Hurricane Katrina

A Bold and Beautiful Vision

In the impoverished, Katrina-ravaged New Orleans neighborhood of Algiers, locals are finally getting healthcare -- and hope -- with the birth of a grassroots medical clinic.
What happens when your feet leave the ground? Answer: you fall down. That's the story of the U.S. government, or at least the story of how it fell flat on its face in New Orleans in the wake of Hurricane Katrina. In failing to connect with local communities, the government stumbled wildly in the mud and floodwaters that left tens of thousands of folks without healthcare, housing, or hope.

I learned this story from the people of Algiers, an impoverished New Orleans neighborhood on the west bank of the Mississippi River. Like he rest of New Orleans, Algiers experienced a mass exodus in the days prior to Katrina. By the time the storm arrived on August 29, only about 20 percent of the residents remained. Their faces bore the same expression of disbelief that the government could be so ineffectual at a time of unprecedented domestic crisis.

I visited Algiers at the behest of one of those who stayed behind: Malik Rahim, an ex-Black Panther and former Green Party city council candidate. Rahim stayed because he feared many of the folks left behind would be neglected, if not abandoned. Unfortunately, his fears came true.

Although Algiers was spared the floods that devastated many neighborhoods east of the river, its stores, public transit systems, and neighborhood health centers remained out of operation for nearly three weeks. Residents who stayed needed food and drinking water. Most who did not evacuate were the elderly and the frail -- folks who required frequent access to pharmacies and doctors. As Rahim waited nervously for official help to arrive, he began receiving calls from neighbors in crisis. One elderly man down the block needed pain medication for a gangrenous finger, yet he could not get to the hospital or find a doctor. He had not slept in days, the stress was making his diabetes worse, and he was close to running out of insulin.

Rahim took action, broadcasting reports from Algiers through radio and newspapers. "This is criminal," he wrote in a widely circulated essay dated September 1. "People are dying for no other reason than the lack of organization."

Some aid haltingly began to flow into Algiers in the days following the storm. The Red Cross established a number of supply stations. Folks could pick up water and emergency meal rations, if they could walk or drive to the depots -- and obviously many could not. There were no doctors, pharmacies, or open health centers. For emergencies, there was a makeshift FEMA center on the lawn of the closed West Jefferson Hospital, but few Algiers residents could get there.

Rahim envisioned a relief framework that would be radically different from that of the Red Cross, FEMA, and the Louisiana Department of Health and Hospitals (DHH). He had in mind a grassroots, humanitarian relief organization that would integrate community members at every level. This vision -- soon named Common Ground -- featured a neighborhood health clinic, efforts to help folks rebuild their homes, and satellite relief operations in other sections of the city.

Rahim secured space for the Common Ground clinic in the Masjid Bilal mosque near the southwest edge of Algiers, one the poorest neighborhoods in New Orleans. Activists from around the nation made plans to come. Getting to Algiers was difficult in the days following the storm, due in part to the enormous military and police presence in the disaster stricken region. There were many reports of black people being turned back at check-points, including a contingent of black clinicians who attempted to come in from Atlanta. Such instances of racism influenced the composition of the activists who could participate. The first caravan of independent relief activists, from the Mayday DC collective, arrived in early September and quickly got to work. By September 9, the Common Ground clinic had opened its doors for business. While the scope of medical care was initially limited by the lack of supplies and credentialed clinicians, many patients were happy simply to have someone to talk to, someone who could check their blood sugar and vital signs, and dispense useful tips on how to stay healthy.

I was among those who heard Rahim's plea for help. I left for New Orleans on September 10 in a three-truck caravan loaded with medical supplies and volunteer healthcare providers. After more than 48 hours of non-stop driving, we arrived at Rahim's house on September 12.

As a medical doctor, I was duly credentialed to work in Louisiana under Governor Kathleen Blanco's state of emergency order, which permitted out-of-state clinicians to provide medical care to disaster victims. I was quickly put to work handling the back-log of patients who desperately needed to have their medical conditions stabilized and their prescriptions renewed. In my seven days at the clinic, I saw hundreds of patients and worked with an astounding team of eclectic clinical volunteers, including nurses, medics, herbalists, counselors, and even an acupuncturist. Moreover, I talked to countless people from around the nation who wanted to help, including Cindy Sheehan and the Veterans for Peace, who donated a large cache of medications.

