Reflections and recommendations on disaster response and preparedness: Katrina and Rita's first responders weigh in on experiences and future planning

In August 2005 when hurricanes Katrina and Rita touched down in Louisiana and Mississippi's Gulf Coast region, it became evident that disaster preparedness protocols had not been sufficiently established to respond effectively to an event of this magnitude. In an effort to respond to the immediate and long-term health needs of populations most affected by the hurricanes, The Children's Health Fund (CHF) and the National Center for Disaster Preparedness at the Mailman School of Public Health at Columbia organized Operation Assist, an initiative wherein mobile units staffed with medical and mental health care teams from CHF national sites were dispatched to the affected region. Following the initial disaster response, ten interviews with CHF physicians were conducted with the intent of describing the first-responder experience. Special attention was paid to differing logistical processes, levels of coordination on various institutional levels, and lessons learned. In this mixed method (quantitative and qualitative) study, questions were open-ended and responses coded for thematic similarity. The majority of study participants noted that they had not had formal disaster preparedness training. Many cited the need for better access to pharmacological services and to have a team member familiar with the local community. This study provides crucial insight into aspects of effective disaster response and those elements requiring additional planning for future disaster preparedness models. It highlights the nature of ailments that clinicians witnessed—relating not only to mental health and physical wellness but also to structural health care disparities; and intuits the needs of first responders themselves.