Hurricane Katrina: What's going on? What are others doing to help? What can you do?
Centers For Disease Control
Guidance for health care providers
Top
Private email
|
N'Orleans News from My-Godson-the-ParamedicDT got home from New Orleans late Sunday morning [Sept 4,'05] and we chatted by phone for the better part of an hour. Here are the highlights-- He says the news can't give you a feeling for what it's really like because the reporters zone in on tiny areas and emphasize the high drama bits. He says there's not so much in the way of these intense incidents, but the low level misery just goes on and on and on... mile after mile after mile after mile after... He was working in a team of four, two Paramedics and two EMT's (emergency med techs), assessing/triaging/treating/transporting easily 400 people himself on a shift, spending mere seconds on most, a few minutes on others. As a clue to how little you can do in these circumstances, of all of the folks he handled over three full days+, only a dozen or so received IV's. You're down to basics, and Medic rules of thumb in mass casualty go like this-- BloodPressure over 70 could do without it, under 60 was probably hopeless anyhow and you couldn't waste either the supplies or the time. A seizure of less than a minute, once a day, most likely wouldn't recur, at least not for another day; multiple seizures or those lasting longer required more immediate attention. He worked out of an area called Kenner, by the airport west of New Orleans old French Quarter, using the I-10 as a conduit. Where they could drive their ambulance, they did. Where they couldn't, they used boats. I used the word 'commandeered' but he said no, it wasn't like that. People were glad to let you. If they could get their boats into the water intact, they did, and made them available for you. He said that in his opinion, people weren't shooting at them, either. There were shots, all right, but he said look at it like this-- there are people stranded on roofs and in attics, and they see me going by in a boat... and I disappear! They can't see where I'm headed to. How are they going to attract my attention? They fired down into the water, not up into the air, and never hit a single boat, didn't even ever fire *ahead* of the boats. On the other hand, one ambulance crew did get abducted for a night... guys were looking for drugs and hoped to find those on board the ambulance... or perhaps in some hospital if the crew could get them in... anyway they wound up letting them go okay by morning... There are 38 bridges in the area, and each was packed with anywhere from 600 to 2000 people. Now, you can't land a chopper in a crowd like that with nowhere for the people to run, it's hard to lift people on a hover, and a helicopter can only carry around 5 passengers anyway, along with the crew -- plus their downdraft tends to blow people *off* the bridges.... So, boats. The boats were all sorts, whatever was still floating and had a motor... they ranged in size from a little 24 horsepower motor to big engine cruisers... and could carry 5 to 10 people away at a time. Travel in the boat would proceed for half a block or so, then you'd stop, tilt the motor up, pull a plastic garbage bag or some other detritus off it, and go again, another half a block.... Health Problem #1 The biggest health issue he had to treat was, without a doubt, dehydration. No drinkable water - for days on end - leads to kidney damage, especially in children and the elderly, but really everybody. Health Problem #2 Second most common health problem turned out to be burns... chemical burns! The flood water isn't just full of sewage, it's full of gasoline and oil. People couldn't wade through the water without getting coated in it, and their legs, especially, were all red and cracked... the tenderer skin of children and old folks was blistering. He broke into a convenience store ("Allowed Looting", he called it, laughing) and got every bottle he could of 409 and all those sorts of degreasers. You suds it on, rinse it off, do it again and again. I asked about water treatment... like iodine, or how anyone could possibly boil water under those conditions... he said on most bridges people had managed to bring little BBQs and charcoal and they were using it to boil water as best they could... he had a rather dubious ring to his voice there though... Then of course there's a need for food, ongoing meds, clean/dry clothes to change into... he said if you wanted to send something other than money, what's needed is shoes! All kinds, any kinds, they just don't have 'em... got drenched, swept away... can't go barefoot... He went down there feeling cleverly prepared, extra socks and things to change into for each of the days... gave 'em all away. Came home wearing what he went down there in. Gave away all his packets of snacks, too. How could you not, he said, after all, you're so-o-o aware that *you* only have to deal with it for four days or so... and then you've got a real home waiting for you. Top Functional Problem The biggest functional problem is communication. There just isn't any. You're cut off. Victims & workers alike... no tv, no cellphones (towers down)... so it's hard to communicate beyond your own group, and you don't know what's being broadcast at all. The victims certainly don't! They're not getting any bulletins telling them what to do. He said he now knows for a fact that he can move 14 firemen at a time sitting up on