Katrina Inspires Medical Guards

When levees collapsed and the Louisiana Superdome swelled with the displaced and despairing, federal officials sent a Bay Area medical team to help the sick and dying.

But with scant security and a crowd in the tens of thousands growing rowdier and in some cases violent amid the rank swelter, conditions proved too perilous for the volunteer doctors, nurses and medical staff.

Doctors were threatened. Patients fought. Helicopters evacuating the sick were fired upon. One man stole a National Guardsman's M-16 and shot him. The small force protecting the Bay Area team at its makeshift clinic left to help with crowd control.

"The crowds, they were frustrated. Some patients were crashing. We lost all our protection. The only protection we had was our own folks watching out for each other," said Darrell Lee, a Moraga-Orinda fire captain and paramedic who served on the Disaster Medical Assistance Team.

"There were just numerous incidents involving guns and snipers and assaults, people lighting fires inside the facility," said David Lipin, who heads the team, based in Menlo Park. "We actually abandoned that mission. We bugged out of the Superdome."

Their flight left a temporary void in care for people rushed or rescued from their homes without medicine for diabetes, kidney failure, psychiatric problems and other conditions, along with those suffering injury, trauma or heat-related illness.

It's a scenario of chaos that could well repeat itself in California, say disaster doctors and planners. And it's one that a group of state Department of Justice agents is working to prevent by creating a security and logistics force to protect disaster medical teams and their supply caches.

They are now setting up dozens of teams across the state to scout triage sites, equipping themselves with rugged vehicles, contamination suits, rescue gear and health supplies in case catastrophe strikes.

It's not their job, but a passion born of the failings they witnessed in Katrina's wake.

Eight of the state agents went to New Orleans a few days after Hurricane Katrina bludgeoned the Gulf Coast. Deputized as U.S. marshals to round up violent fugitives, they spent weeks running search-and-rescue sweeps, disarming street rogues and escorting medical and rescue crews.

What they saw, they say, was disturbing: truckloads of medicine hijacked or diverted, paramedics and firefighters idled with no way to safely enter dangerous "hot zones", absurd bureaucratic delays.

"There was actually no thought of security for these medical crews and hospitals. The fire crews, unless they came with their own trucks, had nowhere to go. They sat in a corner of the gymnasium, 50 or 60 of them with nothing to do," said Special Agent Supervisor Jim Biscailuz.

The new teams would focus on one task -- protecting medical professionals. It's a role that the highway patrol or local police agencies might take, but in a catastrophe other tasks may overwhelm them, said Dale Ferranto, assistant director of the DOJ's firearms division.

"(The doctors) basically said, 'That's one of the resources we lack: protection when we're out in these areas,'" Ferranto said. "Because of some of the ruthlessness and lawlessness that was going on (in New Orleans), they were always concerned for their safety."

The teams are made up of 32 state firearms agents, but they hope to expand it if incoming Attorney General Jerry Brown backs the concept, said Ferranto. Though authorized by Attorney General Bill Lockyer, the plan is barely funded; much of the gear comes from government surplus.

"Let's say there's a terrorist attack in San Francisco, and they're able to take out all the bridges. It would be our job to get the medical crews there safely," said Biscailuz.

Their push comes as state and federal officials shift strategy for dealing with medical disasters, based largely on shortcomings identified in the Katrina response.

This week, for instance, FEMA was stripped of the National Disaster Medical System, which encompasses the 28 federal disaster medical teams, as well as nurse, pharmacy, mortuary and veterinary teams. It also includes a tracking system for available hospital beds.

The teams now will fall under Health and Human Services, the federal agency that oversaw it before it moved in 2003 to the newly formed Department of Homeland Security. The system's leader now must also win Senate confirmation -- a reaction to the criticism over the appointment of former FEMA head Michael Brown and others with little or no disaster experience.

Congress approved the changes in the fall, following recommendations in a White House report issued early last year. Many of the local medical teams had voiced concerns over FEMA's oversight.

"I saw confusion," said Lipin. "You had two different agencies trying to decide where to send their assets, their resources. There was a conflict. This, in theory, will help with that. Now there's only one group controlling the medical (part)."

In the meantime, California emergency officials are working to create state-run medical teams that mirror the federal Disaster Medical Assistance Teams. The nascent program, funded by $1.75 million in Homeland Security and Bioterrorism grants, aims to have three 120-member "CalMAT" teams in place by July 1. The idea: more state flexibility in a disaster, and less dependence on the feds.

Other states, including Illinois and North Carolina, are launching similar teams, said Jeff Rubin, the state's chief of disaster medical services.

"It's just a recognition that the size and scope of Katrina was such that states need to . . . ramp it up a notch or two," said Rubin. "It's the old phrase 'Lessons learned.'"