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8/7/2019 HAITI ONE YEAR AFTER - Medecins Sans Frontieres
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HAITI ONE YEAR AFTER
F e b r u a r y M a r c
h A p r i l M a y J u n e J u l y A u g u s t S e p t e m b e r O c t o b e r N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0 J a n u a r y 1 2
2 0 1 1
A REVIEW OF MEDECINS SANS FRONTIERES' HUMANITARIAN AID OPERATIONS
PUBLISHED JANUARY 10, 2011
© Kadir van Lohuizen / NOOR
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Prec
O
my eet isit to Haiti, the deastatio ased by
the eathqae that hit oe yea ago i Jaay was
still ey isible. I was shoed by the magitde o the
atastophe ad at the same time ey impessed with the extaodiay esiliee demostated by the Haitia people.
This has bee the lagest emegey espose i the 40yea
histoy o Médeis Sas Fotièes/Dotos Withot Bodes
(MSF). We hae bee stethed to the limits by the gey
ad extet o medial eeds i the immediate atemath o the
qae ad beyod. Bt the wo doe by the MSF teams has
bee otstadig. Thas to the geeosity o MSF doos
woldwide, we wee able to qily eat to the medial ad
hmaitaia eeds o Haitias ollowig the eathqae ad,
moe eetly, dig the astmoig holea otbea that hasow illed moe tha 3,000 people.
Oe yea ate the atastophe, it’s impotat to loo ba o
what has bee doe ad ahieed ad to eiew the hoies
that wee made. We mst also be eady to tale emaiig
halleges, omlate eessay stategies, ad lea lessos
that will impoe o emegey esposes i the te.
Iteatioal ageies mst lie p to the ommitmets they
hae made to the Haitia people ad to thei doos. As hma
itaia atos, we hae to be aotable o o opeatioalhoies ad taspaet abot o expedites. MSF has do
meted its expeiee i Haiti last yea i a itial way, ad I
iite yo to ead this epot.
Moe tha oe millio people emai homeless i Haiti today.
Ee beoe the eathqae, hdeds o thosads o Haitias
lied i peaios oditios, patilaly i the apital’s his
toially magialised slms, whee ew aid ogaizatios ae
poidig assistae. Thei immediate eeds mst emai at the
oeot o the hmaitaia atio i Haiti.
Lastly, I wold lie to tha the moe tha 8,000 MSF peso
el who hae woed tielessly to espod to the eeds o the
Haitia people. We ae also gatel to the Haitia people o
welomig s ad sppotig o atios. Ad, oe yea o, we
emembe ad miss the MSF sta, patiets ad amily membes
who lost thei lies i the eathqae.
Dr. Unni Karunakara
Iteatioal PesidetMédeis Sas Fotièes
8/7/2019 HAITI ONE YEAR AFTER - Medecins Sans Frontieres
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InTrODucTIOn
1 IAn OvErvIEW OF MSF’S rESPOnSE: ChoiCes, Challenges AnD lessons learned
1.1 I EMErGEncY PHASE Juy 12 – ap 30, 2010
Triaging the Wounded
Dwindling Medical Supplies
Establishing Field Hospitals
The Challenge o Rebuilding Hospital Capacity
Treating “Crush Syndrome”
Medical Challenges: Managing a Massive Surgical Caseload
Bolstering Post-Operative Care
Providing PhysiotherapyEmergency Psychosocial Care
Psychiatric Care
Basic Healthcare or Displaced Persons
Chronic and Acute Medical Conditions
Emergency Obstetrical Care
Burn Care
Non-Medical Assistance
Water and Sanitation
Human Resources
1.2 I POSTEMErGEncY PHASE My 1 – octb 21, 2010
Reorganisation o Medical Activities
Tents and Drinking Water
Hurricane Season
1.3 I cHOLErA EMErGEncY rESPOnSE octb 22 – Pt
Current situation
2 I FInAncIAL AccOunTABILITY
Categories o spending
3 I LOOkInG AHEAD - PLAnS AnD PErSPEcTIvES
Planned Projects
Emergency Obstetrics
La Fondation Sant Se Ae Pam
Tabarre Container Hospital
cOncLuSIOn
Table ctt
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Introuct
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
T u up tu pp v ty- um tt w uy but ccb by mu w tt w vy . ecmc pptut w w, umpymt w wp, t w w ccutm t pm vc ptc
upv. it w u t t tk ck cc t t c t tmttt utbk vc tt MsF cm t wk t cuty t t pc y 20 y .
F mt ht, v bc t c w ut c, c by t pubc pvt t -
ct m tm ub. Pubc pt cc w t pu by mmt pbm tk, t t, u, mc upp. Ptt cu b tu wy bcu t ptw u, ty wu v t b ttmt w ty ut my. gv bt w t k;ht’ mt mtty t w 630 t p 100,000, t t t mp, 50 tm t t t Ut stt xt .
i Pt-u-Pc, my t p w y pt MsF’ mcy vc. a mj mc umt zt tt’ b pt ht c 1991, MsF w t w ht’ pp xp t -tt u ct v w vc w mut. T cuty cu y vb w-pc t wt t u t m tt tu cttp wu pc tmc uc.
it w t t bckp tt t Juy 12 tquk t wt m t u pw t tw ht t p tum tt wt by yt v t mt bu t kw.
Haïtians aced the adversities o lie on a daily basis even
beore a devastating earthquake struck on January 12, 2010.
© Bruno Stevens/Cosmos
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Introuct
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1 F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Figures at a Glance
T u bw ct t vu ctvt utk by MsF t 10 mt t t t-quk tuck ht. T c cum ccut t t cp ctvt c ut by MsF m
Juy 12 tu octb 31, t tt t wc cumutv u vb ( m
t umb ptt tt c, wc t t 91,000 Juy 2, 2011).
Year to date January 12 - October 31
Human ressources
Haitia sta 2,844
Iteatioal sta 260
Medical facilities
Opeatig theates 15
nmbe o beds 1,121
Hospitals ehabilitated 10
new costtio 6
nmbe o xed sites (maximm o peiod) 12
nmbe o mobile liis 3
cholea Teatmet cetes bilt (Ot. 22 – De. 12) 47
Medical activities
Patiets teated 358,758
Sgial opeatios 16,578
Patiets teated: post opeatie ae 10,939
Patiets teated: ioleeelated tama 7,110
Patiets teated: othe tama 38,534
Patiets teated: holea 91,000
Patiets teated: psyho soial ad metal health 177,212
Patiets teated: delieies 15,105
Patiets teated: sexal iolee 696
Logistical equipment
relie its distibted (as o May 12) 85, 000
Tets distibted 45,940
Lites o wate distibted pe day as o Otobe 31 516,000
Laties bilt 823
Showes bilt 302
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Haiti One Year after
An Overview o MsF’ rp F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
At the time o the eathqae, MSF was ig thee seoday leel health ae sttes i
PotaPie: a emegey health ete i the Matissat slm; a emegey hospital o tama ad
othopedi sgey whih also had a itesie ae it o bs ad a ehabilitatio ete, i the Paot
eighbohood; ad a emegey obsteti ae hospital with ateatal ae liis i the Delmas aea. These ai
lities wee desiged to addess the medial eeds o poplatios liig i ey poo, ioleeplaged ba om
mities.