the beds in his ambulance! As near as he could tell, race did NOT enter into it. His area was full of all sorts, he said, black, white, mexican, every combination... he said the only group he noticed missing was asian... he just didn't see any there. DT's a nice mixture himself. Black/norwegian/english extraction... a lot of people figure him for Latino. I've always suspected with a tinge of envy that this melange is a decided advantage... he can deal completely comfortably with everyone. And DT himself is fine. They were bunked down in a big dorm and a catering company fed them all they could eat... good stuff, he said, catfish, fries, spaghetti... I mentioned he didn't seem to have noticed anything green; should've known better... this is DT, the original non-veggie kid... but he assured me those were there too, and that everything was pretty well prepared (translation probably = "with gravy"). He said the first night was the only time you were actually hungry though... after that you ate just enough to settle your stomach and then laid your body down to get what sleep you could (a nap) before someone came in calling your group number and telling you where you were needed again. He actually managed to get several decent hours sleep before the trip home, tho' he'd only gotten to sleep in two to three hour snatches for the three full days he was down there (Wednesday night to Saturday night). His mom was afraid he would come back changed. I'd questioned that, saying, he's in his thirties and has seen it all before anyhow, but, as she pointed out, not in such quantity all at once -- this is *mass* casualty. Naturally I pestered him for input on that. He says he's not changed - just tremendously aware of how lucky he is to be able to come home to our usual comforts - shower, hot meals, clean clothes, comfortable chair, tv... but, he says, the residents down there *are* changed, forever. He doesn't know if he's going back or not but that's not due to any reluctance on his own part, it's company policy on rotation, and in any event he won't be needed for at least a couple weeks yet, when they'll shift to transport mode (shuffling patients between various hospitals). I asked what if anything --besides sending money of course-- we could do if we were to go down there... clerking at least? Not yet, he said. There are more volunteers coming in than they know what to do with (except docs... those they know what to do with, but even doctors are dreadfully limited without facilities and power)... Non-trained types had so little to do that some of them took to washing the ambulances! ... he came out to his and found it all shiny and even sweet smelling inside! I asked him what, besides "send money" (& shoes), he'd like me to say to or ask of all of you... he didn't hesitate much, said just pray... said it was all you can really do, and they need it... they need it... --G. Web MD Disaster Relief, FirsthandThursday, September 08, 2005 By Brunilda Nazario, MD http://my.webmd.com/content/article/111/109982.htm WebMD Medical Editor Brunilda Nazario, MD, spent three days at shelters in the Atlanta area – and was shocked at the inadequate resources. America is not prepared for disaster, she says. I’m not associated with the Red Cross. But when evacuees began pouring into the Atlanta area, I volunteered to see patients at a temporary Red Cross shelter set up just south of Atlanta. At that time there were no doctors at the center to see the patients; this was only the first stage for many of the arrivals here. Many evacuees were elderly and had special needs; they left their homes prior to the hurricane with the expectation of returning soon. The medical needs at the center initially included assisting older people and helping to arrange daily medications and routine medical care. Basic needs like calling in prescriptions for chronic medical conditions became a tremendous task. Sharing my experience in the aftermath of Katrina may highlight glaring examples of a serious lack of preparedness in this country. Many basic first aid supplies, such as over-the-counter disinfectants for superficial wounds and scrapes, a container for needle disposal, and accessible telephone lines were unavailable. In one makeshift shelter, televisions, radios, and newspapers weren’t available to help keep the victims informed about the disaster. While the rest of the world stayed glued to the media coverage of the disaster, the victims themselves were left with questions about what was going on. Despite the power of medical advances in this country, we did not have sufficient medical manpower mobilized to handle this major natural disaster. As the days passed, a very different group of individuals were being seen in the shelter; a local hospital facilitated medical care during day hours. Nighttime hours, however, were without medical care. Stories of individuals caught in the hurricane were heard everywhere. Bruises, blisters, scrapes, and extreme emotional and physical fatigue were surfacing. People were now coming from New Orleans and Mississippi, and different emotions were beginning to emerge -- denial (as a way to deal with this reality) and anger directed at the staff were reactions being expressed. Elderly victims expressed confusion, teens revealed depression, and parents attempted to provide reassurance with few social resources to help them. The lack of this country’s preparedness is completely unacceptable. I also want to share