Ten weeks after the earthquake of 12th January, which left up to 300,000 people injured, medical needs remain immense in Haiti and continue to grow. A crucial phase has begun, in which thousands of injured people require long-term medical care just as some health providers that responded to the initial emergency phase of the crisis begin to leave the country and discharge patients.
MSF is expanding its capacity to care for the many wounded requiring extensive post-operative care – including secondary surgeries, physical therapy, rehabilitation and mental healthcare – for at least the next year. In recent weeks, more than 200 patients have been referred to MSF medical facilities by other medical teams leaving the country.
MSF is also focusing on primary healthcare, with the opening of new out-patient departments and the creation of additional capacity for secondary health services, including emergency obstetrics, intensive care for malnourished children and inpatient care for paediatrics and adults.
In response to the dire situation confronting people living in makeshift camps or on the street 10 weeks after the quake, MSF is stepping up the distribution of tents and plastic sheeting, as well as blankets and hygiene and cooking kits.
Ongoing surgical support
In the capital, Port-au-Prince, surgical activities are ongoing in the 200-bed capacity inflatable St Louis hospital, which includes two operating theatres. An additional operating room is planned to treat patients suffering from burns. At the moment, around 200 patients are hospitalised and 770 surgical operations have been performed since setup. The hospital provides complete post-operative care: medical and surgical follow-up, physiotherapy, psychological and social care. The hospital aims to treat the same cases that were treated at the now destroyed facility of La Trinité: major traumas (road accident, gunshots, burn victims, etc.) and provide healthcare for victims of sexual violence.
Surgery at Choscal Hospital in Cité Soleil takes place outside because staff and patients are frightened to enter the damaged building.
Photo by MSF
Meanwhile, at Choscal Hospital in Cité Soleil, the team has rearranged facilities into a general hospital serving an extremely precarious population.
MSF intervened in this Ministry of Health hospital initially focusing on earthquake-related trauma. There are two operating theatres for major surgery and one for minor surgery. MSF also works in the emergency room and the maternity ward. The hospital has a 100-bed capacity, all under tents as the building has been slightly damaged by the earthquake and patients are still afraid to enter the hospital.
Psychological care continues for all patients and their caretakers.
Outside the capital, at Carrefour Arts et Metiers orthopedic hospital, around 40 operations are performed every day. It houses two operating theatres and one of the few X-ray machines in the city. Orthopedic surgery, skin grafts and muscle flaps are being performed and post-op care and rehabilitation are provided. Currently, 80 patients are hospitalised. Rehabilitation care is offered to patients in collaboration with Handicap International. Psychological care is offered to patients and their families.
In Léogâne's 90-bed hospital, maternity activities are increasing, with 50 deliveries and three caesarian sections performed in the past week. And at Jacmel, full outpatient and inpatient services are available under tents (81 beds) as the main hospital was badly damaged. Surgery is ongoing in the hospital’s operating theatre and mental health services are also provided.
Specialist care
MSF is supporting the Ministry of Health across Haiti with maternity and obstetric care and nutrition programmes. At Port-au-Prince General Hospital the nephrology team has completed an initial handover to the Ministry of Health, with donations of materials and three dialysis machines to the nephrology unit. Currently, 30 chronic patients are receiving dialysis. Another five dialysis machines have been installed recently to increase capacity of the unit. A nephrologist came for one week to give specific training.
Primary care and population well-being
Displaced Haitians are building shelters with the help of tents and plastic sheeting distributed by MSF.
Photo by Michael Goldfarb/MSF
MSF is working at various sites across the affected region providing outpatient follow-up, dressings and treating diseases such as diarrhoea, skin diseases, upper respiratory tract infections, fever, gynaecological cases, traumas and increasing requests for psychological counseling.
While psychological care is routinely offered to patinets who have had major surgery in MSF-supported structures, other activities are targetting the mental health needs of specific groups.
MSF is also continuing to distribution tents and plastic sheeting for shelters, as well as hygiene and household kits and is building latrines and shower blocks and distributing drinking water to displaced persons camps.