One of the strongest hurricanes in the past 15 years was taking deadly aim at one of the most vulnerable places in the United States. The storm was hurricane Gustav; the place, New Orleans, Louisiana. Two years almost to the day since hurricane Katrina had decimated New Orleans, the city was undertaking a voluntary evacuation as the unthinkable approached, a Category 4 hurricane. Fortunately, fate and maybe a little bayou magic shrank Gustav while the application of lessons learned in hurricane Katrina prepared the region for the unwanted visitor.
Gustav caused far less damage than many predicted and the media immediately told the nation that New Orleans had been spared. It was this news that began an outrage which threatens to undermine all that made New Orleans successful this time around. Within hours of the good news from media reporting from New Orleans, disaster healthcare and disaster medicine providers began receiving phone calls from their employers. Calls ranged from thinly veiled statements that the disaster responders had left work for no reason all the way up to threats of firing if the disaster responder did not abandon their duties and return immediately.
Disaster medicine and disaster response is not glamorous duty. Disaster healthcare providers from all professions willingly leave comfortable beds, hot meals, clean clothes, worried families and profitable jobs to place themselves in harm’s way, sleep in tents or on the floor of a warehouse, eat military rations and earn a paltry government stipend or no stipend at all. These brave and selfless men and women do so out of a feeling of duty and the selfless dedication to the most vulnerable and needy in our nation. There are precious few of these professionals as evidenced by the inability to fill all the needed positions for the response to hurricane Gustav. Disaster healthcare responders are truly everyday American heroes.
Those who deploy with federal disaster medical response teams receive job protection under the Uniformed Services Employment and Reemployment Act (USERA) in the same way that a National Guardsman or Reservist receives job protection, but while no employer would dare call a Reservist or Guardsman during their military service and threaten their job if the soldier did not desert and return home, healthcare employers seem to feel no compunction about indulging in such behavior when it comes to disaster responders.
Not only is the practice of calling disaster responders on deployment in an attempt to force them home outrageous, but many of the employers who perpetrate this offense are the self same facilities who enjoy the benefits of disaster response services when disaster strikes their community.
Disaster field response work is incredibly stressful and there are a precious few who both have the requisite skills to be of value in a disaster healthcare environment and the resilience to sustain them in the disaster area through a standard two week deployment. Adding the stress of having their job threatened or knowing that even if not fired, every effort will be made to punish you in another fashion renders many disaster responders vulnerable to physical or emotional injury. History shows that confronted with this treat to their regular life, these responders cease to respond to disasters. Late in the afternoon on the day hurricane Gustav made landfall, one regional response headquarters had so many responders feeling that their jobs were at risk that the local commander was forced to offer all responders the opportunity to go home early without repercussions.
Which brings us back to the risk of undermining all that made New Orleans successful this time around? New Orleans success hinged upon the ability to evacuate and the ability to medically care for those evacuated. In many situations, it was these disaster responders who provided that care. As more and more disaster healthcare providers feel that they must choose between helping a stranger and saving their career, some, possibly many, will choose to resign from disaster response, leaving New Orleans and the rest of the nation to fend for itself in the next disaster.
The Gustav outrage has happened it cannot be undone; the bell cannot be unrung. A few disaster responders went home, many more now worry that their jobs are soon to be lost. The next disaster it will be even harder to muster a full compliment of medical professionals across the full spectrum of needed specialties. The next disaster there will be more unfilled positions and even more unfilled need. In the end the nation will again be a greater risk, all because of the outrage that followed Gustav.