stories of people I met at the shelters -- especially one New Orleans nurse who braved the rising waters in a children’s hospital before driving hours and hours to Atlanta. In her, I saw the mental distress we will find in many more survivors. She made it through the storm but now must deal with a painful replay of memories. Total Chaos at Shelter When I showed up at the refugee center on Sept. 1, there was a lot of chaos outside as well as inside the facility. There were probably 800 refugees at that center. The parking lot that was jam-packed, and the outpouring of donations was more than the facility staff could handle. People were milling around. People were dropping off lots of donations; there were clothes bags, food and water even on the sidewalk outside. No one could identify who escaped the disaster and who was here to volunteer. Some people from the nearby neighborhoods were walking in and taking the donations. The situation not only was chaotic, it was dangerous. Officers and security initially were nowhere to be seen. No single team was set up to control or coordinate this effort. The positive aspects of this shelter: There were several televisions, which allowed people to congregate -- to watch the coverage, and talk about their experiences. The sleeping area and cots were grouped together to form little communities. I think it helped people feel more comfortable. There was a nurse’s office that was an adequate size to see patients. But one big problem surfaced quickly -- there was no phone jack. We had many elderly people who had run out of medications and needed new prescriptions called in, but we had no phone! We had my cell phone, but my battery was pretty drained. One patient had a history of seizures from a previous gunshot wound to the head; he hadn’t taken medication for several days. The problem with seizure medications is that you have to maintain a certain blood level, so not having taken his medications for a few days made him a high-risk patient that the medical personnel needed to be aware of. He was awaiting the arrival of his medications, which would take a few days. A second high-risk patient had diabetes. She also had open heart surgery just a week before I saw her. She didn’t have her insurance papers, so we couldn’t get insulin for her. But she came with relatives, so she was sharing some of their insulin. Her surgical incision was clean but oozing. The stress of the disaster situation and her lack of insulin would increase the risk of infection to her wound. The shelter’s initial first aid kit had no form of antiseptic – no betadine, no iodine, no hydrogen peroxide. I was shocked and angry at this lack of basic first aid supplies. It is completely unacceptable. Trauma Among Refugees Over the next two days, we began seeing those who weathered the storm but were able to get out of New Orleans. A mother said she had just started walking with her children. They had minor bruises, cuts, scrapes, foot blisters, sores, as well as fungal skin infections and rashes from walking in the dirty water. These were fairly healthy people, with no acute medical crises. But we were beginning to see significant psychological stress. I saw the most significant case of post-traumatic stress disorder (PTSD) in a nurse who had been working at the children’s hospital. She went through the whole storm, seeing patients, seeing the water rising, hearing the rioting, and had been scared for her life. She and her family had planned to spend Labor Day weekend in Atlanta with her father. They knew the storm was coming, and her husband took the kids and headed for Atlanta. She was to follow later. At the last minute, they switched cars -- she got the larger car, which she didn’t want because it was harder to park. She had $12 in her purse when she left the house that morning. She and her co-workers (and patients) rode out the storm. They were lucky, she said. They had a lot of generators there, plenty of water, plenty of food -- although it certainly wasn’t good-tasting food. She had a pretty good sense of humor as she started the story. But as she continued, and the memories replayed the trauma in her mind, she broke down. Her eyes showed despair, and she shook uncontrollably as she recounted her story of survival. She was getting into a traumatic state – really reliving everything that happened, all her fears. There were a couple of kids they had to airlift out, but there was nowhere for the helicopters to land. The hospital staff cut down a few bamboo trees around the hospital to help stabilize the ground and created a stable walkway. They got a child with cerebral palsy onto a gurney and down the bamboo pathway to where the helicopter could pick him up and transfer the child to a safe care facility. In their nursing unit, the staff felt safe. They were listening to the news, to the warnings of armed looters. Anytime they went into the hall, they had no idea who was there, she told me. At one point, she and her co-workers were told they had to evacuate. They pooled their money together -- $7 from one, $3 from another; she had $12. Luckily, she discovered, she also had a full tank of gas in that big car. As they drove off, a man approached the car. They just froze and didn’t know if he was going to hijack the car or what. She was in mission mode, and kept driving, kept driving, kept driving. She said it was a quiet ride up to Atlanta. They made one stop on the way up, at an IHOP or something. Someone