No–health systems today are still not prepared to handle the risk of a Katrina-level disaster, says one Gulf-area health care provider in an interview published today on Health Affairs’ Web site [2-week free access]. Other news stories today, the second anniversary of the Katrina hurricane, also highlight the long road ahead on the health care front. Today’s Washington Post reports that only two-thirds of the region’s hospitals have reopened. NPR reported on a “check-up” on the health and mental health care in New Orleans.

In the Health Affairs Web Exclusive today, Tom Bearden, a correspondent with the NewsHour with Jim Lehrer, interviews Joe Dawsey, executive director of the Coastal Family Health Center in Biloxi, Mississippi. He also interviews David Campbell, executive director of Hands On Disaster Response in Carlisle, Massachusetts, and Kris Cyr, executive director of CAVU (Ceiling and Visibility Unlimited) Foundation in Fitchburg, Massachusetts.

Here’s an excerpt of today’s interview:

Tom Bearden: From a disaster planning perspective, are we any better off today if this hurricane were to occur again tomorrow?

Joe Dawsey: No. That’s the short answer. If Katrina happened tomorrow, I honestly don’t believe we’d be better off. We have a few stronger buildings, the ones we’ve managed to build. I don’t believe the lesson has been learned.

David Campbell: It’s interesting–we sort of primed the pump with volunteers, including substantial pro bono efforts from the folks at Abt Associates to help identify potential sources of financing, and then we used some of our initial funding to bring in sustainable professional resources. Those professional resources will be essential to allow Coastal to both complete the planning and construction and get the facilities open. We can reconstruct that volunteer network and pull together quickly again. But it seems to me that that sort of response ought to come from HRSA or NACHC [National Association of Community Health Centers]–one of those organizations. They should be learning with us right now and then stepping up and taking that role the next time. It would be a smarter way to do it, I think. Joe, have you had any communications from FEMA that were sort of open-minded, in terms of, “Gee, Mr. Dawsey, what do you suggest we do differently?”

Dawsey: No, no.

Campbell: I mean, there’s such a learning opportunity here. Did you see any evidence of anyone trying to make the situation better next time?

Dawsey: No.

Bearden: None whatsoever?

Dawsey: No, I haven’t.

Bearden: Who needs to fix this?

Dawsey: That’s a good question. I think the health care piece would have to be DHHS and NACHC, working with local organizations to provide some national coordination. I don’t think FEMA can fix it unless it changes, unless it can have a separate health care branch–which I think would be unnecessary.

Kris Cyr: I think that’s right in terms of funding, but the reality of any disaster is that local communities are going to have to come up with the solutions, and they need the support structures. They don’t need FEMA to come in and tell them what to do. Communities need to say, “Look, this is how you get barriers out of the way to turn this into a success here.” FEMA needs to ask, “How do we provide the resources to you as a community?” And this all has to be coordinated by the community. Certainly the community leaders came out, supported that, put together a good plan–and nothing happened. So I think we just have to be careful when we talk about things being solved at a national level. Because it’s really the community leaders who have a vested interest and who are going to make things actually happen on the ground. It’s saying, “Look, we’ve got a hundred barriers on the spec sheet. Let’s come up with an action plan to get them all out of the way.”

See the full interview for more discussion. Also see the multimedia extras posted on Health Affairs’ Web site, including links to NewsHour segments conducted by Bearden.

And stay tuned for an upcoming paper by Dennis Andrulis on preparing vulnerable populations for disasters such as hurricane Katrina. The paper will appear September 11 in Health Affairs’ theme issue on vulnerable populations.