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Vice Admiral Richard Carmona
United States Surgeon General

September 9, 2005

Richard Carmona

Hello, this is Vice Admiral Richard Carmona, United States Surgeon General. I'm happy to be with you today to address some of the issues that have come up after Hurricane Katrina.

Casey, from Mammoth Lakes Ca. writes:
Why don't you dump loads of chlorine into the water in new orleans to keep bacteria from growing? This could help with disease.

Richard Carmona
Well, in fact, we’ve had that suggested and we’ve had some discussions about that. The reason we don’t do it that way is that you’d have to put an awful lot of chlorine in that itself could be toxic in order to kill the bacteria. The other problem is that there are already a number of other chemicals in the water and the chlorine could have interactions with that, which would be adverse, as well. So, theoretically, chlorine does well in nice, clean water to keep bacterial counts or fungus down like in your swimming pool but in a large moving body of water like this that’s fast moving, it really would be impossible to be able to use it effectively.

Diane, from Monee, IL writes:
Ms. Sayle: I am a Registered Nurse in the suburbs of Chicago. On Friday I went to and volunteered my services in New Orleans. I would even pay my own way. I have yet to hear anything. I also encouraged several other nurses to register and we would have traveled together to assist in relief efforts. What happened? Diane Quirk RN

Richard Carmona
What’s happening now is that we have a number, 1-866-KATIMED, which is the call in number to give information for those who want civilian volunteers. We also have a web site that can be accessed from or In fact, we have been getting information about thousands of people who have volunteered and we have other databases of thousands of members of corporate America who have volunteered. At this time we haven’t deployed any volunteers; however, this morning we sent out a message to all volunteers acknowledging their input and at this time are working with the President’s direction and Secretary Leavitt’s direction to determine when and where we can use volunteers.

We anticipate that this is going to be a long recovery, and that volunteers will be needed over many months. We will look at where the evacuees are eventually centered and ensure we are meeting all of their needs—social needs, and mental and physical health. Essentially we are recreating an infrastructure to support a whole community that has been displaced. We do anticipate that we will need services of volunteers. We ask you to be patient because it is going to take time to get this all in motion and get the right volunteers to the right place at the right time.

Anita, from New Hudson, Michigan writes:
I have heard that people can often go awhile-days, perhaps a few weeks without food,unless perhaps they have health problems, but that people need water everyday to live. I am very concerned about the areas affected by Hurricane Katrina, especially New Orleans, and am wondering what is happening in order to get water as swiftly as possible to the people there.

Richard Carmona
We have with our other federal partners—Department of Homeland Security and FEMA—been working on getting water as well as food to those persons who are in the environment impacted by the Hurricane who can’t drink the water and don’t have easy access to food.

Just yesterday, we had a call from a water company in Arizona who wanted to transport unlimited supplies of water to the affected areas for the people and we put that through our logistical section here at HHS and hooked that company up with the right people so that the water can be transported as quickly as possible. This is only one of hundreds of inputs we have had for all kinds of donations of water or other fluids and food and medication.

Helmut, from Rowe, MA writes:
Is an epedemic brew forming? The Toxins released in New Orleans water, from petrochemicals and thousands of basements, not counting the corpses, will become a great danger to the already handicapped people and livestock there. Will you send someone to take water samples and analyze them, there is danger of new diseases developing from these severely contaminated waters

Please look in to it. Sincerely, Helmuty.

Richard Carmona
Helmut, thank you for your question. In fact, from day one, we have had public health teams on the ground looking at just that.

It is often very difficult to tell in the acute period after a Hurricane, but as the water settled and we were doing rescues, we began to see that the water was going to be around for awhile, we started to do analysis. We have found that the bacterial counts within the water are very, very high and unsafe. There are also multitudes of chemicals in the water that are toxic that we are attempting to characterize, as well as to find out the actual amount once characterized. All in all, this water should be assumed to be toxic. It should not be used to clean, to wash with, or to cook or drink.

We have environmental health officers, epidemiologists, and sanitary engineers all on the ground. They are assessing how best to remove the water, continuing to sample the water, and getting all of the scientific evidence they need to be able to decontaminate if necessary and examine patients to ensure they do not have ill-consequences of what they have been exposed to.

Anthony, from Houston, TX writes:
Vice Admiral Carmona: My relatives from New Orleans are temporarily staying at my house in Houston, TX. Would you mind to please mention in SPECIFIC details what types of medical help, where, when, etc. I can get for my relatives as they are senior citizens and small kids all. Many thanks.

Richard Carmona
Thank you for your question Anthony. In fact, Houston is one of the evacuation sites, and we have several locations there—some of which Secretary Leavitt and I and other members of our team visited just a few days ago. These are very large health social service and medical complexes that all evacuees can go to. They can check in, receive check-ups, have their questions answered, receive clothes, food, water, and if necessary, even a place for temporary shelter.

Adam, from Rochester, NY writes:
Please tell me a little bit more about the US Public Health Service and its role in Hurricane Katrina relief efforts. Do I need to be a doctor to be in the public health service?

Richard Carmona
That is a great question and one I am very happy to answer, since I am the commander of the United States Public Health Service Commission Corps. The U.S. Public Health Service Commission Corps is an agency that is over 200 years old, first put into action by President Adams in 1798 as the Marine Hospital Service. At that time it cared for our first mariners, as our country was growing. One hundred years later, with greater responsibilities for the health and safety and welfare of the country, the position of Surgeon General was codified, and the responsibilities of the corps were broadened to include things like immigration services.