MSF sttes ad sta wee hit had by the qae. It too days to aot o eeyoe. Sadly, 12 Haitia MSF sta membes wee illed i the eathqae, as wee some patiets ad aetaes who wee iside bildigs that ol
lapsed. Othe MSF sta membes wee ijed o lost amily membes ad ieds, while still othes lost eeythig
they owed ad wee edeed homeless.
Despite the temedos pesoal losses sstaied by may
atioal sta membes, ad despite the haos that ollowed
the eathqae, the majoity o MSF’s siig Haitia sta
immediately set to wo helpig thei otyme ad otied
to do so thoghot this dilt peiod.
The MSF obstetial ad tama hospitals wee destoyed bythe eathqae. Oly the Matissat emegey aility was still
opeatioal, bt it was qily oewhelmed by the ijed ad
dyig people who lled the hospital gods. Matissat had the
apaity to eeie a maximm o 50 asalties. Bt i the hos
i v t cm t wk bcut t t my
bu. i pp m t cut c k t v cm t cu pp, m, ht,
i mut t m.
MSF soial woe chales Joseph,
who lost his home i the eathqae.
“
“
© Julie Rémy
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Haiti One Year after
An Overview o MsF’ rp F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0 F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
ate the eath shoo, sta thee had to ae o moe tha 400 itially ijed ad dyig patiets who aied
almost all at oe.
Patiets aied at othe MSF medial ailities ad admiistatie oes with mltiple ad ope ates, shed
limbs, sll ates, spial od ijies, ad lietheateig bs. Teams oetated o wod leaig, de
bidemet ad dessig, ad ate stabilisatio. I the st days, the immediate ad highest pioity o MSF was
to stabilise ad maage ae o the woded, to ogaise tiage, ad to poide immediate liesaig sgey ad
edolieae.
Althogh mh o its health ae iastte was destoyed,
MSF still had the taied sta ad the spplies—stos o mediies, medial mateial, sgial eqipmet ad logistial ma
teial—to espod. MSF sta adapted to the immediate odi
tios o the god while logistial pesoel qily ogaised
themseles to impoe the eiomet o teatig ad aig
o patiets.
Teams woig at the Matissat health ete osed pimaily
o mio wod dessigs o ijed pesos. At the MSF
ehabilitatio ete i Paot, oly oe opeatig table was
aailable o mio opeatios. I ad aod the ollapsed La
Tiité Hospital, sgey was poided i maeshit tets ad,ate a ew days, i a shippig otaie that was oeted ito
a opeatig theate. La Tiité Hospital had eight speialised
Haitia sgeos, who, togethe with the est o the sta, ad
despite thei ow losses, poided ae with the limited esoes
aailable to them.
MSF logistial sta tasomed La Tiité Hospital’s phamay
ito a sgial opeatig oom as well. Fthemoe, withi ap
poximately 48 hos, MSF idetied aailable ooms ad a des
sig statio at the Miisty o Health’s chosal Hospital ad ma
aged to stat sgial atiities thee i two opeatig theates.Othe patiets wee teded to at a MSF oe. By Jaay 15,
majo sgey was also beig poided i tets aod the MSF
sppoted caeo Hospital.
Fv mut t t quk, pp w b u p. Wt w u,
t w u pp uy.
D. Jeae cabeza, medial oodiato o
MSF’s opeatios i Haiti, who was at MSF’s
ehabilitatio ete i the Paot eighbo
hood ad had, lie some o he olleages,
sstaied mio ijies.
“
“
© Julie Rémy
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F e b r u a r y M a r c
h M a y O c t o b e r J u n e J u l y A u g u
s t S e p t
e m b e r
N o v e m b e
r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
9
Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Triaging the Wounded
Tiage is the poess by whih medial sta detemies whihpatiets ae i the most seee oditio ad whih teatmets
shold be pioitised. Eetie tiage eses that aailable e
soes ae sed to sae the maximm mbe o lies ad to e
de mobidity. I the best o imstaes, tiage a iole
dilt hoies. I the immediate atemath o the eathqae
i Haiti, howee, it was ot possible o MSF teams i some loa
tios to ay ot systemati tiage de to the massie mbes
o woded people foodig hospital gods. The exeptioal
imstaes ad eomos woload eqied ey dilt
deisios to be made. The tiage stategy sta adopted was to
pioitise patiets with the highest hae o sial.
ultimately, MSF was oe o the majo atos i emegey s
gial ae amog the 30 oeig eld hospitals deployed dig
this st theemoth emegey phase. MSF sgeos peo
med 5,707 majo sgial poedes, 150 o whih ioled am
ptatios.
A emegey sgial stategy mst be adapted to aailable e
soes ad eeds; it eeds to be deeloped ad otiosly
eassessed by the most expeieed sgeos i ollaboatio
with othe olleages. This was ot systematially doe dig
the st days ollowig the eathqae de to the massie ifxo woded; thee was o let p i the wo ad ths o time
o efetio ad plaig, oly espodig. Oe o the lessos
leaed o MSF is to the stegthe its expetise with moe
expeieed sgial oodiatos to ll this gap i the te.
T w but wu.
Ty w py ct t t u y, w ppw t b but ut. T
uy ’t vy cmpx, but t’ mt pmtv but uy
mv m tu mputt mb. T
c yu v t tk ucy wt yu c pv tt mb
wt t mut b mv. it cb vy fcut c t tm
mputt cy t t t yu wt t tu t. But w p b cu y
bu, t tu v bvy m, t t
vwm ct ptc ck tt .
MSF Sgeo D. Pal MMaste
who eahed Haiti less tha a wee ate
the eathqae st.
“
“
© Julie Rémy
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
© Julie Rémy
This also delies the eed to otlie a appoah o espo
se to mass asalty eets thogh tiage, stabilisatio, eeal
systems, ad edolie ae. Lessos leaed ae eablig MSF
to impoe its apaity ad expetise to ogaise tiage, eme
gey seies ad itesie ae its i peaios emegey
oditios.
it’ tu tt t ct
vyt pb t p m v my tw . at m t t
y, wt ct tt , tw t pt but t mputt
my . Ty k m ty vm t mc . i t
yt, but i t t b .
23yeaold woma who was teated by MSF
ate the eathqae.
“
“
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Dwindling Medical Supplies
As medial teams got to wo, logistial teams seahed damaged MSF hospitals o eqipmet, mateial, ad dgs.
cotigey stos wee ept speially o emegey pepaedess seaios sh as foods, ladslides, ad epi
demis. residal emegey spplies om MSF’s iteetio ollowig the 2008 foods i Goaies wee still i the
oty, as wee be stos o spplies to maitai ogoig tama, othopedi, ad b teatmet, ad obste
tial ae pogams.
Fotately the sixmoth spply ode o the Matissat emegey ete had jst aied ad old be sed o
the emegey espose i Matissat. MSF teams edistibted existig spplies amog the aios hospitals, bt
the itese pesse ad the la o mobility i those ealy days peeted the establishmet o a tightly oodia
ted spply hai o the medial spplies that wee aleady i the oty. Iomig spplies ad doatios made
thogh the cetal Medial Stoes PrOMESS, whih was sppoted by the Wold Health Ogaizatio (WHO) ad its
egioal am, the Pa Ameia Health Ogaizatio (PAHO), helped oeome itial ealy shotages.
MSF maitais a emegey spply base i Paama, whih allowed s to get spplies ito PotaPie beoe
the aipot way was jammed with iomig elie ad diplomati fights. The mai gaps i majo sgial mateial,
howee, old ot be lled by these maily omedial elie spplies.
