So at his last - and possibly most surreal - press conference as president, George W. Bush broached the delicate subject of his "handling" of the response to Hurricane Katrina, the now famous killer storm that devastated the Gulf coast and flooded much of New Orleans in September 2005.
A reporter asked the president if he had "made any mistakes" during the course of his presidency. The president mentioned the old "mission accomplished" appearance he made on an aircraft carrier just before the situation in Iraq became a long walk into hell. But then he dove right into his handling of Katrina, saying, "I've thought long and hard about Katrina; you know, could I have done something differently, like land Air Force One either in New Orleans or Baton Rouge." Then, entirely unprompted, he mused, "...your questions, I suspect, would have been, 'how could you possibly have flown Air Force One into Baton Rouge and police officers that were needed to expedite traffic out of New Orleans were taken off the task to look after you.'"
Without batting an eyelash, the president identified the failure to land Air Force One as his principal mistake in the aftermath of the storm. After all, he seems to have reasoned, it wouldn't look that good if he had actually caused some additional disruption of the already chaotic response.
A few minutes later, another reporter asked what he could have done to "change the situation for the city of New Orleans, to be further along in reconstruction." Then the president let loose, claiming that the school system has improved dramatically, that people are moving back into their homes - and that things have happened "fairly quickly." To cap it off, the president mentioned, three times, that 30,000 people were pulled off rooftops in the flooded neighborhoods.
Well let's not dwell on the past. Never mind that the many heroes who actually rescued people trapped by the flood waters worked as employees of state and city agencies, volunteers, members of isolated military and National Guard units, and police, fire and EMT rescue teams. And they all had to work around - and in spite of - the profound lack of coordination of federal assets, dysfunctional communications systems and the confusion which stemmed in large part from lack of leadership at the top. Never mind that a federal program established last year to support displaced families who were leaving the notorious trailer parks has never actually started - not a single family aided - even though it is set to expire this March. Never mind that the recovery of New Orleans may have been and still remains more botched than the initial response. Never mind all of this.
The fact is that the recovery from Katrina has been painfully slow. At least 25% of people who lived in New Orleans prior to Katrina have not returned, many now permanently relocated. This is especially true for the neighborhoods, like the Lower Ninth, where many of the city's poorest residents once lived - and very few do now. And according to Associated Press fact checkers, those that have returned are finding that the New Orleans bus system is operating at less than one-third of its former capacity.
Thousands of families still live in temporary, often sub-standard, highly transient conditions, including trailers, motels and temporarily subsidized housing. Of the 125 public schools that were operational pre-Katrina, forty remain closed. While five of the city's acute care hospitals remain closed, federal, state and local officials have still not yet agreed on a plan to create a viable primary health care system for the ravaged city.
President Bush implied that $121 billion was available for reconstruction. Well, not exactly. Most of that money was actually for short-term response to the storm. Only about $15 billion has been spent on or is even available for recovery and reconstruction.
Among the most egregious consequences of this wholesale disaster mis-management has been the harm inflicted on the most vulnerable children and families in the region. Louisiana and Mississippi have long ranked among the worst states in terms of education and health care for children. Now the persistently stalled recovery has set these children even farther behind. Some are experiencing extraordinarily high rates of chronic medical conditions, severe problems in school and a wide range of mental health and behavioral symptoms.
President Barack Obama will enter the Oval Office next week confronting some of the most difficult domestic and international challenges in modern U.S. history. So what should happen to New Orleans and the recovery of the Gulf?
There is every reason to believe that, no matter what else is front and center, the new president will take on the unfinished business of reconstructing New Orleans and provide the needed resources to help bring still displaced children and families back to conditions of normal community life, including decent, affordable housing, and access to health care and schools.
Perhaps we will see the appointment of a new "disaster recovery czar" who will take responsibility for managing the federal aspects of reconstructing the still devastated neighborhoods, hospitals and schools in New Orleans and the rest of the Gulf. Keep in mind that FEMA's job is to focus by and large on disaster response - not recovery. In fact, no federal agency seems to have, at this point, central coordinating federal authority for large-scale recovery.
And beyond the reconstruction of New Orleans, there is reason to hope that president Obama will take steps to make sure that the planning for, response to and recovery from the next killer storm, massive earthquake or act of terrorism will be handled with intelligent planning, coordinated competent response - and compassion - for the vulnerable populations who suffer most in any major disaster. Then, of course, there is also important work to do in fixing some of the problems that have resulted from existing emergency response legislation, specifically the so-called Stafford act, which makes it difficult for federal agencies to work effectively with health and social service providers.
It's been a long, long eight years.
Irwin Redlener, MD
Director, National Center for Disaster Preparedness
Columbia University Mailman School of Public Health