Our most vulnerable citizens don't belong in hurricane danger zones

Hurricane Charley demonstrated last weekend why some of the nation's most vulnerable folk - the ill, the disabled, and the frail elderly - should think twice before taking up residence in the most dangerous parts of the hurricane-prone coastal regions. For those most at risk, public policymakers ought to discourage or prohibit development on the riskiest lands.

Last Saturday morning, rescue workers found a stunned and bewildered elderly woman alone in a smashed cinder-block condominium in a retirement community in one of the hard-hit areas of southwest Florida. Could she have evacuated? Did she understand ahead of time - and in time - the threat to her life? Could she have packed her most precious belongings and driven herself through heavy traffic out of harm's way to a safe place to spend the night? Now that her retirement home is wrecked beyond livability, where will she go?

Especially as they age, retirees should rethink for themselves the problem of living where hurricanes may whip through the landscape with howling winds and storm surges, in some cases, up to 30 feet. Even for healthy 80-plus-year-olds, hurricane preparation and aftermath can be overwhelming.

Along with the responsibility of individuals for their own choices, elected officials have responsibilities for planning and zoning restrictions in the public interest. To often, they fan the fires of growth instead of looking after those unable to help themselves.

Assisted-living facilities have sprung up almost as fast as tennis courts near the nation's beaches. By definition, thousands of their residents are incapable of evacuating themselves when a hurricane whirls offshore and aims landward. Their problems range from aches, pains, and stiffness, to dependence on wheelchairs and bottled oxygen. In short, they need others to help them make it through every day. They should not be subjected either to the stress of hurricane evacuations or to the havoc of hurricane impact.

While everybody in a coastal area is challenged by a hurricane emergency, hospitals and nursing homes deal in life-and-death matters. Their patients cannot help themselves in an emergency. Typically, as a hurricane threat builds, all patients who can be reasonably discharged from hospitals are discharged early, their medications and instructions handed to them as they go out the door. Some patients have to be transferred to inland facilities with which agreements have been prearranged - in which case, they have to be hauled out on gurneys to be taken by helicopter or by ambulances that may find themselves stuck in heavy, slow-moving evacuation traffic.

Whether a hurricane actually comes or not, hurricane evacuation itself is a big deal - fraught with anxiety, discomfort, inconvenience, and expense.

Sometimes patients experience the ordeal of lying in bed in a hospital in imminent danger of serious hurricane damage.

Hurricane Charley battered three hospitals in Florida's disaster region, rendering them useless. The severe damage to such buildings from a Category 4 hurricane was predictable. Warning might have been taken from Deering Hospital in Miami in 1992. While the roaring winds of Hurricane Andrew pounded outside, the staff moved the sick, the injured, and those recovering from surgery to central areas of the building, carrying intravenous equipment, tubes, medications and charts. As they relocated, they abandoned sections of the hospital compound - rooms, corridors, and even whole wings. Only after extensive repairs, nine months later, could Deering reopen.

Lessons also could have been learned from the Medical University of South Carolina's teaching hospital in Charleston in 1989. Hurricane Hugo, also a Category 4 at landfall, tore at the roof and broke hospital windows. Nurses gathered patients into corridors and huddled around them while orderlies leaned against the doors to keep the wind and rain away from the beds.

Since 1886, on average, three to four tropical storms or hurricanes have made landfall on the continental United States every year. They are not new phenomena. What is new is the rapid growth of populations in hurricane-prone zones. (About 1,000 people a day move into Florida.) What is most frightening is the growing number of at-risk people, especially the frail elderly. Florida, where 78 percent of the population lives in coastal counties, has more than 700 nursing homes.

Fast-growing coastal communities build and expand assisted-living apartments, hospitals, and nursing homes because the market demands them, of course, just as the market demands beach houses and other kinds of development near the shore. Real estate of all kinds in the coastal zones is hot.

Living quarters for folk who are fragile, whether because of illness or age, should be sited appropriately - miles inland if necessary - certainly not on land likely to be flooded or subject to a hurricane's highest winds. Further, all buildings anywhere in the coastal zones - but especially those housing the ill and the disabled, and those unable to live on their own - should be required to be built or retrofitted to withstand hurricane-force winds.

Where we call ourselves civilized, policymakers are obligated to protect those who cannot protect themselves.

• Fran Marscher, a retired newspaper editor, is co-author of 'The Great Sea Island Storm of 1893' and 'Living in the Danger Zone,' nonfiction books about hurricanes.