MSF theeoe expeded sigiat eot to see diet ladig aess o essetial medial ad omedial
spplies i PotaPie. This ilded establishig otat with oials om the Haitia goemet, the un,
ad the uited States who wee dietig iomig ai ta i ode to see ladig slots o MSF ago fights.Howee, may fights ayig spplies ad disaste expets wee dieted to the Domiia repbli bease the
Haitia apital’s small aipot was damaged, oeloaded with fights ompetig to lad, ad beset by lea ai
ta pioities.
Betwee Jaay 14 ad Jaay 18, e spplylade MSF plaes wee dieted om PotaPie to the Domii
a repbli. These plaes aied a total o 85 tos o medial ad elie spplies, ildig the mateial to bild a
100bed ifatable tet hospital to eplae the destoyed Tiité Hospital. MSF spoe ot abot the la o pioitisa
tio o medial spplies thogh old ad ew media otlets.
I the ed, most MSF spplies wee oted thogh the Domi
ia repbli, ad MSF established a spply base i Sato Domigo. Ee thogh this meat taig a loge ote ito Haiti, it
poided a moe stable ad eliable optio o the iitial moths,
as Haiti’s aipot ad seapot, while ope, emaied oebde
ed.
Seeal ogaisatios oeed thei seies to sppot MSF’s
wo ollowig the eathqae. Fo example, the eiometal
ogaisatio Geepeae geeosly doated the se o its ship,
Espeaza, to assist MSF with its emegey espose i Haiti.
This doatio eabled MSF to taspot its most get liesa
ig medial spplies as qily as possible by ai, while Espeaza made the slowe joey to PotaPie ayig less
get, thogh essetial, spplies sh as blaets, bets, ad
soap. The ship also aied a eight o thosads o lites o el,
a ommodity i shot spply i Haiti i the immediate atemath o the eathqae.
it k wk
w tut. W ’t v y m mp t m p u ptt. W ct ccpt tt p cy v mc
upp qupmt ctu t
b tu wy wu ptt . Pty mut b
v t mcuppt t cuty.
rosa cestai, MSF medial oodiato.
“
“
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Establishing Field Hospitals
The MSF logisti teams mobilised qily to set p tempoay iastte ad to epai ad expad existig i
astte. Spplies o wate ad eletiity wee established, saitatio poedes pt ito plae, ad, late o,
medial ailities wee istalled.
Yet i the wees ate the qae, sta ad the poplatio alie wee eed by eqet ateshos, ildig
a patilaly powel oe o Jaay 20. Ee i hospitals ad bildigs that had withstood the eathqae, the
Haitia sta ad patiets esed to stay iside oete sttes ot o ea that they wold eetally ollapse, as
so may othes had. I some istaes, theeoe, patiets wee hospitalized, ad some opeatios wee odted,
de tets.
Emegey eld hospitals wee set p sig existig Miisty o Health sttes, MSF sttes, o othe piate
sttes—a detist lii at Bieteaie, a shool i caeo, semipemaet bildigs i Léogae, ad the i
fatable hospital, whih, oe it aied, was eeted o a ootball eld i the Delmas 30 distit.
The ifatable hospital was employed to eplae the destoyed La Tiité Hospital, whih poided tama ad otho
pedi sgial ae, ad to qily establish the apaity to poide highqality emegey medial ae to om
plimet atiities at othe eld hospitals aleady established by MSF medial teams. Despite the at that the plaesayig it wee dieted to the Domiia repbli, the ifatable hospital—whih ame to be ow as Sait Lois
Hospital—was tioal ad eeiig patiets jst 10 days ate the eathqae.
© Nicola Vigilanti
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
The Challenge o Rebuilding Hospital Capacity
To ese pope oditios o emegey sgial atiities ollowig the iitial emegey phase, MSF sed bil
digs that wee deemed saitay ad sae—i.e. ot sttally ompomised by the eathqae—ad also eeted
hospitals made o peabiated otaie modles. A ompliatig ato was that may patiets still esed to be
hospitalised iside ay oete stte ad peeed to oalese i tets.
Fom the otset, the ogaisatio osed o estoig ad stegtheig seoday leel hospital apaity o eme
gey ae. Fo example, MSF ashioed a dediated postopeatie ae pogam, omplete with a ll sgial it,
i a ome waehose. MSF also hose to se loal owhow ad eadily aailable mateials—oete odatios,
timbe wood o the ame ad the walls, io sheetig o the oo—to bild semipemaet sttes that old
late be made pemaet.
MSF eeded to get its sgial its opeatioal as soo as possible i ode to gaatee asepti oditios ad to
eplae the impoised opeai set ps. Sppotig sgial atiities i existig ailities oeed the best asepti
oditios, bt may o these sttes wee ot tioal o sttally sod, o else they had bee oewhel
med with patiets ate the eathqae. Alteaties ilded tasomig osaitay bildigs sh as shools, a
soda atoy, ad a hild ae ete ito eld hospitals with sgial its iside. The tehial soltios applied by
the teams wee siet to peet ay majo otbeas o ietios dig the st moths o the iteetio.
Treating “Crush Syndrome”A MSFailitated real Disaste relie Tas Foe that eglaly wos with MSF i eathqae emegeies ma
aged to estat the idey dialysis i the uiesity Hospital to teat crush syndrome1 patiets with ate idey
ijies (as well as patiets with peexistig hoi idey disease) i less tha a wee.
The whole iteetio at uiesity Hospital lasted exatly two moths ad eqied osideable esoes. Twe
ty ephologists, ses, ad haemodialysis tehiias wee dispathed to Haiti om aios oties. This team
peomed the eqialet o 316 dialysis teatmet days. Bt the oeage ad otpt a be osideed limited gi
e the low mbe o patiets who eeied this speialised ae set agaist the moe tha 300,000 ijed people,
may o whom wee liely “shed” by ollapsig bildigs ad walls.
This is lagely de to a la o detetio o patiets with sh sydome. The iteetio beetted om the s
essl itodtio o a MSFspplied poitoae deie that allowed o immediate detemiatio o the most
itial biohemial tests ad aste deisiomaig o the maagemet o sh sydome patiets. The mai les
so leaed is the eed o moe emphasis o ealy detetio o sh sydome patiets at the eld hospital leel to
peet ate eal aile ad ailitate thei timely tase o idey dialysis.
1. Cu ym ct wc muc tu m by v t juy mv qutt tx t t b, t ky u.
lt utt, cu ym c b t.
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Medical Challenges: Managing a Massive Surgical Caseload
De to the eomos aseload o sgial patiets admitted to MSF ailities, eeals om othe healthae aili
ties, ad patiets let behid by tempoay iteetio teams om goemets o smalle sale ogaisatios, MSF
qily ieased its iitial postopeatie ad ehabilitatie ae apaity. Most MSF ailities had the apaity o
sgey ad itegated physiotheapy ad metal health ae.
I oe MSF aility, 807 ases wee epoted dig the st thee days, bt, sie data olletio was ot a pioity
i these ealy momets, the type ad seeity o ijies emais ow. By the ed o the st wee, thogh,
MSF estimated it had teated moe tha 3,000 woded people i the Haitia apital ad peomed moe tha 400
sgeies.
This atal disaste dieed om othes i two sigiat ways. Fistly, it dietly aeted the iastte o a
ba apital ad, oseqetly, the apaities o all goemetal, un, ogoemetal, ad piate ageies to
espod. Seodly, the sale o the immediate medial eed amog those ijed was the agmeted bease
the eathqae impated desely poplated aeas o pooly plaed ad eglated settlemets withi the apital.
