures shall go a long way in eradicating the dangers associated with substantial contamination and damage brought about by Hurricane Katrina. Eventually, installation of the right medical equipment, restoration of power utilities, and telecommunication infrastructure will enable the hospital to function at competitive industry standards apart from serving its clientele best (Dolfman, Solidelle& Bruce, 2007).
References
Baker, J. W. Douglass S. David B. Sam B. Mary R. Richard W. and William N. (2008). “Explaining Subjective Risks of Hurricanes and the Role of Risks in Intended Moving and Location Choice Models.” Working Paper, Texas: A&M University.
Dolfman, M. L., Solidelle F. W. and Bruce B. 2007. “The Effects of Hurricane Katrina on the New Orleans Economy.” Monthly Labor Review 130 (6): 3-18.
Falk, W. W. 2004. Rooted in Place: Family and Belonging in a Southern Black. Community. New Brunswick, NJ: Rutgers University Press.
Falk, W. W., Matthew O. H. and Larry L. H. 2006. “Hurricane Katrina and First Full Picture from the Census.” Washington, DC: Brookings Institution.
Frey, W. H., Audrey S. and David P. 2007. “Resettling New Orleans: The New Orleanians’ Sense of Place: Return and Reconstitution or ‘Gone with the Wind’?” Du Bois Review 3 (1): 115-128.