Sept. 7, 2005

Hurricane Katrina Disaster
Interview with Dr. Paul Miller in Louisiana

Dr. Miller,

RenalWEB is reporting on the effects of Hurricane Katrina on dialysis patients and providers. Please answer any or all as time permits:

(Answers received on Sept. 7, 2005, 7:26 am)

Q. It is now eight days after Hurricane Katrina. Can you provide a brief summary of the efforts you’ve been coordinating over these last eight days?

A. This has been a team approach LA-DEEP (Louisiana Dialysis Emergency Evacuation Plan) and providers, networks, vendors, people helping people.

Establishing permanent command post for dialysis specific needs:

1. Rendundant communication services
   
2. Supply and transportation depot
   
3. Dialysis needs shelter with dialysis services
   
4. Information center with hotline; (not yet operational)
   
5. Resource management facility including patient tracking, and needs analysis and allocation of services
   
6. Identifying sites for dialysis specific community apartments to place the many displaced dialysis patient victims of Katrina; this would alleviate many of the resources we will be using, and more appropriately and efficiently consolidate resource management
   
7. Establishment of a "first responder" group similar to DMAT of FEMA specifically for dialysis needs
   
8. Providing emergency dialysis and transport of patients out of critical triage areas and shelters helping relieve these first line areas and disperse patients to utilize already existing resources for resource managment; this also helps relieve burdens on the kindness of others who have opened up shelters without any federal funding
   
9. Establishing direct lines of communication: satellite channel: which I just have found out has been set up channel 100 Direct TV; I believe Congressman Jindal set this up?; we tried to set up satellite radio communication channel; AM radio set up for relay.
   

Q. What have been the biggest problems?

I have not been able to get permission for permanent renovation and use of the Wal Mart facilities that were identified in Ville Platte, Opelousas, and up north which has prevented me from completing a full renovation plan.

Communication systems

3. Identifying specific needs and volumes of patients because of lack of central command communication and direction center; individual dialysis providers, large chains, shelters that don't all communicate to one central directing source or "field command control center"; too many "heads making decisions" without coordinated efforts which has prevented efficiency in delivering service, as well as unecessary burden to some providers and patients, and shelters; unfortunately, there has been some "hoarding" of patients for whatever reasons without efficient dispersing to appropriately utilize existing resources.

Q. Are you setting up temporary dialysis centers or focusing on moving patients to existing centers?

At this time, we are focusing on dispersing patients with coordination with appropriate dialysis needs shelters and facilities providing dialysis;

Q. With New Orleans not likely to be reopened for months, what are the current plans for dialysis patients and staff?

I am not aware of a specific plan; this question was posed this week; I feel renovation of existing recently defunct hotels into specific dialysis community dwellings would most appropriately address the placement needs with best utilization of existing resources.

Q. What are your largest and/or most important needs at this time?

1. Locating any remaining alive dialysis patients not accounted for; this week is the critical countdown for this.



2. Helping patients cope with the emotional distress as well as their specific medical needs, and their families.



3. Development of long range planning as addressed by above including housing; possibly for future each dialysis patient could be provided an emergency identifyer "button" to press with a locator signal?



4. Awareness of need for multi-state, entity collaboration for not only Dialysis but Disaster Emergency Evacuation Planning which goes hand in hand; establishment of "first responder groups", and pre-disaster established and recognized "go to shelters, command control and communication facilities"; this is similar to the reconaissance missions with pre-established extraction destination sites with back-up plans.



5. Development of better provider relations, network and CMS, government authority comminications for cross coverage of personnel and supply sharing; in addition, more organized stategies for triage, treat, and relocate to help relieve burden on front lines immediately. Definitely transportation access improvement.
   

Q. Early estimates were that up to 4000 dialysis patients faced non-operational dialysis facilities immediately following the hurricane. Eight days later, are there any estimates as to how many of them have been able to receive dialysis treatments?

Some died without access, you can be sure. I'm not a guessing man, but probably less than 2500 patients in Louisiana. By nature of the high risk group alone, I expect heavy casualties.


Q. Many are interested in helping. What can they do?

1. Pray
   
2. Contribute financially to the American Kidney Fund/LA-DEEP program, or one of the many excellent charities set up
   
3. Pressure legislators to assist with above development plans
   
4. Expand their knowledge through this unfortunate crisis awareness for prevention of kidney disease to help avoid this problem
   
5. Discuss individual assistance on line at hurricane relief
   
6. Adopting a family with a member with kidney disease would help dramatically for housing situations.