These atos ombied both to eate a hge eed ad also to hide the ability o ogaizatios to espod to that
eed.
Eah MSF hospital was ooted with speial ases, sh as eologial tama ijies, whih they did ot hae
the apaity to teat. reeals, howee, wee dilt to poide de to a la o awaeess ad ommiatio
abot what othe apaities wee aailable i Haiti, ildig at othe MSF ailities. Thee was o etal hb thathad a oeiew o aailable seies. Dieet stategies wee gadally deeloped to deal with eeals. Some pa
tiets wee eeed to Sato Domigo o adaed teatmet. Some seee b ijies wee eeed to the uSS
comot ship doed o the mai pot. Bt this eqied extesie logistis. It was ot til late i Febay that MSF
maaged to eate a moe adaed, etalised ae o b ijies.
Bolstering Post-Operative Care
Beig ooted with sh a hge aseload o sgial patiets ad haig leaed om peios eathqae i
teetios, MSF deeloped a sigiat ipatiet ad otpatiet postopeatie ae apaity. I additio to post
opeatie ae ailities attahed to o itegated withi the hospitals, by the ed o Jaay, MSF opeed speipostopeatie ae etes to deal with the oeload o patiets eqiig pologed ipatiet ad amblatoy
postopeatie ae.
May o these ases wee eeed om MSFmaaged o sppoted health ae sttes. Othes wee om militay
o iilia emegey atos who depated ate the st wees o the iteetio, leaig behid may patiets
who still had dessigs, asts, o exteal xatio that eeded attetio. Almost all o the postopeatie ae etes
had to itegate majo sgial seies i ode to poide eessay ollowp wod ae ad othopedi sgey
(debidemet, ietios, iteal ad exteal xatio) ad eosttie sgey.
Fom Jaay 12 thogh the ed o Apil, MSF ogaised ipatiet postopeatie ae o 2,604 patiets ad amb
latoy postopeatie ae o a dometed aseload o patiets.
I Febay, MSF opeed a postopeatie ae ete i a oeted sot di atoy i the Sathe eighbohood o
the apital. With a apaity o p to 300 beds, patiets old eeie wod ae ad moe speialised othopedi o
eosttie sgey. Hadiap Iteatioal physiotheapists woed alogside MSF to help patiets ehabilitate
ad adapt to posthetis.
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
I total, MSF established some 2,000 postopeatie ae beds i PotaPie withi e wees o the eathqae.
While it is bette to hae too mh apaity tha ot eogh, MSF did eate moe postopeatie ae apaity tha
it ltimately tilised i the emegey phase. MSF sgial speialists ad emegey maages ae etly ea
latig meas to ese the geate oodiatio ad moe peise pojetios o eeds i ode to peet, to the
degee that is possible, a oese o hma ad aial esoes aod establishmet o postopeatie ae
apaity i massasalty atal ad mamade disastes.
Providing Physiotherapy
Gie the high popotio o sgial ases, may o whih ioled othopaedi ijies, MSF ehaed its ability to poide
physiotheapy. These seies wee eithe itegated ito MSF’s
emegey hospitals o oeed thogh postopeatie ae a
ilities. The woload o MSF teams was ey high. I oe MSF
hospital, at the pea o physiotheapy atiities i Febay ad
Mah, a aeage o 200 patiets wee eeiig ae i appoxi
mately 1,000 sessios pe wee. MSF pateed with Hadiap
Iteatioal i seeal ailities ad displaed pesos amps to
impoe the qality ad aailability o postheses ad physial
ehabilitatie ae.
© Benoît Fink / MSF
Ty v b tu
muc but v t tttu.i w 30-y- mw b mputt m
t m w wk up, w t cmpt .
T w m t m,‘i’m t mk t.
niole Deis, a MSF se, who woed
eathqae ijies.
“
“
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Emergency Psychosocial Care
Fom the stat o the emegey espose, MSF mobilised ew metal health ae teams, o eioed existig oes,
with iteatioal sta ad ewlyeited atioal sta. These teams osed o the atioal sta, may o whom
had lost elaties ad homes bt oetheless otied to wo despite axieties abot the peset ad e
taities abot the te. They also poided osltatios o seeely ijed patiets ad thei amily membes i
postopeatie ae. As o ealy Febay, metal health ae atiities—psyhoedatie gop sessios, idiidal
osltatios, ad mtal sppot gops—expaded to otpatiet seies ad late ito the ommities o cité
Soleil, caeo Feille, ad Tapis roge; the iteally displaed pesos amps aod Jamel ad Léogâe; ad
the Gae, Pétioille Gol clb, ad Aiatio IDP amps as well.
Psychiatric Care
Psyhiati ae was ogaised at Sait Lois Hospital ad its attahed otpatiet depatmet o all those patiets
who eqied the seies ad who old be eeed om othe MSF pogams o othe atos.
All told, moe tha 40,000 people eeied psyhosoial o psyhiati sppot om MSF sta dig the iitial eme
gey phase.
Basic Healthcare or Displaced PersonsBy the ed o the st moth, i ode to espod to the pessig eeds o basi health ae o displaed people i
PotaPie who had od some type o shelte ea MSF sgial ailities, MSF teams set p otpatiet seies
lied to o itegated withi the emegey hospitals ad postopeatie ae etes. The otpatiet depatmets
o the hospitals o chosal ad Jamel, howee, emaied de the maagemet o the Miisty o Health, with the
assistae o othe ogaisatios.
Soo atewads, MSF also set p xed o mobile OPD seies i seeal IDP amps ad sppoted existig liis
at othe amps i PotaPie—Delmas 24/Fot natioal, champs de Mas, Gae camp, Shiia lii, Petioille
Gol clb, Aiatio amps, caeo Feille ad Tapis roge—ad otside the apital i Jamel ad Léogâe.
Depedig o the loatio ad the eidet eeds, these otpatiet seies poided osltatios, amblatoy
dessigs ad postopeatie ae, metal health seies, ateatal ad postatal osltatios, ae o itims o
sexal iolee, ad aiatios (iitially agaist tetas, ad late to ilde aiatios oeig the ll sope o
the Expaded Pogamme o Immisatios seies).
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Chronic and Acute Medical Conditions
MSF has deeloped a geat deal o teatmet expeiee o ietios diseases sh as HIv/AIDS ad tbelosis.
Howee i Haiti, MSF lagely elied o othe ogaizatios that wee aleady poidig teatmet o these odi
tios to otie the wo. Gie the iedible olme o patiets de its ae, MSF teams wee ot able to ade
qately assess whethe these ogaisatios—both Haitia ad iteatioal nGOs—wee atally able to meet the
eeds o patiets eqiig HIv/AIDS o TB teatmet.
Fthemoe, MSF did ot hae the appopiate mediies o had i the emegey phase to ae o patiets s
eig om oommiable oditios sh as hypetesio, diabetes, ad epilepsy. O 850 patiets teated i
oe loatio betwee Mah ad Septembe, thee wee 72 ases o hypetesio. reogisig this shotall i the
paage o aailable ae i some MSF medial sttes, the ogaisatio is aleady ealatig the easibility o
ildig hoi disease its i the emegey pepaedess stos it maitais i dieet oties.
