Cover Story

Street-level diplomacy

Bottlenecks and gridlock outside, rabid anti-Americanism inside-as the 61st UN General Assembly opens, a city and a president come to grips with terrorists and fanatics

Issue: "Street theater," Sept. 30, 2006

NEW YORK CITY - Not since Nikita Khrushchev beat his shoe on the desk 46 years ago have UN delegates absorbed such a high-level tirade. "And the devil came here yesterday," Venezuelan president Hugo Chavez told dignitaries gathered for the opening of the UN's 61st General Assembly, a reference to President George Bush. "Yesterday the devil came here. Right here." He paused to cross himself. "And it smells of sulfur still today."

Mr. Chavez, seizing the podium a day after Bush and more than two dozen other heads of state addressed the general assembly on Sept. 19, broke open the frosty tension that was felt in the hall as Bush and his allies square off against those who oppose the war on terror. "The hegemonic pretensions of the American empire are placing at risk the very survival of the human species," said Chavez, who took on the UN as well: "Let's be honest. The UN system, born after the Second World War, collapsed. It's worthless."

Each year the inaugural of the UN general assembly is a harmonic convergence of world leaders and causes: Sixty-four heads of state, dozens of foreign ministers, and hosts of VIP attendees watched over by a press corps from around the world filled this year's formal opening session Sept. 19. They covered special interests as wide-ranging as global poverty and as mundane as agriculture: Greek delegates hosted a champagne reception titled "In Praise of the Olive."

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But try as the UN establishment might to appear tolerant and inclusive, the overarching tenor of this year's general assembly was captured by the fanatical lashing out at U.S. policy by Chavez and Iranian president Mahmoud Ahmadinejad. And while their anti-U.S. rhetoric was no surprise, the religious language wrapping it was striking: "I emphatically declare that today's world more than ever before longs for just and righteous people with love for all humanity, and above all longs for the perfect, righteous human being and the real savior who has been promised to all peoples and who will establish justice, peace, and brotherhood on the planet," said Ahmadinejad, a not-so-oblique reference to the 12th Imam, whom Ahmadinejad champions to bring the end of the world (perhaps with the help of nuclear weapons and the annihilation of Israel, which he also champions). The Iranian president used much of his time at the podium to accuse the Bush administration of rigging the UN to do its bidding.

As president and Mrs. Bush helicoptered into lower Manhattan Sept. 18, New Yorkers were thinking more about street-level security than high-level confrontation. Just a few blocks away from the landing pad, health experts gathered to hear the latest on emergency preparedness at a symposium sponsored by Downtown Hospital. Located three blocks from Ground Zero, the acute-care facility was the first among first responders to victims of the World Trade Center attacks, treating 1,200 patients on 9/11 alone.

It has been leading the way for hospitals in the city ever since: focusing the attention of health workers on impending disasters, linking arms with other hospitals in how to prepare for them, and spending millions on improvements to minimize casualties in the next disaster. If President Bush and other world leaders gathered in New York to give voice to the threats of terrorism, nuclear and other potential disasters, these experts put feet to making street-level solutions possible.

"Where are we now?" asked an administrator from New York Hospital in Queens. "What is our ability in the metropolitan area to sustain a long-term catastrophic event?"

Those are questions that work on the sleep patterns of countless city officials, from law enforcement to transportation experts to water-quality specialists. After spending millions and millions to prevent another attack, to protect dignitaries and others who flock to events like last week's UN session, what happens if terrorists succeed here, anyway? How will the city cope again? Most Americans manage thoughts of potential terrorist attacks from a safe distance. New York is the city that can't forget.

Where are we now? "That's not so much a difficult question as a scary one," responded Don R. Boyce, director of emergency hospital preparedness for Continuum Health Partners, a consortium of five public hospitals in New York. Health-care workers recognize that most city hospitals are very old, he said. "The infrastructure is old, the generators are original generators. We have figured out how to sustain ourselves for 24-48 hours. But we are not ready to sustain for a longer period of time without help."

In many ways post-9/11 threats loom larger than ever for these health-care workers-because now they know that worst-case scenarios can come true. Add to terror threats the related threat of biological and chemical sabotage, the prospect of citywide blackouts as occurred in August 2005, and the prospect of an influenza pandemic, and it's easy to see why this sort of health-care war-gaming is essential. This was the second year Downtown Hospital officials brought in public-health experts from Louisiana, acutely aware following Hurricane Katrina that total breakdown in emergency caregiving is possible.

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