HJNO Jan/Feb 2022

SLaMMA 22 JAN / FEB 2022 I  HEALTHCARE JOURNAL OF NEW ORLEANS   functional, offering ongoing 911 services, despite significant impacts to their infrastructure and their personnel’s own lives and property. Other help was provided by the National Guard and out-of-state emergency medical services. Now that the immediate crisis has passed, the doctors believe there will be ongoing public health challenges because of the storm. “I think we are going to see a surge of respi- ratory illnesses, exacerbations of chronic illness caused by inability to get medications and ongo- ing mental health challenges given the stressors,” said De Wulf. Ultimately, the dual crises of the COVID-19 pandemic and the hurricane put a great deal of strain on the health system, and delivery of the highest quality care throughout the region has been very challenging, said the doctors. “The health systems in Southern Louisiana are already under strain due to the pandemic,” said De Wulf. “That means less expendable income and less outreach into vulnerable communi- ties. Undoubtedly, health screenings have been delayed, as we have seen all over the region. We will continue to feel these effects over the long term.” “We are hopeful that resources will be spent to build the resilience of local healthcare assets, including local hospitals, pharmacies and clin- ics, and ultimately into making the regional infrastructure more protected against disrup- tions caused by events such as this hurricane,” said Niyogi. The medication supply chain is one area that definitely needs additional attention, said the doctors. “We ask people to make sure they have at least 72 hours-worth of supplies and medications, but we know from past disasters that supply chains and other health infrastructure like phar- macies and clinics may take more than a few days to come back online,“ said De Wulf. To allow for ongoing shortages during extended recovery and rebuilding periods, the doctors suggest increased exceptions to medica- tion refill limits and perhaps a cooperative effort from retail pharmacies to pool their supplies and work across systems to ensure patients can get medications in a timely manner without having to find a pharmacy with the medication in stock. “After Katrina, there was a centralized phar- macy warehouse, so we could get medications to people even if pharmacies were not operational,” said Niyogi. “I understand this central warehouse is no longer in operation, but that was an amaz- ing resource in the past that the retail pharmacies could perhaps replicate.” “Getting consistent and up-to-date mes- saging out into impacted communities about what resources are available would be of great assistance as well,” added De Wulf. “When peo- ple have no power, no internet and limited phone services, it is hard to get the word out about available assistance, including places like Wolfe’s pharmacy and what healthcare providers were available. With limited gasoline, people were also hesitant to drive around looking for assistance.” The doctors noted that in a world that is cur- rently overwhelmed by disasters and tragedies, no longer does all attention turn to local catas- trophes like Hurricane Ida. “There was very little news coverage and less aid than one would expect for the scope of this disaster,” commented De Wulf. “It underscored that communities and health systems need to look ahead, anticipate these challenges and build internal resilience and disaster plans built with layers of contingency plans. As we grapple with the realities of climate change on a global scale, it is likely unrealistic to expect large amounts of federal, state and international aid.” “We wish we could say that the healthcare infrastructure will be more resilient to the chal- lenges brought about by climate change and more accessible to those with financial chal- lenges,” said Niyogi. “We foresee SLaMMA providing medical aid alongside other mutual aid groups in the future on an as-needed basis, remaining nimble to adjust to on-the-ground cir- cumstances and needs.” n Anjali Niyogi, MD, MPH , is an associate professor of internal medicine and pediatrics at Tulane Medical Center. She is a hospitalist at University Medical Center in New Orleans, a co-founder and co-director of the Resident Initiative in Global Health at Tulane (RIGHT), the founder and director of the Formerly Incarcerated Transitions (FIT) Clinic in New Orleans, and a volunteer physician with the asylum network with Physician for Human Rights. She obtained medical and public health degrees from Tulane School of Medicine and Tulane School of Public Health and Tropical Medicine. She was a resident in internal medicine and pediatrics during Hurricane Katrina and established ad hoc clinics throughout the city in the immediate aftermath of the storm. She has worked internationally in over a dozen countries focusing on medical capacity building and humanitarian aid. Annelies De Wulf, MD , is the director of the International Emergency Medicine Division and an associate program director of the Spirit of Charity Emergency Medicine Residency in New Orleans. She works as academic faculty at both the University Medical Center in New Orleans and the Lallie Kemp Medical Center, a critical access hospital in Independence, Louisiana. De Wulf attended the Tulane School of Medicine, completed an emergency medicine residency at the LSU Spirit of Charity residency, then completed a fellowship in international emergency medicine at the State University of New York Downstate in Brooklyn, New York. She is the director of Haiti programs with EMEDEX International, a nonprofit focused on improving access to high quality emergency care worldwide, and the past president of the American College of Academic International Medicine.