Disaster Medical Assistance Teams

Disaster Medical Assistance Teams are deployable medical units within the National Disaster Medical System. Their work after Hurricane Katrina and in the aftermath of the 2010 Haiti earthquake shows both their role in emergency care and the limits imposed by confused command structures, restricted access, and unreliable supply chains. The book’s account follows that tension from the makeshift hospital at Louis Armstrong New Orleans International Airport to a field hospital in Port-au-Prince, then traces changes made to the larger system.

Organization and Federal Structure

The Disaster Medical Assistance Teams form part of the National Disaster Medical System, a federal network for medical support during emergencies. After the September 11, 2001 attacks, a government reorganization moved the system from HHS to the Federal Emergency Management Agency and the Department of Homeland Security. That transfer complicated command of the medical response during Katrina; afterward, the National Disaster Medical System was returned to HHS, which coordinates federal health resources in emergencies.

The teams’ work depended on more than clinical expertise. Their deployment required clear authority, access to patients, and the transport and supplies needed to sustain treatment. The Katrina and Haiti accounts make those organizational dependencies visible: teams could be present and still be constrained by uncertainty over who was in charge or by shortages of essential equipment and fuel.

Katrina: Airport Care and Command Confusion

After Katrina, Disaster Medical Assistance Teams WA-1 and OR-2 were among the teams involved in the medical effort at the New Orleans airport, which became a field hospital and evacuation point. A congressional review described the airport response as chaotic and identified confusion over the medical teams’ command structure. The report also recorded that many people died while doctors who were not members of the federal teams, including John Thiele, were turned away. In one account cited by the report, the sickest patients were marked and moved to a separate area so they could die apart from others.

The account presents this as a failure of coordination and access, not simply a shortage of medical personnel. Reorganization had changed which federal department oversaw the system, while the emergency demanded rapid decisions about who could provide care and where. The airport’s improvised medical operation made the consequences of that uncertainty especially stark.

Haiti: Supplies and the Limits of Readiness

In January 2010, the author accompanied federal disaster medical teams to Haiti after the earthquake. The American team established a tent-based field hospital on a college campus in Port-au-Prince. Because staff struggled to record unfamiliar names, patients were assigned numbers; Nathalie LeBrun, a thirty-eight-year-old woman with breathing difficulties and swelling that predated the earthquake, was entered in the records as Jane Doe 326.

The team found oxygen for LeBrun, but the tank ran out overnight. Staff located another tank and restored her oxygen, while the supply chain remained unreliable. A portable oxygen concentrator also proved difficult to use: it overheated and shut down, and it required electricity at a time when fuel for generators was scarce. The episode illustrates how treatment depended on a chain of equipment, power, fuel, and resupply—not solely on a team’s presence or medical judgment.

Revisions and Continuing Challenges

The book notes that lessons identified after Katrina did not immediately eliminate logistical problems. During the Haiti response, supplies and procurement constraints again impeded the National Disaster Medical System: some caches included heaters rather than air-conditioners, while bottled oxygen, fuel, and certain surgical equipment ran short. HHS later reported that it had significantly revised supply, resupply, and logistics processes, including distributing stores among warehouses around the country and anticipating particular needs, such as specialized beds.

The teams also used smaller strike teams to respond more flexibly to Superstorm Sandy in 2012. These adjustments indicate an effort to make deployment more adaptable, while the repeated problems in Katrina and Haiti show why organizational reform mattered: emergency medical work could be undermined by the systems meant to support it. The teams’ significance in the account lies in this double role—as providers of urgent care and as a measure of whether federal coordination and logistics can keep pace with disaster.