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Monday, September 5, 2005 - Page updated at 12:00 AM

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Red tape delays volunteer doctors

The Associated Press

BATON ROUGE, La. — Volunteer physicians are pouring in to care for the sick, but red tape is keeping hundreds of others from coming to the aid of Hurricane Katrina survivors even as health officials worry about potential outbreaks.

Among the doctors stymied from helping are 100 surgeons and paramedics in a state-of-the-art mobile hospital marooned in rural Mississippi.

"We have tried so hard to do the right thing. It took us 30 hours to get here," said one of the frustrated surgeons, Dr. Preston "Chip" Rich of the University of North Carolina, Chapel Hill.

The fact that government officials can't straighten out the mess and get them assigned to relief efforts, now that they're just a few miles away, "is just mind-boggling," he said in a phone interview.

The first predictable signs of disease from contaminated water emerged Saturday: A Mississippi shelter was closed after 20 residents got sick with dysentery, probably from drinking contaminated water.

However, the country's leading health official said at a triage center yesterday that her biggest concerns are tetanus and childhood diseases.

"Tetanus is something we'd be especially concerned about," said Dr. Julie Gerberding, head of the federal Centers for Disease Control and Prevention (CDC).

Tetanus lives in soil and can enter the body easily through a scratch, and many flood survivors have endured filthy conditions.

Gerberding also urged health-care workers in the growing multitude of refugee shelters to try to find out a child's shot history and, "If you can't establish that a child has been vaccinated, then vaccinate. We can't take chances."

Diseases such as measles and whooping cough could rapidly spread in the cramped quarters that thousands of flood victims are sharing.

So far, there have been relatively few cases of diarrhea and infections, Gerberding said, but "we're early in the process."

The CDC chief, who traveled to Louisiana with Health and Human Services (HHS) Secretary Michael Leavitt, Surgeon General Dr. Richard Carmona and other top health officials, spoke after visiting a triage center on the basketball court at Pete Marovich Center at Louisiana State University.

Next door in Mississippi, the North Carolina mobile hospital waiting to help was developed with millions of tax dollars through the Office of Homeland Security after the Sept. 11, 2001, terrorist attacks. With capacity for 113 beds, it is designed to handle disasters and mass casualties.

Equipment includes ultrasound, digital radiology, satellite Internet and a full pharmacy, enabling doctors to do most types of surgery in the field, including open-chest and abdominal operations.

It travels in a convoy that includes two 53-foot trailers; the convoy yesterday remained parked on a gravel lot 70 miles north of New Orleans because Louisiana officials for several days would not let it deploy to the flooded city, Rich said.

Yet plans to use the facility and its 100 health professionals were hatched days before Hurricane Katrina devastated the Gulf Coast, doctors in the caravan said.

Other doctors also complained that their offers of help were turned away. A primary-care physician from Ohio called and e-mailed HHS after seeing a notice on the American Medical Association's Web site about volunteer doctors being needed.

An e-mail reply told him to watch CNN that night where HHS Secretary Leavitt was to announce a Web address for doctors to enter their names in a database.

"How crazy is that?" he complained in an e-mail to his daughter.

Dr. Jeffrey Guy, a trauma surgeon at Vanderbilt University who has been in contact with the mobile-hospital doctors, said in a telephone interview, "There are entire hospitals that are contacting me, saying, 'We need to take on patients,' " but they can't get through the bureaucracy.

"The crime of this story is, you've got millions of dollars in assets and it's not deployed," he said. "We mount a better response in a Third World country."

Dr. Bill Winkenwerder, assistant secretary of health affairs for the Defense Department, acknowledged there were problems and said it's a priority "to get the medical community at work and up and operating as soon as possible."

Other volunteer doctors were arriving in large numbers yesterday in Baton Rouge. Several said they worked out arrangements through Louisiana state officials.

Copyright © 2005 The Seattle Times Company

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