HURRICANE KATRINA CAME ASHORE in New Orleans, Louisiana, on Monday, 29 August 2005. This Category 4 storm was the most destructive natural event in US history, and caused destruction in four states (Louisiana, Mississippi, Florida, and Alabama) that totaled 90,000 square miles, an area the size of the United Kingdom. In New Orleans, the massive rainfall resulted in the breaching of the city's levees with flooding that devastated the area's medical and public health infrastructure. Overall, more than 1,800 deaths were caused by Hurricane Katrina and the subsequent flooding, and emergency officials “faced extraordinary de-mands for health services, including evacuation of thousands of hospital and nursing home patients”. Tens of thousands of individuals needed medical care following Hurricane Katrina, and >200,000 individuals with chronic medical conditions were without access to medications and the healthcare systems where they normally received care. While many public health and medical challenges are expected in any disaster, the scope of the damage from these two events (the hurricane and the failure of the levees) posed unique response challenges, such as the loss or separation of medical records from patients, evacuation of medically fragile patients from flooded medical facilities, crippled communication systems, and the destruction of critical medical and public health infrastructure.

This chapter reviews the medical responses to Hurricane Katrina, and presents lessons learned for consideration in disaster planning.