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About a million people were displaced when Hurricane Katrina swept throughthe Gulf Coast in late August, including nearly all 450,000 residents of NewOrleans. Many people escaped with little more than the clothes on their backs.Countless thousands of evacuees left behind possessions, money, pets—andprescription medications to manage diabetes, cardiovascular disease, and othermedical conditions.
The additional impact of Hurricane Rita was not fully known at presstime.
After an initial government response to Katrina that many felt was toolittle and too late, health professionals, medical organizations, and thepharmaceutical industry have ramped up an unprecedented relief effort toattend to the medical needs of evacuees.
According to the Department of Homeland Security, emergency shelters wereopened at 774 locations around the nation to house 248,200 people. In Houston,where evacuees at the Reliant Park complex peaked at around 25,000individuals, a new mini-city emerged at the city's sports and entertainmentcomplex. About 4,700 cots were set up at the Reliant Center convention hall,while the Astrodome held 2,500 cots. Reliant Arena was transformed into amedical center with an X-ray machine, pharmacy, mental health center, and 40hospital beds.
RUDIMENTARY CARE
In the first days following the disaster, however, health care wasrudimentary. On a Medscape blog for health professionals involved in reliefefforts, a physician described caring for people under the most adverseconditions at the New Orleans Superdome. "The patients were sosick," wrote a doctor identified as Amy. "It became routine to seeblood sugars over 400 [mg/dl] and blood pressures way over 200/100 [mmHg].They hadn't had their medications for days, and no food or water."
She described her "toughest patient of the night," a young manwho began seizing after sitting in the waiting area for 12 hours. "Therewas no patient chart, no family with him, and no one knew anything abouthim," the physician wrote. "His finger-stick glucose reading wasoff the charts, so we began injecting whatever insulin was available. We hadto hold two IV bags wide open while he was still lying on the floor, becausewe didn't have enough help to get him into a bed. Finally, we got him onto astretcher. He told us he was diabetic and epileptic and had been off all hismeds since the hurricane. He hadn't had anything to eat for 4 days. We didn'thave any lab services, so I still had no idea if he was in ketoacidosis or ifhe was seizing from his lack of meds."
Eventually, the patient's blood glucose levels improved and he wastransferred to a Veteran's Affairshospital.
As the scope of the disaster became clear, health professionals respondedto provide more definitive services to special populations, including peoplewith diabetes. A group of endocrinologists at the Pennington BiomedicalResearch Center of the Louisiana State University System in Baton Rouge formedthe Pennington Hurricane Diabetes Relief Team. Backed with 50 volunteermedical personnel, the team brought diabetes care to evacuees at 40 sheltersaround the state. The American Red Cross is now managing the operation.
SUPPLIES FOR THE DISPLACED
Even for people with the means to have prescriptions filled, findingavailable medications was a challenge in the first days following thedisaster. CVS, the nation's largest retail pharmacy chain, had 80 stores inLouisiana and Mississippi shut down by the hurricane. With 75% of its 1,000employees in the region missing, the company struggled to make prescriptiondrugs available to evacuees. More than 200 employees were brought in fromother states to help run four stores 24 hours a day in Baton Rouge, accordingto the company.
CVS owns 30 mobile pharmacies equipped with computers, medications, andprescription bottles. When more than 25,000 people were moved to theAstrodome, CVS dispatched two mobile pharmacies from a warehouse in Texas. Inthe first 72 hours, pharmacists filled more than 10,000 prescriptions,providing insulin and other critical drugs.
At the time this issue went to press, the Pharmaceutical Research andManufacturers of America reported that within 2 weeks the drug industry poniedup nearly $25 million in cash for relief efforts and donations of medicationand other products.
Abbott pledged $2 million in cash and at least $2 million in nutritionaland medical products; Amgen donated $2.5 million and established acompany-wide hurricane relief program; Amylin donated $100,000 to the AmericanRed Cross and $50,000 to support the emergency diabetes clinic of PenningtonMedical Center; AstraZeneca made an initial $1 million cash donation and willdonate products in affected areas; Bayer initially committed $2 million incash and products; Boehringer Ingelheim donated $600,000 in cash and willcontribute products "as needed"; Bristol-Myers Squibb donated $1million in cash and an unspecified amount of products; Eli Lilly donated $1million to the American Red Cross and $1 million in insulin products and isshipping 40,000 vials of refrigerated insulin to the affected area;GlaxoSmithKline donated $1 million; Merck donated $1 million and anunspecified amount of products; Novartis donated an unspecified amount of cashand products; Novo Nordisk donated $1 million and an unspecified amount ofinsulin and delivery devices; Pfizer donated $1 million to rebuild hospitalsand health centers and $1 million to relief organizations; Sanofi-Aventis gave$1.2 million in diabetes drugs and 20,000 vials of injectable insulin;Schering-Plough donated $500,000 in cash and $2 million in products; and Wyethdonated $1 million and an unspecified amount of drug products. Other companiesagreed to match employee donations and secure medicines to donate to therelief effort.
Leading medical groups stepped up to the plate as well. The AmericanDiabetes Association, along with the American Heart Association and theAmerican Cancer Society, jointly pledged $1 million to help restore healthcare to Katrina evacuees.
Although no one knows how many health-related casualties Katrina caused,it's nearly certain that the outpouring of goods, services, and goodwillintended to ease the suffering is just a drop in the bucket. Immediate healthneeds will be addressed, yet public health officials have months—if notyears—of work ahead in order to deal with shortcomings and ensure thatmedical crises are minimized in the future. 
Footnotes
For more information on providing medical resources and information onsupporting relief efforts and care for people with diabetes, visitwww.diabetes.org/hurricane-katrina.jsp.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
