Group Debriefing - All 40 PHAST Gulf Trip members finally met in whole last Thursday. One promising outcome is a strong interest in starting some kind of satellite group that will focus on sustainable Katrina/Rita efforts along the Gulf Coast. Good to get input from members of other projects, as we all had very different experiences and perspectives on how to move on productively.

I'm not sure about how I felt about the meeting. I noticed a relatively quiet New Orleans group throughout. By the end the meeting, I burned with unresolved points I had wanted to bring up, but had missed the time or opportunity. So many people wanting to chime in. Great to hear all the different perspectives, but it was hard at times to believe that that some of my peers had spent the week in the same hurricane-devastated area. I certainly didn't feel as optimistic as some of them.

Different Takes - After the meeting, a teammate/friend and I went to see a screening of The Grace Lee Project (check it out). On the way, she talked about how hadn't been able to contribute to the meeting at all because she felt like her experience had been so different. So many peers talked about experiencing "the call to service" because it was their first time to witness disparity and poverty. Well, what if we already knew about poverty and disparity before going on the trip? What if we already understood the call to service? My friend has not had much support and feels quite alone. I felt a different reaction as well, not surprised by the poverty or disparity, but more overwhelmed by the enormity of this problem. People still don't seem to grasp it, even those who were on this trip.

First Debriefing - One week after our return from New Orleans. From free association talk, everyone divulged that this past week had been very overwhelming and difficult. I'm glad everyone was able to get it out on the table. How did some people deal with it? Some tried to tell the stories of our experiences to friends and family, but most became frustrated because those who have not seen it, who have not been there, cannot understand the enormity of the situation. And it just gets frustrating talking about it because the other party just seems to not care. What can we do about it? It's so true that you just cannot understand it without seeing it, but since most people will not have the opportunity, how can we bring New Orleans and the Gulf Coast to Ann Arbor?

Shawn and I had been tossing around ideas of creating sustainable student-led grassroots activities to keep working with the area. This would be an organization separate from PHAST that any SPH student could be a part of. And by sustainable, we mean that it would continue even after we graduate. That's the difficult part about organizing anything at SPH since, at two years, our programs are so short and intense. I hope for a good reception at the group PHAST debriefing this Thursday.

72 to 27 Degrees- I really didn't want to leave New Orleans today. Two days with my family, buffering the two ends of spring break week, was not enough time at home, especially since it was my first time back since before the hurricane. My knowledge of geography is much better after this week, so lifting off from the airport, I could look down and recognize City Park, UNO, the Lower Ninth Ward, New Orleans East.

Immediately near the airport in Kenner were rooftops covered in blue, signalling bustling activity by do-it-yourself-ers and construction workers, many migrants, I'm sure. This photo I took on the way to the aiport, evidence of the number of migrant workers rushing to this area. Farther to the east was the city, and even farther the areas hit hardest by Katrina. And they noticeably lacked the blue rooftops, signalling little or no activity.

I cried when the flight left New Orleans, and I cried again when we arrived in Detroit. I feel as if I have the weight of New Orleans on my shoulders. For a week I've felt the pain and hope of a Re-New Orleans, and for an infinite day I've spent at home helping my parents rebuild their lives. This time I leave home a changed person.

Gotta See It to Believe It - No matter how much this is covered in the news, no one can understand the extent of the damage and the overwhelming consequences of inaction, social injustice and political will...unless you GO and SEE it with your own eyes. Even I, who was familiar with the area already and the mess that existed before Katrina, was shocked by the extent and degree of the devastation.

I have difficulty imagining the reaction of my peers, many of whom have never seen or experienced such extreme inequality before. Kind of ironic, since we are entering the field of public health to combat just that. No wonder so many of them just tried to ignore their experiences when we got back. It's sad that they did so, but I guess they didn't know what else to do.

Retrospective, April 5, 2006

Katrina Kough - After 17th Street Canal & Lower Ninth Ward I developed Katrina Kough. My dad has been on antibiotics for bronchitis during these few weeks since he and Mom got back to the city, but I think it must be Katrina Kough too. From all that mold and mildew...off of every single building in the metropolitan area. And then the asbestos and pollution from de-construction and re-construction efforts. Environmental hazard.