overheard them talking and said she wanted to pray with them. At this point in telling her story, the woman began to break down. She began to realize what she had been through. She remembered the 18-wheelers coming by with generators, the helicopters, the shooting. She remembered the image in her rear-view mirror of the scene she left behind, like a war zone. She also remembered the smell. When she arrived in Atlanta, she ate some macaroni and cheese, probably the most unhealthy thing you can eat. But she had been so tired of eating Jell-O and the hospital food. The comfort food tasted really good to her. Worst-Case Scenario Within a couple of days, this New Orleans nurse and the other refugees had to be transferred to a different shelter -- a sports dome at Georgia Tech University in downtown Atlanta. That change stirred up real problems. The Georgia Tech volunteers initially looked at this strictly as a shelter and would not allow the same services to be given to the victims, including medical services. The facility itself was the worst set-up for these people, most of whom were elderly. They had to go down steep stairs into the playing field, where cots were set up barracks-style. These cots were very low to the ground -- just a few inches off the ground. I could see instantly that elderly people would have a hard time lying down on them and getting back up. They could easily trip and fall on these cots, because they were set so close together. Eventually they took some of the better cots from a shelter at the natatorium, but it took some convincing. Even though it had been chaotic in the natatorium, at least it felt more like a home and we were allowed to handle medical problems. Refugees in Shock, Anger Also, many of the volunteer staff did not understand the emotional state that occurs when a disaster of this nature occurs. There are stages you expect people to go through. The first stage is usually denial. These people were still in shock. The next stage is anger. If you’re a volunteer, you have to be prepared for people to be angry at you. It’s not that they’re angry at you -- they’re angry at the situation. You have to accept that and let them vent, because it’s part of the healing process. The evacuees were told they had to shut off TVs at 11 p.m., that they had to go to bed. One woman said, “I’m not turning off that TV. I lost five children.” She, like the others, was feeling anger, shock, and was beginning to realize what had happened. You could see it on their faces: “Now [we] have nothing – yet this is what’s being done to us.” I visited another shelter later on – a camp with buildings for housing 400 people. This shelter was staffed with a few nurses, a psychiatrist, a pediatric doctor, and a primary care doctor. The next day, a cardiologist was there. That shelter was the best-prepared from an organizational standpoint. My bottom-line message is this: This country is not prepared. We don’t have enough medical personnel to help people in a major disaster. Even when doctors try to help, there is no one in charge to facilitate the process. We need to roll up our sleeves and do what needs to be done. Brunilda Nazario, MD, is a medical editor for WebMD. Her opinions and conclusions are her own.
DirectNIC
|
A New Orleans based Blog of Katrina & Recovery
There are 3 employees, the president & VP
for operations & head of security, of DirectNIC in NO who are holed
up in their building on Poydras, which is downtown, not far from
Charity Hospital. Mike, the head of security, has been running a blog
the whole time. |
||||||||||||||||||||||||||||||||||||||||||||||||
Stratfor New Orleans: A Geopolitical PrizeBy George Friedmanhttp://www.stratfor.com/news/archive/ 050903-geopolitics_katrina.php The American political system was founded in Philadelphia, but the American nation was built on the vast farmlands that stretch from the Alleghenies to the Rockies. That farmland produced the wealth that funded American industrialization: It permitted the formation of a class of small landholders who, amazingly, could produce more than they could consume. They could sell their excess crops in the east and in Europe and save that money, which eventually became the founding capital of American industry. But it was not the extraordinary land nor the farmers and ranchers who alone set the process in motion. Rather, it was geography -- the extraordinary system of rivers that flowed through the Midwest and allowed them to ship their surplus to the rest of the world. All of the rivers flowed into one -- the Mississippi -- and the Mississippi flowed to the ports in and around one city: New Orleans. It was in New Orleans that the barges from upstream were unloaded and their cargos stored, sold and reloaded on ocean-going vessels. Until last Sunday, New Orleans was, in many ways, the pivot of the American economy. For that reason, the Battle of New Orleans in January 1815 was a key moment in American history. Even though the battle occurred after the War of 1812 was over, had the British taken New Orleans, we suspect they wouldn't have given it back. Without New Orleans, the entire Louisiana Purchase would have been valueless to the United States. Or, to state it more precisely, the British would control the region because, at the end of the day, the value of the Purchase was the land and the rivers - which all converged on the Mississippi and the ultimate port of New Orleans. The hero of the battle was Andrew