HAITI EARTHQUAKE

Haiti Earthquake

Haiti Earthquake

Introduction

On January 12, 2010, at 4:53 pm, a powerful 7.0-magnitude earthquake struck 15 miles southwest of Port-au-Prince, Haiti, destroying not only that capital city-home to 3 million people-but also the towns of Leogane, Gressier, Petit-Goave, Grand-Goave, and Jacmel, as well as countless mountain villages. The 35-second tremor devastated the administrative infrastructures of the government, several healthcare-delivery facilities, and many nongovernmental relief agencies. It left more than a million people displaced, more than 300,000 injured, and an estimated 230,000 to 316,000 dead, making it one of the deadliest natural disasters in modern history. The cost of the destruction was estimated at 120% of the country's gross domestic produc (Lindell, 2008).

This earthquake gave rise to an unprecedented outpouring of sympathy and offers of assistance from around the world. The Mount Sinai Medical Center of New York, like many institutions, participated in that effort. Taking into account Haiti's fragility and its notorious unpreparedness, as well as the reported scale of destruction, the administration decided to intervene quickly and strongly. While volunteers were being assembled, a surgical intensivist was dispatched along with a team from the Boston-based Partners in Health (PIH) to assess specific needs. Based on information they provided, Mount Sinai sent to Haiti's State University Hospital (HUEH) a 29-person multidisciplinary team, including people who could speak French and Creole. The group included senior surgeons, orthopedists, anesthesiologists, a plastic surgeon, a pediatrician, intensive care unit nurses, operating room nurses and technicians, the director of perioperative services and the director of emergency preparedness. They carried a substantial complement of medications, battery-operated equipment, orthopedic supplies, communication gear, and other paraphernalia. The mission was clear: to closely partner with PIH, provide the best possible care to as many patients as possible, help set up a system to manage the operation, and rapidly transition to the local providers. The Mount Sinai staff in New York would remain in constant communication with the remote team, sending additional medications and other supplies and equipment as needed.

This mission was locally regarded as a success. In addition to the medical and surgical interventions it performed, the mission quickly helped expand operating capacity at the HUEH, centralize the logistics, and manage the surgical workflow of different surgical teams around a single operating schedule. It also helped smooth the relationship between the international teams and the local staff integrated in a common workflow. This experience highlights several valuable lessons to be learned and mistakes to avoid when planning for disaster relief and serves as a basis for the discussion that follows.

Historical Perspective

A disaster implies that the number of sick and injured overwhelms the local capacity for rescue and treatment, mandating a request for national or international assistance.1 Because the local coping capacity varies among countries depending on their level of socioeconomic development and their level of preparedness, the threshold at which outside help may be requested is also variable. Resource-poor countries like Haiti are likely to need external assistance even for relatively moderate natural occurrences, whereas a country like Chile, ...