Two faculty members in the Hayward Genetics Center, Jess Thoene, left, and Hans Andersson, write about the challenges from disasters such as hurricanes in caring for special needs of patients with genetic and metabolic disorders.

Hurricane Katrina revealed a disaster in health care: the long existence of an essentially third-world healthcare system that left many of the region's poorest residents without even the most basic primary care. Now, several Tulane physicians are sharing the lessons they learned with their colleagues through journal articles and lectures around the country.

That theme runs throughout "Witness to Disaster," a series of first-person accounts by those whose lives were touched by the storms, collected in the March/April 2006 issue of Health Affairs as a special edition of the journal's "Narrative Matters" section, which presents first-person essays that provide personal perspectives on health policy issues. Health Affairs, published by Project HOPE, is the leading peer-reviewed journal of health policy.

Among the 13 essays by 15 authors are three written by Karen DeSalvo, C. Thorpe Ray Professor of Medicine and chair of general internal medicine and geriatrics; Jason Block, a native of Thibodaux, La., who received his MD/MPH from Tulane in 2003 and now is a primary care internal medicine resident at Brigham and Women's Hospital in Boston; and Benjamin Springgate, a 2001 Tulane MD/MPH grad and former resident in medicine/pediatrics at Tulane, now an internist and pediatrician at UCLA.

Springgate returned as a volunteer to his native New Orleans three days after Hurricane Katrina ravaged the city's health care system. He writes "Day Five" from his vantage point on Concourse D of the New Orleans airport, where rescue helicopters flew patients from various area hospitals.

Block writes "Shouldering the Task" about his experience with a joint American Red Cross--U.S. Public Health Service team: "The hurricane hadn't created new health problems - it had worsened old ones."

DeSalvo, along with James Moises, a Louisiana State University emergency physician and Joseph Uddo, a general surgeon at East Jefferson General Hospital in Metairie, writes about the "Nine O'Clock Meeting," coordinated by the U.S. Public Health Service team.

"Witness to Disaster" can be read here. De Salvo, Springgate, and Janis van Meerveld, a New Orleans resident who was undergoing cancer treatment when Katrina struck, provide additional, more recent material on the Health Affairs website, and Meerveld offers a portfolio of photographs.

A number of faculty members at the Hayward Genetics Center at Tulane wrote an article about special needs of patients with genetic and metabolic disorders that was published in Molecular Genetics and Metabolism. Lead authors, Jess Thoene and Hans Andersson, also presented their work at the American College of Medical Genetics Annual meeting.

"Provision of health care to patients during and after events like those that occurred with hurricanes Katrina and Rita poses particular difficulties for rare disease patients," Andersson says. "In the article, we recount the obstacles encountered in attempting to maintain and restore essential, specialized medical care to these patients who need rare medications, foods, equipments and so forth."

Thoene has been invited to help plan a national conference on the impact of mass casualties on patients with rare disorders, a joint effort of the American College of Medical Genetics and the National Institutes of Health Office of Rare Diseases. "This is a new and important emergent orphan disease issue and Tulane is taking the lead in this matter," Thoene says.

Read here for the paper by Thoene, Andersson et. al.

The lessons learned by Tulane physicians following Hurricane Katrina may benefit other healthcare professionals and their patients facing future disasters.