By Dr. Sanjay Gupt
July 12 2010
It was hard to know what to expect a half-year after the Haiti earthquakes. Driving through the town of Port Au Prince a few days ago, rubble seemed to have been merely swept off the streets, and into alleyways. Debris and garbage had simply shifted around the city, more out of sight, but still present. It was like a college kid, knowing his parents were coming to visit, sweeping things under the rug and throwing things into closets. Things were frighteningly familiar.
I looked out the window, expecting to see the most awful and indelible images that I remembered during the first days after the earthquake. The bodies stacked high, in front of homes with parents searching frantically for a place for their dead children. At that time, children were seen everywhere, doing the same for their deceased parents. Thankfully, those images are for the most part gone.
In medicine, we think of things in the acute phase: stop the bleeding. The intermediate phase: recovery and follow up. And, in the chronic phase, it is about rehabilitation and building up. The acute phase is coming to an end, but without adequate resources and money, the intermediate phase will never happen. Talking to large relief organizations, it seems they are planning for the long-term chronic rehabilitation of the country, which may explain why only a small percentage of the money donated has actually been put to use. (see the breakdown here by organization). The concern, though, is that rehabilitation cannot happen, unless the resources are there to let the patients, and the country adequately recover.
For a while, there was a venting of compassion. At General hospital, the largest public hospital in Haiti, there was at one point too many doctors and too many supplies. People saw the need, and they opened their pocket books and booked their flights. I was often asked, “what can I do to help?” I said “wait 6 months, because too many people will forget, yet the need will still be there.” When I visited General hospital yesterday, there was hardly anything happening there. The operating tables that were donated looked desolate, and the rooms were empty. A handful of diligent Haitian nurses, who haven’t been paid in months, were trying to do the best they could with hardly any resources.
The largest private hospital in the city, which serviced the small percentage of Haitians that could pay for their health care, has chains on the doors and is shut down for business. Six months later, the need is still here, and in many ways, things are worse than ever.
It is true that clean water now exists in many places, and the predicted widespread outbreak of disease hasn’t happened. There are food distribution stations in many of the larger camps, and even schools that are starting up this summer. It is also true that many amputees are now walking around the rough roads of Port Au Prince with newly obtained prosthetic legs. But, too much has remained the same.
I saw a 6 month old girl, born just before the earthquake, who lay dying at Bernard Mevs hospital. She developed an infection, that untreated, turned into meningitis. Her head became large, as fluid had started to build up inside her brain, a condition known as hydrocephalus. She didn’t receive antibiotics in time, and now she was beyond treatment. The same stupid story. Six months later. Needless deaths, despite the generosity of millions all over the world. Source
Haiti: Key data on earthquake emergency relief published by MSF
Living conditions remain dire for thousands of Haitians
Published 08 July 2010
Six months after the January 12 earthquake in Haiti, the international medical humanitarian organization Médecins Sans Frontières (MSF) has published a report describing the organization’s largest ever emergency response. The report also describes the dire living conditions of Haitians today and provides an explanation of MSF’s commitment in years to come.
MSF’s medical work in Haiti has evolved during the past six months, from an emergency response to a wider range of medical and relief activities. “Haitians were the first to respond to this disaster and we have reinforced their effort with a massive aid intervention. Today, medical provision for Haitians has improved, and is certainly more accessible than before the earthquake, allowing poor people to receive proper health care,” explains MSF Head of Mission Stefano Zannini, who was already in Port-au-Prince when the earthquake killed and/or injured hundreds of thousands and left over a million people without shelter.
However, the situation for many Haitians is still hugely precarious, while frustration grows among people who are disappointed with the pace of rehabilitation. “There is a staggering gap between the enthusiasm and promises for aiding the victims of the earthquake in the early weeks, and the dire reality on the ground after half a year,” adds Zannini.
MSF’s report publishes figures on the scale of its relief intervention. Up to May 31, in the first 138 days following the disaster, MSF staff treated more than 173,000 people and performed over 11,000 surgical procedures. More than 81,000 Haitians received support to help them cope with their psychological trauma. MSF brought in almost 27,000 tents and distributed more than 35,000 relief kits.
In the report, MSF describes some of the choices which had to be made in the first few weeks following the earthquake. For example, the extremely high number of injuries forced teams to focus almost exclusively on the stabilisation of patients and emergency surgery at the expense of other crucial activities. Finding locations for temporary medical facilities was done in haste as there was little time for more in-depth assessments.
An extraordinary number of foreign aid workers had to be brought into the country quickly; two months after the earthquake MSF had over 350 international staff in Haiti, since many Haitian health workers were also victims of the earthquake. This put a huge strain on MSF’s human resources and management capacity. MSF was eventually able to reduce the number of foreign workers, as more Haitians were hired to work in the organization’s facilities. By the end of May, 93 percent of MSF staff-members on the ground were Haitians.
MSF also reports that, up to May 31, around C$120 million was received in donations from the public earmarked for Haiti relief. The organization spent $70 million by that same date, including more than $14 million on surgery, $5 million on maternal health (MSF helped deliver 3,700 babies) and over $11 million on shelter. MSF foresees that, by the end of the year, it will have spent around $118 million on assistance to the Haitian population.
Although there are uncertainties around the speed of reconstruction and the extent to which other organizations will still provide health care, MSF commits to continue working for the victims of the earthquake in years to come.
“Health care was already fragile in Haiti before January 12,” says Dr. Unni Karunakara, the International President of MSF. “The earthquake destroyed much of the medical services that were available. It will take many years before the country is back on its feet. MSF is determined to play our part in rebuilding health care for Haitians and will dedicate our staff and means to this task as required.”