Emergency Obstetrical Care
With the desttio o MSF’s emegey obsteti hospital,
MSF stated oeig hma esoes, dgs, ad obstetis ex
petise to sppot to the Miisty o Health mateity hospital,
Isaïe Jeaty, whih had ot bee damaged i the eathqae.
The hospital teats pegat wome with medial ompliatiossh as elampsia ad malaia ad poides eoatal ad post
atal seies ad a blood ba.
W’v v my
pmtu bb ut tum. Wm cm t uwt p-cmp cmp
-- u ct xcbt by t. Tu ht xtmy
t cmp bt tquk,
t mv t t t pbby ut
vt t ct.
Ea de Plee, a MSF midwie
at Isaie Jeaty mateity hospital.
“
“
© Julie Rémy
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Burn Care
Whe La Tiité Hospital was destoyed, Haiti lost its oly speialised teatmet it o seee bs. reestablishig
this it beame a pioity, espeially gie the dageos liig oditios aed by eathqae sios.
By late Mah, a ew dediated it had bee set p de aas withi the Sait Lois Hospital ompod. The
it poided thee tets ad 30 beds o seee b patiets, both hilde ad adlts.
Bu cy qut v w bcu t pp v v m u ct.
a pct my tk pc jut , t vy cmp pc: my mmbp, py ck t m .
Wm c t bu bcu pt b wt tp v, c t t bkt.
M mty bu w mmb puct, pmy u ct. F
vctm v bu, t 24 u w t cct cuc.
emcy uy mut b pm wt x u t cct pp ty qu vy u c t wk t mt.
D. rémy Zilliox, a MSF plasti sgeo ad b speialist.
“
“
© Nicola Vigilanti
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Non-Medical Assistance
Jst days ate the eathqae, MSF teams aied ot assessmets o the eeds otside PotaPie ad iitiated
mobile liis i ommities sh as Petit Goae, Gad Goae ad Léogâe, all o whih ae sitated ey ea the
epiete o the eathqae, ad i Jamel to the soth. By the ed o the moth, MSF was edeaoig to the
aid these ad othe hadhit ommities by establishig xed ad mobile liis ad ogaisig spplies o wate
ad the osttio o hygiee ad saitatio ailities.
Qily, it beame lea that hdeds o thosads o people
eeded shelte—ad that the la o shelte was haig medial oseqees—bt wee ot eeiig mh assistae i
that egad. I late Jaay, MSF bega distibtig plasti shee
tig, tets, ad othe elie items, salig p these eots the ol
lowig moth oe it beame lea that ew o the ogaisatios
expeted to addess these eeds wee atally doig so.
Seeal gops expessed oes oe seity, whih wee ot
etiely oded. Axiety ad despeatio was peasie ate
the eathqae, whih i some istaes eated est ad at
times age amogst people awaitig assistae. MSF’s st dis
tibtios i the al aeas otside o PotaPie te days
ate the eathqae wee hampeed by owd otol isses.
MSF ths deided to miimize seity iss by exetig qi,
lagesale ealy moig distibtios, sig bses to taspot
beeiaies i small gops to moig distibtio poits, ad
distibtig items thogh hhes ad othe ommity oga
izatios.
By the ed o Je, MSF had distibted lose to 85,000 elie
spply its made p o items sh as ooig tesils, hygiee
items ad blaets, appoximately 2,800 olls o plasti sheetig
ad moe tha 28,640 tets. I Léogâe, o example, MSF madedistibtios to 3,000 amilies. MSF eetally spet €11.7 mil
lio (uS$15 millio) i shelte ad oood item distibtio.
T mm tm t, y, bc v
ct t b mt.
F t , w v tt ttbut 26,000 tt wc w
pv t t u 100,000
pp. abut 7,000 v y b tbut tbut
t t t mmt. MsF
tbut ck ut,y kt—p, b, tw,
tc.—bkt mqut t t m umb pp. hwv,
t tbut w t bu. humt t
mut w t m, t wy.
chistophe Stoes,Geeal Dieto o MSFBelgim
“
“
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
at t vy b, w v t c tt w cv tt y qupmt. it w Juy, t wt w cmt, wt . W
tut w’ b t jut cup mt. My u b cmpty ty. i cm wt my my u t t cmp bcu t w t t t my pvum. W cv b tt, bkt, y ktc qupmt, v m .
W w vy ppy. But w t’ m t v mt c t tquk pp. Ttt t u – t y bk m pc – w t
uc p. i yu v tm, i vt yu t cm p .Yu w .
34yeaold Haïtia ma, leaig i IDP amp i PotaPie
“
“
© Kadir van Lohuizen/NOOR
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
Water and Sanitation
Mh o MSF’s wate ad saitatio wo osed o eatig the appopiate hygiee oditios to ay ot medi
al ad sgial pogams ad to stem the spead o disease. MSF teams poided sae wate, ostted o ehabi
litated laties ad esed the eaatio o waste wate ad solid ad medial waste at the 26 ailities opeated
dig this emegey phase.
Wate poisio atiities wee also established o poplatios shelteig ea MSF medial ailities, ad watead
saitatio teams stated hygiee pogams i the amps whee MSF had medial atiities ad whee eeds wee
still ot oeed by othe atos. This ilded tyig to ese aess to laties, showes, ad lady zoes, as well
as hygiee pomotio ampaigs.
Almost all o the iomal displaemet amps elied o di
ig wate that was ted i ad teated osite. Most sites had
isiet wate o spae o bathig piately, whih amo
ted to a hygiee isse as well as a seity isse, patilaly o
wome. Laties wee badly ad widely eeded. De to la o
spae, a elatiely high wate table i some loatios, ad the
ate o the soil i the ity, howee, it was dilt to ahiee
the aeptable stadads o laties i some amps.
h t cmp,w ’t v u t,
w t t ut t t wt u t t ck
tbut pt. at t vy b, t w
, bcu t w t t pp, but w t’ k
v wt t cty.
A 22yeaold woma,
i the caeo Feille IDP amp.
“
“
© Ron Haviv / VII
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Haiti One Year after
Emergency p F e b r
u a r y M a r c h M a y O c t o
b e r J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1A p r i
l 3 0
cosideig how may people had bee displaed, MSF’s oeall wate ad saitatio eot was qite modest. This
was lagely a tio o the deisio to pioitise medial isses, the pesee o othe atos woig i this aea,
ad patial ostaits.
A additioal isse o MSF’s opeatios, i tems o saitatio, was the la o a sae disposal site o medial waste i
PotaPie, whih otied to pose a poblem late o i the yea with egads to the massie holea otbea.
I the absee, MSF has istalled iieatos to poess the waste om its ailities.
Human Resources
A ommo eate o disastes is that ogaisatios qily ome to ely heaily o thei most expeieed ad qa
lied loallyhied sta—bt the mst qily hie ad tai additioal loal sta.
MSF maaged to mobilise a peedeted mbe o sta om aod the wold bt stggled ate the iitial
stage o the emegey to spply the eessay iteatioal aid woes with the expetise o a disaste o this
id. Seio maages ad oodiatos ted to toe at a high ate i the ealy moths o emegeies, ad its
eessay to otate people i both to eep sta membes esh ad eetie ad also to allow them time to est a
te what is ieitably a extemely itese, extemely taxig expeiee. The high demad o sta i Haiti ate the
eathqae—ad, late i the yea, i Paista dig the histoi foods—plaed seee pesse o MSF i some
loatios to maitai stag leels i eld pojets.
