Waiting for Charity in New Orleans

When Hurricane Katrina forced Charity Hospital to close four years ago, it was a dream come true for many officials in Louisiana’s state government who had long wanted to see it shuttered. Charity was the troubled medical facility that poor and uninsured residents of New Orleans turned to as their last resort for medical care. But like the large housing projects where many of those patients and their families lived, Charity had become a source of controversy for many in the public and private sector.

But the debate was more than just an ideological one; Charity was the go-to hospital for the city’s poor and now, when they need it most, it’s gone. Community organizations, low-income family advocates, teams of doctors and historic preservationists have been fighting the past four years to bring Charity back to life.

Now Louisiana State University is looking to build a mega-medical complex that is projected to cost at least $1.2 billion in the historic Mid-City New Orleans neighborhood. This new project would spread over 35 acres of land currently occupied by dozens of houses—many with historic designations—and would cost at least $120 million more than refurbishing the existing Charity Hospital building. But as the debate rages about whether to repurpose Charity or build anew, those who need hospital care continue to be underserved.

Shortly after Katrina, James Moises, a doctor at Tulane University, led a group of doctors and volunteers, in an effort to clean out the basement and bottom floor of Charity, the only damaged areas of the 21-story building. Still the hospital never reopened, and poor residents have been forced over the years to seek treatment at one of the scattered community health-clinic sites situated throughout the city.

Meanwhile, the LSU tied its own project up for so long by refusing to budge over governing structure. LSU wanted a majority of seats on the board of directors but only recently acquiesced to the state’s negotiating of a memorandum to give more seats to other health care stakeholders. And while all these elephants fight, the physical and mental health of Katrina-traumatized New Orleans residents continues to get trampled. Recent polls state that New Orleans voters overwhelmingly want the old Charity building to be reused as opposed to building a new facility. And much of the support LSU once had for their project is now waning. So what will it take to get a hospital opened up for the city's poor?

There's a shortage of primary-care physicians in a city in which one-third of the residents do not have health insurance. And by all measures, the city is sick and getting sicker. Louisiana ranks dead last in all states for quality of health conditions, according to the United Health Foundation's 2008 rankings, and much of those health problems are concentrated in New Orleans. Half of all the residents of New Orleans live at less than 200 percent of the federal poverty level; the cancer rate is an astronomical 256.7 per 100,000 residents (in the state, 202 per 100,000); the HIV/AIDS infection rate is 40 per 100,000 (in the state, 16 per 100,000) and the suicide rate 12.3 per 100,000 (in the state, 7.4 per 100,000). If ever there was a case for health care reform, it is in Louisiana, and New Orleans specifically.

Charity Hospital was the public option for the families who lacked insurance and for those who needed health care. It also trained doctors for war situations and had emergency trauma centers for treatment of the many gunshot victims who too regularly end up in the city. It’s perhaps for all these reasons that in a recent poll, conducted by respected political scientist Ed Renwick for Smart Growth for Louisiana, most registered voters in New Orleans supported plans to rebuild a medical facility inside the closed Charity Hospital 2-1 over LSU’s plans to build a new facility in Mid-City.

LSU has resisted holding public hearings on its plans, and as a result, has lost favor with those in government and media who once supported the project. Louisiana’s Speaker of the House, Jim Tucker, recently introduced a bill that would rescind all governing board powers from LSU. He has since dropped that bill, but in the meantime, the Gambit Weekly newspaper recently pulled its endorsement of the deal, concluding that LSU had "behaved like bullies" in the process and "tried to steamroll residents and businesses in the historic Lower Mid-City neighborhood" with their plans.

The state has set aside $300 million for the LSU project, about a quarter of the lowest projected costs. The state is waiting and hoping for FEMA to kick in the $492 million it says the federal agency owes for Katrina damages. But FEMA’s position is that Charity did not suffer that kind of damage—a position with which many residents and community advocates agree with. FEMA will only commit to $150 million for the project. President Obama has only said that he supports a "major medical complex in downtown New Orleans." But even if FEMA gave the state what it’s asking for, that would leave roughly $400 million left on the tab. While the state and LSU wrangles over plans, poor patients continue to live with illness, much of it from the toxic legacy of Hurricanes Katrina and Rita, which spread arsenic, lead and contaminated sediments all over the city's soils and water sources.

A recent Chinese drywall exposure outbreak in city housing has added to health risks. And for a city that is reeling from a Katrina-depleted housing stock, the last thing it needs is a plan for a hospital that would bulldoze even more houses. There are many arguments for building a brand new hospital, but newer doesn't always mean better. On the fourth anniversary of Katrina, New Orleans can ill-afford to wait longer for a new hospital.

Brentin Mock is a regular contributor to The Root.