1 in 5 Unemployed - With 1 in 5 in the city of New Orleans unemployed, according to my now very beat up U.S. World News & Report magazine (which I can't find anywhere online, strangely), how can we allow migrant workers to come gobble up all these high demand jobs? With Dilma's story of $10/hour for cleaning hotel rooms and the McDonald's offers of weekly bonuses, what's the deal? But then Flo insightfully reminded us of who are the people who have not returned to the city. The wage earners have not been able to come back yet. The bite stings at both ends. These people cannot come home to rebuild their lives yet, and they are missing these job opportunities. Why can't they come back? As Ben at St. Augustine Church put it, what do they have to come back to? No community, no support, no groceries...even though they want to come back. If you're neighbors aren't back and no one's around, who'd want to live and rebuild with that?

Here's an interesting piece from the Nation called "Purging the Poor from New Orleans" dated September 2005. Not much has changed. Recall institutional racism.

Day 1: St. Thomas Clinic - Monday and Tuesday are Lundi Gras and Mardi Gras, so basically the city shuts down, and we can't start our tobacco project (Project 2) until Wednesday. So the entire New Orleans group went to St. Thomas Health Services at St. Andrew and Magazine Streets to help rebuild the clinic. One of the New Orleans groups will continue to help the clinic throughout the week. One this day, we repainted the downstairs clinic rooms, after a small discussion with Dr. Mary Able, the doctor who manages the clinic.

St. Thomas Clinic is the only community-based primary health clinic that serves the Irish Channel community in New Orleans. With a predominently African-American patient base, the clinic has a particular understanding and interest in the intersections between health and race and the (in-) ability of the health care infrastructure to provide adequate care.

Dr. Kimberly Richards of the People's Institute gave us even more insight into the problems produced by the history of this nation based on race and their manifestations in health and health care.

Institutional 'isms - Finally I am able to verbalize what the social anxiety I've always had about living and growing up in this area. I never really understood the meaning of institutional racism until now, thanks to Dr. Richards. Instititutional racism is not necessarily an intentional or conscious effort to discriminate, but rather, often the design of a policy, process or system disproportionately affects certain races or ethnic groups more negatively others. From the People's Institute's standpoint, the entire nation of the United States was founded on an institutionally racist document, the Constitution, which set out the principle that an African American (slave) was less of a human than a white person. And even with the civil rights movement, the systems and processes still discriminate against the poor, uneducated and disadvantaged. This is why New Orleans was in bad shape before Katrina, and this is why the the recovery efforts are so slow.

New Rooms - We painted about nine rooms on the first floor of the clinic, which will be up and running on Wednesday when the patients start coming. The group that will be coming back all week will also help reorganize the pharmacy and paint the nursery upstairs. The rooms were all initially pink and blue, and we wondered by we'd go and paint all the rooms "Walmart White." I guess it is the cheapest, but a patient that came in Wednesday also said that the newly-painted rooms looked clean. It's important that all patients feel like they're getting good care, and a clean environment is important for that.

Day 6: Katrina Krewe - Today was the last day of our PHAST Spring Break trip. Members of all four sites packed up and drove into New Orleans early this morning to participate in the Katrina Krewe ("Keep it Klean!") trash pickup along St. Charles Avenue. Most of the trash was from Mardi Gras, with beads, plastic bags and cups making up most of the trash. I found an impressive stock of old cans, beer and wine bottles in a bush all to myself. There were so many volunteers - families, schools, groups - that it was getting hard to find trash to pick up. The Katrina Krewe group focuses on cleaning up "commonly used thoroughfares throughout the city." But depending on who we're talking about that commonly uses them, lots of areas get left out.

Thanks to sandwich lunches provided on-site, we were able to take it easy going to the airport. Some of the groups from outside Biloxi and Baton Rouge wanted to see the Lower Ninth Ward, so I gave them directions. None of the New Orleans site members could take another go-through. Giao's car went to the Quarter for one last round of beignets (hardy stomachs, these folks). She deemed me a live Mapquest after I gave her directions to the Quarter and then to the airport. I've really enjoyed being the navigator and commentator this week, talking about my experience growing up here and my fascination with nutrias. Flo says I talk about them like their the state animal. I have nothing against the brown pelican; they are very nice too and the population has made a great rebound in recent years.

