Haiti: Ripples

(10 am. – promoted by ek hornbeck)

Conditions are improving, slowly, steadily, 3 weeks after the earthquake but we have a really long way to go. The rainy season is coming in a other month and there is a need to provide shelter and sanitation needs that must be addressed quickly.

After enduring delays in receiving urgent medical supplies and equipment, as well as continuous aftershocks that threatened already-damaged facilities, MSF staff are now treating patients inside an inflatable hospital.

Originally the plan was to keep the Inflatable Hospital open for 3 months. It was then extended to 6 months, now, the plan is to keep it open indefinitely and expand it from 100 beds to 200 beds by adding 4 more sections to the already existing 9.

Now cross posted at The Wild Wild Left

The focus changes, the needs expand.

Haiti: Immediate and Long-term Health Needs

Every natural disaster unfolds a bit differently and the priorities in Haiti are evolving. In the beginning we saw large numbers of trauma and wounds and crushing injuries. We have for the most part passed the acute surgical phase that addressed those needs. Infected wounds and fractured bones are now a serious concern.

The concentration now is on wound infections, tetanus, communicable diseases and sanitation. Clean water and sanitation are essential to preventing the spread of disease and infections.

Medical facilities such as they are are now being hit with the second surge of patients

Doctors brace for second surge

At the Médecins Sans Frontières makeshift tent hospital in the poor district of Cité Soleil, there is a relative lull from the deluge of severe trauma cases that poured in in the first days.

But in a land where misery rarely takes lengthy holidays, medical personnel are bracing for a new flood of the dying and diseased.

“There is going to be a second wave,” said Anne Khoudigcoff, a registered nurse and medical co-ordinator with MSF from Belgium.

“The people who couldn’t get to us before, those who had fractured bones that broke the skin or open wounds that are now becoming infected, they are starting to come in.”

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n the first five days, they treated 1,000 patients a day with crushed limbs and pelvises, head traumas and torn flesh. The four surgeons, four anaesthesiologists and 10 operating room nurses worked 24 hours a day, performing 130 operations.

Now they treat 250 patients a day, with less serious cases transferred to the Canadian team of 19 doctors and nurses and others working with Médecins du monde next door, treating about 400 daily.

Besides the inflatable hospital, there are other locations throughout Port au Prince, as well as, outside the city.

Haiti: As Situation Evolves, So Do Services

In Port-au-Prince, for instance, surgeons at the two school buildings now serving as the “New Carrefour Hospital”-the quake and its aftershocks rendered the original hospital unsafe-performed 40 operations on Wednesday. In the Carrefour Feuille neighborhood, where 9,000 people are living in temporary shelters, a team consisting of two nurses, a doctor, and an obstetrics specialist are running a clinic in a tent, tending to both people with injuries from the quake and also people afflicted with diarrhea and fevers.

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In area called Delmas 30, a post-operative “village” has been assembled in tents, a place people who were operated on elsewhere can rest and recover.

snipSimilar services are available in a former kindergarten known as “Mickey” that is now a 60-bed facility. There are another 30 beds in Bicentenaire, and a former secondary school in the Champs Mars area is now a clinic that will provide inpatient accommodations as well. Outside Port-au-Prince, in the hard-hit town of Jacmel, MSF is working with the local hospital to provide care in their building and in tents surrounding it.

MSF is also supplying clean water to these locations

One important part of recovery is addressing the psychological, post operative and nutritional needs.

Haiti: MSF Teams Adapting to Needs on the Ground

The wider and longer-term consequences of the disaster are also very much on the agenda of MSF teams. The psychological impact of the disaster is becoming more apparent in the symptoms being seen at MSF’s general clinics; one, in Leogane, reported that approximately half of the people receiving treatment were suffering from mental trauma. Nutritional deficiencies are also becoming readily visible. Near MSF’s hospital in Carrefour, where the medical staff has been running clinics for the people in the surrounding areas, teams are starting to provide supplementary feeding programs for some of the children.

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At the same time, MSF’s efforts to expand its services are ongoing. The team that recently built MSF’s inflatable hospital in Port-au-Prince is now working on a plan to create a post operative “village” in the city. The wards would again be made of canvas, thus alleviating the fears many people still have of being inside a building if another quake hit. The village will provide nursing care and wound dressing along with physiotherapy and psychological assistance for approximately 100 post-operative patients.

None of this could be accomplished without the wonder Haitian staff that is the backbone of operations here. Despite the loss of colleagues, their own family members and even persona injury, they have continued to take care of the sick and injured.

