Haiti one year after: Emergency Phase
At the time of the earthquake, MSF was running three secondary level health care structures in Port-au-Prince: an emergency health centre in the Martissant slum; an emergency hospital for trauma and orthopedic surgery, which also had an intensive care unit for burns and a rehabilitation centre, in the Pacot neighborhood; and an emergency obstetric care hospital with antenatal care clinics in the Delmas area. These facilities were designed to address the medical needs of populations living in very poor, violence-plagued urban communities.
MSF structures and staff were hit hard by the quake. It took days to account for everyone. Sadly, 12 Haitian MSF staff members were killed in the earthquake, as were some patients and caretakers who were inside buildings that collapsed.
Take care, organise and stabilise
Patients arrived at MSF medical facilities and administrative offices with multiple and open fractures, crushed limbs, skull fractures, spinal cord injuries, and life-threatening burns. Teams concentrated on wound cleaning, debridement and dressing, and fracture stabilisation. In the first days, the immediate and highest priority for MSF was to stabilise and manage care for the wounded, to organise triage, and to provide immediate lifesaving surgery and end-of-life-care.
“Five minutes after the quake, people were banging on our door in need of help. Within a few hours, there were hundreds of people in need of surgery,” said Dr. Jeanne Cabeza, medical coordinator for MSF’s operations in Haiti, who was at MSF’s rehabilitation centre in the Pacot neighbourhood and had, like some of her colleagues, sustained minor injuries.
Forced adaptation to the conditions
Although much of its health care infrastructure was destroyed, MSF still had the trained staff and the supplies - stocks of medicines, medical material, surgical equipment and logistical material—to respond. MSF staff adapted to the immediate conditions on the ground while logistical personnel quickly organised themselves to improve the environment for treating and caring for patients.
The MSF logistic teams mobilised quickly to set up temporary infrastructure and to repair and expand existing infrastructure. Supplies of water and electricity were established, sanitation procedures put into place, and, later on, medical facilities were installed.
3,000 patients in a week
By the end of the first week, MSF estimated it had treated more than 3,000 wounded people in the Haitian capital and performed more than 400 surgeries. Ultimately, MSF was one of the major actors in emergency surgical care among the 30 foreign field hospitals deployed during this first three-month emergency phase. MSF surgeons performed 5,707 major surgical procedures, 150 of which involved amputations.
Being confronted with such a huge caseload of surgical patients and having learned from previous earthquake interventions, MSF established some 2,000 post-operative care beds in Port-au-Prince within five weeks of the earthquake.
Caring for displaced people
By the end of the first month, in order to respond to the pressing needs for basic health care for displaced people in Port-au-Prince who had found some type of shelter near MSF surgical facilities, MSF teams set up outpatient services linked to or integrated within the emergency hospitals and postoperative care centres.
In late January, MSF was endeavouring to further aid hard-hit communities by establishing fixed and mobile clinics, organising supplies of water and the construction of hygiene and sanitation facilities as well as distributing plastic sheeting, tents and other relief items.