BILOXI, Miss. – The neighborhood called Point Cadet at the east end of Biloxi has no clean running water and a foul stench — the residents are certain it's human decay — pervades the air, burning the throat when the wind blows right.
In addition to the many hurricane-flattened houses no one could live in, there are some still standing, though heavily damaged. And people are staying in them, in some of the most unsanitary conditions imaginable.
"This is a public health nightmare," said Dr. Mary Wells, a pediatrician from Mobile, Ala., who used her day off to drive Biloxi's debris-strewn streets to see what people need.
She found squalor and desperation. She saw people who can't get medicine, who are drinking contaminated water, who have untreated cuts and bruises from a night battling Hurricane Katrina, who don't have badly needed insulin.
While attention remains fixed on the medical emergency in New Orleans, clogged roads and communication breakdowns in some parts of devastated Mississippi have cut residents off from hospitals, the Red Cross and dire health warnings.
Bottled water and donated food have reached churches and the neighborhood handout points. But doctors and emergency aid workers have gone unseen, let alone the critical public health warnings that could help save residents from dangerous diseases.
"We've got a first aid station in the church, but not to where we're practicing medicine," said Jill Leggett, volunteering to hand out water at the Lighthouse Apostolic Holiness Church. "If the (conditions) here are going to affect people, they need to tell people or get them out of here."
Medical officials and political leaders are worrying that the word — and the medicine — aren't spreading. Democratic Rep. Gene Taylor (news, bio, voting record) has urged FEMA to send 150,000 doses of tetanus vaccine to the coast now.
Federal public health teams are stationed at various points around the Gulf Coast, but are typically set up at hospitals or central locations — not deep in the areas where conditions are worst. These days the residents of Point Cadet have little or no transportation. The lack of phone service and electricity — no TV and only car or battery-powered radio — has kept them cut off from news.
Just west of Biloxi, three people died when they had wounds infected with Vibrio vulnificus, a bacterium that lives in warm salt water.
Last week a shelter in Biloxi was shut down after more than 20 residents came down with dysentery-like symptoms, and officials are also starting to get scattered reports of another stomach virus, known as norovirus, in places where large numbers of evacuees are staying.
Luckily, the fetid conditions haven't led to large outbreaks of the diseases nearly every doctor expects: illnesses caused by contaminated water, bad hygiene and people with weak immune systems.
"I think that what we have to this point is a good news story about communicable disease outbreaks," said Dr. Mills McNeill, Mississippi's state epidemiologist. "Fortunately, we are not seeing major outbreaks of illnesses. To me, that's a blessing."
But there are other potential health-related problems — one of the biggest being people who haven't been able to take their regular medications.
Carrie Jackson escaped to the roof of her Point Cadet home and since hasn't been able to take medicine for her lupus or her high blood pressure because she can't get any.
"So far, no problems," she said. Jackson said residents in her neighborhood have had no visits from health officials warning about unsanitary tap water.
"We're not getting sick, but everybody is getting a ... rash," says Janyne Evan, slogging through the mud in rubber boots as she tries to throw out rotting food at her now-ruined Turtle Landing restaurant on Cowan Bayou in Pearlington, west of Biloxi on the Louisiana line.
Like others here who've learned about the disease threat, she's been washing her hands in a bleach solution. As a restaurateur she's better versed in hygiene than some others.
On a recent day, she went looking for a Red Cross station in town but found none. Then she drove to Bay St. Louis, more than 20 miles away. Still, she couldn't find one. So more than a week after the storm, she still relies on bleach and tiny packets of antibiotic cream that the ambulance crew left.
Evan said she saw people swimming in the reeking, polluted East Pearl River, which serves as the state's southwestern border with Louisiana.
Sgt. Chuck Strain, who patrols the river for Louisiana's Department of Wildlife and Fisheries, wrinkles his nose at the thought, pointing to a blob of fur in the water. It is, he says, a roughly 10-pound nutria rat.
"There's millions of them dead out there," he said. "They're floating around with their little legs sticking up in the air and their little yellow teeth showing."
Sgt. Grady Brecheen said two of his agents have been hospitalized with dysentery. Both were in the flood waters in New Orleans.
"I think it's going to get bad," he said. "I really do."