Everyone Goes Home - The group went back to Ann Arbor this afternoon, after Rohan, Shawn and Flo dropped me off at home. It's a short time, but at least I have a full day to spend with my parents before going back. JoLynn scheduled a group meeting for two Thursdays from now, but I requested an earlier separate meeting for just the New Orleans group since we hadn't had a proper debriefing/reflection session yet. The members around the breakfast table seemed to agree. We've experienced so much this week and many of us still have not been able to grapple with all of the issues and controversy surrounding recovery efforts. We need to be able to understand those if we can ever have hope of doing anything with public health. Too bad that the meeting must wait a whole week. I hope everyone can keep fresh in their minds the events, experiences and emotions of the week.

King Cake Survives - But do stomachs? Speaking of breakfast, I am excited beyond belief that we could finally eat my king cake! The famous Manny Randazzo cake that Dad had gotten for the group had been sitting, sweating, in my room all week. Each morning I examined it for signs of ill health, but the purple and green spots were luckily "natural". Lee insisted that we must eat the cake, even if everyone gets sick on the flight back. Outbreak control seeking cause of stomach bug - What's the bug?...Kiiiing Caaaake. No one showed signs of sickness later in the day, so I'm glad everyone got to partake in the rich gooey goodness of Mardi Gras. Chinwe got the baby!

Day 5: Tobacco-Free Living 3 - The team surveyed restaurants and bars along Frenchman Street, but otherwise, spent the better part of the day speaking with locals and exploring the disaster relief efforts on the ground.

Distribution Centers - We saw a number of distribution and disaster relief centers that offer hot meals, canned goods, clothing, cleaning supplies, health kits to those we need them. Every center had its own purpose depending on the organizing party. In Chalmette, St. Bernard's Parish, there were two centers across the street from each other. One, which our Bucket Brigade team used as a meeting point, was operated by Emergency Communities and welcomed any visitors. The "tent city" was like an odd hippie enclave, but they serve healthy, balanced meals and welcome anyone - residents, workers, and volunteers alike. Across the street was a similar center operated jointly by a variety of Christian organizations. However, they only serve people who can prove St. Bernard Parish residency. Interestingly, their "chapel tent" was also situated right next to the official FEMA trailer. Rohan and I went in for a peek, and the security guard wanted to frisk us. He was a business-only, no smiles, you-got-handguns-? kinda guy. Absolutely unnecessary. It was apparent he searched a woman who came in after us that they do this to everyone. Absolutely unnecessary, again. After everything these people have experienced, do they really need to be searched before they can get help. Security, schmecurity. At this point, it just becomes a sign of disrespect.













In the 9th Ward, we found Common Ground, a community-based relief organization started by a local after the storm. It has branches throughout the metropolitan area. Some of my teammates heard some negative opinions about this group from other volunteers in the area. I'm not clear if it's over philosophy or organization, but I did hear that they focus more on long-term recovery, so any short-term volunteers tend to get left out of the process.

In New Orleans, we learned that Tulane students are helping Second Harvest with a food bank at St. Augustine Church. It was an off-day when we got there, but at least we heard some interesting stories from a local volunteer in the kitchen. Lots of locals tend to bring up th war in Iraq a lot when talking about the shortage in aid given to New Orleans and the Gulf Coast. How can we send billions of dollars to fight some unknown enemy when people in our own country cannot survive?

Day 4: Tobacco-Free Living 2 - Today was zipped through the rest of Magazine Street, as well as the Riverbend area of St. Charles Avenue and South Carrollton Avenue. We notified the LPHI and received some additional streets that we may want to hit up. But in general, the team is finding it difficult to stay motivated with this project since it has nothing to do with hurricane efforts. In fact, the team has found it quite frustrating, especially when we explain that we're from UMSPH down for recovery efforts, describe our project, and get blank stares and "What does that have to do with anything?" We can read the group blog too and see other groups driving over buckled roads and wearing spacesuits, doing things directly related to storm recovery efforts.

Our project is a continuation of a pre-Katrina initiative. Of course, smoking policy is an important issue, but under these circumstances, it's hard to believe that there aren't more pressing issues that we could be addressing during our week here. How has Katrina impacted your business? Have you seen changes in the smoking habits of your clientele? Would the storm cause you to change your establishment's smoking policy?

In general, we have committed to this project for PHAST, but we must use initiative to get something greater, more personally fulfilling out of this week. And I think we're doing that. We're talking to locals about their experiences, reading the local news, exploring the areas most affected by levee breaches and flooding, and visiting the disaster relief centers to see what's being done on the ground in the community.