Haitian Staff Determined To Help Their People

PORT-AU-PRINCE – Haitian surgeon Dr. Philippe Brouard has worked with Doctors Without Borders/Médecins Sans Frontières (MSF) at Trinité hospital in Port-au-Prince since 2006. On January 13, the morning after the earthquake, he came to work at the trauma surgery centre only to find that most of Trinité had collapsed. Two of his colleagues and several patients had been killed. MSF had immediately evacuated surviving patients from the hospital and was treating them outside, while wounded people from the surrounding areas flooded toward what was left of the hospital. Dr. Brouard performed triage on that first day, identifying patients who needed urgent medical attention. By the second day, he was doing amputations in an improvised operating theater because the ones inside the decimated structure could no longer be used.

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Unlike Dr. Brouard, many other Haitian staff-members lost their homes and family members. Charles Joseph, a social worker at MSF’s Martissant hospital, lost a cousin and his entire house in the earthquake. “Now we are in the streets with the children, my wife, everyone,” he says. “I have come to work because this is a disaster and it is my business. It is everyone’s business. If people from other countries can risk their lives and come here to cure people-me, as a Haitian, I must do the same.”

Wednesday, January 26

Our driver Christobal and I had a moment to chat this morning before we got back on the road. I asked him – as I asked all our staff – about his experience during the earthquake. He explained that although his house had been destroyed, his wife and two young sons survived, and they now sleep in the street like everyone else. But he went on to tell me an incredible story.

The day after the earthquake, when he showed up at the MSF office, he learned that one of our expats (international staff) was buried alive after the house she lived in was destroyed. One of Christobal’s colleagues had heard her muffled yell from deep in the basement, below the two floors that had crashed on top of her. Christobal with three other colleagues convinced the MSF head of mission to let them dig her out of the house with their bare hands. The alternative was to wait for a clean-up crew with a crane and truck but the probabilities of that team showing up were at best 48 hours, at worst, several days. They could not accept to wait that long when they knew they could roll up their sleeves and try their best to pull her out.

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Eventually, about five hours after they started, they made contact with the expat, and slowly pulled her out. She escaped with cuts and bruises and fortunately no broken bones. Her survival was a true miracle. But Cristobal and his colleagues’ bravery, and potential self sacrifice trying to save her, is humbling. Not once did he or his colleagues think twice about risking their life to save hers. I don’t know if I would have the courage to do the same. As he said to me this morning: “There is no tomorrow. There is only today, and living for today. Because we just don’t know what can happen tomorrow.”

The  latest news is that the evacuations to the US will resume

U.S. to Resume Haitian Evacuations

By DAVID GAUTHIER-VILLARS, BETSY MCKAY  And JENNIFER LEVITZ

PORT-AU-PRINCE-Five days after suspending medical evacuations of critically ill Haitian earthquake victims, the U.S. government said Sunday evening that it planned to resume them “in the next 12 hours.”

“Patients are being identified for transfer, doctors are making sure that it is safe for them to fly, and we are preparing specific in-flight pediatric care aboard the aircraft where needed,” said White House spokesman Tommy Vietor in a statement.

He said that Florida is identifying facilities to receive the patients and that some evacuees might be sent to other countries.

And some news we really didn’t need to hear since the tremors continue

Haiti warned to brace for another big quake

PORT-AU-PRINCE (Reuters) – Haiti should be preparing for another major earthquake that could be triggered by the catastrophic one last month which killed up to 200,000 people and left the capital Port-au-Prince in ruins, experts say.

Teams of geophysicists, who have been tracking movements in the fault line that slashes across Haiti and into the Dominican Republic, came to the nation last week to measure changes in the Earth’s crust after the 7.0-magnitude quake on January 12.

Increased pressure on the fault after the quake could unleash another of the same size or bigger, although scientists acknowledge they have no way of knowing exactly when or where it will hit.

“Faults are always waiting for the right moment but if another earthquake gives them a little kick they go before their time,” said Eric Calais, a professor of geophysics from Purdue University in Indiana, who is leading the seismology project in Haiti.

Preliminary calculations by his group show the January 12 quake could be the “little kick” that sets off another temblor along the 186 mile fault where two regional tectonic plates have been scraping together for millions of years.

More than 50 aftershocks, including one measuring 5.9 magnitude, have shaken Port-au-Prince after last month’s quake. The U.S. Geological Survey says the aftershock sequence will continue for months, “if not years”, and “damaging earthquakes will remain possible in the coming months”.