The disaster response for the Haitian earthquake has been swift and coordinated, channeling massive international resources to the affected area. But the logistics of deploying the resources, personnel and technology needed to deliver comprehensive disaster assistance, are beyond complicated, with roads and transport overwhelmed, and means of contacting the wounded almost non-existent.
The relief effort needs to deliver as much fresh medicine —already in chronic shortage in Haiti before the quake—, clean drinking water, safe blood for transfusions, food aid and temporary shelter, to the victims of the quake, as soon as possible. The logistical complications are extreme, as no stable means exists of locating and reaching each of the victims. Time is, however, of the essence, because quick delivery of medical assistance can help prevent non-lethal injuries from becoming fatal.
As time passes, water, food and medicine remain scarce, and dead bodies continue to accumulate in public areas, in the street, in building entrances, near water flows —established or spontaneous—, the risk of infection can escalate exponentially. Concerns about cholera, malaria, dysentery and other water-borne and communicable diseases, are dire, widespread and worsening.
Haiti already had the highest rates of infant, under-five and maternal (childbirth) mortality, in the western hemisphere, meaning the collapse of health services in the midst of the disaster, with all its attendant increased threats, means young children and pregnant women are particularly at risk, even if they are not yet injured or suffering ill health.
It is estimated that as much as 60% of the population of Haiti lacks access to even basic health services. HIV/AIDS is the nation’s leading contagious cause of death, and tuberculosis, which is more prevalent in Haiti than in any other country in the Americas, is second. UNICEF reports that: “It is estimated that about 5.6 per cent of people aged 15-49 years old in Haiti are living with HIV/AIDS. This includes about 19,000 children. Antiretroviral drugs are extremely scarce.”
High rates of disease associated with intestinal worms, such as ascaris, trichuris, and hookworm, also plague Haiti. These worms cause anemia, stunted growth, malnutrition, and impaired physical and cognitive development. The dire state of the water and sanitation infrastructure in Haiti are a main cause of these diseases, which prompted a recent effort to tackle these problems using grants by Spain and the Inter-American Development Bank, according to a news release from the latter in October 2009.
The widespread public health crisis that already afflicted Haiti before the quake means the nation is particularly at risk for epidemic outbreaks of infection in the aftermath of such a natural disaster. The extreme depletion of basic resources, like shelter and sources of food and water, due to the destruction of the built environment, means those in need of treatment may be harder to locate, and may fail to access treatment, even as aid flows in.
Doctors without Borders (MSF) is reported to have found at least two hospitals in the quake zone that are in good working condition, and is working to set up ongoing emergency treatment facilities there. But the clock is ticking, and two hospitals are just the smallest start on what could be a population of millions in need of varying degrees of emergency aid and medical attention.
Due to the chronic shortage of fully functioning hospitals, medical infrastructure and medicines, a proliferation of free clinics, run by charities or by local physicians, have come to be increasingly important in Haiti’s sporadic and unreliable health services delivery system. Over the last two days, such clinics have been overwhelmed with unprecedented numbers of patients seeking treatment, and according to some media reports, in some cases have been forced to start laying dead bodies outside, to reduce the risk to the health of those inside.
The ICRC is possibly the world’s most experienced and far-reaching blood-distribution system, and as of this writing reports it “is meeting any requests for blood due to this tragedy through current supplies”, but urges those who wish to donate, especially type O-negative or type B-negative (always in short supply), to make an appointment with a Red Cross blood donation center. There is a proper procedure for preparing to donate blood and for donating, which is laid out on the Red Cross website, and which urges donors to hydrate after donation and avoid heavy lifting or strenuous activity after giving blood.
ABC News is reporting the Obama administration’s text-to-donate program for the Red Cross’ Haiti relief mobilization has raised $5 million in just 2 days. According to their report:
The Obama administration’s program to raise money for the Red Cross’s relief for survivors of the earthquake in Haiti through text messaging has raised $5 million in just over two days, administration sources tell ABC News.
By texting HAITI to 90999 through their cell phones, donors give $10 to the Red Cross, a charge that will appear on their bills.
The Red Cross is donating in excess of $10 million to provide emergency relief for Haiti, but will also mobilize people and resources. Foreign teams are entering the country, joining a 15-person in-country staff aided by thousands of Haitian volunteers. A news release from the organization specifies:
The International Committee of the Red Cross (ICRC) is helping to reconnect separated families within the country. They have established a special Web site, enabling persons in Haiti and abroad to search for and register the names of relatives missing since the earthquake: www.icrc.org/familylinks. An ICRC plane carrying 40 tons of supplies — mainly medical items — is expected to leave Geneva today. Included are specialized kits to help treat the wounded, basic medicines and chlorine for water treatment. Other Red Cross partners have deployed a mobile hospital as well as medical teams to support it as well as more than 40 others who can coordinate the relief activities, including sheltering, water, sanitation and telecommunications.
The Red Cross provided blood and blood products to the US Naval Air Station in Jacksonville, Florida. That blood, requested by the US Navy, was shipped by the US Navy to their facilities at Guantanamo Bay, Cuba in support of Haitian evacuees and patients. In addition, the American Red Cross sent a shipment of blood products to the United Nations Mission in Haiti. To date, the Red Cross has sent more than 100 units of blood and blood products to Haiti and Guantanamo Bay. The American Red Cross is meeting the needs of this tragedy through current supplies. At this time we do not anticipate the need for a special donor appeal to support our efforts. As always, blood donors are encouraged to call 1-800-RED CROSS or visit us online at www.redcrossblood.org to make an appointment.
Two days into the earthquake aftermath, the scarcity of safe drinking water is now becoming a much more immediate concern. Security and public health concerns converge, as lack of shelter, panic, grief and repeated aftershocks, prevent people from sleeping, which together with potentially severe dehydration, not only diminishes the body’s defenses, but also inspires desperation. If illness and infection take hold among those already grieving and/or wounded, the situation could seriously deteriorate and more deaths will be likely.
The next 24 hours will be crucial in terms of getting aid delivery centers and health treatment facilities set up. Aid workers and government officials will need to be able to move out into the field, to search for survivors, especially the vulnerable or immobilized. The equation for sustaining the population through the next phase of disaster relief will boil down to: medicine, water, blood, food and shelter, assuming the logistical challenges are overcome, and help can get through.