Nightmare In Haiti Options

[alex]

Hoping to fly out with colleagues from IMC within 24 hours.*

Toss us a few bucks, eh?

Other organisations on the way




*conflicting reports, at this hour, re. extent of airports/hangar/roads damage. gotta be able to safely land and discharge our supply bird.

[alex]

At dawn's early light -

Very sad news continues to pour out of Haiti; brief updates:

- MSF clinics/hospitals in Port-au-Prince destroyed; some staff still un-accounted for

- Other NGOs on the ground have taken major hits, including UN peace-keeping mission (and UN's attendant agencies, such as UNICEF), along with a umber of private religious/medical missions

- Port-au-Prince civi airport open; tower OK, too - but no transport communications up-and-functional at this writing

- Red Cross reports that up to 3 million people may be injured, homeless, or dead

- Governments from around the world co-ordinating to get both search-and-rescue eqipment and nominal infrastructure set up so that Haiti is able to receive the multi-months (perhaps years) worth of aid she is going to need

- USNS Comfort (hospital ship) on the way

[alex]

From MSF

From From IMC

We need multi-capacity landing arenas; USS Carl Vinson (the first of more to follow, we hope) on the way.

[Capn Sunshine]

The National Palace in Port-au-Prince before and after earthquake crushed thousands of structures.

This was probably the best-built structure on the island.

PLEASE DONATE AT ONE OF ALEX'S LINKS

[alex]

Thanks, Cap

Additional note: most major newspapers, in their online editions, have posted links to rescue/relief organisations. Readers may select from any number of aid agencies.

Bear in mind two things:
- what is needed first, foremost, and always: clean water and medical facilities/supplies. In addition to MSF and IRC, I also recommend OxFAM, major world-wide supplier of portable water/sanitary systems.

- this will be an ongoing operation, like the tsunami of 2005

Every five bucks helps, folks.

[bozola]

Hoping to fly out with colleagues from IMC within 24 hours.*

Toss us a few bucks, eh?

Done.

[alex]

My heartfelt gratitude, Brother Boz

US SpecOps has set up communications at Port-auPrince airport; handful of supply planes (from Canada, Finland, and Iceland; coupla C-130s; S&R teams from Faifax Co. VA) actually landed earlier today.

There remain problems with transporting relief 'from here to there,' so to speak. We are dealing with increasingly dire conditions and desperate population; unfortunately, security concerns looming large on the horizon.

Coast Guard still assessing potential (or lack-thereof) for conducting fixed-wing missions. (My ed-ja-ma-ca-ted guess is that helos better suited for immediate tasks).

Turns out that our great floating bastion, USS Carl Vinson, left Norfolk with neither full complement of personnel nor choppers aboard. She's picking up some the latter on her way down, but will need pilots for those transports.

Yrs Trly has a date with (I hope) an MH-60S Knighthawk late tomorrow afternoon.

Which could turn out to be an MH-60R Seahawk

No matter: can we get an inflatable surgical unit into one of those birds? You'm betcha.

[Capn Sunshine]

Our Prayers are with you, Dr. Alex. I'm sure you're too busy to be posting for awhile.

[alex]

Our Prayers are with you, Dr. Alex. I'm sure you're too busy to be posting for awhile.

Home after three weeks - which, i' troth, feels more like three months spent in DRC

We are drops in a vast ocean.

May return in another couple of weeks. Working at health facilities in Artibonite region, where thousands of survivors walked - literally: people began walking out of PAP in immediate aftermath of quake - in search of sustenance and medical care.

Haiti remains desperately short of medical supplies - in particular, orthopedic provisions and reserves. The SO tells me that there is an organisation somewhere (website info, anyone?) gathering crutches, canes, and walkers to send.

All very much needed, as are follow-up support services for amputees.

Need physical therapists, occupational therapists, variety of prostheses and accompanying med personnel, and a g'zillion other diverse long-term care/support professionals.

Rainy season approaching. Lack of proper sanitation for tent cities causing quiet, mounting anxiety re. public health. . .

OxFAM doing best to provide clean water, latrines, personal hygiene/sanitary supplies, but the country is so 'broken' (ie: basic infrastructure remains stressed-to-non-existant), that best efforts may not prevent water-borne diseases in the weeks and months to come.

To that concern, a number of groups (Pan-American Health Organisation, WHO, UNICEF) have begun vaccination program for tent cities.

Thanks to everyone here for their care, concern, donations, suggestions, help, awareness, smarts, creativity and sense of humour.

[alex]

Poor Sanitation in Haiti’s Tent Camps Adds to Risk of Disease

- Simon Romero; NYT, 19 February 2010

PORT-AU-PRINCE, Haiti — As hundreds of thousands of people displaced by last month's earthquake put down stakes in the squalid tent camps of this wrecked city, the authorities are struggling to address the worsening problem of human waste. Public health officials warn that waste accumulation is creating conditions for major disease outbreaks, including cholera, which could further stress the ravaged health system.

Some American and Haitian public health specialists here consider the diseases stemming from the buildup of human waste in the camps as possibly the most pressing health threat in the city. Doctors are already seeing a spike in illnesses like typhoid and shigellosis, which arise from contaminated food or water.

