Dr. Christophe Fournier, the International President of Médecins Sans Frontières/Doctors Without Borders (MSF) went to Port-au-Prince to offer his moral support to Haitian staff and emergency teams. Just over two weeks after the earthquake, he gave his impressions to MSF's Avril Benoit.
Christophe Fournier discusses plans for his trip with his MSF driver in Port-au-Prince
Photo by Julie Remy/MSF
"What I’ve seen is doctors, nurses, surgeons, logisticians, making it possible to treat hundreds, if not thousands of patients – first in the streets, on sidewalks, behind or in front of the collapsed hospitals, in conditions that you cannot even imagine – and save their lives. And then enabling the transfer of these patients from the streets where they were, to new hospitals that they had cleaned or hospitals made of tents. All of this was very impressive, incredible work that has a huge impact in terms of life-saving and number of patients treated."
What worries you most, then, about the health conditions right now for Haitians?
Well there’s one thing, we’ve treated so many patients, it’s now over 6,000 patients that we’ve treated because they were injured. We’ve also performed over 1,000 major surgical interventions, amputations among them, of course.
Now what worries me most is our ability to absorb the number of patients that still need to be hospitalised. We need to increase the number of beds we have for them. We have to set up new tents, a little bit everywhere in the city, but also create villages of convalescence where patients can be sheltered with their family and still receive the visits of nurses and doctors, physiologists, psychologists, to slowly recover from their injuries, both physical and mental.
We do hear a lot about post-operative care. Can you explain what that involves, exactly?
There are a number of patients who have infected wounds, because they have not come to the hospital in time. Staying in their collapsed houses, their wounds have become infected, and this requires very, very long treatment to halt the infection, and slow work on stitching and healing their wounds. We also have all these people we have had to perform amputations on, and it’s going to be a very long recovery. So you see that due to the nature of the wounds of all these people their convalescence will be quite long.
Just to give an example. I helped to transfer a woman from Leogane, a city south of Port-au-Prince, which was also hit by the earthquake. This lady stayed in her collapsed house for three days. Among other things she lost her left eye, so we had to remove not only her eye, which was already dead, but also the area around her eye. That we were able to do on the spot, in the hospital, in this small city of Leogane. But then, because she had stayed for three days in her collapsed house, she was also infected, the infection spreading into her body. She was really critical because of that infection, so that’s why we transferred her by helicopter to the new hospital. MSF had set up the hospital here in a very short time, and we have intensive care units, emergency doctors, anaesthesiologists, that will be able to handle her case.
I could also talk about tetanus. We have more and more tetanus cases because, again, these people have been staying in what remains of their houses, trapped for days. I remember a little girl suffering from tetanus, who almost died from it. She had heart failure, but we were able to resuscitate her - again, in the street - and then we managed to treat her. After a couple of critical days now she’s recovering little by little. We were all very happy to see that but this tells you about the nature of these wounds because of the infections, including tetanus that they have contracted, after staying in the houses like this.
Many people are concerned that so many Haitians are dying, but at the same time, with all the efforts that are under way not only from MSF, many lives are being saved. As you’re leaving, any thoughts on the effort that’s under way, and the amount that it’s helping.
What is striking to me is that it is a very chaotic situation with a remarkable lack of coordination between the United Nations, all these aid workers, militaries, the US army. A chaotic situation that you usually see in any kind events like this. But in this whole confusion, MSF has been able to treat many, thousands of patients effectively. It has also been able to set up all these hospitals made of tents, or find buildings that are not collapsed to organise around, and they are remarkably efficient.
Before the earthquake, the health system in Port-au-Prince was already collapsed and that’s the reason why MSF was already involved in Port-au-Prince doing surgery, with a big maternity programme that was delivering more than 1,000 babies a month because of the important problem of maternal mortality in Port-au-Prince.
This problem will remain. Not only do we have now to deal with the incredible number of injured people, people who will have a life-long handicap, but we will also have to try to resume the hospital capacity that a capital of three million inhabitants needs as soon as possible. That is also going to be one of our priorities for the weeks and months to come.