New Orleans Health Care Heads in New Direction

NEW ORLEANS -- Towering over much of the Central Business District, Charity Hospital at once represents the past, present, and future of healthcare in New Orleans.

Built in 1939, Charity was the second largest hospital in the U.S. at one time, with more than 2,600 beds. The hospital succeeded a half-dozen predecessors of the same name, the first of which was built in 1736, using a bequest from a French shipbuilder who saw the need for a health care facility for the growing city's poor and indigent population.

Scaled down over the years to about 700 beds, Charity remained the principal source of health care for New Orleans' indigent and uninsured residents. And 70 percent of Louisiana's physicians received part or all of their training at Charity, often called "Big Charity" to distinguish it from the smaller University Hospital, which also is part of the network of state hospitals.

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All of that changed on Aug. 29, 2005, when the storm surge from Hurricane Katrina breached the concrete walls atop the levee system that provided a barrier between New Orleans and the waters of Lake Pontchartrain and Lake Borgne. Flood waters that exceeded 10 feet in many areas of New Orleans also inundated the Central Business District and essentially destroyed the infrastructure of most buildings, including Charity Hospital.

More than four years after Katrina, Big Charity still towers over much of the area, but only a darkened shell of a building remains. Charity may never reopen, at least not as a hospital.

"What we do know is that Big Charity is not going to be rebuilt as a hospital," said Dr. Larry Hollier, chancellor of Louisiana State University Health Sciences Center in New Orleans. "It's not cost effective. It's not appropriately sized for modern health care today. The city and the state have decided that they do not plan to tear down Big Charity. There will be a lot of discussions about what options there might be."

Discussions thus far have included reopening the building as a new city hall, as a research facility, or as a residential facility, he added.

Devastation Reigns

The fetid flood waters stood for weeks in some places, until the concrete barriers could be repaired and water pumped from the city. When the water finally receded, the late-summer New Orleans heat had fueled an overwhelming growth of mold, bacteria, and filth.

All but three of two dozen hospitals in Orleans Parish remained closed for months. Tulane University Hospital, for example, did not reopen until February 2006.

Some hospitals remain closed to this day, such as Lindy Boggs Medical Center and a portion of Memorial Medical Center.

The latter facility provided the setting for some of the darkest moments of Katrina's destruction, as a physician and two nurses were charged with second-degree murder in the deaths of four patients. The charges were eventually dropped, but the nightmarish memories and lawsuits remain.

Making a bad situation worse, physicians and other health care providers left New Orleans in droves, seeking assurances of stable income and better working conditions elsewhere. Moreover, their patients left, too.

At one point, New Orleans' population was estimated to have dropped to about half its pre-Katrina level. About 75 percent to 80 percent of the homes in the city had been destroyed or rendered uninhabitable. Thousands of residents had nowhere to live when the water finally did recede.

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