This week marks the 20th anniversary of Hurricane Katrina, one of the most devastating natural disasters in U.S. history. The storm’s toll was staggering: 1,833 lives lost, more than 2 million people evacuated or displaced, and 350,000 homes destroyed. Entire neighborhoods disappeared. The hallmarks of daily life — clean water, electricity, roads, pharmacies, and doctors’ offices — were simply erased.

Beyond the physical destruction, Katrina revealed deep vulnerabilities in our health system, many of which persist today. In the immediate aftermath, people living with chronic conditions like diabetes, hypertension, and asthma faced life-threatening gaps in care. Pharmacies were flooded, medications lost, medical records destroyed, and thousands of physicians displaced.

Because Katrina made landfall at the end of the month, many people had only a few days of medication left. When the storm cut off access, thousands suddenly found themselves without the medicines they needed to survive.

One story I’ve read that stays with me comes from Janet Mentesane, who was then executive director of MLK Health in Shreveport, Louisiana. In the weeks after Katrina, her small clinic — its pharmacy no larger than a walk-in closet — was suddenly treating hundreds of displaced patients arriving without prescriptions, records, or supplies. “They had no medications and no physicians,” she recalled. “Their pharmacies were destroyed, along with the records and data.”

Her experience reflected a larger truth: for survivors of Katrina, the most urgent needs were not always storm-related injuries, but care for chronic conditions left unmanaged when the public health system collapsed.

Katrina as a Turning Point

I joined Direct Relief just a few months ago, and I’ve learned how profoundly Katrina shaped the organization’s work in the U.S. At the time of the storm, Direct Relief’s efforts were primarily international. But Katrina revealed, in stark and urgent ways, that devastating gaps in healthcare access exist right here at home, especially during disasters.

Direct Relief mobilized swiftly, providing more than $50 million in medical aid and cash assistance to Gulf Coast community health centers and free clinics within six months of Katrina’s landfall. This aid included essential medicines like insulin and tetanus vaccines.

For small facilities like MLK Health, this support was transformative. Direct Relief helped them secure a generator to power their pharmacy, ensuring that temperature-sensitive medications could be stored safely during prolonged outages.

The response didn’t just meet an urgent need — it set the course for Direct Relief’s work in the U.S. moving forward. The organization became licensed to distribute medicine in all 50 states and began building long-term partnerships with community health centers, free clinics, and charitable pharmacies. It was also the start of Direct Relief’s enduring partnership with the National Association of Community Health Centers (NACHC), supporting clinics that became lifelines for their communities during and after the storm.

Today, that network includes more than 2,000 U.S. healthcare partners, with 65% located in FEMA-defined moderate to high-risk zones. Together, we work to strengthen preparedness from the ground up, ensuring every response is rooted in community knowledge and empowering local providers to act quickly and effectively, reducing delays and maximizing impact.

Evolving Challenges, Shared Commitment

Katrina was a singular event, but the challenges we face today are increasingly interconnected. Hurricanes bring prolonged power outages. Wildfire smoke travels hundreds of miles, triggering respiratory crises far from the burn zone. Extreme heat pushes emergency rooms to capacity and threatens patients managing chronic disease.

At last week’s NACHC CHI Conference and Expo, I heard firsthand from health center leaders about how they’re preparing for these growing risks — by safeguarding medications, securing backup power, managing electronic health records, and training staff for continuity of care. These local investments ripple across entire regions, making communities safer and more resilient.

Looking Ahead

I’m still learning from the history of Katrina and from those who have been doing this work for decades. But one thing is clear: resilient health systems are built from the ground up — clinic by clinic, patient by patient.

This anniversary is both a solemn reminder of lives lost and a call to keep strengthening the systems that keep people healthy in times of crisis. Preparing for what’s ahead isn’t something any one organization can do alone. It happens when we listen, learn, and act — together.

This story first appeared in Amy Weaver’s LinkedIn newsletter, Direct Relief: Hope Ahead.

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