During the past several days, we have helped more earthquake patients to leave the hospital; others remain, recovering from surgery, and benefiting from rehabilitation services. Almost all have been bed-ridden for almost 3 weeks, and for some of them, learning to walk again is precarious challenge.
It has also become possible to travel to Port-au-Prince to establish personal relationships with the international aid agencies which have established offices in tents on the grounds of the airport. HAS is now represented in the Health Cluster, with daily briefings to the more than 130 participating health-related organizations, and a rich opportunity for networking. In addition, through the good offices of Dr. AJ Neusy, who has been at HAS this week, we have established links with senior officials at the United Nations and several European aid organizations. Also visiting HAS now is Gozde Akci, a Turkish veteran of many UNDP postings in troubled areas, and now a consultant to UNDP in economic development. She has arranged for a meeting with UNDP staff next week, to discuss long-term economic development strategies in Haiti.
Dr. Erlantz Hyppolite and Shaun Cleaver (the Canadian physical therapist who implemented the Friends’ Rehabilitation Technician Training Program here) attended a special meeting yesterday of the rehabilitation section of the Health cluster. There is a growing concern about the long-term needs of the many persons who endured traumatic amputations of limbs, or whose injuries resulted in therapeutic amputations. At HAS, among the many surgeries performed in the past weeks, some were amputations, and a proportionally greater number of other amputations have been performed in field hospitals in Port au Prince. The planning group forecasts a significant need for follow-up services for these patients, as their amputations were done by visiting teams under field conditions and a number will require revisions.
The loss of a limb is devastating to any person, but the challenge is compounded in the case of subsistence farmers or laborers whose independence and economic survival requires physical labor. The demand for prostheses will be significant during the coming months, and discussions have begun with several entities which could establish a fabricating plant in Haiti.
These needs are being considered in the context of a growing realization of the true scope of the devastation which the earth quake has wrought on Haiti. In a recent news conference, Edmond Mulet, acting head of the UN mission in Haiti, warned that emergency relief efforts were the start of a commitment that would be much longer than the international community might realize. "I think this is going to take many more decades … this is an enormous backwards step in Haiti's development," he told the BBC. "We will not have to start from zero but from below zero."
One of the major impacts of the earthquake has been the internal migration of many residents of Port au Prince to outlying regions. All estimates of these patterns are unconfirmed, however according to the Government of Haiti (GoH) Minister of the Interior, as of January 29, more than 482,000 people had departed Port-au-Prince for secondary cities, including at least 162,500 people displaced to Artibonite.
We have started to see the impact in our immediate area; at our monthly meeting of the community health workers (CHW) on Friday, Dr Heyliger and I learned that people from Port au Prince had been arriving and settling with distant relatives or acquaintances. How many is unclear at this time, however we asked our CHW team to provide an estimate based on thier field work during the coming week. All of the children in these groups will have to be immunized, and many of them will require medical attention. The CHW’s will register them as new residents in our census, and give them identification numbers for the Electronic Medical Record system, so that they will be easily registered at our dispensaries or at the hospital.
Our son Edward, Gozde and Starry Sprinkle (HTRIP Coordinator) visited several families in the Deschapelles area. Some of them had untreated injuries and were referred to the Deschapelles dispensary, and almost all needed food and financial help. Edward and Gozde went to the Verettes market to buy rice and beans, and are now revisiting the houses to distribute these supplies. These emergency efforts will have to be replaced by a more structured relief effort soon, as their hosts may not be able to provide shelter for them over an extended period.
One of our visitors this week has been Dennis Roddy, a reporter from the Pittsburgh Post-Gazette, who made his way to Deschapelles and has written several thoughtful pieces about HAS and Pittsburghers who have joined our efforts recently. Today’s newspaper carries a front-page article at