Amanda Spake researched and reported on the long-term impact of Katrina on the health of Gulf Coast residents; special focus was given to residents who had moved into FEMA-supplied trailers, which are now creating a major health care crisis of their own.
Spake discusses her findings:
Just after Hurricane Katrina hit, it was estimated that as many as 200,000 Americans had lost their health insurance in one day as a result of the storm. In fact, some estimates are even higher. As businesses, schools, government offices, hospitals, clinics, and physicians' practices were destroyed, health benefits—health care in general—evaporated. Patients in coastal Louisiana, Mississippi, and Alabama, who had depended upon local doctors, hospitals and clinics to provide their care—even when they could not pay for it—suffered massive medical shortages, as local health care systems crumbled. Disparity in access to medical care in these communities was common even before Hurricane Katrina. The storm exacerbated an already problematic picture, as working people lost jobs, coverage, and the ability to pay for extensions of coverage, such as COBRA plans. The ranks of the uninsured swelled just as the local safety net for medical services disappeared.
My research in Mississippi, Alabama, Louisiana, and in Washington, DC, made it clear that the Gulf Coast residents who had moved into FEMA-supplied trailers for temporary housing were those whose health was most severely harmed by the storm. These people were largely poor, elderly, or working-class families who were renting apartments, houses, or trailers when Katrina and Rita struck, or they had owned homes without flood insurance. Even if they had health insurance and access to good health care before the hurricanes, they no longer had it after the storm. Some were jobless, but the majority had been forced to move down the economic ladder and take one of the few low-pay service jobs available in storm-devastated areas. Their children usually were eligible for Medicaid or SCHIPS, the federal health insurance program for children of the working poor. But the adults had no health care, and the elderly were left searching for physicians who would take Medicare, often when no physicians were available at all, particularly in New Orleans.
The second major finding on trips to the region was that there was something about the trailers themselves or trailer life that was making a significant number of these Katrina survivors sick. Along the Gulf Coast, in the towns and fishing villages from New Orleans to Mobile, survivors of Hurricane Katrina were suffering from similar health problems. Trailer residents told me stories of wheezing, coughing and gasping for breath. Their eyes burned; their heads ached; they were tired, lethargic. Nosebleeds were common, sinus infections and asthma attacks were frequent. Children and seniors were most severely afflicted; two women and two infants died as a result of breathing problems linked to air inside their trailers. But no one was immune.
The one similarity is that all of these people suffering these illnesses lived in trailers supplied by the Federal Emergency Management Administration. By the winter of 2007, nearly 275,000 Americans were still living in more than 102,000 travel trailers and mobile homes that FEMA purchased after Hurricane Katrina. The price tag for the trailers was more than $2.6 billion, according to FEMA. FEMA said there was no problem with the trailers. The agency claimed it had received only one or two complaints about odors. The trailers were safe, the agency maintained.
In Mississippi, I met a pediatrician, Dr. Scott Needle, who had been treating children for a variety of unusual and constant respiratory illnesses, and a Sierra Club activist, Becky Gillette, who believed the air inside the trailers was causing the health problems. Gillette had documented many reports of respiratory illness suffered by people living in the FEMA trailers. Her research led her to begin testing the indoor air of trailers for formaldehyde, a toxic chemical used in glues, particleboard, and pressed wood, sometimes in carpeting, and other materials used to make these trailers. Needle had also suspected formaldehyde and had repeatedly tried to get the Mississippi Department of Health and the federal Centers for Disease Control and Prevention involved—without success.
It was Gillette who first discovered the high levels of formaldehyde in trailers in Mississippi and Alabama in the spring of 2006. In the summer, the Sierra Club tested another group of trailers in Louisiana and came up with similarly high formaldehyde levels in these trailers as well. Though there had been some spotty local coverage of the problem, the national news media had stayed far away from the story.
For me, the story illustrated the increasing health problems both the hurricane itself, and the "recovery," was inflicting on those least able to get their health needs met—the poor, elderly, and working class families of the Gulf states. I felt this was exactly the type of investigation the Katrina Media Fellowships were awarded for us to undertake.
I had no idea at the beginning I would end up spending all of my fellowship year on it. But as this national scandal keeps unfolding and growing, it is now clear that contrary to FEMA's denials to trailer residents, the media, to Congress, its own staff, and to me, FEMA officials knew early on that there was a major formaldehyde problem with the trailers, and the agency worked for over a year and half to cover it up. FEMA administrator David Paulison lied to Congress as recently May 15, 2007, when asked directly about the safety of formaldehyde in the trailers. Before the House Committee on Homeland Security, Paulison claimed, "The formaldehyde issue was brought to our attention, and we went out and investigated, and used the EPA and other agencies to do testing." Then he added, "We've been told formaldehyde does not present a health hazard." After the House Committee on Government Oversight and Reform subpoenaed internal FEMA documents and emails showing the agency's attempt to cover-up this scandal, Paulison finally had to admit in a hearing before the Committee in July 2007, "We realize now we have a problem." But Paulison still refuses to say that the cause of the illnesses is formaldehyde.
FEMA had started selling these trailers for low prices both to evacuees and others, and it has now halted these sales, as well as stopped shipments of trailers to other disaster areas. The CDC has finally become involved and is apparently beginning some sort of testing program in the trailers, but details of the testing program are still a mystery, both to trailer residents who have asked to have their trailers tested, and to the public in general. New problems, such as mold in the trailers and mobile homes and fires resulting from poor maintenance, are surfacing as well.
There are close to 60,000 travel trailers and thousands of mobile homes still occupied by more than 162,000 people in four states. In March 2008, Katrina and Rita evacuees are supposed to begin paying rent for the trailers. Nearly all of the survivors living in FEMA-supplied housing would love to move out to a real home in a real community, but little or no rental and low-income housing is available in these areas, and virtually none is being built. FEMA announced in August that it would begin moving people out of the trailers, and providing six-month rental subsidies to those who could find an apartment, pay for the first month's rent and deposit on their own, and cover the utilities. No plan has been made public to address the long-term resettlement of trailer residents, a task that officials at Catholic Services say may take over five more years to complete.