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DISCOVERY! |
Louisiana State University School of Dentistry, 1100 Florida Ave., New Orleans, LA, and 8000 GSRI, Bldg. 3100, Rm 296, Baton Rouge, LA 70820, USA;
* corresponding author, pfidel{at}lsuhsc.edu
Martin Taubman, Editor
KEY WORDS: research • Hurricane Katrina • dental • disaster
THE DAYS PRIOR AND LANDFALL: TAKEN BY SURPRISE
Friday, August 26
It was a typical Friday at the LSU School of Dentistry (LSUSD). Few conversations focused on a hurricane named Katrina in the Gulf of Mexico. By then, Katrina was a category 2 hurricane projected to make landfall along the Florida Panhandle.
Saturday, August 27
New Orleanians woke to find that the storm had changed direction and strengthened to category 3 status (Wikipedia, http://en.wikipedia.org/wiki/Hurricane_Katrina) and was heading directly toward the city. As people prepared to evacuate, long lines at grocery stores and gas stations created chaos and a notable feeling of imminent threat to life and property. At the LSU Health Sciences Center (LSUHSC), a mass e-mail from the Chancellor announced that the schools were closed as a precaution for the hurricane. This short timeline left little opportunity for university emergency preparedness plans to be activated.
Sunday, August 28
The storm intensified to category 5 status, and a mandatory evacuation was issued for New Orleans. By noon, most who chose to evacuate were on their way out of town. At the LSUHSC, University Police took posts at the schools to maintain security of the buildings.
Monday, August 29
Katrina made landfall southeast of New Orleans as a Category 3 hurricane (Fig. 1
), leaving much destruction in its path. What followed 12–24 hours later would be the demise of the New Orleans area. The levees broke at several places, and water from Lake Pontchartrain came barreling in, flooding over 80% of the city, including the schools in the LSUHSC (Fig. 2). The flood waters remained for weeks until it could be pumped back into the lake. The University Police who remained at the HSC to protect the buildings were stranded for several days.
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THE EARLY AFTERMATH: ASSESSING THE DAMAGE AND EFFORTS AT RECOVERY
Damage to the entire LSUHSC was extensive. Generators that would normally allow the school to retain rudimentary power for several days were rendered non-functional from the flood waters. Without power, and with flooding that refused to recede, perishable and irreplaceable research specimens could not be retrieved and were lost forever. Many also lost priceless research animals (Dalton, 2005; Fidel, 2005; Kaiser, 2005).
The LSUSD suffered significant damage, to both the grounds and the buildings (Fig. 3). The dental school had a basement that held all major infrastructure for the school as well as cadaver storage, the animal facility, and the biomaterials research enterprise. The first floor of the school housed a new patient screening area, Clinical Research Facility, the Faculty Dental Practice, Radiology, the Bookstore, Cafeteria, and Security offices. The first floor, which was elevated 4 feet above street level, took on 4 feet of water. The basement was completely immersed for 5 weeks and had to be pumped several times before it was fully accessible. It then took considerable time to remove the damaged contents, that covered over 75,000 square feet.
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Canceling the dental school’s academic program was not an option; the LSUSD is the only dental school in the state and educates over 80% of Louisiana’s dental professionals. Accordingly, it was soon decided that the seniors would complete their clinical training in private practices. Freshmen and sophomores resumed classes at the LSU Veterinary School and Pennington Biomedical Research Foundation in Baton Rouge by the beginning of October. The larger issue of identifying appropriate clinic facilities to provide training for the juniors had yet to be addressed.
OCTOBER TO JANUARY: UNCERTAINTY AND TOUGH DECISIONS
By mid-October, the schools of the HSC had moved to small vacant areas in a new research building at the Pennington Complex. By this time, it was apparent that returning to the New Orleans campus was not days or weeks away, but likely months away if not longer. Hence, research investigators began working in small areas at Pennington, in labs of collaborators around the country, or at the Children’s Research Institute in New Orleans, which had not flooded. Conducting research in any of these settings was extremely difficult, with the lack of specimens and/or equipment.
In the dental school, having the research enterprise housed on the 6th, 7th, and 8th floors, and without power and elevators, investigators were relegated to removing only what they could carry down the long flights of stairs. In addition, a team of investigators carried a transport dewar of liquid nitrogen up 7 flights of stairs numerous times over the ensuing several months, to replenish the larger dewars that held the only surviving research specimens.
Re-establishing the clinic enterprise in Baton Rouge proved extremely challenging. Remarkably, a set of vacant buildings that had recently been donated to LSU was offered by the University president to house the dental clinic and academic operations temporarily. Since it was LSU property, the buildings could be renovated by LSU facilities personnel, thereby by-passing the traditional bureaucracy of the state system. Construction teams worked day and night during the next 8 weeks, renovating the approximately 800,000 square feet of space that would eventually become the temporary LSUSD.
