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Last Updated: Tuesday, 20 September 2005, 06:28 GMT 07:28 UK
Community spirit prevailed over hurricane
By Michelle Roberts
BBC News health reporter

Image of Dr Cavey in Mississippi
Dr Cavey visited the areas destroyed by Hurricane Katrina

Since Hurricane Katrina struck the Gulf coast last month, the news has been dominated by reports of crime and criticisms about officials' slow response to the devastation.

A UK doctor working for the American Red Cross explains first-hand how the true picture he encountered was one of community spirit and solidarity, with people travelling thousands of miles to help.

Dr Andrew Cavey, a doctor at St Mary's Hospital, London, with a background in public health and crisis management, was contacted by Harvard University, which was helping recruit expert staff to the new public health unit of the American Red Cross.

You will have a plumber from Oregon who has got in a car and driven all the way down just to help
Dr Andrew Cavey

Dr Cavey's job was to help coordinate the public health response, which in Mississippi involved assessing the state's 145 shelters and trouble shooting any problems as they arose.

"We found great variability in shelters," he said.

Some had air conditioning and wireless internet and offered a breakfast of heated waffles with strawberry puree, maple syrup and cream, while others had no electricity and too few outdoor toilets or showers to be sanitary.

"People were making do in very difficult circumstances. But I quickly realised the situation changed day by day.


"If you go to a shelter on the Monday and there is no electricity, by the time you have come home to think this is awful we have to sort it, you find out that by the Tuesday the community or people from the other side of the country have come along and fixed it.

"You will have a plumber from Oregon who has got in a car and driven all the way down just to help.

"It's a wonderful display of community spirit and solidarity."

He and his team created a monitoring system to allow them to continuously check for serious health problems or infectious diseases outbreaks, map what was happening in the shelters and react to any public health crisis.

They met every shelter manager and nurse and explained what warning signs of a potential disease outbreak to look for, such as fever or diarrhoea.

They set up a hot line number, manned at head quarters 24 hours a day, to deal with the problems and stop them spreading.

Trouble shooting

"As soon as a shelter knows or sees a case of blood diarrhoea or what looks like a contagious rash they call the hot line.

Image of Hurricane Katrina aftermath in Waveland, Mississippi
Hurricane Katrina left mass destruction

"For example, the first day we set it up was a Wednesday. By that night, we knew that one of the shelters had a case of nausea and vomiting and that one small child in Orange County had a case of chickenpox.

"We managed to confirm the case with a paediatrician, isolate the child and have the public health response by evening from the state."

Having worked mainly in sub-Saharan Africa before, Dr Cavey, senior house officer at St Mary's Hospital, London, and honorary lecturer in conflict, migration and human rights at University College London, said the state of preparedness he encountered in the US was not really what he had expected.

The quality and the breadth of the work that has been done here is quite remarkable
Dr Cavey

"What was very different was that resources were available.

"There were all the technical and material competencies you needed everywhere you looked to sort out the problems.

"Things got done very fast. The quality and the breadth of the work that has been done here is quite remarkable."

He said that after only a week, the majority of shelters were providing consistent standards of good care.

He hopes that the Red Cross will use the same monitoring system approach in its future crisis responses.

He said the focus in the areas where Hurricane Katrina struck was now shifting towards rebuilding neighbourhoods and residents' lives.

Dr Cavey said the next few months would see a mixed picture.

The destroyed Grand Casino in Biloxi, Mississippi
Gulfport, Mississippi, was once a tourist town

"I suspect it's very geographically variable. You will have people who were fortunate because their houses did not get destroyed and who will go back. Many of them have gone back already.

"You will have people who want to go back to their homes and communities, but have a destroyed house."

He said they might live in a mixture of community centres, trailer parks, mobile homes, tent cities or even cruise ships, and would try to find jobs and rebuild.

"I suspect you will also have some people who may or may not have their house completely destroyed but who had problems before - mental health, alcohol, drugs or unemployment - who take to shelter life.

"Conditions in shelters that are very good don't incentivise people who were living in poor conditions with no money before the hurricane to go back to those conditions.

"This represents a minority, but that minority could be a chronic difficult situation to manage," he said.

Dr Cavey has now returned to the UK to continue his work there.

Viewpoint: Pulling together
19 Sep 05 |  Americas
US Congress starts Katrina probe
14 Sep 05 |  Americas


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