Medical teams make frantic efforts to care for victims

Emergency care: Legions of doctors and nurses are frantically patching together a new medical care network to handle the swelling…

Emergency care: Legions of doctors and nurses are frantically patching together a new medical care network to handle the swelling flow of Hurricane Katrina's victims. The extraordinary process includes the task of converting basketball arenas, an abandoned Kmart and even the New Orleans airport into working hospitals and clinics.

The storm - and more significantly the flooding, lack of food and exposure to the baking sun that doctors say left victims to "rot alive" - have presented medical workers with an overwhelming challenge. Overnight, New Orleans and surrounding communities lost 6,000 hospital beds.

In what seemed like endless days and nights, doctors have delivered babies, revived failed hearts, hooked up diabetics to dialysis, bandaged snakebites and distributed thousands of medications, including many antibiotics for cases of gangrene and other infections caused by the lethal pairing of open wounds and putrid water.

"This is the worst disaster I've ever seen in my life," said Robbie Prepas, a midwife from San Diego who arrived a week ago with a federal Disaster Medical Assistance Team, or Dmat. "And I have been to disasters in Afghanistan, Asia, Africa, Guam after the typhoon."

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With an influx of patients who are predominantly poor and in poor health, the emergency medical challenges are compounded by longer-term issues of managing chronic conditions such as high blood pressure, heart disease, diabetes and mental illness.

At the same time, officials say they remain on the alert for outbreaks associated with flooding, such as typhoid and cholera, as well as increasing numbers of asthma attacks, fevers, rashes and suicide attempts.

Disaster care in New Orleans was far more difficult than in typical hurricane situations because of the flooding that not only forced downtown hospitals to evacuate but made it impossible for the Federal Emergency Management Agency to set up triage units in hospital parking lots, as it has done in the past.

Predictions about infectious disease outbreaks have yet to come true, though the flooding in New Orleans and disintegrating corpses throughout the Gulf Coast continue to make that a possibility. Hospitals here, operating at full capacity, have seen a spike in cases of pneumonia, stroke, lice, diarrhoea and premature birth, said Louis Minsky, medical director of the Baton Rouge emergency response unit.

In many cases, people already weakened by underlying afflictions found the trauma of the storm, the days of heat and a hellacious evacuation through water, sewage and rotting garbage almost too much to endure.

"These are mostly elderly people with chronic diseases who were herded into the convention centre with no medications, scared out of their minds," said Lieut Col Constance McNabb, commander of a Texas Air National Guard unit overseeing medical evacuations in New Orleans.

More than 5,000 medical workers have been dispatched to supplement hundreds of state, local and private healthcare workers. Already, the federal government has flown in 100 tonnes of medical supplies, including 90,000 doses of tetanus vaccine, portable oxygen tanks, gloves and antibiotics.

The unprecedented effort to provide care to tens of thousands of people has required millions of dollars, improvised medical techniques and, in at least one case, theft by a physician who persuaded local police to help him snatch medications from a pharmacy. For one full week now, doctors have worked in MASH-style surroundings, leaning over patients on flimsy military cots, flipping through textbooks to make sense of symptoms they have never seen before.