Contact: Will Sansom
Phone: (210) 567-2579
E-mail: Sansom@uthscsa.edu

CURIEL
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People in the 21st century are under more imminent danger than ever before, whether the catastrophes are natural, such as Hurricane Katrina, or man-made, such as September 11. “Things that were almost unimaginable 50 years ago are realities today, which means our health care teams must be prepared for many more crisis scenarios,” said Tyler Curiel, M.D., M.P.H., of The University of Texas Health Science Center at San Antonio and the Cancer Therapy & Research Center (CTRC). He is director of the institutions’ collaborative San Antonio Cancer Institute, a National Cancer Institute-designated Cancer Center.

Dr. Curiel and his wife, Ruth Berggren, M.D., an infectious diseases specialist, relocated to San Antonio this past summer from New Orleans, where they practiced academic medicine for five years. They found themselves in the middle of crisis efforts to care for patients at two hospitals as Katrina lashed the city Aug. 29, 2005, and in the week afterwards when rescue did not materialize.

Dr. Curiel has written an article about New Orleans hospital decision making, which was placed under extreme strain during the crisis. “Murder or Mercy? Hurricane Katrina and the Need for Disaster Training” is in the Nov. 16 issue of The New England Journal of Medicine.

“Hurricane Katrina showed us that even after September 11, we have not learned our lessons sufficiently,” he said. “Even today, we still spend more time reacting rather than preparing, and those preparations are not necessarily the ones that will be the most useful.”

Dr. Curiel wrote the article to sound a clarion call for better disaster preparedness in medical institutions. Readiness exercises should fortify health care providers who could face life-and-death decisions during unusual and prolonged times of stress, he said, such as when hospital generators are out, medication stockpiles are depleted, equipment or facilities are in limited supply such as during an influenza pandemic, or if health care providers find themselves amidst violence, particularly armed conflict. In addition, health care providers must be better equipped to work with administrators for effective centralized decision making in the event of a disaster.

“I was able to write this article because I was in New Orleans when the hurricane hit,” Dr. Curiel said. “I saw firsthand how the infrastructure failures and lack of preparedness to deal with that catastrophic scenario greatly hindered doctors, nurses and the rest of the health care team in the trenches from achieving their ultimate goal of rendering appropriate medical care, including saving lives.”

The article is not an analysis of what happened at any one hospital, Dr. Curiel said. It is a call for hospitals and clinics to better prepare themselves, and for schools educating health care providers to offer appropriate, timely and effective training on disaster preparedness in their curriculums, something the Health Science Center in San Antonio already has done. In April 2003, the Health Science Center also established the Center for Public Health Preparedness and Biomedical Research, which has expanded homeland defense and bioterror readiness exercises within the academic environment of the Health Science Center.

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The University of Texas Health Science Center at San Antonio is the leading research institution in South Texas and one of the major health sciences universities in the world. With an operating budget of $500 million, the Health Science Center is the chief catalyst for the $14 billion biosciences and health care industry, the leading sector in San Antonio’s economy. The Health Science Center has had an estimated $34 billion impact on the region since inception and has expanded to six campuses in San Antonio, Laredo, Harlingen and Edinburg. More than 22,000 graduates (physicians, dentists, nurses, scientists and allied health professionals) serve in their fields, including many in Texas. Health Science Center faculty are international leaders in cancer, cardiovascular disease, diabetes, aging, stroke prevention, kidney disease, orthopaedics, research imaging, transplant surgery, psychiatry and clinical neurosciences, pain management, genetics, nursing, allied health, dentistry and many other fields. For more information, visit www.uthscsa.edu.