Six days after Hurricane Katrina triggered the worst natural calamity in US history, officials prepared the country for a heavy death toll that is expected to number in the thousands across the devastated US Gulf coast.

"It is going to be about as ugly a scene as we've witnessed in this country, with the possible exception of 9/11," Homeland Security Chief Michael Chertoff said, referring to the 2001 terror attacks that killed nearly 3,000.

"I think we need to prepare the country for what's coming," Chertoff told Fox News Sunday from a suburb of flooded New Orleans. I really want to tell people that we have got some tough days ahead of us."

Senior medical officials said 59 bodies had been collected in New Orleans so far, but cautioned that was just a fraction of those killed.

Before the grisly hunt for the dead began in earnest, US troops scrambled to move out thousands of survivors still eager for evacuation amid the largest refugee operation ever seen in the United States.

Chertoff said the troops would start a house-to-house search for trapped residents who had opted to weather Katrina at home, and suggested they would have to leave whether they wanted to or not.

"We are not going to be able to have people sitting in houses in the city of New Orleans for weeks and months while we de-water and clean this city with the hope that we're going to continue to supply them with food and water.

"The flooded places, when de-watered, are not going to be sanitary, not healthy. There's not going to be a way to get food and water," he told NBC's Meet the Press program.

Even as he spoke, residents of one New Orleans suburb were thronging police checkpoints in a bid to return to their homes.

Chertoff made the rounds of talk shows as part of a public-relations blitz launched by President George W. Bush's administration to counter widespread criticism of its response to Katrina.

Secretary of State Condoleezza Rice and Defense Secretary Donald Rumsfeld fanned out across stricken areas Sunday and Bush planned his second tour in three days on Monday.

Chertoff defended the administration's handling of the crisis and stressed the immediate need was to deal with recovery and the needs of hundreds of thousands of refugees rather than getting bogged down in assigning blame.

"We are basically moving the city of New Orleans to other parts of the country," he said. Authorities have estimated it would take several months to drain the one-time bustling jazz capital and make it habitable.

"We have to shelter people, we have to feed them, we have to educate their kids, we have to get them medium-term housing and we have to give them hope," Chertoff said.

Relief and rescue efforts picked up steam over the weekend, with New Orleans' two major refuges cleared Saturday of the last of tens of thousands of survivors who had spent nearly a week trapped in squalor and fear.

But the authorities were still struggling to get on top of the situation after the hurricane that had left mostly poor and black residents fending for themselves for days.

Mayor Ray Nagin said some New Orleans police and firefighters had been driven to suicide by the trauma of the past week as they struggled in vain to prevent a complete breakdown in law and order.

"They've been holding the city together for three or four days, almost by themselves, doing everything imaginable," Nagin said, "and the toll is just too much for them."

For many rescued survivors, evacuation was not the end of their ordeal, with packed buses reportedly turned away from shelters outside the disaster area.

New Orleans Council President Oliver Thomas said he accompanied 200 people who were rejected by three shelters.

At New Orleans airport, which was transformed into a holding pen for the elderly and infirm as well as a gateway for the departing, dozens of people from nursing homes and hospitals lay dying on stretchers on the floor.

"Their organs are shutting down. They are septic. They are storm victims," said chaplain Mark Reeves, 43, from the federal Disaster Medical Assistance Team. "We've already had 25 die here."

The spectre of disease also haunted recovery efforts with doctors fearing the fetid waters and squalid conditions in shelters could breed cholera or typhoid, or spawn mosquitoes carrying malaria or West Nile Virus.

The authorities in the city of Biloxi, Mississippi had to evacuate hundreds of people from one shelter amid a suspected outbreak of dysentery.

Bush ordered 7,000 active duty troops to the affected Gulf Coast region to back tens of thousands of National Guardsmen deployed. Some 3,000 soldiers from the elite 82nd Airborne Division entered New Orleans on Saturday.

A Washington Post-ABC poll published Sunday found that 46 percent of those surveyed approved of the way Bush has handled relief efforts while 47 percent disapproved.

Fifty-one percent rated the federal effort as not so good or poor and 48 percent said it was excellent or good.

Chertoff acknowledged Sunday that Washington was still not fully prepared for disasters and suggested that a new model for dealing with "ultra-catastrophes" might give the federal government more of a leading role.

But he refused to discuss major failings in the federal effort on Katrina. "In due course, if people want to go and chop heads off, there will be an opportunity to do it."

Katrina Brews A Cocktail For Disease
by Christophe Vogt
Washington (AFP) Sep 04 - Between the heat, the mosquitos, the body-strewn waters and thousands of people trapped in sweaty squalor, Hurricane Katrina has left behind a fetid cocktail ripe for a health disaster.

Nearly a week after Katrina swamped the US Gulf Coast, leaving thousands feared dead, doctors cautioned the stricken area could become fertile terrain for cholera, malaria, typhus, West Nile virus or other ailments.

Several hundred people were already evacuated from a shelter in the city of Biloxi, Mississippi, because of a suspected outbreak of dysentery. It appeared for the moment to be an isolated case.

But with a patch of territory equal in size to Britain suffering the effects of Katrina's fury and deprived of power and running water, doctors wonder how long their luck will hold.

"Public health officials and doctors tell me that we have the ingredients for a bad situation there if we don't practice good public health practices," Health and Human Services Secretary Michael Leavitt said Sunday.

"You have standing water. You have hot weather. You have the potential of mosquito hatches, other vectors that can carry diseases," Leavitt told CNN.

"You also have lots of people in the same area, and all types of infectious diseases, particularly those that could infect the intestinal track."

Leavitt said relief workers were seeing a large number of a sick people, including many coming out of emergency centers in need of serious medical treatment.

He said 24 federal public health teams would fan out through the disaster zone to work with state and local authorities on preventing epidemics.

But the region also had a high incidence of chronic disease such as diabetes, hypertension and cardiovascular illness, former US surgeon general David Thatcher told CNN.

He said such people were in dire need of their medication and many died without it while they were awaiting rescue.

The Wal-mart retail chain said it would provide medication free of charge for seven days to displaced people able to provide prescriptions. It will ask its pharmacists to review the cases of those unable to produce prescriptions.

Another upbeat note came from the federal Centers for Disease Control (CDC), which sought to provide words of reassurance to those bracing for a spate of epidemics.

"Although infectious diseases are a frightening prospect, widespread outbreaks of infectious disease after hurricanes are not common in the United States," the CDC said on its website.

It said that, generally speaking, there had been no sign of an eruption of contagious diseases that had not already been present in the region. This meant a reduced risk of cholera or typhus.

Even more comforting was its conclusion that "decaying bodies create very little risk for major disease outbreaks" despite their look and smell.

But the CDC added that "communicable disease outbreaks of diarrhea and respiratory illness can occur when water and sewage systems are not working and personal hygiene is hard to maintain as a result of a disaster."

This was precisely the situation facing the disaster area.

If the prospects for a health epidemic were unclear, more certain was the likelihood of an outbreak of trauma and other emotional problems stemming from terrible ordeals experienced by survivors.

Millions of people could end up with scarred psyches, including survivors, rescue and relief workers and even the families of anyone involved in the Katrina disaster.

All rights reserved. � 2005 Agence France-Presse. Sections of the information displayed on this page (dispatches, photographs, logos) are protected by intellectual property rights owned by Agence France-Presse. As a consequence, you may not copy, reproduce, modify, transmit, publish, display or in any way commercially exploit any of the content of this section without the prior written consent of Agence France-Presse.

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