Direct patient care during an acute disaster: chasing the will-o'-the-wisp

Well developed disaster plans are essential in today's atmosphere of natural and man-made disasters. We describe the problems faced by a community hospital on the Mississippi Gulf Coast during and in the wake of Hurricane Katrina. Because of significant damage to surrounding health care facilities, this hospital was called upon to provide care to a large section of the affected population. In spite of a previously successful disaster plan, a number of unforeseen difficulties were encountered. These included staff shortages due to inability of relief personnel to re-enter the affected area, insufficient power generation by hospital generators, breakdown in communication, fuel shortage, limited mortuary space, and stretching of emergency room resources. These unexpected developments emphasize the importance of contingency planning as part of disaster preparedness.