Sorry but there is so much more that FEMA does

I begged him to let me continue, said Perlmutter, who left his home and practice as an orthopedic surgeon in Pennsylvania to come to Louisiana and volunteer to care for hurricane victims. People were dying, and I was the only doctor on the tarmac (at the Louis Armstrong New Orleans International Airport) where scores of nonresponsive patients lay on stretchers. Two patients died in front of me.

I showed him (the U.S. Coast Guard official in charge) my medical credentials. I had tried to get through to FEMA for 12 hours the day before and finally gave up. I asked him to let me stay until I was replaced by another doctor, but he refused. He said he was afraid of being sued. I informed him about the Good Samaritan laws and asked him if he was willing to let people die so the government wouldn't be sued, but he would not back down. I had to leave.

FEMA issued a formal response to Perlmutter's story, acknowledging that the agency does not use voluntary physicians.

We have a cadre of physicians of our own, FEMA spokesman Kim Pease said Thursday. They are the National Disaster Medical Team. ... The voluntary doctor was not a credentialed FEMA physician and, thus, was subject to law enforcement rules in a disaster area.

Perlmutter, Dr. Clark Gerhart and medical student Alison Torrens flew into Baton Rouge on a private jet loaned by a Pennsylvania businessman several days after Katrina hit. They brought medicine and supplies with them. They stayed the first night in Baton Rouge and persuaded an Army Blackhawk helicopter pilot to fly them into New Orleans the next day.

I was going to make it happen, the orthopedic surgeon said. I was at Ground Zero too, and I had to lie to get in there.

At the triage area in the New Orleans airport, Perlmutter was successful in getting FEMA to accept the insulin and morphine he had brought. The pharmacist told us they were completely out of insulin and our donation would save numerous lives. Still, I felt we were the most-valuable resource, and we were sent away.

Gerhart said the scene they confronted at the airport was one of hundreds of people lying on the ground, many soaked in their own urine and feces, some coding (dying) before our eyes. FEMA workers initially seemed glad for help and asked Gerhart to work inside the terminal and Perlmutter to work out on the tarmac. They were told only a single obstetrician had been on call at the site for the past 24 hours.

Then, the Coast Guard official informed the group that he could not credential them or guarantee tort coverage and that they should return to Baton Rouge. That shocked me, that those would be his concerns in a time of emergency, Gerhart said.

Transported back to Baton Rouge, Perlmutter's frustrated group went to state health officials who finally got them certified -- a simple process that took only a few seconds.

I found numerous other doctors in Baton Rouge waiting to be assigned and others who were sent away, and there was no shortage of need, he said.

Perlmutter spent some time at the Department of Health and Hospital's operational center at Jimmy Swaggart Ministries before moving to the makeshift Kmart Hospital doctors established at an abandoned store to care for patients. After organizing an orthopedics room and setting up ventilators there, Perlmutter went back to the Swaggart Center and then to the LSU Pete Maravich Assembly Center's field hospital to care for patients being flown in from the New Orleans area.

We saw elderly patients who had been off their medicine for days, diabetics without insulin going into shock, uncontrolled hypertension, patients with psychosis and other mental disorders, lots of diarrhea, dehydration and things you would expect. I slept on a patient cot there every night until I came home.

Gerhart said he felt the experience overall was successful and rewarding, although frustrating at times. You don't expect catastrophes to be well organized. A lot of people, both private citizens and government officials, were working very hard.

Perlmutter did not return home empty-handed. He brought a family of four evacuees back with him and is still working with Baton Rouge volunteer Hollis Barry to facilitate the relocation of additional hurricane victims to Pennsylvania.

He also returned with a sense of outrage. I have been trying to call Sen. Arlen Specter (of Pennsylvania) to let him know of our experience.

I have been going to Ecuador and Mexico (on medical missions) for 14 years. I was at ground zero. I've seen hundreds of people die. This was different because we knew the hurricane was coming. FEMA showed up late and then rejected help for the sake of organization. They put form before function, and people died.

Both FEMA and the Coast Guard operate under the U.S. Department of Homeland Security, which has been widely criticized for its disjointed, slow response to the devastation caused by Katrina. Federal officials are urging medical personnel who want to volunteer to help with disaster relief to contact the Medical Reserve Corps or the American Red Cross for registration, training and organization.

Katrina & Recovery

Woes at Embattled FEMA Spur Employee Exits

by Laura Sullivan

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Tim Sloan

The FEMA command center in Washington, D.C., Aug. 30, 2005, shortly after Katrina hit the Gulf Coast. AFP/Getty Images

Mark Wolfe

Bill Carwile, in an October 2005 photo taken before he retired from FEMA. Days after Katrina struck the Gulf Coast, the head of hurricane response in Mississippi e-mailed FEMA headquarters: System appears broken. FEMA

All Things Considered, January 13, 2006 � FEMA is having trouble holding on to its best people. Several FEMA staffers have told NPR that people are leaving because the agency is in trouble and no one appears to be addressing the problems. These departures are raising concerns about FEMA's ability to respond to the next disaster.

Leo Bosner, a union chief and manager of the emergency operations desk at FEMA, says morale was bad Katrina, but it's only gotten worse. He notes there have been several retirement parties at the agency in recent weeks.

They're getting out not because they're tired and want to work in the garden but because they're just sickened by the agency's failure -- very public failure -- and just sickened to see nobody doing anything to lift a finger to fix the problems, Bosner says of the departing employees.

According to half a dozen other current or former FEMA managers who did not want their name used for fear of retribution, more than 50 people have left FEMA in the past four months. One official inside FEMA who has seen the agency's attrition data says 56 people have left in the past five weeks alone.

But FEMA says only 20 people have left. FEMA spokesman Nicole Andrews says the information Bosner and other employees shared with NPR is either incomplete or imprecise. She says there's an influx of applications to work for the agency, adding, To suggest that there is any sort of a trend related to Katrina and attrition would be absolutely false.

One recent retiree is Bill Carwile, a 10-year veteran of FEMA and former Army colonel who left in November. Carwile led FEMA's hurricane response in Mississippi.

Katrina struck New Orleans and the Gulf Coast on Aug. 29. Three days into Katrina recovery operations in Hancock County, Miss., Carwile couldn't get any food, water or even body bags. System appears broken, he wrote in an e-mail to FEMA headquarters. Carwile says it was the worst moment of his FEMA career.

The exhaustion frustration he felt in Mississippi wasn't the only thing pushing him to retire. Carwile says he was upset watching FEMA's training programs get cut year after year, leaving his teams unprepared.