I have seen a lot of this country's natural disasters, having lived through hurricanes in Long Island, New York, snowstorms in Albany, New York, and tornadoes in Birmingham, Alabama. However, nothing could prepare me for the events surrounding Hurricane Katrina. In Baton Rouge, Louisiana, where I am the medical director for a long-term juvenile correctional facility, the damage from Hurricane Katrina was more collateral, as opposed to the direct hit that New Orleans, Louisiana, suffered. Nonetheless, we received the brunt of the hurricane's aftermath.
My facility, the Jetson Center for Youth (JCY), is located approximately 80 miles northwest of New Orleans. Louisiana has 2 other long-term facilities, Bridge City Center for Youth on New Orleans's west bank of the Mississippi River, and Swanson Center for Youth in Shreveport (more than 280 miles from landfall). In the past 2 years, youth from the Bridge City facility had been evacuated to JCY twice in anticipation of hurricanes. Fortunately, both evacuations were false alarms but, as it turns out, useful trial runs.
AUGUST 27: 2 DAYS BEFORE LANDFALL
As we had done in the past, 48 hours before we expected the hurricane to reach landfall, 120 youth from Bridge City were evacuated to JCY. The Bridge City youth were kept apart on the Baton Rouge campus. They were housed in empty dormitories, gymnasiums, and the infirmary, where care was provided to the kids in a coordinated, rehearsed fashion. Leadership personnel prepared to stay overnight at JCY in case transportation and communication became impossible after the hurricane reached the coast.
AUGUST 28: 1 DAY BEFORE LANDFALL
The night before we expected the hurricane to hit, the director of nursing and I decided to stay overnight at JCY. The evening was uneventful. I slept in my office without any interruptions. The rest of the staff, including nurses, was able to make it to work by 7 am the next morning.
AUGUST 29: LANDFALL
Around 9 am, Baton Rouge started getting pounded by wind and rain. As the weather worsened, it was fortunate that we had decided to keep the kids from moving around campus. Instead, the JCY staff had to fight 50-mph winds to bring the youth food and medication. As the news of deteriorating conditions in New Orleans spread through the facility like wildfire, the kids became anxious and restless, voicing concerns about the safety and well-being of their families and friends. The staff worked tirelessly to calm the youth, even while being troubled themselves by similar concerns. Fortunately for us, Baton Rouge was on the good side of the “eye,” so we were not hit as hard as New Orleans was. By afternoon, the worst had passed. A quiet calm fell over the campus, mixed with a sense of relief that we had survived without any major problems. Little did we know what was in store for Louisiana.
On returning home in the evening, I learned that all means of distant communication were down in the state. The telephones were all dead, including cell phones and beepers as well as landlines. The power was out, so we had no Internet access. The few homes and businesses with generators kept the rest of us informed about what was going on and allowed me to contact my family out of state. We settled in for a more primitive, communication- and power-free existence.
AUGUST 30: 1 DAY AFTER LANDFALL
The next 2 days at the facility were uneventful. The biggest problem was the lack of power, or more precisely, the lack of air conditioning during the hot Louisiana August. We continued to provide basic services to the youth, although the facility was more secluded than the rest of the city from the hurricane's aftermath. It was during my few hours at home that I began to feel the real impact of the hurricane. I live very near the basketball coliseum that housed medical evacuees from New Orleans and the southern-most parishes. In Baton Rouge, people roamed the streets in search of food, shelter, and their loved ones. Throughout Baton Rouge there was the constant hum of helicopters and the endless whine of ambulance sirens. I cannot imagine a war zone being much worse.
AUGUST 31: 2 DAYS AFTER LANDFALL
Even after 2 relatively uneventful days, JCY was not yet in the clear. Late in the afternoon, we were notified that a large group of youth from detention facilities in New Orleans would be arriving some time that evening. Until that moment, we thought that all of New Orleans' juvenile detention centers had been evacuated. It turns out that, before the hurricane, these detained kids, some of whom were not yet adjudicated, had been transferred from juvenile facilities to an adult jail in New Orleans. The subsequent flooding forced the prisoners, adults and juveniles alike, to seek higher ground. These kids were some of the thousands we have seen in the media, wading through flooded streets only to be stranded on a highway overpass waiting for helicopters and boats.
