The Health Situation in
At this stage of the crisis following the earthquake of January 12, health assessments have been fragmentary and anecdotal. A comprehensive damage assessment is essential to developing an acute and long term response plan. What appears certain is that at least 50,000 Haitians have perished, and another three million are hurt or homeless. Many of the most vulnerable are children. Further, the infrastructure in Port-Au-Prince (PAP) (water, electricity, sanitation, and telephone service) has been nearly completely disrupted. UN and foreign Governmental Agencies have initiated plans to open the airport, which is now closed to non-governmental relief groups, repair the cell phone system to establish communication to coordinate relief efforts, clear debris from streets to develop a rudimentary transportation system so supplies accumulating at the airport (180 tons of relief supplies delivered so far) may be distributed, and placing more police and soldiers on the streets to maintain security. There are scattered reports of looting, and violence at a number of food distribution centers. People are under extreme stress and losing patience.
The most pressing health-related needs, not yet in place mainly because of logistical difficulties, are the following:
· Secure shelter. The Government completed a number of over flights to determine where to establish 14 camps around the city to provide temporary shelter for the homeless. A number of the camps will be situated close to the large slums in PAP. Temporary camps can offer an opportunity to deliver food, clean water, sanitation and first aid to a large number of displaced people.
Some items have been distributed (tarpaulins, plastic sheeting, etc) that may provide temporary makeshift shelter.
· Food and water delivery. Clean water was available to only fifty percent of the population before the earthquake, and is now in critically short supply. World Food Program distributions included high-energy biscuits, jerry cans and water purification tablets to only 13,000 people, but hope to reach 1 million people in the next two weeks
· Search and rescue teams. The major priority still remains the rescue of survivors trapped under fallen debris. Twenty-six search-and-rescue teams from around the world are on the ground at the present time. Trauma, crush injuries and fractures of the lower limbs, hips and spine are common during and after an earthquake and there is a pressing need for medical teams expert in both acute stabilization of the injured, as well as definitive treatment of injuries(by emergency medicine specialists, and trauma and orthopedic surgeons).
· Health facilities and supplies. Hospital and local clinics have been severely affected and many are not functioning. Structural damage assessments have not yet been made. The main hospital in PAP has collapsed and a number in the outskirts have been destroyed. Plans to partially restore services in hospitals and to establish mobile clinics to administer first aid are underway. Two mobile field hospitals will arrive from the
· Burying of the dead. President Rene Prevail announced that 7,000 bodies were buried in a mass grave. There were 1,500 hundred corpses piled up in front of the main hospital before they were buried. Heavy equipment is needed for the rapid burial of dead bodies that are unable to have a private burial by family members.
Information obtained from colleagues on the ground in PAP, and reports from the Haitian Red Cross, Reuters, Oxfam, UN World Food Program and Office of Coordination of Humanitarian Affairs and International Organization for Migration, IRIN, and Partners in Health.- M. Viola