By Ronda Kaysen
New York hospitals have a lot to learn about terrorism from doctors in Jerusalem.
Two hundred healthcare providers and corporate leaders gathered at the Goldman Sachs Training Center in Downtown Manhattan on Sept. 9 for an emergency preparedness symposium hosted by NYU Downtown Hospital. Physicians from Madrid, Jerusalem and New York City shared their experiences dealing with mass casualty events and addressed ways hospitals could better improve their response.
Located a stone’s throw from the World Trade Center, on William St., NYU Downtown Hospital was the first responder to the Sept. 11 attacks as well as the first responder for the 1993 W.T.C. truck bombing, which killed six people and injured 1,040. The hospital was founded in 1922, two years after a bomb exploded in front of the J.P. Morgan building on Wall St., killing 38 people and injuring more than 300. “Our hospital was formed in response to that,” Dr. Bruce Logan, president and CEO of NYU Downtown Hospital said during a break. In 1975, when a bomb exploded in Fraunces Tavern, killing four and injuring more than 50, NYU Downtown Hospital shouldered the casualties. “This type of thing [another large scale attack] can certainly happen here again,” he said.
With Homeland Security Director Tom Ridge’s August announcement that the New York Stock Exchange tops the department’s list of high risk targets, NYU Downtown Hospital has reason to be concerned.
In the wake of the Jakarta terrorist attack that morning and last week’s hostage disaster at School No. 1 in Beslan, Russia, Professor Jonathan Halevy, director of Shaare Zedek Medical Center in Jerusalem, remembered his colleague, Dr. David Applebaum. Dr. Applebaum spoke at the same symposium last year and was killed the following day — Sept. 9 — with his daughter in a terrorist bombing in Jerusalem. Calling him “one of the forefathers” of modern emergency medicine, Dr. Halevy reminded the audience, “No one is immune from terror.”
In order to prepare for the threat of a chemical, biological or nuclear attack, U.S. hospitals need $10 to $20 billion a year each in preparedness training, according to Dr. Irwin Redlener of Columbia University. Currently, American hospitals receive approximately $500 million a year in preparedness training funding. “I want to know if collectively we have a master plan that is going to save New York City if we have a massive attack here,” he said.
That kind of funding is not going to happen, New York State Senator Michael Balboni told Downtown Express. “To make every single hospital, not only in the city of New York, but in the state of New York and in the nation, prepared for a major attack would cost trillions. We don’t have that kind of money, unless we want to get rid of education and healthcare,” he said.
Balboni, Republican chairman of the committee for State Senate Veteran Homeland Security and Military Affairs, suggested developing decontamination areas in the city and coordinated computer systems between hospitals. “It’s about money, but it’s also about smart money. The way that money is invested is crucial,” he said.
The federal government has come under heavy scrutiny for its disbursement of $20 billion in funds for first responders. 40 percent of all Office of Domestic Preparedness funds are allocated to states equally, regardless of threat risk; the remaining 60 percent is distributed according to a blind per capita formula. Last fiscal year, Wyoming received $38 per person in funding while New York received less than $5.50.
The Urban Area Security Initiative, a federal program created last year, distributes funds to urban areas according to threat risk. New York City received $25 million in UASI funding last year, according to the Department of Homeland Security.
Without adequate funding, a hospital that finds itself on the front lines of a catastrophic emergency faces the potential of bankruptcy if it does not keep proper records during the event, said Dr. David Goldschmitt, director of NYU Downtown’s emergency department. Grants, he said, are hard to come by, and promised funding is not always delivered. His hospital lost millions of dollars of revenue — the hospital treated 1,200 patients in the first hour of the attacks and many of those patients were not properly accounted for. Last year, according The New York Times, the hospital was running a deficit of less than $10 million.
Dr. Halevy of Shaare Zedek suggested approaching philanthropic divisions of corporations for funding, noting the abundance of large corporations in Lower Manhattan. “Try to fundraise and expand emergency services,” he said. “Involve corporations in a worldwide campaign to make them aware that emergency preparedness is important for them.” His hospital, which has handled 38 percent of all casualties in Jerusalem since fighting re-ignited in October 2000, opened a new state-of-the-art emergency facility this week — with the help of philanthropic donations.
NYU Downtown Hospital is in the midst of building a new two-story emergency room expansion in its courtyard, which will be capable of treating 850 to 900 patients an hour. Much of the funding for the $25 million project will come from private financiers. A $5 million contribution from the Lehman Brothers secured the new building’s name: Lehman Brothers Emergency Center.
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