An interview on BBC radio with a trauma surgeon at Vanderbilt University, Nashville, who has been waiting for days to send medical teams to help out in the affected areas.
The audio is about 3 minutes 40 seconds into this clip:
http://www.bbc.co.uk/radio4/today/listenagain/ram/today2_20050906_.ramHere's a partial transcript:
Dr. Geoffrey Guy is a trauma surgeon at Vanderbilt University in Nashville who's been coordinating the nationwide response by paramedics. He's had teams of doctors and supplies ready to go in to provide relief, but says that bureaucracy has prevented it. I asked him first how medics in Louisiana were coping.
Well, I've been working with Dr. Norm McSwaine who's been at Charity Hospital for five days after the incident, and clearly inside the hospitals it was a real struggle - getting patients out of the hospital - AIDS patients - was difficult. We've been talking to people both in Baton Rouge and New Orleans today who are providing direct medical care, and many of those providers have not had any rest since the storm actually came ashore. The thing that people need to keep in mind about that it that aside from just working unbelievable hours, these people are also storm survivors.
And you have medics, though, ready to go in and take over?
We're networked in, right now, to several thousand EMTs and paramedics. We're basically very eager to get in and relieve those providers.
So what's the problem? Why can't they go in and replace the people who are suffering?
Well, the one thing that we've seen is a lack of a unified command structure. It's really difficult to get the assessment of who's in charge. You have multiple national agencies, variable state agencies and dozens of local agencies in cities and parishes that all have some sort of jurisdictional authority over a variety of the effort. Unlike a military operation where you've got a unified chain of command, you really have hundreds of various agencies all kind of doing their own thing.
So at the moment is it just bureaucracy that's holding up this shift change?
Yes, there's no question, it's been bureaucracy. We are a resource-rich country. There are innumerable amounts of resources that are just hundreds of miles away that could be driven in in a matter of hours.
Have you worked out who ultimately it comes down to to say 'do this'?
If we knew that, then we would know where the problem is. Unfortunately you have a lot of mid-level bureaucrats, politicians and so forth that have their own little piece of the pie. It's the unwillingness of those people to communicate, cooperate, or try to put their heads together and make synergisms that's part of the problem.
Do they need to, though? Is this not something you could just arrange on a local level with a particular hospital?
Well, what's been going on is that, rather than having a single chain of command that says "I need helicopters, I need water, I need bandages, I need medics", each of these separate agencies or different providers have basically picked up the phone and started calling people saying "I need help with this". This is how Dr. McSwaine got out of Charity Hospital, was he wasn't getting any progress going through government channels, so he picked up the phone and started calling us, we've got providers in the South, who basically picked up the phone and have called us for help.
And have you been able to send people in?
We've got people assembled that are getting down there. I'm in communication with a group of firefighters from Illinois that are driving down, but even in that response there's still lack of coordination. One fire company out of Illinois, they're halfway down there, when their local city official said "come back home". Clearly there was a fire chief that perhaps said "go respond to the disaster", and somebody higher up on the food chain decided that wasn't what they wanted to do, so they had to break out from this 500 man convoy. We've had medical assets from North Carolina, mobile surgical hospitals, with hundreds of skilled nurses and doctors, basically sitting around for days, because their orders weren't authorized by the right government agency.
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