"We're witnessing the setup for the spread of severe diarrheal illnesses in a place where the health system has collapsed and without a functioning sewage system to begin with," said Ian Greenwald, chief medical officer for a Duke University team of doctors working here this month.

The problem has become impossible to overlook in many districts of Port-au-Prince, with the stench of decomposing bodies replaced by that of excrement. Children in some camps that are still lacking latrines and portable toilets play in open areas scattered with the waste. The light rains here this week caused some donated latrines in the camps to overflow, illustrating how the problem would grow more acute as the rainy season intensified in the months ahead.

"Haiti's pigs live better lives than we do," said Dora Nadege, 28, as she wandered back to her tent camp in Place St.-Pierre from a ravine on the camp's edge, where its hundreds of inhabitants relieve themselves throughout the day in the open air. "When the rains come, we'll be lucky not to drown in our own excrement," said Ms. Nadege, a mother of four, who sold bread on the street before the earthquake.

Aid groups are trying to address the problem by distributing more than 10,000 latrines and portable toilets, and employing dozens of new desludging trucks to empty the toilets. But these solutions seem to be a stopgap measure, at best.

"It's a drop in the ocean of what's needed," said Jessica Barry, a spokeswoman for the International Committee of the Red Cross, which is distributing latrines with special sludge pumps. "You can have 100,000 latrines, but you need a way to remove the excrement."

With the number of people displaced here by the earthquake estimated at 700,000, emptying the latrines from one location creates a new problem when the waste is disposed in another. Haiti, a nation of 10 million, does not have a single sewage treatment plant. Trucks often simply take the waste to the Troutier trash dump near the slums of Cite Soleil on this city’s edge.

Read that boldened sentence again.

Haiti, a nation of 10 million, does not have a single sewage treatment plant.

Renders one speechless.



photos that accompany NYT story

[alex]

Lost Limbs Redefine Life for Thousands in Haiti

PORT-AU-PRINCE, Haiti —"Don't cut off my leg!" Fabienne Jean screamed repeatedly as they carried her through the gates of the General Hospital here after the earthquake. "I'm a dancer. My leg is my livelihood. Please, don’t take my leg."

After four days on the hospital's cluttered grounds, lying among what she described as the "dead and living all mixed up," Ms. Jean was wheeled into an operating tent where her crushed, infected right leg was amputated below the knee.

"It is a sad story," Ms. Jean, 31, a slim, graceful former dancer with the Haitian National Theater, said recently, massaging her bandaged stump. "But what can I do? I can't kill myself because of this, so I have to learn to live with it."

More than a month after the earthquake, thousands of new amputees are facing the bracing reality of living with disabilities in a shattered country whose terrain and culture have never been hospitable to the disabled.

Some remain in hospital tents swarming with flies; others have moved to makeshift post-surgical centers; and those who healed quickly, like Ms. Jean, have been discharged to the streets where they now live. All need continuing care in a nation with no rehabilitation hospital, few physical therapists, no central prosthesis factory since the quake and a skeletal supply of crutches, canes and wheelchairs gradually being reinforced by donations.

[snip]

Rough estimates of the number of new amputees are based on information from overburdened hospitals that did not keep good records of surgeries. The Haitian government believes that 6,000 to 8,000 people have lost limbs or digits. Handicap International estimates that 2,000 to 4,000 Haitians underwent amputations, and many thousands more suffered complicated fractures, some of which could turn into amputations if not managed well.

[snip]

Haiti's disabled — some 8 percent of the population even before the quake — had long been treated as second-class citizens. But the government has recently taken legal steps to recognize their rights and opened offices to serve them in the countryside, he said.

[snip]

For the moment, though, the urgent focus is on the uncertain present: making sure the thousands who underwent life-saving amputations have a future.

Handicap International, based in France, has been coordinating the postdisaster rehabilitation effort with CBM, a Germany-based Christian disability group, and with the Haitian government. Its volunteers — about five dozen therapists, nurses, technicians and community workers — have been providing postsurgical care and physical therapy at 12 hospitals here, and the organization is setting up a prosthetics workshop, too.

"We know that persons with injuries and disabilities are going through a difficult time right now, but they should not feel they're alone," said Aleema Shivji, an emergency response specialist with the group. "There are services available, and they’re increasing by the day."

Recently, Caryn Brady, a physical therapist from Canada, made rounds through the sweltering postoperative tents outside the General Hospital. The patients there are being seen by such a revolving cast of international medical professionals, with charts so poorly kept, that scribbled messages on bandaged stumps communicate the essentials: "See again on Feb. 23. Thanks. (Smiley face.)"

Bedside, Ms. Brady led Emmanuel Souverain, a university student whose right arm was amputated above the shoulder, through a series of exercises meant to prevent contractures and keep his muscles healthy for a prosthesis — although there is no plan yet to manufacture upper-body prosthetics.

[full article at link, above]

Second only to public health concerns (ie, issues surrounding lack of access to clean water, waste treatment and sanitation) is emerging crisis for new population of amputees.

A thousand thanks to forum administration for pinning this thread so that we can all continue to add information and post commentary as situation evolves during the course of these next few months.