Of course, we did not know any of this at the time. Without any method of communication, there was no way to know from where these kids were coming or when they would arrive. A trip that usually takes about an hour turned into a 7-hour bus ride from New Orleans to Baton Rouge. When they finally arrived at 10 pm, they were met not only by teams of nurses and physicians but also by a large contingent of Louisiana Office of Youth Development (LAOYD) staff. The adult correctional system did an admirable job coordinating the evacuation of the juveniles and adult prisoners, especially considering the lack of resources and inability to communicate.
Forty-seven youth, 13 of whom are female, got off that bus. They were wet, hungry, scared, and visibly stressed. They gave histories of waiting on the overpass for more than 24 hours. Many had had to wade through streets full of water, sometimes up to their chests; some were not able to swim. No food or water had been available during that period of time.
JCY provided the youth with a place to shower and clean clothes. We opened the kitchen and gave each of them a hot meal (or 3). Each was given a complete medical and mental health screening. Three had psychiatric emergencies and were seen immediately by a mental health professional. Other than some mild dehydration and sunburn, there were no medical problems. At about 2 am, 20 youth were transported to another facility in the northern part of the state. The remaining 27 youth were provided with on-site sleeping quarters. The next morning, a more complete evaluation was completed on each of them.
NOVEMBER: 2 MONTHS AFTER LANDFALL
The Bridge City staff has been living in trailers on the JCY campus for all of the previous 2 months. Although, there were no short-term detainees remaining in long-term care facilities, the Bridge City youth are still at the JCY facilities. (It is interesting to note that the first functioning trailer park funded by the Federal Emergency Management Agency, regularly shown by the national media, was developed on land donated by LAOYD adjacent to the JCY campus.) The hope is for Bridge City to reopen their facility in New Orleans soon and then slowly reaccept youth.
The LAOYD worked tirelessly to reconnect the detained youth with their families. They have transported children all over the United States by airplane, bus, and car (see “Reuniting Fractured Families After a Disaster: The Role of the National Center for Missing & Exploited Children,” pp S442–S445).
LESSONS LEARNED AND COMMENTS
Some people questioned whether it was legal to keep detained youth in a secure facility during the worst of the storm. For the following reasons, I feel strongly that there was no other choice at the time. It took days, sometimes weeks, to locate families. No youth can be released without a judicial order, which was difficult to obtain during the weeks it took to reconvene the court system. Additional difficulties included a lack of hard-copy legal charges and the difficulty of ensuring that evacuation centers housing families were willing and able to provide space for detained youth. Housing previously detained kids in secure facilities temporarily was the best option available at the time.
Staff needs are paramount if care is to be provided to the needy and displaced. The LAOYD was able to acquire house trailers very early. Besides a place to stay and food for staff and their families, there were medical needs as well. Some staff with chronic conditions required medicines and medical care of their own. Having these needs included and rehearsed in an existing disaster plan was key for providing care to children in need. We now can reevaluate and modify the disaster plan.
Disasters always complicate transmission of medical information. When combined with legal records, care becomes even more complex. We look forward to an electronic medical chart system that could provide accurate, timely information.
Because the LAOYD has been under a federal settlement agreement for years, it is rare for anything positive to be heard about the office. However, I cannot say enough about the dedication and hard work of the LAOYD employees and the staff of the Juvenile Justice Program at Louisiana State University Health Sciences Center. In the midst of chaos, the kids were provided with an emotionally supportive, safe, and secure environment. A huge amount of staff time was dedicated to connecting the youth with their families. The staff, many of whom were equally devastated after losing everything and having their own families displaced, committed themselves to ensuring the well-being of the youth. As we hear all that went wrong in Louisiana, I would shed light on all of those people who helped safeguard those who were under the state's care. Hurricane Katrina revealed not only the darker side of society but also its best. The storm also serves as a reminder that proper preparation, including dreary drills and false alarms, can make all the difference.
- Accepted January 25, 2006.
- Address correspondence to Ronald A. Feinstein, MD, FAAP, 3147 E Lakeshore, Baton Rouge, LA 70808-2852. E-mail:
The author has indicated he has no financial relationships relevant to this article to disclose.
- Copyright © 2006 by the American Academy of Pediatrics