Terror Fears Bring New Health Funding Priorities, Budget Gaps into Question

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Thirty-seven percent said the new funding has simultaneously helped other public health programs and activities.

In California, Berkeley volunteer health commissioner Tom Kelly says he and other commissioners are concerned that staff time has been diverted from the city's low-income minority communities. Dr. Poki Namkung, director of Berkeley's health department, feels the preparations are worthwhile because the threat of terrorism is real. "It isn't a fantasy," she said. "We have the responsibility to be prepared."

According to Namkung, terrorism preparedness can only be a benefit to a public health system that has been underfunded for decades.

"These funds are not just for terrorism," she said. "Nature is by far a more fierce opponent than bioterrorism ... We live in an age of emerging infectious diseases, SARS being the most recent example, and West Nile virus just around the corner for California."

Namkung said she now spends about 80 percent of her time "rebuilding the public health infrastructure" using the new federal funding. "We haven't cut back on anything," she said. "[T]his is the first significant money we've received to rebuild public health."

Berkeley is using federal funds to upgrade communication systems with local hospitals and clinics, vital in case of a smallpox attack and in the ongoing battle against infectious diseases like SARS, food-borne illness and meningitis, she said.

Dr. Wendel Brunner, public health director for Contra Costa County, located near Berkeley by the San Francisco Bay, cites a recent case of tuberculosis at a local high school. A letter to parents was rapidly translated into Spanish and sent home with students; simultaneously, the information was put onto a Web site.

"Normal communication procedures were enhanced by bioterrorism expenditures," Brunner said.

"All hazards"

In Texas, the San Antonio Metropolitan Health District has used federal terrorism funds to expand laboratory capacity and develop an "all hazards approach" that can respond to a biological attack, a flood or hurricane.

San Antonio also cross-trained its nurses, so that a nurse working in pre-natal care is able, for example, to respond to a "dirty" bomb. "If we can cross-train staff, we get a bigger bang for the buck," said Tom Fletcher, emergency management coordinator for the city.

San Antonio's health district director Dr. Fernando A. Guerra said his district has been reimbursed for about 80 percent of their costs, but that "some of our other efforts have been displaced for a while ... We can't let [terrorism preparedness] take us too far in that direction or we'll miss the childhood diseases, the diabetes, the early loss of life."

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