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1993.08.11 :  Partnership to Fight Flood Health Problems

Contacts:  Morrie Goodman FEMA (202) 646-4600 
           Dale Blumenthal PHS (202) 690-6867


     WASHINGTON -- Federal and state emergency forces responding to the
Midwest floods have teamed up to right the threat of disease in an
unprecedented partnership for aiding disaster victims, according to the
nation's top emergency manager.
     James Lee Witt, director of the Federal Emergency Management Agency
(FEMA), which is coordinating federal flood relief operations, announced today
that cooperative multi-agency agreements have been reached that shift the
current focus of response efforts for health control from individual flood states
to region-wide surveillance.
     Witt said that under the agreements, the first of their kind for a
Presidentially-declared disaster, FEMA will fund the U.S. Department of Health
and Human Services (HHS) with approximately $10.6 million for mosquito
control and other vector services, and the U.S. Environmental Protection
Agency (EPA) with an estimated $6.5 million for environmental monitoring.
     The heads of the three agencies expect the new approach will result in
more efficient and effective use of health resources because they can now be
concentrated on solving an identified problem wherever it may occur in the
nine-state recovery area.  The plan also is expected to provide for more
consistent measurement and data collection throughout the damaged region.
     Witt termed the agreements a revolutionary break with the traditional way
of delivering disaster assistance, which in the past has been solely organized
between the federal government and the individual states.
     "President Clinton has encouraged us to be more resourceful and
innovative, and the massive scope of the flooding called for a different
approach," the FEMA Director said.  "Help must be people-oriented and not
constrained by bureaucratic barriers."
     Donna E. Shalala, HHS Secretary, noted, "We and the states have identified
common needs for environmental health monitoring and vector control.  We
recognize--and this area-wide plan recognizes -- that germs and insects don't
stop at state boundaries."
    HHS Assistant Secretary for Health Philip R. Lee, who heads the U.S. 
Public Health Service (PHS), added, "We are pleased to cooperate with the 
states in a way that will produce uniform information -- and the biggest bang
for the buck."
     Said EPA Administrator Carol M. Browner, "EPA is working hard to ensure
that people in the flood states have safe drinking water and safe places to
dispose of their household waste.  We're monitoring air quality as people begin
to get rid of the enormous quantities of garbage.  And we're keeping an eye on
the Superfund sites in the area."

     The agreements follow a flood-health summit meeting of nearly 90 state
and federal public health, agriculture and environment officials held August
3-4 in St. Louis, Mo.  Funded by FEMA, the conference was hosted by the
states and PHS's Office of Emergency Preparedness, acting for HHS.
     Over the past month, PHS officials had met with state and local health
directors in four states -- Illinois, Iowa, Missouri and Nebraska, and made
resources available on request to all nine flood-tom states.  EPA two weeks ago
hosted a technical meeting of environmental experts in Kansas City, Mo., a
first step toward the cooperative agreement.
     In what they termed a triage approach to area-wide monitoring, state public
health and natural resource directors, EPA, PHS and the U.S. Army Corps of
Engineers (USACE) conceived a federal-state partnership combining federal
technical and laboratory assistance with state monitoring efforts.
     Illinois Department of Health Director John Lumpkin, M.D., told the
August 3-4 meeting the flood states need a collaborative strategy to assess
whether debris from the flood waters contain health contaminants.  He said,
"We need to measure what is in the environment, and the measurements need
to be done consistently among the states."
     Lumpkin and Iowa Department of Health Director Christopher Atchison
co-chaired the federal-state meeting along with PHS Commissioned Corps Rear
Admiral Frank E. Young, M. D.
     Health officials from the nine flood states, PHS, EPA, USACE, U.S.
Department of Veterans Affairs, U.S. Department of Defense, U.S. Department
of Agriculture, and FEMA met into the night August 3 in working groups on:
environmental health (with a focus on safe drinking water); communicable
diseases; primary care and mental health; and food safety.
     A week before, two technical workshops on vector control were conducted, one
led by the Centers for Disease Control and Prevention (CDC), and the other by
EPA.  CDC, an agency of the Public Health Service within HHS, will have the lead
role in managing and coordinating mosquito control.
    Summary reports of the workshop sessions:
    -- Hundreds of private wells in rural areas have been contaminated by the
flood.  Individual farmers will need "creative" federal help for disinfecting their
water supplies in the same way that community water systems receive aid.
      -- States are concerned that primary care, mental health and injury
prevention may grow in importance as residents embark on recovery efforts. 
Participants in this work group suggested high blood pressure screening to
identify both physical as well as mental stress, and urged training community
leaders to recognize early signs of health problems before they escalate.
      -- Farm states expressed concern about possible contamination of
flood-affected grain with the naturally occurring toxin aflatoxin.  Federal
government agencies agreed to provide a clearinghouse approach for assessing
food and grain safety.
      -- Public information similar to the recently released CDC publication,
"Beyond the Flood: A Prevention Guide for Personal and Health Safety," is needed
and is being developed.  Consistent, coordinated messages were urged among the
states and federal agencies.
      -- The impact of this wide-ranging, multi-state disaster will continue for
months, and possibly years.  The state and federal officials participating in the
flood health summit agreed to document the disaster response so that
multi-agency, multi-state activities for future events can be quickly coordinated.