A humanitarian disaster, acute and chronic

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We're off the coast of Haiti near Port-au-Prince, providing assistance to areas in the north and southeast of the country cut off when the roads washed out in the flooding from the recent hurricanes. Our helicopters are transporting hundreds of thousands of tons of relief supplies (mostly rice, beans, flour and oil) to people who have no food and no water. At the moment, the helicopters from the USS Kearsarge are the only means available in the country of moving these goods. Some areas are so isolated even our helicopters can't reach them. People are getting more and more desperate. There was fighting the day before yesterday over the food (you may have seen it on Fox.

Hurricanes and flooding are only a part of the problem for this small country, the poorest in the Western Hemisphere. The infrastructure is almost non-existent, with an underfunded health care system, no money to build and maintain roads and bridges, and lack of personnel to provide services to poor and isolated communities. The government just recently changed (today was the 5th day in his position for the new Minister of Health), which compounds the problems. There are difficulties with the economy, with job loss as companies moved to China for manufacturing (baseballs or softballs used to come from here, but not any more). According to Wikipedia, there were food riots here before the hurricanes ever entered the picture, which led to the change of government with a new Prime Minister. An interesting side note is that all services by the government shut down on the weekends. And we were told the food rioters also quit rioting on Saturdays and Sundays. Definitely a different rhythm of life.

Since we arrived in Haiti, the medical/dental/optometry/public health/veterinary, etc. team has been on standby (meaning we wander around the ship looking for things to fill up our time - you can only do so much laundry.) Two issues we face are lack of interpreters for Haitian Creole (which I have learned is nothing like French), and lack of force protection (the guys with the guns). For the latter we are dependent on the Haitian government. There are also problems with having lots of NGO (non-government organizations) and external government agency staff on the ground (at least in Port-au-Prince) but little or no coordination of their activities. So it has been difficult to find a location where we could be of use. One colleague reports that he met a dynamic woman sent here by the CDC who was frustrated in not being able to get information about the impact of the hurricanes on the health care system. So she took the initiative to simply call all the hospitals and health centers and inquire about their current condition - roof blown off, inadequate staff, whatever. She currently seems to know more about the situation than anyone else, including the Ministry of Health people who report that all the hospitals are intact and operating as normal (not true).

My colleagues who went ashore to the airport to help load the helicopters with supplies and be available in case our ship's crew needs medical attention report that there is a warehouse at the airport FULL of expired medications and equipment - hundreds/thousands of doses of tetanus toxoid (important in this country where in the rural areas people still apply dung to the umbilical cord of newborns and neonatal tetanus is a major problem), that expired in 2005. Thousands of doses of antibiotics, ulcer medications (expired 2004), acyclovir for herpes and other viruses, and more. This was all left over from the last hurricane, and reflects the breakdown in the health care system and distribution mechanisms to make use of supplies when they are available.

I met last night with the US Public Health Service team, and it's possible we are going to start some public health efforts, focusing on villages/towns that have not yet received any assistance. I may participate with that team. It also looks like they are getting closer to organizing some medical teams to go out. So my mini-vacation aboard ship may soon be over. I actually have made use of the time to create some handouts for patients (in Spanish - useless here but could be helpful if/when we get to another Spanish-speaking country), and to put together a PowerPoint presentation for the new volunteers (when they finally get to come aboard) on how to get around the ship and find important locations like food, laundry facilities, etc. I included an introduction on how to put on the gear and seat restraints when flying in the helicopter (I selected that one because as a clueless novice the first time my team got flown back to the ship, I held up the rest of them while people helped me get all harnessed and helmeted). So much to learn, so little time....

Below are some pictures (I hope) of the Kearsarge and our transportation to and from the ship. I can only load pictures before 6:30 am (after that the Internet is too slow to allow the download). So the pictures are always going to be posted long after the blog to which they relate. Oh, well. I'm having to load them into my Gallery, then I'm trying to imbed them with the blog. I won't know if this is successful until I publish this blog, so if it doesn't work, sorry about that. I'll keep working on it. Got to get up at 0200 to make this work .







More to follow.....

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