Monday, February 15, 2010

Coordinating Care in Haiti

(Photo by John Carroll)

Coordinating and Prioritizing Aid in Haiti

Now that there are many disaster-relief organizations on the ground in Haiti, it is critical that we coordinate efforts, both during this acute phase of the response and as we move forward. There is still an overwhelming number of patients who require advanced orthopedic care. These patients must be identified quickly and transported safely to the numerous operating rooms now in place in field hospitals. Lives and limbs are being lost with every bottleneck in the flow of aid — a major hitch being our limited ability to move patients.

We might not have been able to predict this earthquake, but we can predict a lot of what happens after natural disasters — the details are different, but on the grand scale, the needs are known. Nongovernmental organizations (NGOs) and government agencies can save for another day the dissection of the problems seen in the response to this disaster. For the moment, we must focus on the task at hand and what lies ahead. With so many patients undergoing surgery, we need to focus on postoperative care: many patients have lost their entire families under the rubble, and most will have nowhere to go to recuperate. This is a need that we can anticipate, and we must get ahead of it with a concerted international response.

Once people have made it through the first phase of surgery and recovery, additional surgical interventions will be necessary and physical therapy essential. Furthermore, we should not leave Haitians with an unmet need for prosthetics. We know these needs are coming. The psychological trauma of surviving a disaster, losing a limb, and losing loved ones will need to be addressed with large-scale mental health interventions. The toll that this kind of trauma can take is already evident in the terror each aftershock sends through the city, but the effects will persist long after the ground stops shaking.

While medical personnel continue to do everything possible to save lives, the international community needs to prioritize medium- and long-term investment in the health care system of Haiti, which was weak before the earthquake. Support must be sustained and promises kept if Haiti is to be rebuilt not only with stronger buildings, but also with a greatly strengthened ministry of health that sets the priorities. NGOs must then adopt these priorities and work in partnership with the Haitian government to achieve them. We at Partners in Health — which has worked in Haiti for 20 years — continue to believe that the Haitian people can be empowered to take care of one another if they are given monetary support and solidarity.

Louise C. Ivers, M.D., M.P.H.
Kimberly Cullen, B.S.
Partners in Health
Port-au-Prince, Haiti

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