Critical Condition

It's the people Gary Peters couldn't save who haunt him. An emergency medical technician from northern Louisiana, Peters spent last week evacuating scores of patients from New Orleans's flooded hospitals, ferrying them to makeshift medical centers. On one run, Peters and his team floated by a crowd of "two, maybe three thousand" people at the water's edge, screaming for help. But his team had to finish its mission. "These are civilians," he said, his voice breaking. "It hurts."

Solomonic choices abounded. "People have died and will die because there's not enough resources," said a tearful Dr. Fred Cerise, Louisiana's secretary of Health and Hospitals, who was in charge of evacuating "special needs" patients from the city's University and Charity hospitals. "We're being forced to make the sort of horrible calculations you make when you're trying to direct these efforts," he said--like deciding who gets powered ventilators.

The brutal realities of the health crisis will linger for weeks to come. New Orleans is now a cesspool that poses numerous hazards, including outbreaks of hepatitis A and E. coli. Desperate survivors who ingested spoiled food and contaminated water could get salmonella, and people could suffer carbon-monoxide poisoning as they attempt to use generators indoors. Mosquitoes will breed rapidly in the stagnant water, and some could harbor the West Nile virus. About the only good news is that typhoid and cholera are unlikely, because, experts say, those microbes weren't present before the storm.

The disjointed nature of the relief effort has only compounded the crisis. As refugees from the festering Superdome started arriving at Houston's Astrodome, medical staffers scrambled to deal with cases of gastrointestinal illness and dehydration, and screen for infectious diseases. Families searched desperately for relatives who were medevaced to hospitals as far away as Texas; several newborns in intensive care were separated from their parents. For those suffering from health problems before the hurricane, like diabetes and heart conditions, getting medication became a life-or-death struggle.

The Department of Health and Human Services stepped in to set up 40 shelters with up to 10,000 beds apiece in the Gulf region. But there was still no timetable for the relief effort. "This is a herculean task," said Secretary Mike Leavitt. Mental trauma will be the biggest long-term concern, health experts predict. Children, especially those separated from their families, will be hit hardest, overwhelmed by "feelings of abandonment, isolation and disconnection," says Dr. Irwin Redlener, director of Columbia University's National Center for Disaster Preparedness. Typically, neighbors might comfort survivors. But Katrina cut such a wide swath that there's nobody left standing for anyone to lean on.