Because the clinic planned for the Baton Rouge campus could not be fully equipped with materials from the New Orleans campus, and since acquisition of equipment through the normal state bidding process would significantly delay the start of operations, vendors were contacted and asked to donate equipment and dental materials. Soon an outpouring of help came from around the nation. The vendors even sent personnel to set everything up free of charge. The donated equipment would also prove to be the catalyst to modernize the school’s operations, including implementing a centralized sterilization process, digital imaging, and paperless clinic management.
Faculty and staff became the next challenge. In the days following the storm, the school asked all LSUHSC students and employees to provide current contact information. Thousands of employees lost their homes and personal belongings and were scattered around the country. Despite this, faculty and staff were contacted to identify who could return to work in Baton Rouge. Many expressed interest in returning, but had few options for housing. Those still residing in New Orleans had to bear the 75-mile commute to Baton Rouge, which could take hours due to traffic delays. To accommodate the housing crisis, an international cruise liner was brought to Baton Rouge, along with 100+ mobile housing units. This provided temporary housing for up to 900 faculty, staff, and students.
By early December, the LSUSD was re-established in Baton Rouge, albeit at 20% of the New Orleans clinic capacity. Once prospective patients heard of the services being offered, it took no time to fill the students’ schedules. It was a perfect example of "build it and they will come". Visitors were in awe that the school could be restored on a new site within three months of the storm. Those involved in the rebuilding effort demonstrated that desperation brings forth the highest quality in people.
JANUARY TO MAY: FINDING A SENSE OF NORMALCY IN A SEA OF CHANGE
The events that transpired post-Katrina between January and May set the tone for what was in store for the LSUSD. Although most hoped that the dental school would return to the New Orleans campus by spring, 2006, it was not possible. Remediation to the New Orleans buildings had just begun, together with mitigation plans to ensure that the school would not flood again. Hence, the School’s presence in Baton Rouge would be necessary until the summer, 2007, and decisions were made to expand operations, including another patient clinic, research labs, and faculty offices in remaining vacant space. The additional clinic would bring the operatories on the Baton Rouge campus to ~ 50% capacity of the New Orleans campus.
The smaller clinic capacity in Baton Rouge created a need for modifications in several key operations that were superior to those that had been used for years. For example, since the new clinic lacked designated areas for each discipline, patient treatment moved from a disciplined-based model to a comprehensive care model, with more integration among departments and an expanded view of patient care.
The operations at the Baton Rouge campus became more routine as spring arrived. It was the new home of the LSUSD. A site visit by the Committee on Dental Accreditation found the new school to be "outstanding". And, as promised by Dean Hovland, the seniors graduated on time.
In New Orleans, the buildings on the medical school campus that sustained less damage were re-opened to researchers by March, 2006. This provided dental school basic science investigators an opportunity to return to New Orleans to resume their research programs. Clinical research activities continued to be slowed by the minimal patient base in New Orleans, and the difficulty in establishing infrastructure in other regions. Despite these challenges, the National Institutes of Health and other funding agencies extended grant deadlines and provided supplements or cost-extensions to aid in the recovery of research programs.
MAY TO AUGUST: THE FINAL PIECES OF A TEMPORARY FIX
Between the months of May and August, significant progress was made regarding the repairs and remediation at the dental school campus in New Orleans. In mid-May, temporary power was finally restored with some water services that allowed investigators to clean laboratories and discard freezer contents. Although most equipment powered up, it is yet unknown whether the heat and humidity affected ultimate function.
In Baton Rouge, construction was completed on the additional patient care clinic by early August. In addition, existing research laboratories were renovated to house new biomaterials equipment and a Clinical Research Laboratory.
This final construction effectively completed the rebirth of the LSUSD. The Katrina disaster created an opportunity that was seized by the LSU leadership, resulting in an accomplishment few outsiders believed was possible. For many, the rebirth of the LSUSD was a second life-changing experience following the storm, but an extremely positive one, giving those who participated pride in the accomplishment and preparing them for the challenges that lay ahead.
Received August 22, 2006; Last revision November 15, 2006; Accepted November 15, 2006
REFERENCES
Dalton R (2005). New Orleans researchers fight to salvage work from submerged labs. Nature 437:300.[Medline]
Fidel PL Jr (2005). Hurricane Katrina ravages New Orleans and affects many local medical mycologists. Medical Mycological Society of the Americas Newsletter, November, p. 5.
Kaiser J (2005). After Katrina. New Orleans labs start their uncertain comeback. Science 310:1267–1269.
Wikipedia. Hurricane Katrina. http://en.wikipedia.org/wiki/Hurricane_Katrina
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