Residents of the area, at first wary that their apartments had been polluted, began to accept official reassurances and soon streamed back to the co-ops of Battery Park City and the lofts north and south of the Trade Center site. Despite their fears, parents, clinging to the consoling pronouncements that poured from the EPA, the city administration, and even the Department of Health, sent their children back into what some were calling a “war-zone.”
The Bush administration’s triumph in bringing “normalcy” back to the area around Ground Zero would, however, turn out to be a victory of style over substance — of a sort that would become far more familiar to Americans in the years ahead. Just as the challenging questions and assessments of intelligence analysts and State Department experts would be ignored or drowned out by administration pronouncements on supposed Iraqi weapons of mass destruction as well as Saddam Hussein’s alleged links to al-Qaeda, so, in those first weeks, the EPA’s official pronouncements of safety trumped the skepticism of scientists at Mt. Sinai and other area medical schools, reporters like Juan Gonzalez of the Daily News and even local residents and politicians all of whom knew something was wrong. “The mayor’s office is under pressure” to reopen lower Manhattan, reported one official who worried that the city’s own Department of Environmental Protection felt the air was not suitable to breathe.
Before long, parents of children in the neighborhood were engaged in screaming matches with local officials who had the hapless task of carrying out policies they didn’t necessarily support. As it happened, they were all correct in their fears. Class action lawsuits from over 7,000 residents and workers subsequently led to the discovery of documents showing how intense pressure from Mayor Giuliani had indeed led the Department of Health to certify areas in lower Manhattan safe so that they could be reopened for residents and businesses.
Style over Substance
What began with the dismantling of an effective public-health response at Ground Zero later spread to the entire national and local public-health systems. From September 12th, 2001 on, public-health professionals called ever more vigorously for resources to revamp a sagging health infrastructure of hospitals, emergency services, disease-reporting systems, and preventive health care — in essence, the country’s first line of defense against all sorts of health catastrophes, whether caused by terrorism or not.
As state after state faced fiscal crises, what public health departments got was “yo-yo funding,” up one year, down the next. What they did not get from the Bush administration were adequate resources to face a more dangerous world — to make sure we knew when a strange disease pattern was emerging or where increased reports of peculiar symptoms might indicate a terrorist plot. The public-health community never got sufficient equipment to detect higher than expected levels of radiation emanating from a container at some port, nor sufficient lab facilities and trained epidemiologists to track local outbreaks of disease. Instead, it got funding for a high-profile, showcase, mass smallpox-inoculation campaign for a disease that may not even exist on the planet, and ineffective, color-coded public-warning systems that made everyone cynical about any alert that might come from public officials.
In general, administration officials worked doggedly in the public health arena to create great media images that drew attention away from real, if sometimes humdrum, reforms that might have cost money. In the meantime, such public-health basics as laboratories, well-baby clinic care, and inoculation campaigns were quietly drained of money badly needed for a war-gone-wrong in Iraq. Administration cronies with no particular skills or experience in emergency management were put in charge of FEMA and on scientific panels at the Centers for Disease Control. As in other areas, administration officials evidently hoped that nothing revealing would happen on their watch and that they could slide away into history before anyone realized the public’s health was in danger.
Then Hurricane Katrina blew into town, allowing the world to see just how unprepared they were. From a public health point of view, Katrina was the dark underside of the 9/11 experience. From lack of emergency-power supplies for hospitals to an inability to collect dead bodies (in some cases for months), administration-managed public health services proved hopeless and helpless in New Orleans — which increasingly meant anywhere in the U.S. If that was what Katrina could do, what would happen if terrorists actually released a dirty bomb in the middle of Atlanta, Los Angeles, or Houston? Would the public-health community even have the crucial equipment available to detect the nature of such an attack, much less respond quickly? Would anyone be lining up the ambulances, passing out the medications, checking those restaurants and puddles this time around, no less organizing an orderly evacuation of residents?
In the wake of September 11th, the public health community saw its sanest initiatives stifled and its priorities distorted. While money is now less available for the inoculation of babies from the real threats of rubella, mumps, and measles, as hoped-for funds to prevent as many as 350,000 children from getting lead poisoning are no longer on anyone’s agenda, as federal funds to support health education have been rescinded, and as (unbelievably enough) money needed to protect U.S. ports from dirty bombs or bioterrorism have all-but-vanished, Katrina victims still wander the nation wondering whether they will be able to see a physician.
For the next 9/11, when it comes to public health, don’t think New York, Ground Zero, 2001; think New Orleans, August 29, 2005. Think: “Brownie, you’re doing a heck of a job…” Then sit back amid the disaster and wait for the private charities to appear, wait for FEMA to send in the mobile homes.
David Rosner and Gerald Markowitz are the authors of the just published Are We Ready? Public Health Since 9/11, (University of California Press/Milbank Fund). Rosner is Professor of History and Public Health at Columbia University’s Mailman School of Public Health. Markowitz is Distinguished Professor of History at John Jay College and CUNY Graduate Center. On September 11th, Markowitz anxiously awaited word from his wife, who worked only a few blocks from the World Trade Center, while Rosner frantically biked toward the collapsing buildings, looking for his daughter whose school was only blocks away.
[This article first appeared on Tomdispatch.com, a weblog of the Nation Institute, which offers a steady flow of alternate sources, news, and opinion from Tom Engelhardt, long time editor in publishing, co-founder of the American Empire Project and author of The End of Victory Culture, a history of American triumphalism in the Cold War, and of a novel, The Last Days of Publishing.]
September 5, 1006
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