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Public Health Preparedness of Post-Katrina and Rita Shelter Health Staff

  • Daksha Brahmbhatt (a1) (a2), Jennifer L. Chan (a3) (a4), Edbert B. Hsu (a5), Hani Mowafi (a3) (a6), Thomas D. Kirsch (a5), Asma Quereshi (a5) and P. Gregg Greenough (a3) (a4)...



During 2005, Hurricanes Katrina and Rita struck the US Gulf Coast, displacing approximately two million people. With >250,000 evacuees in shelters, volunteers from the American Red Cross (ARC) and other nongovernmental and faith-based organizations provided services. The objective of this study was to evaluate the composition, pre-deployment training, and recognition of scenarios with outbreak potential by shelter health staff.


A rapid assessment using a 36-item questionnaire was conducted through in-person interviews with shelter health staff immediately following Hurricanes Katrina and Rita. Data were collected by sampling at shelters located throughout five ARC regions in Texas. The survey focused on: (1) public health capacity; (2) level of public health awareness among staff; (3) public health training prior to deployment; and (4) interest in technical support for public health concerns. In addition, health staff volunteers were asked to manage 11 clinical scenarios with possible public health implications.


Forty-three health staff at 24 shelters were interviewed. Nurses comprised the majority of shelter health volunteers and were present in 93% of shelters; however, there were no public health providers present as staff in any shelter. Less than one-third of shelter health staff had public health training, and only 55% had received public health information specific to managing the health needs of evacuees. Only 37% of the shelters had a systematic method for screening the healthcare needs of evacuees upon arrival. Although specific clinical scenarios involving case clusters were referred appropriately, 60% of the time, 75% of all clinical scenarios with epidemic potential did not elicit proper notification of public health authorities by shelter health staff. In contrast, clinical scenarios requiring medical attention were correctly referred >90% of the time. Greater access and support from health and public health experts was endorsed by 93% of respondents.


Public health training for sheltering operations must be enhanced and should be a required component of pre-deployment instruction. Development of a standardized shelter intake health screening instrument may facilitate assessment of needs and appropriate resource allocation. Shelter health staff did not recognize or report the majority of cases with epidemic potential to public health authorities. Direct technical support to shelter health staff for public health concerns could bridge existing gaps and assist surveillance efforts.


Corresponding author

Research Director Harvard Humanitarian Initiative 14 Story Street, 2nd Floor Cambridge, Massachusetts 02138 USA E-mail:


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1. Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina: A Failure of Initiative.U.S. Government Printing Office. Available at Accessed 13 October 2008.
2. Department of Homeland Security: National Response Framework Resource Center. Available at Accessed 12 October 2008.
3. Homeland Security Institute: Heralding unheard voices: The role of faithbased and non-governmental organizations during disasters. Available at Accessed 14 October 2008.
4. Greenough, PG, Lappi, MD, Hsu, EB, Fink, S, Hsieh, YH, Vu, A, Heaton, C, Kirsch, TD: Burden of disease and health status among Hurricane Katrinadisplaced persons in shelters: A population-based cluster sample. Ann Emerg Med 2008;51(4):426432.
5. Centers for Disease Control and Prevention (CDC): Injury and illness surveillance in hospitals and acute-care facilities Aater Hurricanes Katrina and Rita—New Orleans Area, Louisiana, September 25–October 15, 2005. MMWR 2006;55:3537.
6. (US) Centers for Disease Control and Prevention: Surveillance in hurricane evacuation centers—Louisiana, September–October 2005. MMWR 2006;55;3235.
7. (US) Centers for Disease Control and Prevention: Morbidity surveillance after Hurricanes Katrina—Arkansas, Louisiana, Mississippi, and Texas, September 2005. MMWR 2006; 55(26):2731.
8. Vest, JR, Valadez, AM: Health conditions and risk factors of sheltered persons displaced by Hurricane Katrina. Prehosp Disaster Med 2006;21(2):5558.
9. Brodie, M, Weltzien, E, Altman, D, Blendon, R, Benson, J: Experiences of Hurricane Katrina evacuees in Houston shelters: Implications of future planning. Am J Public Health 2006;96(5):14021408.
10. Laditka, S, Laditka, J, Xirasagar, S, Cornman, C, Davis, C, Richter, J: Providing shelter to nursing home evacuees in disasters: Lessons from Hurricane Katrina. Am J Public Health 2008;98(2):16.
11. Coker, AL, Hanks, JS, Eggleston, KS, Risser, J, Tee, PG, Chronister, KJ, Troissi, CL, Arafat, R, Franzini, L: Social and mental health needs assessment of Katrina evacuees. Disaster Manage Response 2006;4(3):8894.
12. Madrid, PA, Grant, R, Reilly, M, Redlener, M: Challenges in meeting immediate emotional needs: Short-term impact of a major disaster on children's mental health: Building resiliency in the aftermath of Hurricane Katrina. Pediatrics 2006;117(5):S448–S453.
13. Mills, MA, Edmondson, D, Park, CL: Trauma and stress response among hurricane katrina evacuees. Am J Public Health 2007;97:S116–S123.
14. Rodriguez, SR, Tocco, JS, Mallone, S, Smithee, L, Cathey, T, Bradley, K: Rapid needs assessment of Hurricane Katrina evacuees—Oklahoma, September 2005. Prehosp Disaster Med 2006; 21(6):390395.
15. Cavey, A, Spector, J, Ehrhardt, D, Kittle, T, McNeill, M, Greenough, PG, Kirsch, TD: Mississippi's infectious disease hotline: A surveillance and education model for future natural disasters. Prehosp Disaster Med 2009:24(1):1117.
16. Parker, CL, Barnett, DJ, Everly, GS Jr, Links, JM: Expanding disaster mental health response: A conceptual training framework for public health professionals. Int J Emerg Ment Health 2006;8(2):101109.
17. Slepski, LA: Emergency preparedness and professional competency among health care providers during hurricanes Katrina and Rita: Pilot study results. Disaster Manag Response 2007;5(4):99110.
18. (US) Centers for Disease Control and Prevention: (US) Centers for Disease Control and Prevention-OCSO-Advancing the Nation's Health: A Guide to Public Health ResearchNeeds,2006–2015.Ed.Office of the Chief Science Officer.19 Dec.2007. Available at Accessed 29 February 2008.


Public Health Preparedness of Post-Katrina and Rita Shelter Health Staff

  • Daksha Brahmbhatt (a1) (a2), Jennifer L. Chan (a3) (a4), Edbert B. Hsu (a5), Hani Mowafi (a3) (a6), Thomas D. Kirsch (a5), Asma Quereshi (a5) and P. Gregg Greenough (a3) (a4)...


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