Monday, January 25, 2010

Health Update.January 25,2010.
Nearly 2 weeks after the earthquake hit Haiti, more complete assessments of the damage have been assembled. 111,481 people are confirmed dead and 609,000 are homeless and in the streets in Port-Au-Prince alone. 20% of the building have collapsed in the capitol; further west, closer to the epicenter in town like Leogane and Carrefor, 50% of the structures are down. Approximately 500 tent cities have sprung up around Port-Au-Prince(PAP) and the Government is making a decision about consolidating these temporary camps. It is estimated that 100,000-300,000 people have left the city and returned to families living in the countryside(see map). The Government is encouraging migration out of the city, and it is anticipated that close to a million people will leave Port-Au-Prince within the next few weeks. The internal displacement of Haitians is already putting an enormous burden on poorly supplied and inadequately equipped hospitals and clinics in towns outside of Port-Au-Prince, changing the the relief priorities of the disaster. It should be kept in mind that the mean income of people living in the countryside is 1 dollar/day, a cumulative resources hardly enough to sustain a large displacement of the population without food assistance.

Medical Care Needs. There are 48 hospitals and 8 field hospitals with surgical capabilities in PAP. Numerous makeshift mobile clinics have sprung up around the city with varying amounts of medicine and supplies. Jackie Picard, RN, the co-director of Medicine For Peace's Women's Health Initiative in Gros Morne has been working in CDTI Hospital in PAP since shortly after the earthquake. She reports:

"During the immediate period after the quake the CDTI surgical team did primarily acute trauma and a large number of amputations of limbs. We ran the OR's constantly. We had plenty of anaesthesia but ran out of surgical supplies, things like gowns, masks, gloves, etc. Unfortunately we lost a number of young people from renal failure from crush injuries--they just got to us too late. But that phase of treatment of acute trauma is over. Now we need space and nurses to help with post-operative care and for the general medical care of patients."

Jackie's assessment is echoed in official reports from the from the health cluster of the World Health Organization and Pan-American Health Organization. In this phase of the disaster, medical care needs will move towards primary care, surveillance for infectious diseases, prompt treatment of infections, and resuming of the nationwide immunization program(UNICEF) that has been put on hold. Chronic diseases still must be treated. There are 130,000 patients with HIV infection in Haiti; nearly fifty percent of them are receiving anti-retroviral agents. They must resume therapy that has been interrupted for many because of flooding of the health care system with acute injuries related to the earthquake.

Medicine For Peace is assembling containers of antibiotics and medications for the treatment of infections, tetanus antisera, and drugs for chronic diseases that have been neglected during the crisis. Health improvements we have made in the past must not be set back. Medicine and hospital supplies will be distributed in hospitals north of PAP where there has been a large, and increasing, migration of people searching for security and shelter.- Mike Viola