Charity Hospital remains closed in downtown New Orleans at a time when the poor are finding a shortage of medical services. (Photo: Robert Corsini / t r u t h o u t)
President Obama's Nobel Peace Prize award is a historic and symbolic gesture from the world, that the new direction being charted for the nation has the tacit approval of leaders and intellectuals, impatient for a new American renaissance of ideas and vision for the future of our nation and planet.
The president speaking from Martin Luther King Middle School in the Lower 9th Ward of New Orleans is precisely the right place to begin the debate on how we as a people will reinvent our nation, let go of the petty and debilitating debates of right and left and engage our higher minds and souls to embrace and comfort the afflicted of our nation - whether they be internally displaced citizens, soldiers returning home damaged by war or individuals devastated by the economic crisis.
The impact of Hurricane Katrina and subsequent human failures have been vast and far-reaching. The only way anyone can begin to grapple with what has occurred along the Gulf Coast, where nearly a third of the US population resides, is to go there. See it. Feel it. Live a little bit side by side with those fellow Americans who have literally endured hell on earth. And today, although the bleeding has stopped and recovery is underway, there is a clear, underlying malaise that grips the region from New Orleans to Gulfport/Biloxi to Mobile, Alabama.
Unquestionably, the Crescent City is on a path to recovery. Great strides have been made to reestablish the verve of this dynamic and rich American city. The tempo of the city is reemerging. Much of Katrina's physical devastation today marks New Orleans like a patchwork of scars. Touring the city, one sees the remnants of the disaster all around. Skyscrapers with shattered windows, boarded and shuttered businesses. It's a war zone. A bombed-out city. Nearly one-third of the urban environment has been wiped clean, where one can see mother nature in the process of reclaiming much of what was once New Orleans. The psychological devastation of the population, however, remains an open wound.
It doesn't take a psychiatrist to understand that health care begins with an individual's state of mind. Mental health care is the prerequisite to everything else. Medical experts can agree that great strides in recovery from illness - whether cancer, spinal cord injury or any other affliction - begin with the patient's mental state. If the Crescent City were a patient, her temperature is elevated and rising. An infection has set in. She is in need of treatment, love and respect.
Mental health care professionals in the city and their frontline counterparts with the New Orleans Police Department agree that they are witnessing a pandemic of mental illness; clinically speaking, Post-Traumatic Stress Disorder (PTSD) and schizophrenia. The numbers of people at risk are literally in the hundreds of thousands. Making matters worse, nearly 40 percent of the overall population and 70 percent of the African-American population are uninsured, that alone would be enough to constitute of public health emergency. But in New Orleans post-Katrina, the capacity to deliver health care, independent of who's paying the bill, has simply vanished. N.O. Care.
As the great American health care debate rages on in Washington and on the public airwaves, the plight of the people of New Orleans in this post-cataclysm era, where the health care system has been denuded to a state of languid torpor, people are literally walking the streets in prolonged states of "shell shock" with few places to go for help. The fact that much of the nation continues as if everything is just fine in New Orleans can only be described as dangerously delusional. How is it that the broader national debate on health care has completely overlooked the unfolding catastrophe directly in front of the nation's eyes? Why have the media failed to consistently report on these issues?
This lack of treatment of people in dire need has translated into a myriad of social ills: crime, drug abuse, physical abuse, homelessness, budgetary collapse - all impacting public safety in unimaginable ways. In the past year of officer-involved shootings, the murder of officer Nicola Cotton by a diagnosed schizophrenic underscores the nature and scope of the problem. Pre-Katrina, there were over 400 hospital beds available for mental health care treatment; today the number is under 100 and 60 of them are only available through the parish prison system. That's right. According to NOPD Crisis Intervention Administrator Cecile Tebo, the best way to receive treatment for mental illness in the greater New Orleans metropolitan area is to get arrested.
Charity imprisoned. Pre-Katrina, the Louisiana and New Orleans maintained a two-tiered medical delivery system. One for the "haves" and the other for the "have-nots." Although it clearly had its problems, like any publicly administered program, the system was able to handle the basic medical needs of the poor in the city and Charity Hospital was the cornerstone of that system. The facility not only delivered health care services to the needy, it was also a critical linchpin in the city's trauma care system and was a well-regarded training facility for medical professionals nationwide.
Charity Hospital sits in downtown New Orleans, directly across the street from the Tulane University medical center. It's a quick jog to the Superdome in one direction and Bourbon Street in the other. When Katrina struck four years ago, the facility's lower floors were inundated. The damage was immense and the facility was closed. After the waters subsided, hospital personnel, including doctors, nurses and facilities staff, rallied themselves to clean and scrub the hospital down. Within a year, it was ready to reopen. But then powerful local, state and federal political considerations lead by Republican Governor Bobby Jindal intervened to keep the doors of Charity Hospital shuttered, when the people of the city needed it most.
Three years later, cyclone fencing and barbed wire surround the hulking structure. Windows are broken and a grimy, blackened residue of oxidizing concrete stains the exterior from top to bottom. Warnings are posted along the perimeter, warning of guard dogs on patrol inside and out. How could this be that in a city where there is so much need, a facility such as this remains closed?
The decision to keep Charity closed says as much about the dysfunction of the national health care debate as it does about the profound challenges that face any city trying to reinvent itself following a disaster or war. Enemies of public health care and proponents for a new "state of the art" research hospital want to keep Charity closed and pool state and federal funds to achieve a new and prestigious facility. The problem is that FEMA doesn't believe it should cough up the $492 million the State of Louisiana is demanding - when the primary facility in question, Charity Hospital, could be renovated and re-outfitted for a fraction of that amount. The new facility, if it ever happens, is five to ten years away from reality. In the meantime, the poor and uninsured of the city must rely on scant and diffuse health care services throughout the city.
The controversy surrounding Charity Hospital is emblematic for the entire recovery of New Orleans. Should the new health care system be a highly centralized administrative showcase - embodied in new hospitals and medical infrastructure? Or should it be a more flexible and modest system, revitalizing and enhancing existing systems and reaching out to neighborhoods and citizens to better engage and empower them to take health care into their own hands?
In order to make time for this political debate, the state of health care for New Orleanians and the rest of the nation's poor and uninsured is hidden from the public. The national media, enamored with its convenient "anniversary journalism" approach to disasters, turns its attention elsewhere once the dramatic, now-archival pictures of flooded neighborhoods no longer have the relevancy of a birthday to be commemorated. It's history. Time to look forward and not back. Maybe we can expand coverage for the fifth anniversary? In the meantime, the reality of the ongoing struggle for New Orleans' recovery has subsided from the national consciousness. The great new American tragedy is that the not-so-television-friendly spectacle of an ailing and wounded society, like a cancer patient in recovery, cannot compete against the debutante dabblings of Paris Hilton, or an imagined boy in a hot-air balloon, for the hearts and minds of the nation.
Holding up the arguments for and against various aspects of health care reform against the backdrop of the health crisis in N.O. would do much to contextualize the political farce that has evolved over the past few months. Those living in the city, dealing daily with the challenges and symptoms of an ailing society, have no illusions about America's crisis in health. Nor do they have patience for the lofty posturing of politicians and the health industry complex. The plight of New Orleans needs to be considered as a barometer for the future of the nation, and not as an inconvenient truth.
Field Producer Natalie Noel and Daniel Rhone contributed to this report.