Jackson, and when he became president, his obsession with Texas had much to do with keeping the Mexicans away from New Orleans. During the Cold War, a macabre topic of discussion among bored graduate students who studied such things was this: If the Soviets could destroy one city with a large nuclear device, which would it be? The usual answers were Washington or New York. For me, the answer was simple: New Orleans. If the Mississippi River was shut to traffic, then the foundations of the economy would be shattered. The industrial minerals needed in the factories wouldn't come in, and the agricultural wealth wouldn't flow out. Alternative routes really weren't available. The Germans knew it too: A U-boat campaign occurred near the mouth of the Mississippi during World War II. Both the Germans and Stratfor have stood with Andy Jackson: New Orleans was the prize. Last Sunday, nature took out New Orleans almost as surely as a nuclear strike. Hurricane Katrina's geopolitical effect was not, in many ways, distinguishable from a mushroom cloud. The key exit from North America was closed. The petrochemical industry, which has become an added value to the region since Jackson's days, was at risk. The navigability of the Mississippi south of New Orleans was a question mark. New Orleans as a city and as a port complex had ceased to exist, and it was not clear that it could recover. The Ports of South Louisiana and New Orleans, which run north and south of the city, are as important today as at any point during the history of the republic. On its own merit, POSL is the largest port in the United States by tonnage and the fifth-largest in the world. It exports more than 52 million tons a year, of which more than half are agricultural products -- corn, soybeans and so on. A large proportion of U.S. agriculture flows out of the port. Almost as much cargo, nearly 17 million tons, comes in through the port -- including not only crude oil, but chemicals and fertilizers, coal, concrete and so on. A simple way to think about the New Orleans port complex is that it is where the bulk commodities of agriculture go out to the world and the bulk commodities of industrialism come in. The commodity chain of the global food industry starts here, as does that of American industrialism. If these facilities are gone, more than the price of goods shifts: The very physical structure of the global economy would have to be reshaped. Consider the impact to the U.S. auto industry if steel doesn't come up the river, or the effect on global food supplies if U.S. corn and soybeans don't get to the markets. The problem is that there are no good shipping alternatives. River transport is cheap, and most of the commodities we are discussing have low value-to-weight ratios. The U.S. transport system was built on the assumption that these commodities would travel to and from New Orleans by barge, where they would be loaded on ships or offloaded. Apart from port capacity elsewhere in the United States, there aren't enough trucks or rail cars to handle the long-distance hauling of these enormous quantities -- assuming for the moment that the economics could be managed, which they can't be. The focus in the media has been on the oil industry in Louisiana and Mississippi. This is not a trivial question, but in a certain sense, it is dwarfed by the shipping issue. First, Louisiana is the source of about 15 percent of U.S.-produced petroleum, much of it from the Gulf. The local refineries are critical to American infrastructure. Were all of these facilities to be lost, the effect on the price of oil worldwide would be extraordinarily painful. If the river itself became unnavigable or if the ports are no longer functioning, however, the impact to the wider economy would be significantly more severe. In a sense, there is more flexibility in oil than in the physical transport of these other commodities. There is clearly good news as information comes in. By all accounts, the Louisiana Offshore Oil Port, which services supertankers in the Gulf, is intact. Port Fourchon, which is the center of extraction operations in the Gulf, has sustained damage but is recoverable. The status of the oil platforms is unclear and it is not known what the underwater systems look like, but on the surface, the damage - though not trivial -- is manageable. The news on the river is also far better than would have been expected on Sunday. The river has not changed its course. No major levees containing the river have burst. The Mississippi apparently has not silted up to such an extent that massive dredging would be required to render it navigable. Even the port facilities, although apparently damaged in many places and destroyed in few, are still there. The river, as transport corridor, has not been lost. What has been lost is the city of New Orleans and many of the residential suburban areas around it. The population has fled, leaving behind a relatively small number of people in desperate straits. Some are dead, others are dying, and the magnitude of the situation dwarfs the resources required to ameliorate their condition. But it is not the population that is trapped in New Orleans that is of geopolitical significance: It is the population that has left and has nowhere to return to. The oil fields, pipelines and ports required a skilled workforce in order to operate. That workforce requires homes. They require stores to buy food and other supplies. Hospitals and