CorrectCare

9-11: Day of Terror Triggers Emergency Response
Amid Turmoil, Manhattan Detention Facilities Keep Their Cool
by Jaime Shimkus

If ever a disaster plan was needed, this was it: September 11, 2001, the day the twin towers of New York City’s World Trade Center were felled in a horrendous attack that claimed more than 5,000 lives.

While sirens and smoke filled the air, while untold numbers of rescuers converged on the scene, passing on their way untold numbers of fleeing evacuees, while Americans everywhere, and New Yorkers especially, were shaken to their collective core, the detention facilities near “Ground Zero” had a job to do: maintain security and ensure the safety of staff and inmates without skipping a beat.

This they did, underscoring the importance of sound planning and periodic training and drills to enable staff and systems to function in times of emergency.

THE AFTERMATH
And what an emergency it was. Like virtually every site of any significance across the nation—government buildings, military bases, financial and commercial centers, public utilities—the city jails and local Immigration and Naturalization Service detention facility immediately took measures to bolster security. But with responsibility for the thousands of people in their custody, the stakes were even higher.

Firm details on what transpired in those facilities were hard to come by in the days after the attack. Telephone lines were down in lower Manhattan, officials and staff-level workers were incredibly busy trying to restore normal operations, and some topics—especially those pertaining to INS security—were top secret.

Some information was available, however. The INS New York Service Processing Center on Varick Street, about a mile north of Ground Zero, was closed and detainees were evacuated and sent to a number of undisclosed locations, says Karen Kraushaar, a spokeswoman at INS headquarters in Washington, DC. No detainees were injured, she says, and the removal was intended to “keep them out of harm’s way.” Functioning as a medium security facility, the SPC had an average daily population of 213 in 2000.

Kraushaar declined to discuss details about the evacuation or other actions taken after the attack. She did say that clinicians from that facility joined a team of other U.S. Public Health Service personnel to aid recovery workers (see related story).

Meanwhile, at the Manhattan Detention Complex, about half a mile from the crash site, the impact was “relatively benign,” says James Lawrence, CCHP, director of operations, New York State Commission of Correction. The commission regulates and oversees the operation of all state and local correctional facilities.

While emergency measures were implemented, they were, for the most part, only a precaution. “The facilities were locked down for the first day shift and the perimeters were strengthened, but by early evening the system was back to normal,” Lawrence says. “The New York City correctional facilities are heavily fortified and exceptionally safe. They’d be very difficult to disrupt even in conditions as trying as these.”

Some of the biggest problems at the complex, where a recent renovation increased capacity to 881 beds, related to staffing and to phone service failure. Much of the district was cordoned off and access was restricted to those with special IDs, says John Russell, deputy director of the Correctional Health Services office of the New York City Health and Hospitals Corp. CHS oversees the work of the health services contractor for the Manhattan facility and Rikers Island, the city’s main detention complex.

That made it hard for second-shift personnel to report to work, so the first shift was extended, Lawrence says. “The entire health care complement was already at work on the day shift when the disaster occurred, and there was no real interruption of essential services, although communications were a serious problem.”

Despite the thick smoke that permeated the region, no inmates or staff reported respiratory complaints. “The facilities’ air handling systems are exceptional. I don’t believe there were any problems,” Lawrence says.

The Manhattan facility wasn’t the only site affected. For example, Rikers Island, situated in the East River near LaGuardia airport, had some staff shortages on the evening shift, but things were operating normally by Sept. 12. The Department of Correction office in Manhattan also lost phone service. It was restored Sept. 13 with a new area code and prefix.

At press time, Correctional Health Services officials were planning to conduct a debriefing to review exactly what happened at the various detention centers and to assess their response procedures.

QUICK INVENTORY
Across the nation, jails and prisons far removed from the crash sites nevertheless felt the impact. At Pendleton Correctional Facility, located in a rural community an hour northwest of Indianapolis, health services workers were deeply distressed about the news coming from the East Coast.

But they didn’t have time to grieve: They had to kick into high gear to ensure that they would have adequate stores of essential pharmaceuticals and medical supplies in the days ahead. That’s because the grounding of virtually all nonmilitary aircraft meant that Pendleton’s usual express air shipments would be delayed for an unknown period.

The director of nursing and three other staff members quickly conducted an inventory and determined their needs, which they classified as immediate, short-term (within a day or two) and long-term (within seven days). “We have 420 people in chronic care clinics, so we needed a good picture of what we had in stock and which inmates needed to use what we had,” says health services administrator Tom Applegate, CCHP.

After reviewing demand for “life-sustaining” medications (such as insulin and cardiac meds) and consulting with physicians, they found they had enough in stock to last two or three days. They made arrangements with a local outlet of a national pharmacy to replenish supplies after that. Regular shipments resumed Sept. 15.

SUMMONING STRENGTH
Back in New York, correctional health professionals mustered the strength to carry out their duties despite the trauma of the day. “It’s amazing that people were able to proceed as normal. I give them a lot of credit,” says Laura Szapiro, CCHP, health services administrator, Brooklyn Detention Complex.

After employees at the Correctional Health Services central office were evacuated, those government workers were told to report to the nearest facility. “People came here and just pitched in. They wanted to stay occupied,” Szapiro says.

One correctional health care consultant who stayed occupied for the next 18 hours is Joseph DiMino, DO. A Philadelphia resident who works in New Jersey, he happened to be in Manhattan at the time of the attack. “All hell broke lose. I had been in Viet Nam and have trauma experience so I went to the nearest hospital and volunteered,” he says, clearly uncomfortable about assigning too much valor to his actions.

That effort was for naught: “We stood around and nothing happened, unfortunately. A lot of those people [in the World Trade Center] were dead. The few people we got had cuts and bruises, broken bones and burns.”

DiMino left and hitched a ride with a police officer to Hackensack, NJ, where he went to a trauma hospital and helped take blood donations from volunteers. “It was unbelievable how many volunteers there were. There was a line of over 100 when I started at 4 p.m., and there was still a line when I left at 2 a.m.”

Despite the fortitude with which people focused on their work, the attack on U.S. targets produced intense shock waves, and the long-term effects remain to be seen.

Certainly there will be ramifications for the INS, but the full scope is not yet known, says Capt. Nina Dozoretz, CCHP, chief of the Integrated Health & Support Services Branch, Immigration Health Services, a division under the umbrella of the U.S. Department of Health and Human Services. Dozoretz also serves on the NCCHC board of directors.

“Many individuals are being investigated and detained, but we have to see what this means for correctional settings,” says Dozoretz. “It’s possible that state and local facilities will be involved, and that will place more demands on medical services.” Also, the faltering economy and rising unemployment may lead to more crime and incarceration, she notes, and the “massive call-up” of reservists may cut into staffing at correctional facilities.

More optimistically, Judith Cox, CCHP, director of case management at the New York State Office of Mental Health, sees a glimmer of hope in the outpouring of support from all sectors of society. “For me what stands out is the unity we’re seeing. Everybody feels proud to be American.”

[Note: This article first appeared in the Fall 2001 issue of CorrectCare.]