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One year has passed since airplanes hijacked by terrorists toppled the World Trade Center towers, hit the Pentagon, and crashed into a Pennsylvania field, shocking New York, the nation, and the world.

Thousands died even as firefighters, police, paramedics, doctors, nurses, and regular citizens scrambled to help. The events of Sept. 11, 2001 showed how hate could destroy but also how compassion and honor could rebuild.

Columbia, like the rest of the world, has not forgotten 9/11. Many in Columbia University Health Sciences contributed initially, providing immediate medical and mental healthcare, helping in victim identification (See Point of View), and raising funds for victims.

The work continues: In response to 9/11, more than two dozen Columbia faculty, staff, and students are involved in providing mental health services, performing research, and doing emergency preparedness planning to benefit New York and the rest of the nation.

Easing the Mental Health Burden

Psychological fallout from 9/11 led Columbia staff to become involved in a variety of mental health programs. Dr. Edward T. Kenny, assistant professor of clinical psychiatry in P&S and a founder of Disaster Psychiatry Outreach, helped organize 700 psychiatrists who counseled people affected by the events. The group is now trying to determine how much stress remains in those treated.

Dr. Ezra Susser, professor and chair of epidemiology in the Mailman School of Public Health and professor of psychiatry at P&S; Dr. Daniel Herman, assistant professor of psychiatry at P&S and epidemiology at Mailman; and Barbara Aaron, project director for many of the Mailman 9/11 projects, are leading "A Common Ground," a collaboration of Mailman, the New York State Psychiatric Institute (PI), the Columbia School of Social Work, state and city government, and labor unions to ensure recovery workers and others who live or work near Ground Zero continue to receive mental health services.

Dr. Randall Marshall, associate professor of clinical psychiatry in P&S, and Dr. Yuval Neria, research scientist at Mailman and PI, are participating in the New York City Consortium for Trauma Treatment, a collaboration of psychiatrists at four New York medical schools that trains clinicians about treating trauma disorders. Approximately 250 healthcare professionals will have completed the training by the end of September.

Dr. Frederic I. Kass, professor of clinical psychiatry in P&S, and colleagues also have been providing mental health services to New York City police officers, in a program that may serve as a model for law enforcement counseling nationwide. (See story)

How Many People Affected?

While treating psychological effects is important, assessing the extent of the mental health problem is critical so services can be targeted. In a study commissioned by the city Board of Education, Dr. Christina Hoven, a child psychiatric epidemiologist at Mailman and the P&S department of child psychiatry, along with Columbia colleagues, found that probable rates of psychiatric disorders were significantly higher in New York City public school students six months after 9/11 than in other U.S. communities surveyed before the attacks. "One of the most important results of the study is that additional federal funds have been allocated to the city to improve mental health service delivery to school children," Dr. Hoven says.

Dr. David Vlahov, director of the New York Academy of Medicine's Center for Urban Epidemiologic Studies and professor of clinical epidemiology in Mailman, and Dr. Sandro Galea, an epidemiologist at the academy and a Mailman doctoral student, have found that post-traumatic stress disorder (PTSD) rates for Manhattan residents are starting to subside. A telephone survey they did two months after 9/11 showed about 7.5 percent of Manhattan inhabitants had PTSD and about 10 percent had depression related to the towers collapsing. A follow-up survey of the entire city done five months after the attack showed PTSD rates dropped by two-thirds and depression dropped by about half.

Dr. Frederica Perera, professor of public health and director of the Columbia Center for Children's Environmental Health is leading a study to determine whether air pollution from the burning and collapse of the World Trade Center also may have caused health effects in children. She and colleagues are carrying out a three-year study of 350 pregnant women—including women who lived or worked in Lower Manhattan on 9/11—and their children to determine whether prenatal exposure to World Trade Center air pollutants adversely affected the children's growth and development.

Preparing For the Unthinkable

Columbia also is leading local and national efforts in emergency readiness. Dr. Stephen Morse, director of Columbia's Center for Public Health Preparedness in the Mailman School, and his center colleagues have trained New York City school nurses in emergency preparedness and developed a similar program for the senior management of the city health department and a generic version for other health agencies. The center is working with the New York City Department of Health and Mental Hygiene to complete, by fall, an evaluation of the department's response to 9/11.

Dr. Kristine Gebbie, Elizabeth Standish Gill Associate Professor of Nursing, is specifying competencies needed by public health workers for bioterrorism readiness and response and is creating a preparedness plan for every local health department in the country. P&S fourth-year student and Mailman master's of public health graduate Katerina Christopoulos, who volunteered at a triage center on 9/11, participated in an effort led by local physicians to create a national volunteer corps of medical professionals and students to assist in disasters.

Bioterror defense programs also are taking shape. Dr. Ian Lipkin, professor of epidemiology at Mailman and neurology at P&S, and director of Columbia's Center for Imunopathogenesis and Infectious Disease, is leading a biodefense consortium of tri-state institutions to study and respond to emerging infectious diseases and bioterrorist threats. This consortium will develop new rapid diagnostic tools, vaccines, and drug therapies and will study the mechanisms by which infectious agents cause disease in animal models. Dr. Scott Hammer, professor of medicine and Harold C. Neu Professor of Infectious Diseases at P&S, Dr. Jingyue Ju, associate professor of chemical engineering and head of DNA sequencing and chemical biology in the Columbia Genome Center, Drs. Eneida Mendonca and Yves Lussier, assistant professors of medical informatics, and Dr. Morse are collaborating with Dr. Lipkin.

Dr. Hammer also is working with Dr. Edward Shortliffe, professor and chair of medical informatics, and Dr. Frank Lowy, professor of medicine in P&S, to develop a quick notification system in the hospital to monitor the spread of infectious agents. The system would also detect bioterrorist agents, too.

Sept. 11 spurred Health Sciences efforts that are providing valuable insights to the university, hospital, city, state, and nation. "The university and hospital did a fine job responding to the events last September," Dr. Morse says. "We are all working to be even better prepared for whatever happens next."


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