NEW ORLEANS -- New Orleans' two public hospitals will have to be condemned, according to Don Smithburg, who runs the state's public hospital system.
That decision will prevent the reopening of the city's only trauma units capable of handling the most serious car accidents, gunshot wounds or construction mishaps that any city is bound to have.
Charity and University hospitals were also the backbone of the state's public hospital system and of the medical schools in New Orleans.
"We're still taking on water at both hospitals," Smithburg said Thursday. "We don't know if the water table is rising or what, but water is still seeping - no, not seeping, pouring - into the basements."
So he is working with the U.S. Public Health Service and lobbying Congress to get enough money to set up a military-style mobile trauma ward.
"We're trying to set up the kind of field hospital you would find in Iraq or another war zone," he said. "We think we can get a full-fledged trauma center up and going fairly quickly, in a matter of weeks, as soon as we get the funding."
But the money is not in hand, and there's no timetable for how long it could take. It's one example of the fundamental difficulties that face not only New Orleans but cities in Mississippi and, soon, those in Texas in recovering from a catastrophic storm.
Smithburg estimates he needs about $625 million so he can continue paying his staff, many of whom will work at the trauma unit, and to buy and outfit modular buildings to house the new temporary hospital.
Additionally, he estimates it will cost about $1.5 billion to build new hospitals to permanently replace Charity and University. Some of that money will also go to expand operations at hospitals in Baton Rouge, La., which are now serving a population swollen with New Orleans evacuees.
Smithburg was in Washington this week to talk to members of Congress about a supplemental appropriations bill to fund the city's hospital needs. He thinks the cost of replacing Charity and University with permanent hospitals will be covered by FEMA, but the more urgent need - a temporary trauma unit - apparently will not be, he said.
The two hospitals were also the primary teaching facilities for Tulane University and Louisiana State University's operations in New Orleans.
"We are looking at relationships with other hospitals where we might have some of our students rotate, but that's just a patchwork, bailing wire and chewing gum solution," he said. "When you talk about what life was like pre-Katrina, studies indicated we already were producing too few doctors for Louisiana."
Smithburg's staff was frantically trying to salvage what little equipment in University wasn't destroyed before the rains from Hurricane Rita hit. In Charity, everything was lost, he said.
For the short term, Touro Infirmary is ready to open an emergency room when Mayor Ray Nagin allows residents to begin returning. It will only have triage capabilities, and the most critical cases will have to be airlifted out of the city.
"It appears we'll be the only hospital open in Orleans Parish for a while," said Touro president Les Hirsch.
Hirsch said every major hospital in the city sustained damage. It's not clear when they will reopen, or how much of the void created by the loss of the public hospitals they will be able to fill.
Hirsch said Touro is not set up to be a full-service hospital, or to handle trauma yet.
"For that, you need inpatient, you need critical care, you need operating room capabilities. Blood banking, for instance, is very, very important," he said. "We're looking at all of that."
Touro, a not-for-profit Jewish hospital, will also need money to pull this off. Insurance and FEMA will cover some of the costs, but Hirsch is going to be appealing to the Jewish community around the country for donations.
"We're going to need millions and millions of dollars to do this," he said.
Hospitals outside the city are expecting an influx of patients. Aimee Goforth, spokeswoman for Ochsner Clinic Foundation, about eight miles from downtown New Orleans in Jefferson Parish, said the hospital has a 580-bed capacity, but only 211 beds are now filled. "We're looking forward to the patients coming in, because we have the capacity," she said.
However, Goforth said that long term, as more people return to the area, the ability to handle their needs will depend on how many hospitals open.
Nesmith reports for The Miami Herald. Malcolm Garcia of The Kansas City Star contributed to this report from New Orleans.