doctors. Schools for their children. In other words, in order to operate the facilities critical to the United States, you need a workforce to do it -- and that workforce is gone. Unlike in other disasters, that workforce cannot return to the region because they have no place to live. New Orleans is gone, and the metropolitan area surrounding New Orleans is either gone or so badly damaged that it will not be inhabitable for a long time. It is possible to jury-rig around this problem for a short time. But the fact is that those who have left the area have gone to live with relatives and friends. Those who had the ability to leave also had networks of relationships and resources to manage their exile. But those resources are not infinite -- and as it becomes apparent that these people will not be returning to New Orleans any time soon, they will be enrolling their children in new schools, finding new jobs, finding new accommodations. If they have any insurance money coming, they will collect it. If they have none, then -- whatever emotional connections they may have to their home -- their economic connection to it has been severed. In a very short time, these people will be making decisions that will start to reshape population and workforce patterns in the region. A city is a complex and ongoing process - one that requires physical infrastructure to support the people who live in it and people to operate that physical infrastructure. We don't simply mean power plants or sewage treatment facilities, although they are critical. Someone has to be able to sell a bottle of milk or a new shirt. Someone has to be able to repair a car or do surgery. And the people who do those things, along with the infrastructure that supports them, are gone -- and they are not coming back anytime soon. It is in this sense, then, that it seems almost as if a nuclear weapon went off in New Orleans. The people mostly have fled rather than died, but they are gone. Not all of the facilities are destroyed, but most are. It appears to us that New Orleans and its environs have passed the point of recoverability. The area can recover, to be sure, but only with the commitment of massive resources from outside -- and those resources would always be at risk to another Katrina. The displacement of population is the crisis that New Orleans faces. It is also a national crisis, because the largest port in the United States cannot function without a city around it. The physical and business processes of a port cannot occur in a ghost town, and right now, that is what New Orleans is. It is not about the facilities, and it is not about the oil. It is about the loss of a city's population and the paralysis of the largest port in the United States. Let's go back to the beginning. The United States historically has depended on the Mississippi and its tributaries for transport. Barges navigate the river. Ships go on the ocean. The barges must offload to the ships and vice versa. There must be a facility to empower this exchange. It is also the facility where goods are stored in transit. Without this port, the river can't be used. Protecting that port has been, from the time of the Louisiana Purchase, a fundamental national security issue for the United States. Katrina has taken out the port -- not by destroying the facilities, but by rendering the area uninhabited and potentially uninhabitable. That means that even if the Mississippi remains navigable, the absence of a port near the mouth of the river makes the Mississippi enormously less useful than it was. For these reasons, the United States has lost not only its biggest port complex, but also the utility of its river transport system -- the foundation of the entire American transport system. There are some substitutes, but none with sufficient capacity to solve the problem. It follows from this that the port will have to be revived and, one would assume, the city as well. The ports around New Orleans are located as far north as they can be and still be accessed by ocean-going vessels. The need for ships to be able to pass each other in the waterways, which narrow to the north, adds to the problem. Besides, the Highway 190 bridge in Baton Rouge blocks the river going north. New Orleans is where it is for a reason: The United States needs a city right there. New Orleans is not optional for the United States' commercial infrastructure. It is a terrible place for a city to be located, but exactly the place where a city must exist. With that as a given, a city will return there because the alternatives are too devastating. The harvest is coming, and that means that the port will have to be opened soon. As in Iraq, premiums will be paid to people prepared to endure the hardships of working in New Orleans. But in the end, the city will return because it has to. Geopolitics is the stuff of permanent geographical realities and the way they interact with political life. Geopolitics created New Orleans. Geopolitics caused American presidents to obsess over its safety. And geopolitics will force the city's resurrection, even if it is in the worst imaginable place. Stratfor is "relied upon by multinational corporations, private investors, hedge funds, and even Government's own spy agencies" --Fortune Magazine |
||||||||||||||||||||||||||||||||||||||||||||||||||
National Geographic
Louisiana's Wetlands:
By Joel K. Bourne, Jr. |
||||||||||||||||||||||||||||||||||||||||||||||||||
A service of
designwest.com
|