The U.S. Public Health Service Commission Corps is also the medical corps of the U.S. Coast Guard, the Bureau of Prisons, Immigration, and Indian Health Service. So a lot of the agencies that people hear about might not be aware that they are part of the U.S. Public Health Service.

In addition, our officers are researchers at the National Institutes of Health, and serve as epidemiologists, researchers and clinicians at the CDC. So, we are throughout government in any place that there is a health need. Often it is the public health service that provides that fills that gap and we do that through 11 different disciplines that we have within the public health service.

Today, in the response to Katrina, it is our officers who on the ground are doing everything from clinical care to epidemiological surveys, and there are environmental and structural engineers, all looking at how to help mitigate the damage and how to restore the structure of the community so that those who want to return home can return home.

Tony, from Zion writes:
Mr. Carmona, We all know the horrible affects that are rolling before our eyes in the gulf right now. What do you think are the most common sicknesses that we will see for the survirors trying to survive this devestation?

Richard Carmona
My guess is that the most common sickness we will see is mental health over the long term. We will have bouts of diarrhea and we will have people who were physically injured. Having been to the centers and seeing what the folks have suffered, the injuries have been relatively minor for such a large population. We are seeing some problems with rashes and people who are already sick getting sicker.

But once that is all under control, the psychological impact of this devastation I think is going to be what impacts us most. Depression, post traumatic stress disorder, anxiety, and a whole host of other cases—we are already preparing for that by having mental health teams deployed and are working with the community to be able to make sure that everybody has the mental health support that they need to get them through these very difficult times.

jennifer, from illinois writes:
I have heard that the government is going to be hiring temporary medical staff (6 months) to aide the overworked medical employees that are needing replacements. Is this true and where would I find information on it? Thanks

Richard Carmona
What we are doing with Health and Human Services is not hiring specifically, but we have a volunteer telephone line where we are able to make volunteers temporary federal employees, so that they are protected while working for us. So whether you are a professional—a doctor or a nurse or a lawyer—versus somebody who would be a support personnel, such as someone transporting patients or a housekeeper, all types of volunteers are needed. We have the opportunity to federalize some of those groups and make them temporary employees so that their liability is covered but they are working as volunteers for us.

There maybe other programs within government that are hiring people, but we would not be involved in that.

Debra, from Brigantine, NJ writes:
Are Electronic Medical Records being utilized during the Katrina disaster? It would seem that a disaster of this magnitude would benefit greatly if EMR's were in place for victims. As an IT Professional who supports 12 Emergency Departments in the US that use EMR, is there a way to volunteer to help Katrina victims who would benefit from electornic capture of their pertinent, current medical information?

Richard Carmona
That is a great question and one we have been discussing that further strengthens the President’s position on moving forward aggressively with developing the electronic medical record and something that Secretary Leavitt is already doing and has high on his priority list.

At some of the sites in fact they are developing an electronic record. We saw computer bases out, we saw data entry, and so although it wasn’t very sophisticated, there was an attempt of digitalize the records so they could be portable and transmitted wherever the patients go. Now obviously all communities don’t have that expertise and don’t have the logistical support to do that. But certainly in disaster medicine we know very definitely that there is a very important value in the electronic medical record because it is totally portable, secure, and protects your privacy, but yet as you get moved during a disaster, your medical record can be transported electronically any place you go so that your providers are able to have that information.

In addition, it provides a great deal of information for those who study disasters, for those who want to plan for the future, as to what the needs are during a disaster, and helps us to better model our systems for the future.

Mark, from Baton Rouge writes:
Will the administration provide federal funding to fast-track construction of a public trauma unitmedical center that has been planned for Baton Rouge?

Richard Carmona
Right now, I think we are focused on the acute care and making sure that those persons that had to be evacuated are safe and have the services they need and those that remained in place are safe and have the services they need. As we move along in planning, many questions have already come up—how do we help these communities restore their integrity, their structure, and so on. My guess is that those discussions will come up as far as trauma centers and trauma systems and emergency medical systems, and if we are going to rebuild how do we do it in such a way that makes these communities even better and even stronger. So I am sure that it will be part of the future discussion when we get to that and we are over the acute event.

Richard Carmona

I would like to close by thanking all of the first responders and citizens in the affected communities. As we traveled through the affected regions, Secretary Leavitt and I were profoundly humbled by the volunteerism and by the wonderful spirit of America that we saw exemplified, by just common people reaching out to one another and helping them. Such as putting together shelters and huge medical centers within convention centers and building that were standing where nothing had been before. And witnessing Police Officers, EMS, and Firemen risking their lives repeatedly to save others. What we really saw was how wonderful a country America was and how we can come together under the most adverse circumstances and reach out and help one another and provide an infrastructure for those who are hurting.

As we see today we have evacuees who are in Houston, in San Antonio, and in other cities, where those communities have reached out to provide a home for them, provide safety, shelter, and are providing schools for their children. I know Secretary Leavitt and I feel that we are very proud to be Americans because of the uniqueness of this country in being able to reach out to the rest of the world and help when it has a need, but also that we take care of our own and we do it so well.

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