August Anniversaries
Fans of government-run health care seem eager to forget the French heatwave of 2003.


August, and golden oldies. Serious thought is forbidden this month, which is why every middle-aged pop critic in America is still waxing on Woodstock and talking about how Janis changed the world and Arlo shut down the New York State Thruway, man. The vacuousness of August might explain why the White House thought it was the perfect month to go Kerouacing with Obamacare — ending up in Montana, no less.

I wonder how it would play in Paris? After all, this is the month that marks what must surely be one of the most important anniversaries in the history of government-run medicine. But so far, there’s been scant mention of the August 2003 heatwave that descended on France and left the nation’s oldest and weakest citizens to the mercy of a state-run health-care system.

Summer heat generally makes many Parisians happy, because in August, almost every working person in France takes an annual congé and leaves stonking hot Paris for places even hotter. The evacuation of the cities is a grand tradition: Families pack kids and dogs and leave empty streets to the tourists, and those too old or frail to travel. In an emergency, there’s always a hospital nearby, and Assurances Maladies — the government-run insurer that covers the ailments of one and all — to pay the bill.

But July 2003 had been miserable. On the 28th, Dr. Patrick Pelloux, the president of France’s association of emergency-room doctors, took a look at the long-range forecast, the number of health-care workers who would be off-duty, and the number of doctors and nurses left behind who were restricted by law from working more than 35 hours. He issued a warning saying the number of available hospital beds would be reduced by “25 to 30 percent” — not enough to meet an emergency situation. President Jacques Chirac and the government of Prime Minister Jean-Pierre Raffarin, including Health Minister Jean-François Mattei, disregarded the warning — and left town.

Right on time, on August 1, Météo-France warned of a canicule — a heatwave, one that most of France only learned about sitting in traffic jams in their Peugeots on the sweltering roads to the beach. By August 4, the temperature in parts of the country had reached 40° C (104° F), and more than 300 people — almost all of whom were elderly and alone — had died.

The next day, a blanket of heat covered almost the entire country — and by August 7, Paris hospitals were collapsing in chaos under a flood of elderly victims who made their way to a hospital — only to find there were no beds, no staff, and — as throughout energy- and environmentally conscious France — no air conditioning. In some hospital rooms, even those filled with unattended elderly people, temperatures reached 120° F.

On August 8 alone, more than 1,000 people died. In just four days, the death toll was staggering. The network of 39 hospitals and clinics serving the Franciliens — the residents of Paris and the surrounding Île-de-France — was put on alert and ordered to increase capacity, somehow.

On August 10, Pelloux issued another warning and chastised his superiors. “At the level of the health ministry,” he said, “absolutely nothing is happening. They venture to speak only of ‘natural deaths.’ ” Health minister Mattei responded furiously from his vacation getaway, issuing a statement saying the death rate was “comparable to previous years, except in certain facilities and one or two départments in the Île-de-France.”

On August 12, some 2,200 people died.

By now, the actual death toll was more than 10,000. Raffarin, at his villa in the south of France, held a casual press conference and denounced “partisan politics.” Meanwhile, jammed funeral homes began turning bodies away and a rather alarming number of corpses began stacking up — because nobody was around to identify them. Still, coverage in the French press was muted, irregular, and not particularly alarming. The best coverage came from the Paris bureau of the Guardian.

On August 13, another 2,000 people died. Raffarin authorized Paris-area hospitals to implement the government’s so-called “White Plan,” which would allow local administrators to recall medical-health workers from vacation. Pelloux immediately responded that help was needed everywhere in the country.

That same day, Jean-Louis San Marco, director of the National Health Prevention and Education Institute, told the Guardian, “We are facing a human drama, carnage the like of which doubtless has never been seen in France. Yet the impression given is of radio silence. It makes me want to scream.” The next day, Mattei announced that 3,000 people had died from the canicule so far. In fact, the death toll had already passed 12,000. Aides to Chirac, who had been silent so far, reassured the nation that the président was “closely following the situation.”


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