Stories - I believe it was Dr. Button who emphasized that we really need to listen to the stories of the people. To sit down and really listen. I have already seen the rewards of that two days ago in meeting Dilma and my former professor. Today was stopped in the French Market for some souvenir shopping (about 1/4 the size and no where near the usual crowds), and I got to talking with an older woman setting up shop with her Mardi Gras and NOLA trinkets. I was stocking up on items for my summer in Beijing souvenir baggies. We were talking about all the Cajun recipes on the pot holders when I casually slipped in a question about how she has fared since the storm. Every local I've met loves to talk about the storm, and every local has interesting stories.

Her sister in Plaquemines Parish got water up to the ceiling of the first floor, and it was two months before they could return. She could have saved and washed many items, but decided to throw out everything after finding nine black snakes in the house and a wild pig in the upstairs bed! One of the neighbors decided to ride out the storm because they'd rode out Betsy (i.e. Hurricanes Betsy and Camille, the big ones), but they didn't make it. Their children found them in the house after they were able to return. Imagine finding your parents like that. It makes me shiver. Worse yet, I've heard this story more than once. Rohan also met a very interesting man who rode out the storm and had a very interesting perspective on the entire post-Katrina situation. We hear all these conspiracy theories, but when you start hearing the same stories from disparate sources, you really start to reconsider your initial doubts.

"Someone has to do it" - This morning at breakfast I was flipping through the Times Picayune, full of post-Mardi Gras reports. The picture and caption indicated that this year's Mardi Gras was a success, judging by the tons of trash generated. We joked that perhaps our Glad Bag efforts might have messed up the count. On page 4 were small blocks of information, and one was about voting in the upcoming New Orleans mayoral election. It noted that anyone needing to vote absentee should email/mail so and so (see "elections"). The problem is this - anyone who needs an absentee ballot has difficult access to this information. Where are these displaced people (everywhere), and who is informing them of the procedures, the changing ballots, their rights? And obtaining an absentee ballot is a complicated procedure; I was never able to obtain one myself while I was an undergrad in Houston because the process was so convoluted. And so, considering the crazy situation now, and the decision to follow the old guidelines, what displaced people will actually be able to obtain absentee ballots, and who really will get to vote in this election? It's not difficult then to jump to questions of who are making these decisions, and whose interests are they really looking out for? Obviously, those most affected by the difficulty of procuring absentee ballots are those who cannot move back yet...the poor and minority.

But what frustrated me most was this - when I asked these questions at the table, incensed by the obvious injustice, the general sentiment was just of agreement, "Someone has to do it." Yes, someone does have to do it, but WHO? In most cases, I am a political inactivist, sorry to say. There always seemed to be enough loud mouths to cover any one side of an issue, but his time around, WHO's going to do it? We talk about community-based health care, but what is it without the community, when we don't know where that community is? I hear that FEMA won't release the names of the displaced, so it's difficult to locate them.

WE have seen this week the level of destruction and inactivity that still plagues this city. And without new ways of thinking and infusions of new ideas and structures, I fear that what I've described will come to pass, and that this city will be dominated by...classist, racist, sexist pigs. Wow, that's a lot of sentiment I don't usually wear on my sleeve, but it is something that really bothers me about the subconscious of this city. Finally, my teammates are understanding the severity of the problems here, which comforts me from Tuesday when I lamented and carried the weight alone. I feel that we can do something. We need to organize...decide what message we want to bring back to Michigan, what alliances we can build, and how to spread the stories and to bring the people back to New Orleans.

The Power of Water - We visited the levee breach at the 17th Street Canal, guided by my U.S. News & World Report article on rebuilding the levees. I've been the week's navigator, and in general I've done a good job, but I totally led the group in the opposite direction, coming to the conclusion that some bumpy broken pavement at the levee's edge was it. Luckily, Shawn's map-reading skills kicked in and led us to the real site. This breach is located just across the parish border between Jefferson and Orleans.

It was incredible. The entire breach was blocked off by a chain-linked fence, but the break in the cement wall was clean and obvious. The 150-200 meter hole was plugged up by tall metal pillars. The force of the wall of water that broke the barrier and came gushing in was obvious when we looked at the homes directly behind the wall. They were completely smashed and had been lifted from their foundations completely such that houses actually crashed into one another. Roofs caved in, eight-foot-high water lines, house frames stood leaning or completely destroyed, living rooms and home lives laid bare. The scene was spellbinding, and knowing that we were standing on a site that witnessed a force that would have killed us instantly on impact, even before we could drown, was almost overwhelming. And after six months, no one has yet returned to their homes, to pick up their lives. Now that's scary.

