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     No, this isn't a story about people being marooned on an island full of prehistoric dinosaurs. But in many ways, the perils are the same or even worse.

     I am in New Orleans, Louisiana. I have been here since December 1st, displaced initially by Katrina and Rita in September of 2005. I have to say that my love for this city continues to hold me here. It's cultural diversity, timeless architecture, music, and, of course, the food, presents a temptation like few other places on earth. But this is also traditionally a place of rampant poverty, subtle discrimination, and good ol' boy politics that has held many people down for generations.

     When I returned to the city in 2004, I felt the potential for a renaissance-type awakening. Community-based programs were finally replacing many of the traditional institutional settings and special schools. Groups like Catholic Charities, Volunteers of America, the ARC, the Alzheimer's Association, and Cerebral Palsy Centers of America seemed to be making headway in their efforts to identify and serve the disability community. The public school systems, however, still had a long way to go in serving even the regular education students, let alone those with special needs.

     For the seniors living in this community, a host of services were becoming available, including in-home care and assistance. New programs were springing up overnight. It appeared that the time was right for some real reform and I wanted to be involved in that process.

     Susequently, I assisted a program administrator in setting up an in-home care program for adults and children. Medicaid funding had become available to provide waiver alternatives to nursing home and institutional placements. One of the aspects of these independent programs was to prepare a system for dealing with emergency situations. I created this system to be client specific, with routine reviews of information from medical emergencies, to fires, to floods. In each case, the ability to utilize emergency services, provider staff, or family members to transport and care for the consumer was individualized through a support team meeting process. I am happy to say that the program and clients that were there before the storms in September of last year are still very much alive and well.

     But the picture throughout the South is now significantly different. In many neighborhoods in New Orleans, homes are uninhabitable; there are reports of contaminated soil, deadly molds, and pollutant-filled air around thousands of cleanup sites. It would be hard to envision this if you could not actually experience it. Seeing is believing. It is truly much like a war zone, houses completely demolished, telephone, electrical, gas, and primary medical care wiped out in entire areas. The National Guard continues to police the streets and hundreds of thousands of people have been completely displaced.

     Despite this, there are still over 100,000 people in the city. Many people refused to evacuate during the hurricanes. They had seen the gulf storms come and go. They stayed to protect their property. However, others, especially the elderly and disabled, had little say in the matter. They remained, often trapped in flooded areas. Many died as a result.

     It is not just a point of putting the pieces back together now. It is a matter of providing essential services, especially health and education related systems. There is much work to be done assessing the needs including the basics: food, shelter, clothing, medicine, and transportation for critical appointments. At this point there is a significant shortage of care providers, hospital staff, and social workers. The dilemma lies in the critical housing shortage. It is a catch 22 situation; no workers without homes, providers who are only serving 25% or less of their original populations, and a city and state government paralyzed in debt and red tape.