The New York area's 170 hospitals responded quickly to the attack on the World Trade Center—but most victims were already dead.
Five people were pulled alive from the ruins; 5422 people are missing and presumed dead; 201 bodies have been found, of which 135 have been identified, 34 of them firefighters. No one has been found alive since Wednesday 12 September, the day after the attack.
Dr Steven Garner, chief medical officer of the Catholic Medical Centers, was in a meeting of the board of trustees at the group's flagship hospital, the 622 bed Saint Vincents in Greenwich Village, when the disaster began to unfold.
“We heard a loud airplane noise. I thought a plane was coming straight at us. Then we heard cries from the street for help. I ran downstairs. I could see a hole in the World Trade Center. We called the disaster plan into effect. Then the second tower was hit.”
Saint Vincents was the closest hospital with a level one trauma centre (the highest). Police closed Seventh Avenue, in which the hospital is situated. Ambulances came screaming up the avenue, transmitting information to the emergency department, whose ambulance bays face the avenue. “We're a mile north of the World Trade Center. The ambulances took one to two minutes to get here. They came in a steady stream. The smell of the smoke was different from that of an ordinary fire. It was flesh that was burning,” Dr Garner said.
Saint Vincents received 543 patients—four dead on arrival—and admitted 102. Two to three hundred people were covered with a white soot that irritated the respiratory tract, the eyes, and skin. Other patients had cuts from glass, anxiety and chest pain, broken bones, and other trauma.
Burn patients were sent to the burn centre of the New York Presbyterian Hospital Health Care System farther north on East 68th Street. It admitted 25 patients in critical condition; three died. That system's 30 hospitals treated more than 500 patients and admitted 166. Other hospitals saw hundreds more.
By 3 pm the flow of ambulances to Saint Vincents stopped. “We had more rescuers, more doctors and nurses, than patients,” Dr Garner said.
The wind, blowing to the southeast, carried smoke and debris across New York harbour into Brooklyn, but by Saturday air quality was within normal limits. Tests for asbestos levels have had varying results; new reports are awaited.
The Centers for Disease Control and Prevention in Atlanta sent 35 epidemic intelligence service officers to help monitor public health and decide whether there are new medical needs.
Three doctors who were on the hijacked airplanes are presumed dead. On the plane that crashed into the Pentagon were Dr Paul Ambrose, a research fellow at the Association of Teachers of Preventive Medicine, and Dr Yeneneh Betru, an Ethiopian internal medicine specialist at Providence Saint Joseph Medical Center in Burbank, California. Also on board was Sandra Teague, a physical therapist with Georgetown University Hospital in Washington. On the plane that hit the World Trade Center was Dr Frederick Rimmele III, a family physician from Marblehead, Massachusetts.
Thousands of body bags were shipped to New York to store the dead in refrigerated trucks. The New York City Medical Examiner's Office plans to use DNA testing on about 20000 body parts, working with other DNA labs.
Relatives of missing people were asked to provide DNA samples by bringing in toothbrushes, hair brushes, electric razors, and other personal items. Relatives will provide their own DNA to match with victims. Body parts that cannot be identified will be buried in the Potter's Field on Hart's Island in the East River.
Victims of the disaster and their rescuers saw sights normally seen only by the military in wartime. Psychiatrist Dr Herbert Pardes, president and chief executive officer of the New York Presbyterian Health Care System and former head of the National Institute of Mental Health, said that in counselling the victims the key message is, “Don't ask; listen to their concerns.”
“You want to create a receptive climate, not be judgmental. Let people know they should not be embarrassed to cry, to be anxious or depressed,” he said.
More than 1000 psychiatrists, psychologists, social workers, psychiatric nurses, and psychiatric researchers from his system provided help.
Medact statement on the terror attack on the United States
Medact, a UK based organisation of health professionals, concerned with major threats to health, wishes to:
unreservedly condemn the attack on the citizens of the USA and extends its deepest sympathy to the relatives, friends, and colleagues of the victims
urge President Bush to undertake a well considered and measured response in consultation with countries that are supporting the USA; action needs to be within international law, and non-military means need to be exhausted before military action is resorted to
ask the US government to look at the causes of terrorism
urge health professionals to call for a search for non-violent and just solutions rather than vengeful acts, to help to promote a climate of tolerance and understanding, and to contribute to an understanding of the psychosocial causes of violence
Figure.
AP PHOTO/GULNARA SAMOILOVA
Survivors help each other through debris from the twin towers