Aothe ey lesso leaed is the itial impotae o etai oles i this day ad age. These ilde Iteet ad
teleommiatios expets; biomedial eqipmet tehiias to istall ad maitai adiology ad adiosopy
eqipmets, hoizotal steilisatio its, ad bloodba, oldhai, ad speial aesthesia eqipmet; eleti
ias; ad sttal ad osttio egiees to assess the saety o medial bildigs, oes, sta hoses, ad
waehoses.
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Haiti One Year after
Post-emergency p F e b r
u a r y M a r c h A p r i l J u n e J u l y A u g u
s t S e p t
e m b e r
N o v e m b e
r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 1
M a y 1
gey medial opeatios, losig some medial ae ailities, ad edig atiities i seeal displaed pesos
amps i the apital, whih wee by the beig well seed by othe ogoemetal ogaisatios. As it happe
ed, i at, the histoially magialised slms, whih wee less see bt wee ot by ad lage see by istittio
al doos as haig bee hit had by the eathqae, eeied a less adeqate assistae tha did the amps. MSF
theeoe hose to maitai its medial ailities i ommities sh as cité Soleil ad Matissat.
Additioally, MSF ageed to bild a geeal hospital i Léogâe, a emegey obsteti hospital i Delmas 33 o
PotaPie, a speialised tama hospital i Tabae, o the otheaste otsits o PotaPie, ad a gee
al hospital i Doillad, o the apital’s peiphey, jst otside the cité Soleil slm.
MSF did ae some dilties dig this logetem plaig phase. restitios o the amot o aailable lad
ompliated the poess o iitiatig ew osttio whe it was eessay. Ad the plaig o the hospital i
Delmas 33 was hampeed by isiet ommiatio betwee MSF ad the Haitia Miisty o Health ad othe
eglatoy obstales. This lead to a sbstatial delay i the pojet, ad ths a sbstatial delay i the poisio o
timely teatmet to the people o the ommity, patilaly pegat wome i eed o emegey obstetial
ae. (costtio was eetally ompleted, howee, ad the aility poed espeially alable last all, whe it
was sed as a holea teatmet ete ate the holea otbea spead to the apital.)
Additioally, i Otobe MSF opeed a 120bed hospital i Léogâe desiged to os o obsteti, tama, ad pe
diati emegeies ad iteded to allow MSF to phase ot the teted hospital it established o the gods o the
Miisty o Health hospital i the ity jst ate the eathqae.
© Ron Haviv / VII
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Haiti One Year after
Post-emergency p F e b r
u a r y M a r c h A p r i l J u n e J u l y A u g u
s t S e p t
e m b e r
N o v e m b e
r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 1
M a y 1
F e b r u a r y M a r c
h A p r i l M a y J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0 J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 2
Tents and Drinking Water
By May, MSF had ompleted its distibtios o tets, bt the ogaisatio otied to distibte basi eessities
sh as ithe tesils ad hygiee its i a host o loatios both iside ad otside o the apital. At this poit
moe tha 28, 000 tets had bee distibted. Tets ad basi eessities wee also distibted to abot 200 amilies
i emote illages o Léogâe egio,
Dig this seod phase, the ogaisatio eded the amot o wate it was distibtig om a high o 870,000
lites pe day dig the emegey phase to 713,000 lites o wate pe day, oghly eogh o 71,000 people.
Hurricane Season
The hiae seaso was a majo peopatio oe the smme bease so may people wee (ad still ae) liig
i peaios oditios ad bease may MSF patiets, eaig aothe eathqae, wee still way o stayig i
doos o ay exteded peiod o time. Fo this easo, may MSF ailities still sed massie tets to elose hospital
wads.
Fotately, the ais ad wids wee ot as deastatig as so may had eaed they wold be. MSF did poide a
emegey spply o tets to ewly esettled amilies ollowig a Jly stom that aeted the coaille amp ad a
a shelte epai pogam i the Petioille Gol clb ad othe amps.
From January 12 to October 31, MSF treated more than 358,000 people, perormed more than 16,570 surgeries,
and delivered more than 15,100 babies. MSF also uses mobile and xed-point clinics to provide primary medical
care and relie supplies to displaced persons living in various camps in Port-au-Prince. The organisation carried
out water-and-sanitation services to displaced persons in the Cité Soleil slum and Carreour.
MSF was operating seven private, ree-o-charge, secondary-level care hospitals and supporting two Ministry
o Health structures in Port-au-Prince, accounting or nearly 1,000 hospital beds in the capital by the middle
o October. These acilities provided emergency, trauma, obstetrical, pediatric, maternal, and orthopedic care
services. Mental health care and treatment and counseling or victims o sexual violence are also provided by MSF. Outside the capital, MSF supported Ministry o Health hospitals in Jacmel with nearly 100 beds o patient
capacity and runs a private, 120-bed container hospital in Léogâne that opened in October.
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Haiti One Year after
Cholera emergency p F e b r
u a r y M a r c h A p r i l M a y J u n e J u l y A u g u
s t S e p t
e m b e r
N o v e m b e
r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0 J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 2
At this poit, it was lea to MSF’s eld maages that the
holea otbea was goig to be a hge isse that e
qied a lagesale espose aoss seeal setos. O
Otobe 31, lage mbes o patiets bega omig to
MSFsppoted hospitals i the PotaPie’s cité So
leil slm with the symptoms o holea.
It’s a really
worrying situation or us at the moment.
All o the hospitals in Port-au-Princeare overowing with patients and we’re
seeing seven times the total amount o cases
we had three days ago.
Steao Zaii , MSF’s head o missio i Haiti,ommetig o the otbea o holea i the apital.
cosess was that holea was ey liely to spead wi
dely i a oty whee most people laed aess to
lea diig wate o saitatio, whee the poplatio
was amilia with the eessay peetio meases,ad whee atioal health sta, too, had o expeiee
with the disease po whih to daw. Bt the tasmis
sio dyamis wee dilt to pedit, bease the oly
peedets wee seeal deades old.
The poplatio’s axiety was heighteed by the PAHO
epidemi pojetios. At o poit did PAHO’s epidemi
modelig lead to a eetie aid deploymet. O the
otay: hge amots o aid wee oetated i
PotaPie while isiet sppot was poided to
the iexpeieed health woes battlig the disease’s
aggessie spead i al aeas. MSF teams od
some health etes aig shotages o liesaig oal
ehydatio soltio ad othes that had simply bee
shtteed.
The mbe o si patiets was gowig. I the api
tal, the mbe o people seeig teatmet at MSF
ad sppoted medial sttes jmped om 350 o
the wee edig noembe 7 to 2,250 ases the wee
edig noembe 14. I the noth, MSF teams logged
280 ases dig the wee edig noembe 7, bt that
mbe jmped to 1,200 o the wee edig noem
be 14. They otied to gow ate that.
MSF was able to otie woig thoghot seeal
bots o iolee i the oty. Dig iots i the othe ity o cap Haitie, MSF teams still maaged to
ope ew cTcs ad tael thoghot the ity to poi
de teatmet seies. I ealy Deembe, ollowig the
oty’s eletios, MSF was still able to poide teat
met i its etwo o cTcs i the apital whe iotig
hit PotaPie.
Despite the hge pesee o iteatioal ogaisatios
i Haiti, the holea espose had bee iadeqate i
meetig the eeds o the poplatio. MSF issed epeated
pbli statemets poitig ot that itial shotalls ithe deploymet o wellestablished meases to otai
holea epidemis ae demiig eots to stem the
ogoig otbea i Haiti. O noembe 18, MSF issed
a pess elease allig o othe aid atos to do moe, to
sale p thei esposes ad to do it qily.