While some of the patients coming to Common Ground required care for injuries directly related to the storm, most were dealing with chronic illnesses such as diabetes, asthma, and high blood pressure. For some, these conditions had been exacerbated by the interruption of routine medications. For others, their medical conditions had long been under-treated, given the lack of primary healthcare services in the neighborhood. Some had not seen a doctor in years. It became clear that Common Ground was not only plugging the gap in hurricane relief aid, but in long-term primary health care for a drastically underserved population.

Lacking the red tape and hefty bureaucracy that slowed large government-sponsored relief operations, Common Ground is highly flexible. While it has attracted skilled professional clinicians, it also incorporates people with little or no formal clinical training. Anyone -- including local residents -- who wants to learn how to take blood pressure, test blood sugar, or perform initial triage is given on-the-job training. This commitment to share knowledge and skills sets Common Ground apart from other relief efforts run by the Red Cross, FEMA, and the state DHH.

Although Common Ground arose independently from state-sponsored relief efforts, it has become increasingly integrated, working with DHH officials to extend services throughout Algiers and beyond. As outside support has stimulated Common Ground's expansion, the clinic faces two critical internal challenges.

First, although Common Ground sprang from the community, it required the leadership of a talented, charismatic individual to get it off the ground. To sustain itself, the collective will depend upon many more local individuals adopting and carrying forth Malik Rahim's vision, motivating volunteers to come help and incorporating Common Ground into the fabric of the community Though folks from the community shouldered incredible responsibility in building and sustaining the operation, at first so many community residents were either out of town or struggling to deal with crises in their own lives that much of the clinic's work was performed by outside volunteers. In the weeks to come, hopefully, much more of the clinic operation will be collectively sustained by local and outside volunteers together. The motto of the clinic remains "Solidarity, not Charity."

Second, the first volunteers who answered Rahim's call in early September were by and large "radicals" -- members of decentralized, self-help organizations, many of them self-defined anarchists, who are skeptical of the willingness and ability of state institutions to respond to the needs of the people. Most were white, due in part to the greater difficulty volunteers of color faced in dealing with the military and bureaucracy. In the beginning, Common Ground resembled a radical political gathering, and it was not until a few of the local residents drew attention to the activists' unconventional appearance (tattoos, hair styles, piercings) that efforts were made to bridge the cultural divide. The folks coming to the clinic were there for humanitarian relief, not necessarily out of solidarity with a revolutionary anti-government movement. With time, awareness of this reality changed the ethos of the clinic. Hospital scrubs replaced T-shirts bearing political slogans, and greater attention was placed on personal professionalism and administrative organization. Yet collective members -- including myself -- wonder how we'll be able to sustain a radical vision of a better world as we become increasingly enculturated within the world of established medical provision, upholding conventional standards of care. I personally hope the Common Ground clinic will find the proper balance between creating a space that is inviting and supportive of all people who seek health care, while maintaining its original vision of social justice, political change, and mutual aid.

Common Ground tells an important story. Katrina was merely the latest disaster to strike the people of Algiers. It is but one chapter in a long history of disastrous neglect and abandonment. The fact is that Algiers is a predominantly impoverished black community, and race and class factored heavily into the equation of who escaped the hurricane and who was left behind to fend for themselves. The poor, and especially poor people of color, were essentially abandoned by the state, and this reflects the awful reality of the Bush regime: the government cannot be entrusted to work on behalf of its people. Bush cares more about tax cuts for the rich, as he decimates critical services for the poor. He is captivated by a mentality of war, the only purpose of which seems to be global economic domination. Yet in Algiers residents and outside activists did more than simply blame the government. They created a bold and beautiful vision of an altogether different system of humanitarian relief than the one doled out by visionless public and private sector bureaucrats whose lackluster approach to humanitarian aid echoes Bush's own moribund disinterest in the needs of the poor.

Common Ground has its feet planted in the community of Algiers. It is supported by the people and it stands tall and proud in a region that has witnessed the stumbling steps of official relief operations that could not connect with the people. Perhaps with time, state officials will become increasingly appreciative of the strengths of an effort like Common Ground, helping to fund and support other similar operations throughout poverty-ridden and disaster-stricken regions of the nation.

Yet each step of the way, collectives like Common Ground will have to conceive their own vision, for different communities have different problems, different histories, and different individuals. Understanding the uniqueness of a community's needs,tailoring relief efforts to fit each community's struggles, and respecting communities' and individuals' diverse values and beliefs are a few of the challenges that must be faced as others begin to create their own common ground.
Michael Kozart, MD, works on a psychiatric ward at San Francisco General Hospital. Liz Highleyman also contributed to this article. The first twelve reader comments refer to a slightly different earlier version of this story.
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