Our disaster medicine colleagues who respond to catastrophic public health emergencies worldwide have educated us on the nuances of the prolonged effect that such disasters have on the community. Following the prototypical wars that destroyed their countries’ public health infrastructure, the decay factors that cause preventable deaths continued for many years after the shooting had stopped. Years later, retrospective studies recorded many more deaths from indirect causes, and those that suffer the most typically are women, children, old people, and people with disabilities. Ninety percent of excess deaths were preventable.We couldn't agree more. If the deaths are preventable and the agencies and officials don't do anything, aren't they responsible?
The US is not a developing country, but the uncomfortable reality of the public health impact and management of Katrina is painfully similar. The authors’ study has exposed that glaring deficiency—that an attentive and proactive surveillance and response mechanism is justifiably obligated from state and federal agencies.
Sunday, June 24, 2007
We need more than band-aids
According to a widely reported-on analysis ("Excess Mortality in the Aftermath of Hurricane Katrina: A Preliminary Report," Disaster Medicine and Public Health Preparedness 1(1) 2007: 15-20), the New Orleans mortality rate has climbed nearly 50% since Katrina. Less frequently cited is the editor's note at the end of the article:
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Of course, for the government to be "responsible," one would have to believe that it is the role of the government to provide public safety. And while this may be the motive and rationale for the classical social contract and also the founding principle for enlightened states for centuries, it's less clear that the current administration adheres to this view. In both word and deed, highly placed officials have challenged the idea that it is the government's role to provide services to its citizenry.
To my mind, it is one of the great shortcomings of our political discourse that responsibility appears almost exclusively retroactively -- we try to hold individuals responsible FOR what went wrong, but rarely talk about proactive responsibilities TO one another.
A nice essay on responsibility and Katrina-
www.dissentmagazine.org/article/?article=158%22target=%22_blank%22
Absolutely! At least one lesson I'd hope people not living in New Orleans would take away from Katrina is what you can expect after the next great tragedy that befalls you.
It's time to wake up. I hope it's not too late.
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