Haiti Earthquake Relief, Phase Two — Long-Term Needs and Local Resources (New Eng Jour Med)

[pinto]

Haiti Earthquake Relief, Phase Two — Long-Term Needs and Local Resources
Dominique Bayard, M.D.

A month and a half after January's devastating earthquake in Haiti, the National Organization for the Advancement of Haitians, a U.S.-based nonprofit organization with a division dedicated to improving health care in Haiti, sent in teams of U.S. physicians and other health care professionals, primarily of Haitian descent, as the acute phase of disaster response was ending. As part of this group, I worked in a makeshift hospital in Tabarre, a section of northeast Port-au-Prince.

As a first-generation Haitian-American and an internist, I expected to be prepared for the situation I was walking into. Haiti was a country I knew, I spoke the language, I understood the people, and by this point I had been watching the disaster on television daily for over a month. I knew that with the threat to life no longer minute to minute but week to week, the long-term recovery phase was beginning. According to my relatives in Haiti, the initial shock was passing. Dead victims had been cleared from the streets, families were either reunited or mourning their losses, the roads were somewhat drivable, and food and water were slowly making their way to survivors. Yet when I came face to face with the disaster, I realized that the media hadn't even begun to capture the extent of the devastation. Seeing Haiti through a framed television screen had given me only a snapshot of destroyed buildings, misplaced families, and stories of loss and survival.

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Ultimately, it became clear to me that the most important resource for the ongoing relief effort is the one most threatened by the earthquake: the local people. Though I had not been back to Haiti in 15 years and was there for only 2 weeks, the local people were what enabled me and my colleagues, both emotionally and logistically, to provide care to more than 800 patients a day. Local volunteers — who constituted about half our staff, though they could easily have been devoting time to their own recovery instead — spent every day, sunrise to sunset, making it possible for us to provide care. They triaged patients, organized the physicians, distributed medications, and rose to any necessary task. Patients were grateful that the Haitian diaspora was returning to help. Despite their own loss and tragedy, they would laugh at my American-accented Creole and tell me how proud they were of me for coming back. Neighbors living in tents in their backyards cooked a full breakfast and dinner for me and several coworkers every day. In exchange for our provision of a 2-week proverbial Band-Aid, the people helped, encouraged, and took care of us. While international volunteers come and go, the local people will remain the backbone of the recovery process, and integrating them into international relief efforts will be vital.

The road to recovery will be long, and with the rainy season beginning, circumstances will get worse before they get better. Six months after the 2005 earthquake in South Asia, a similar pattern of respiratory infections, diarrhea, infectious disease outbreaks, poor sanitation, and insufficient shelter persisted and worsened despite a strong initial relief response.4 In Haiti, the initial response has also been strong, and we have learned from previous disasters what to anticipate in the months and years to come. Clear insight into the changing medical needs, together with the collaboration of the strong-willed Haitian people, will drive an effective effort to rebuild Haiti and, I hope, make it stronger than ever.

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http://content.nejm.org/cgi/content/full/NEJMp1003839?query=TOC

The New England Journal of Medicine is owned, published, and copyrighted © 2010 Massachusetts Medical Society.

[Truth2Tell]

1. Rec 5 for the greatest. The NEJM has taken it to a new level

with their Haiti coverage. Major kudos.