Legacy of Katrina: The Impact of a Flawed Recovery on Vulnerable Children of the Gulf Coast

摘要

It is estimated that in the aftermath of Hurricane Katrina, which made landfall on August 29th, 2005 and was followed a month later by Hurricane Rita, approximately 1.5 million people, including some 163,000 children were displaced in Louisiana and Mississippi alone. Since children and families who had the means fled the city, those who were left were often the poorest and most vulnerable. These populations became the most dependent on the government’s efforts to help in the recovery process, and were the most affected when those efforts were less than sufficient. Those who previously had been marginalized and underserved were now faced with an unfathomably steep slope to climb in gaining access to resources. In the months after the storms, obstacles to health care became entrenched through the combination of facility closures and shortages of health care providers. In addition, federal disaster case management initiatives, which were meant to help victims access recovery resources, were slow to start and lacked both the comprehensiveness and continuity that were needed. To make matters worse, many of these case management programs were terminated prior to resolving challenges facing families and without making appropriate arrangements for satisfactory follow-up. Five years following the disasters of 2005, there have been significant signs of economic, infrastructural, and educational recovery in the Gulf. However, there are still serious shortfalls in certain areas of human recovery, particularly regarding mental health and housing stability. Compounding the remaining needs from the hurricanes, the region is now facing a man-made disaster—the aftermath of the BP oil spill. Identifying, assessing and providing professional assistance to children still in need remains an unmet challenge with highly worrisome consequences for the future. But most importantly, the affected families need urgent assistance to, five years after Katrina, return to a state of "normalcy". Immediately after Katrina, Children’s Health Fund (CHF) responded to the vital health needs of the Gulf Coast by establishing Operation Assist in collaboration with the National Center for Disaster Preparedness (NCDP) at the Mailman School of Public Health at Columbia University. As part of this project, CHF dispatched mobile medical units to provide disaster relief health services, which eventually led to the creation of three permanent CHF pediatric programs in the Gulf region. This collaboration also included a longitudinal cohort study, the Gulf Coast Child and Family Health Study (G-CAFH), which was designed to track the progress of a representative population of severely-impacted Gulf families over the ensuing years. The findings from the most recent G-CAFH surveys are included in this paper as well as on the ground anecdotal information from CHF Gulf Coast pediatric programs, which are consistent with the G-CAFH study results.