Day 3: Tobacco-Free Living 1 - Today was the first day of our official project for the PHAST trip, but I feel like I've already had a full week after only just two days. Luckily, it was also our first day with a decent sit-down breakfast: pancakes, bacon, and eggs at Victoria Inn. Afterwards, the 9-person tobacco group and JoLynn went over the procedure of the day and prepared the questionnaires for the next few days' use. We also had our first formal debriefing session, and labored mentally over how New Orleans will ever be able to rebuild after the storm when the health care infrastructure was inadequate even before the storm. I lamented over the institutional racism that pervades the system and (un-) consciousness of the people, and whether the power of democracy is enough or capable to transcend it. Right now, I don't think so.

We all got very sad, but JoLynn emphasized that we must seek out the positive and the small steps of improvement. For example, Taylor's friend is a FEMA worker and is getting very frustrated with the job because people generalize the failings of FEMA to the individual workers when they came from above. We have to remember that although vast failures span all levels of organization, there are people who are doing their jobs and doing a good job. We just need more of them.

Tour of the Lower Ninth Ward - We didn't start the day on an energetic note with our subsequent tour of the Lower Ninth Ward. We took N. Claiborne off of I-10 East through Arabi and towards Chalmette. The destruction and inactivity was palpable, especially when we crossed the bridge over the Navigation Channel. Up to that point, the neighborhoods looked devastated, with trash, broken homes, spray-painted indecipherable codes -- of when they'd been checked and who was found. But across that channel was a completely different story. A ghost town. Eerily silent streets of inactivity, no signs of life or reconstruction. The destruction of upper Ninth Ward (before the channel) could not compare to this. Of course, no one's back. No trash pickup, no streetlights, no traffic lights. Stores destroyed, churches destroyed. When will these residents return? When, or will they be able to?

Whatever resources available are make-shift. The disaster relief center was set up in the Walmart parking lot, along with a yellow and white big top tent as the temporary chapel. We passed by churches with blown-in windows and fallen steeples that have not been touched. The chapel is an important place for returned residents and workers alike to gain solace. Addendum: The big tent is not a chapel. See Day 5 for a visit to this site.

Louisiana Campaign for Tobacco-Free Living - After the expectedly sobering tour, we met with Adam Becker of the Louisiana Public Health Institute (LPHI) downtown to talk about the next three days' project. We are interviewing restauranteurs along Magazine Street, and possible Carrollton Ave and St. Charles Ave if we have time, about their smoking policies and opinions towards possible local ordinances. We had wanted to insert some additional questions regarding the impact of Katrina, but although they weren't discouraged, the idea was certainly that the tobacco-related questions took priority. Some of us have had issue with the entire project in general because the change of circumstances makes this kind of survey, without modification, seem strange. But we'll go with it. We've come down to help with existing projects and to build alliances between UMSPH and local public health efforts. In a way, this is an exploratory trip.

We split up into two teams, each starting at an opposite point of Magazine and working towards the middle. I was tired and was glad that our car got to start Uptown, where I foresaw slightly more pleasant settings. Rohan and Taylor took one side of the street, while Shawn, Rachel, and I took the other. We each made it to about six establishments, but returned with very different responses. We had pretty good luck, with only one refusal because of the absence of the owner or any manager. Otherwise, we had encouraging participation with a few noticeable trends in responses, including an emphasis on 100% smoke-free environs inside, with outdoor seating to allow smoking, and the possible of support for local ordinances against smoking in establishments that serve only food, but not in places that serve alcohol only or with food. And in general, for businesses that have been able to reopen, business has been on the up and up since so few restaurants have reopened. Those that are open get a lot of business.

However, Rohan and Taylor got only 2 responses (versus our 5) out of 6 attempts, and came back to the car dejected. Either the managers were too busy or they were distrustful of the survey or purpose of the visit. Adam had warned us to not say that we were from LPHI because the words "public health" may imply some surprise inspection, but after some group reflection, we found our methods to be quite similar. They noted that the cafes were particularly rude, and we didn't have any cafes...interestingly, Starbucks still has not been cleared to reopen. It was the only establishment on our side so far that hasn't made steps towards reopening. I can't explain the differences in reaction we received. Frustrated, tired? Possibly reflected in this picture of a house next to the poboy shop we ate at for lunch?