MSF otlied a seies o meases that eeded to be ta
e immediately to ty to get the epidemi de otol.
These eeds wee shaed with goemet oials, the
un leadeship ad hmaitaia elie oodiato, ad
othe nGOs
“
“
Cholera is an easily preventable disease. It may be new to Haiti,
but the ways to prevent and treat it are long established.
Without an immediate scale-up o necessary measures by international agencies
and the government o Haiti, we alone cannot contain this outbreak.
caolie Segi, MSF emegey medial oodiato.
“
“
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29
Haiti One Year after
Cholera emergency p F e b r
u a r y M a r c h A p r i l M a y J u n e J u l y A u g u
s t S e p t
e m b e r
N o v e m b e
r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0 J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 2
Current situation
At peset, MSF is still salig p atiities, osig o
maig moe beds aailable ad o ase maagemet,
while maig se that oholea atiities otie
omally. By late Deembe, the ases i the noth, no
thwest, ad the Sotheast depatmets, the Atiboite
egio, ad the aea jst west o PotaPie wee all
seeig ases deease. Howee, MSF admitted 8,450
ew ases i its cTcs atiowide i the wee edig De
embe 26. Thee seems to be a widespead belie that
the holea espose i the apital will hae to last seeal moe moths, thogh ealy 2011, at the ey least.
I a smalle otbea, MSF wold be as osed o tyig
to bea tasmissio as it is o teatmet, ayig ot
ommity awaeess ad edatio eots, distib
tig wate, ad so oth. I this sitatio, thogh, it has
bee eessay to deide how the ogaisatio a be
most eetie gie the esoes it has. The ogaisa
tio has doe some o the aoemetioed peetio
atiities, bt it maily has osed o seig the most
seee ases, o saig lies, essetially, while hopig
ad pshig othe atos will ll i the gaps elsewhee.
Besides MSF, cba medial bigades hae bee themost atie ato i the aea o teatmet o holea a
ses. Moe tha 3,300 people had died om this lagely
peetable ad teatable oditio by Deembe 26.
These included:
reassig a poplatio ighteed by a disease that
is ompletely ow i the oty, ommiatig
the low is ad positie beets o haig popely
holea teatmet etes i lose poximity to omm
ities;
Poidig sae, hloiated wate to aeted ad atis
ommities atiowide, i additio to blaet disti
btios o soap;
Bildig laties ad saely emoig waste o a eg
la basis;
Esig waste maagemet ad emoal at medial
ailities, i ode to peet otamiatio;
Establishig waste disposal sites lose to ba aeas i
appopiate ad otolled eiomets;
Establishig adeqate oal ehydatio poits i aeas
whee holea ases ae appeaig;
Maitaiig a sae ad eiet etwo o eeal o
seee ases to holea teatmet etes;
Esig sae emoal ad bial o dead bodies.
© François Servranck / MSF
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Haiti One Year after
Cholera emergency p F e b r
u a r y M a r c h A p r i l M a y J u n e J u l y A u g u
s t S e p t
e m b e r
N o v e m b e
r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0 J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 2
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
MsF w mb c mcy p c vy mttv ptmt ht.
By dcmb 26, t Mty ht pt 150,000 c m t 3,300 t c t
cuty. at t m tm, Juy 2, 2011 m t 91,000 c c b tt by MsF
mc tm 47 c ttmt ct tuut t cuty. (T ccut ppxmty 60
pct c tt t t cuty.) MsF tb v 4,000 b ptt cp-
cty t c utbk b b t mt t c tty t t 2 pct t
ct.
M t 1,000 t mc tc upp v b but t t cuty, MsF m
t 5,500 ht tt t ct t c ttmt.
MsF tmt t w p ppxmty €10.8 m ($14.2 m) c mcy pm
2010. at €7.5 m ($9.9 m) pjct t b qu t ctu c-t ctvt
ht 2011.
© Gregory Vandendaelen / MSF
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F e b r u a r y M a r c
h A p r i l M a y J u n e J u l y A u g u s t
S e p t e m b
e r N o v e
m b e r D e c e
m b e r
J a n u a r y 1
2
2 0 1 0 J a n u
a r y 1 2
2 0 1 1 O c t o
b e r 2 2
31
Financial accutbty
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
MSF eeied massie aial sppot o the Haiti emegey om hdeds o thosads o doos
aod the wold. By the ed o 2010, MSF has estimated it will hae spet all o the €104 millio 2 ($138
millio) doated by piate sppotes o Haiti.
MSF estimates that it will hae spet a total o €94 millio ($124 millio) o the eathqae elie eot i 2010. The
emaiig piate estited ds aised o Haiti (appoximately €10 millio o $13.2 millio) will hae bee sed to
mobilise MSF’s holea espose.
As o Otobe 31, MSF had spet 76 peet—some €79 millio ($104 millio)—o these estited ds i the st
10 moths ollowig the disaste.
Major Operational Spending Categories January 12 to October 31, 2010
2. T mut t v b cvt t eu u t v mty t cuc wc t u w y t. a Us u
t pt v b ccut b eu t Us d v xc t m Juy 1, 2010 t octb 31, 2010 (1.32 Usd t 1 eu)
Category Euros US Dollars Percentage
National Staf 18,571,604 24,514,517 23%
International staf 12,622,519 16,661,725 16%
Medical 12,271,641 16,198,567 15%
Logistics 18,395,034 24,281,445 23%
Transport & Freight 14,964,735 19,753,450 19%
Running costs 2,114,144 2,790,670 3%
Training 102,269 134,995 0,13%
Consultants 305,999 403,919 0,38%
Other 180,674 238,490 0,23%
TOTAL 79,528,620 104,977,779
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Financial accutbty
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1 F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
Use o expenses through October 31st 2010
TOTAL: € 79.5 MILLION
Opeatig sh lagesale emegey health pogams eqies a age o iestmets. Gie the deastatio i
PotaPie ad beyod, ildig the eatotal desttio o may health etes ad hospitals, oe 20 pe
et o MSF’s expedites as o Otobe 31 wee deoted to logistis, sh as the ehabilitatio o osttio o
medial ailities as well as the distibtio o shelte mateials ad the bildig o laties. Withot this iestmet,
medial sta wold ot be able to opeate ad patiets wold ot eeie the sope ad qality o teatmet MSF
oes.
A the 15 peet o MSF’s expedites wee attibted to the medial ategoy. This ildes medial spplies
ad eqipmet sh as dgs, aies, sgial its, hospital eqipmet ad mateity health spplies.
Gie the medial ate o the iteetio ad the peedeted leel o deploymet o atioal ad iteatio
al sta, both sta ategoies aot o a sigiat amot o the expedite (almost €32 millio). They ilde
all the elated expeses o the moe tha 8,000 (maily medial ad logistis) sta that hae patiipated i the
iteetio.
Bease ast amots o elie goods had to be boght ito Haiti, taspot ad eight aoted o 19 peet o
the total spedig thogh Otobe 31. rig osts ildes expeses elated to all MSF oes i Haiti.
All these expedite lies otibted to ahiee a mbe o emegey assistae atiities. To gie some exam
ples, the amot dediated to sgial ad postopeatie ae amoted to €17.2 millio ($22.7 millio) thogh
Otobe 31, while €10.1 millio ($13.3 millio) wee dediated to mateal health ad €11.7 millio ($15.4 millio) tothe distibtio o shelte ad oood items.
