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Lessons Learned from Hurricane Katrina and the Future of the LSU Dental School(s)

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 • disaster preparedness • dental

LESSONS LEARNED

Most New Orleanians had heard of the potential "catastrophic storm"; however, no one was prepared for the magnitude of the disaster brought on by Hurricane Katrina. Looking back, it is amazing that what has taken place over the past year was due to an event that occurred over a six- to ten-hour period. While disaster preparedness plans existed, neither New Orleans nor the LSU Health Sciences Center (LSUHSC) was fully prepared for the storm and the flooding that ensued. The Katrina disaster revealed many weaknesses in an untested system. The following are the lessons learned, together with solutions that should be applicable to any disaster affecting an academic institution.

Research
One of the toughest lessons learned for the research enterprise was taught by the loss of research animals housed in the first floor of the medical school and basement of the dental school. Mitigation plans will remedy this from any recurrence by housing animal facilities above the first floor. This is sound advice for all institutions where flooding is a possibility.

Another lesson learned relates to storage of irreplaceable perishable research specimens in freezers. While the LSUHSC had emergency generators to power vital equipment, including –80°C freezers, the flooding rendered them non-functional. To avoid reliance on power, an alternative for specimen storage is liquid nitrogen, with dewars placed at points where they can be accessible to supply sources. However, if freezers are to be used, the following should be considered. One option is to transport the –80°C freezers in refrigerated trucks to another location prior to a pending emergency. In this case, freezers should be identifiable with fluorescent markings or clearly labeled as requiring emergency power or transport. Another option is to split banks of specimens, sending an aliquot to a collaborator’s laboratory or an off-site freezer where at least a portion of the specimens will be safe in the event of an emergency. A note of advice for freezers is to avoid the use of high-porosity cardboard storage boxes that promote mold growth when dampened. Plastic storage boxes that lack porosity should be used instead.

Administration
The most costly lesson learned on the administrative side was the lack of adequate contact information for faculty and staff that affected communication following the hurricane. Although ’phone trees were in place, the lack of ’phone service and institutional e-mail service following the storm made establishing contact impossible. Solutions to this are plentiful. For key administrators, it is recommended that satellite ’phones be distributed to eliminate the need for cell towers. For others, it is important to gather several pieces of information that can be distributed widely. This includes an alternate e-mail address, a ’phone number of someone outside the state, cell ’phone numbers, and PIN numbers for BlackBerry devices that will by-pass the university server. It should be noted that text messaging through cell ’phones is often functional when voice transmission fails.

Vital operations must be re-established following any disaster. In the aftermath of Katrina, the executive team was scattered throughout the state, and it was difficult for individuals to position themselves near the temporary administrative site in Baton Rouge. To avoid this, a location outside of the danger zone, with housing accommodations, should be identified and used as a centralized muster station for the team and their families.

In the case of computers, it is suggested that data on network drives be backed-up on external drives that can be easily removed prior to or after any disaster and used off-site. As a prelude to any disaster, it is also wise to set up computers for automated weather bulletins or alerts.

In general, it is suggested that any disaster preparedness plan be reviewed annually by specific committees, including both clinical and research representatives. It is also recommended that preparedness activities be initiated prior to any season for natural disasters. This includes having mandatory disaster plan informational meetings, updating contact information, and conducting drills for implementation. A summary of the lessons learned, together with solutions, are provided in the Table.

Standouts and Fallouts
The determination, dedication, and energy displayed by many of our dental school students, faculty, and staff during the first few months post-Katrina were unprecedented and clearly a standout. Many faculty and staff took on new leadership roles during those desperate times that had a tremendous impact on the school’s recovery. Each person demonstrated the "do whatever it takes to get it done" attitude. It is because of these people that the LSU School of Dentistry (LSUSD) still exists and will continue to prosper in the months and years ahead.

Along with standouts often come fallouts. We were not immune to such actions. During the initial period of the tragedy, several department heads and faculty decided that their careers would be better served by moving to other institutions. There were also several research faculty who moved temporarily to work in other laboratories and later accepted positions outside LSU. Others chose to retire. Finally, there were several faculty who were furloughed or forced into early retirement due to the economic circumstances of the LSUHSC.

The faculty and staff who remain possess the qualities to ensure continued growth and excellence in the subsequent phases of the recovery. Although the school now has a different appearance and composition, the same commitment to excellence is not only being maintained, but also many aspects of the educational mission have been made stronger as a result of the changes that were necessary to adapt to our new environment.

FUTURE PLANS

Our general plan for the LSUSD is to resume primary operations from the New Orleans campus, but to continue to maintain a presence for patient care on the temporary dental school site in Baton Rouge. Activities we anticipate for the Baton Rouge campus include: an expanded distance learning dental hygiene program, senior clinic rotations, and some advanced education and continuing education programs. The New Orleans campus is expected to be certified for permanent re-entry by early 2007. This requires permanent restoration of power, water/sewage, and elevator service, along with other remediation and repairs. Reoccupation of the school is dependent not only on the repairs to the school, but also on the restoration of city infrastructure, including water supply, electrical substations, ’phone service, etc. The resumption of these services has its own challenges.

Once the remediation and restoration are complete on the New Orleans campus, there will be a phase-in of operations. Continuing education, Faculty Dental Practice, and research are speculated to be the first enterprises to resume activities. However, additional issues will influence the recovery of research programs because of the necessity to restore the precise function of specialized equipment as well as other internal research components. The resumption of the Faculty Dental Practice will be the first significant step to reestablishing the patient base in the New Orleans area, allowing some faculty and staff to have a limited presence again. Once the patient base is re-established, a phase-in of post-graduate clinics is expected prior to resuming the entire pre-doctoral academic enterprise, which will take place in July, 2007.

Mitigation construction will commence once the school has resumed operations. While plans have not been finalized by this publication date, it will ultimately depend on the most cost-effective option to prevent future flooding. Options currently include an additional building or a flood wall similar to what was constructed at the University of Texas Health Sciences Center at Houston following Tropical Storm Allison (Bates, 2003).

The major challenges to continued operations on both campuses are funding and recruitment of new faculty and staff. Recruitment will ultimately be dependent on the recovery of the New Orleans area, and funding will depend on additional state and Federal appropriations that are currently being lobbied for.

We at the LSUSD have been through a remarkable sequence of events in our quest for survival. It is unprecedented when one considers the devastation of the New Orleans campus and the speed at which the new campus in Baton Rouge was constructed. Our losses were great, but the outpouring of support from the nation during a very difficult time was extremely comforting. While we recognize that considerable time will be needed to re-establish pre-Katrina levels of activity throughout the institution, the perseverance of the remaining faculty and staff are firmly dedicated to the high quality of research and education, despite the challenges we face in the years to come. The phrase, "That which does not kill me will make me stronger" is heard often among our faculty and staff. Prior to Katrina, it was just a phrase. In the aftermath of this storm, we have come to recognize these words as a tested fact.

Received August 22, 2006; Last revision November 15, 2006; Accepted November 15, 2006

REFERENCE

Bates DR (2003). $10 million FEMA flood protection grant benefits UT-Houston. Texas Medical Center News 25(5):6.

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