The health care system in New Orleans is in critical condition due to a shortage of services, doctors, nurses, technicians, paramedics, funding, clinics and hospitals.

There is a severe shortage of doctors and nurses as many have not returned and the difficulty in recruiting health care workers to the area. Blue Cross Blue Shield states that "about three-quarters of the physicians who'd been practicing in the New Orleans area are no longer submitting claims to us.” However the president of the Orleans Parish Medical Society states that approximately 50% of doctors have returned. There is a shortage of nurses though much ground has been made up in re-staffing through marketing and recruitment tactics such as offering bonuses and loan repayment plans. Still it is difficult to convince people to come to live in a city with a severe housing shortage and the many other infrastructure problems.

11 major hospitals are in operation in New Orleans which is half of what was available pre-Katrina according to the Brookings Institute. The number of hospital beds or services available may be a different story. According to WWL “in the four worst-hit parishes, 2 out of 5 hospital beds are out of circulation; in New Orleans itself, it's 2 out of 3.” Likewise hospital services needed may not match up with the populations needs or be available. For example….

Susan Seip's eye surgeon was back, but the laser needed to clear the milky haze from her vision was destroyed in the floods at Memorial Medical Center, which is still closed. Her doctor referred her to another ophthalmologist, whose laser was safe but in storage. She finally found another doctor with an accessible laser.

"I waited probably three months to have my procedure done," she said. "When I did get it done, it was 30 seconds an eye."

Unfortunately it looks that things will only become worse as “within the next two to three months, "all the hospitals" will be considering cutting services, said Dr. Mark Peters, board chairman of the Metropolitan Hospital Council of New Orleans.”

With less doctors and more travel time to find a doctor more people are waiting to receive care often until their situation worsens necessitating going to the ER.

"The patients we're seeing are very sick," said Becky Gab, operations director for the emergency department at Tulane University Hospital and Clinic. About half the people who come to the hospital's ER end up admitted, up from 15 to 30 percent before the storm, she said.

"Before the storm, diabetics would come in with high blood sugars," said Brent Becnel, at the Touro ER. They were easily and quickly treatable. Now, when they come in, they're in much worse shape, needing ICU treatment to prevent a diabetic coma.

Additionally all parts of the health care system are hemorraging money due to rising staff costs, longer hospital stays, fixed Medicare payments and providing services to the indigent and uninsured.

"Since the storm, everybody's losing money -- anywhere between maybe a million dollars a month to about $9 million a month," said Finn of the Metropolitan Hospital Council.

As challenging as it is for the health care system to attempt to meet physical health care needs, perhaps the greatest challenge is dealing with mental health care issues. Depression and post traumatic stress are epidemic….

"Post-Katrina stress syndrome," as some professionals call it, has seeped into the lives of just about every resident in the New Orleans area, people who are waging war with contractors, electricians, building inspectors, insurance companies and nature itself.

The Louisiana Survey found that among adults 70% in Orleans and 63% in suburban Orleans parishes "said they had felt depressed because of the storms." One St. Bernard Parish doctor has had to prescribe antidepressants for up to 35% of his patients. The suicide rate in New Orleans tripled in the months after the storm though indicators recently point to a leveling off in that rate.

However mental health services are practically non-existent. New Orleans has lost 89% of its psychiatrists. There were 400 psychiatric beds in the New Orleans area pre Katrina while now there are 65. There are only 10 public psychiatric beds for adults and 15 children/adolescent beds available in Orleans. As a result patients are shifted to hospital ER’s often in surrounding areas.

"It's an enormous problem," said Dr. Jan Johnson, a Tulane University psychiatrist. "If someone needs to be stabilized because they're suicidal or psychotic, they end up going to an emergency room, and the wait is days, not hours.

And it is usually the police who are left to deal with those with acute problems.

"When you don't have a place to send that wandering schizophrenic directing traffic, guess what? Law enforcement is going to wind up taking care of that," said Dr. Rouse, the deputy coroner. "When the Police Department is forced to do the job of the mental health system, it's a lose-lose situation for everyone."

People are being urged to seek help for post traumatic stress and depression. The Ad Council has begun a Hurricane Mental Health Awareness Campaign. Blogger TravelingMermaid is helping organize volunteers for photographer Clayton Cubitt who will be “making portraits of survivors for use in public service announcements.” At Cubitt’s site one can see an excellent ad from the Ad Council.

Hopefully those who have not sought help yet will respond to such ads. Hopefully they will find services available. But if hope were in abundant supply then the patient, that is New Orleans, may not be in such grave condition to begin with.

UPDATE: It was announced today that FEMA has awarded a nearly $35 million grant for crisis counseling. For perspective $132 million was given to New York after 9/11.