Introduction

Hurricanes develop in the trade wind zone over sea, when the water temperature rises above 79.7 °F. A temperature difference between sea level and high heights might lead into a tropical whirlwind. A hurricane develops air speeds of more than 75 mph (rotation speed) according to the wind force of 12 Beaufort. The moving speed of the swirl is only 9.32 - 18.64 mph. The circumference of the storm can be hundreds of square miles. Hurricanes can stay active for weeks and devastate areas of thousands of square miles. The yearly time of origin is limited from May to December (Kim et al., 2009).

The City of Galveston is settled in the greater Houston area, about 50 miles southeast of Houston, Texas on an elongate offshore island in the Gulf of Mexico. This island is the south boundary of the Galveston Bay and the Houston Ship Channel. In September 1900 a hurricane devastated Galveston, destroyed much of the city and claimed the lives of approximately 6,000 to 8,000 people. At that time the average elevation of the island was only slightly above sea level. After the storm Galveston was rebuilt at a raised level and further protected from the sea by a concrete seawall that rises 17 feet above mean low tide (Alperin, 1977). The University of Texas Medical Branch (UTMB) was founded in the year of 1891. Today UTMB consists of four schools (Medicine, Nursing, Health Professions and Graduate School), seven hospitals on campus, as well as three institutes and a network of more than 100 campus and community based clinics. Although not owned or operated by UTMB, the campus is also home to the Shirner's Burn Hospital, which is staffed by UTMB faculty and researchers. The number of employees is approximately 13,000, plus 2,900 students. Furthermore, the Galveston National Laboratory, which is one of two biodefense laboratories of the US government is located on campus. UTMB is also the site of a regional Level-1 trauma center and the University's annual budget is approximately $1.6 billion (Sexton et al., 2007) . In September 2005 UTMB was threatened by hurricane Rita. Abandoning its historic practice of sheltering patients and staff in-place or clearing the hospital of all but the sickest patients, UTMB rapidly organized and conducted the first total evacuation in its 114-year history. Threatened for the first time by the possibility of a category five hurricane with a 20-feet storm surge that carried the potential to inundate the island. UTMB's leadership was determined to avoid the disastrous effect of hurricane Katrina seen in New Orleans only weeks earlier. Three days before landfall the incident command center which functioned as the decision-making and communication hub throughout the storm, was activated as specified in the UTMB emergency operations plan. The primary spokesperson and sole person responsible for the evacuation, was the Incident Commander who lead UTMB through this challenging event. However, the evacuation went smoothly and was successful. Hurricane Rita caused only minor damage on Galveston Island and the UTMB campus. Therefore, the clinical and scientific staff could resume work less than one week after the landfall of Rita. Just three years later in September 2008, UTMB was again threatened by hurricane Ike and again had to be evacuated (Maybauer et al., 2009). In the following we will report how this was accomplished, what impact Ike had on Galveston Island and UTMB, and what lessons were learned from both hurricane evacuations.

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