National staf Logistics
Transport & Freight
International staf
Medical
Running costs
Consultants
Other
Training
3%
15%
16%
23%
23%
19%
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Looking a
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
wold eate a pblipiate hospital i the apital i
the yeas ahead. Aothe €7.5 millio ($9.9 millio) is
pojeted to be eqied to otie holeaelated a
tiities i Haiti i 2011. Beyod these pojeted atiities,
MSF will emai eady to espod to ew emegeies i
the oty—as it does i all o the ealy 70 oties it
opeates i today.
MSF had aleady bee peset ad atie i the oty
o the past 19 yeas. It was theeoe eady to espod
whe the disaste st. Ad it is ow pepaed to dothe wo that will emai i the days, moths, ad yeas
to ome.
Planned Projects
MSF will os its esoes o the otied poisio
o emegey ae o tama, othopedi ad iseal
sgey, as well as pediati emegeies:
Lad is beig phased o the osttio o a ew
hospital i the idstial aea o Tabae. It will hae 110
bed apaity ad will at as a eeal stte o eme
gey ases i the cité Soleil ad Matissat slms, po
idig pediati, othopedi, ehabilitatio, ad metal
healthae seies as well.
The et medial ailities i Matissat, chosal, ad
Bieteaie ae to poide teatmet, stabilisatio, ad
tase o emegey ases.
The MSF otaie hospital i Léogâe will otie its
os o obsteti, tama, ad paediati emegeies.As othe nGOs moe i with pimay health ae ati
ities, the hospital’s otpatiet depatmet will lose
dow o oetate o speialised osltatios. The
goal is to d a solid pate who a tae oe the hos
pital i de time.
By Jaay 2011, the ifatable hospital at SaitLois
will be defated, ad the medial pogam—ebilt with
otaies—a moe to a moe pemaet stte
o 120 beds i Doillad.
MSF will t oe ll esposibility o the Jamel hos
pital to the Miisty o Health i Jaay 2011.
Bieteaie Hospital, a 80bed aility i a stoe
stte, will otie its atiities with a os o
emegey ad pediati ae til at least the ed o
2011.
Emergency Obstetrics
Emegey obstetis ad eoatal ae will estat i
the ewly ostted otaie hospital i Delmas 33
that eplaed the ollapsed Hôpital Mateité Solidaité.
This 135bed mateity hospital ow meets eathqaead hiae esistae stadads. The ew aility will
poide aess 24/7 to ee ad highqality emegey
obsteti ae o ompliated pegaies ad delie
ies.
MSF will poide aess to peatal osltatios ad ol
lowps to patiets with poblems elated to pegay,
sh as elampsia, peelampsia, pegayelated
hypetesio, ad peexistig hypetesio. Thee will
be postatal osltatios ad ollowps o patiets
who delieed i the mateity hospital.
MSF will oe oltay oselig ad testig o HIv
to all wome admitted to the Delmas 33 Hospital o the
basis o thei seologi ad imme stats, while esta
blishig a eeal system o those who test positie.
All ewbos who ae ill ad/o bo pemate at the
Delmas 33 Hospital will eeie eoatal ae. MSF will
hie moe tha 155 Haitia sta to the hospital ad
exted taiig oppotities o medial esidets om
i PotaPie.
La Fondation Sant Se Ae Pam
MSF is also woig o a ew poposal o a geeal
hospital with a apaity o 212 beds, a taiig pogam
o medial stdets ad speialist dotos, ad a log
tem tasitio pla. With this i mid, MSF has set p a
odatio whih will iole pates om Haitia iil
soiety, iesities, ad othe sposos.
Medial speialties will ilde othopedis, geeal s
gey, b ae, maagemet o hoi pathologies ithe ate phase—asthma, diabetes ad hypetesio,
i patila—ad tioal ehabilitatio. Most o the
sta woig i the hospital will be eited i Haiti a
odig to the sills ad qalities eessay o the po
pe tioig o medial atiities.
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35
Looking a
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
The maagemet steeig ommittee will be gadally
appoited om sta eited at the begiig o the
pojet. To do this, they will eeie appopiate taiig
sppoted by MSF i ollaboatio with othe pates.
MSF will gide ad aially sppot the statp pha
se o this stadaloe Haitia odatio with the aim o
leaig it to loal maagemet oe it is sstaiable.
Tabarre Container Hospital
Followig the Jaay 2010 eathqae, the espose
by aios atos ote (ad destadably) osed
o pimay athe tha seoday health ae. Howee,
tama ijies ae oe o the majo ases o mobidity
ad motality i Haiti.
Sgey apabilities ae eeded, as ae pemaet st
tes i whih to ay them ot. MSF ths deided to
eate a otaie hospital that wold bidge the gap
betwee the emegey espose ad the logetem
espose ad wold poide a aiety o essetial s
gey seies i a site that old be sed by the ity.
I seod hal o 2011, MSF will ope a 110bed otai
e hospital i Tabae, PotaPie, with the aim o
tig it ito a tama sgial ete o the ity able
to ay ot 150 sgeies a moth. Tamatology, o
thopedi, ad iseal sgey will be poided, alog
with emegey pediati sgey ad patiet ehabilitatio.
This will allow a apid espose to the eeds existig
i the time iteal betwee emegey espose
ad logtem aswe. (util the ew stte opes,
Sathe Hospital is beig sed as a eeee tama
ete.)
8/7/2019 HAITI ONE YEAR AFTER - Medecins Sans Frontieres
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Concu
Haiti One Year after
F e b r u a r y M a r c
h A p r i l M a y O c t o b e r J u n e J u l y A u g u
s t S e p t e m b e r
N o v e m b e r D e c e m b e r
J a n u a r y 1 2
2 0 1 0J a n u a r y 1 2
2 0 1 1
MSF wishes to acknowledge the sufering o the Haitian people, who have endured so much during and ater
the earthquake. However, much o the afected Haitian population continues to live in very precarious
circumstances. With the continued support o our donors and staf, MSF remains committed to addressing
the needs in Haiti to the best o our ability in the coming years.
The earthquake in Haiti was an unprecedented disaster or the Haitian people and created enormous medical and
non-medical needs. The aid response has been unable to ully meet these needs; throughout the year the assistance
provided, whether or shelter, clean drinking water or cholera treatment, was not enough.
There is much about the international aid system that can be improved, and MSF also recognises that there are areas
in which we ourselves can improve in terms o deploying our own resources, especially regarding shelter and prepa-
ring or mass casualities, as well as in voicing our concerns and engaging with others to improve the aid response.
With the ongoing generous support o our donors and commitment o our staf, MSF is dedicated to using our expe-
rience in Haiti to prepare our actions in uture emergencies.
Over the past year, MSF attempted to meet the most critical medical needs in Haiti. As in every context, we had to
make choices on how we could best employ our expertise and resources, keeping in mind other critical needs and
emergencies elsewhere in the world in 2010.
In the rst phase, this was through trauma surgery and other emergency medical activities, along with shelter and
water and sanitation activities. In the second phase, this was through post-operative, mental health, and primary
and secondary health care services. When cholera broke out in October, we reoriented our activities to respond as
robustly as possible to treat those afected, while keeping up our other programs as well.
In 2011, we will ocus on running six hospitals and supporting two Ministry o Health hospitals. Unortunately, more
© Nicola Vigilanti