Before and after the Haiti earthquake: An

interview with MSF physician Dr. Wendy

Lai

Object 1

January 12, 2015

On January 12, 2010, a devastating earthquake struck Haiti, killing
more than 200,000 people and causing horrific injuries to over
300,000. More than 1.5 million people were left homeless after
buildings in the capital Port-au-Prince collapsed or were left
unusable.
One affected building was Mdecins Sans Frontires/Doctors Without
Borders (MSF)s obstetrics hospital, where Canadian physician Wendy Lai
worked before and after the earthquake. She tells her story in the video
above.

Haiti: Five years after earthquake, healthcare is under-prioritized in

reconstruction
Haiti: Despite increasing needs, too few beds to treat patients with

cholera

Over the 10 months following the devastating 2010 earthquake in Haiti,

MSF treated 360,000 patients, performed over 15,000 surgeries, and
distributed over 50,000 tents and half a million square litres of water per
day. MSF currently manages four hospitals, providing emergency trauma
and obstetrical care, neonatal emergency healthcare and treatment of
severe burns, and has additionally treated more than 204,000 victims of
cholera since 2010, with a mortality rate less than one percent. MSF has
worked in Haiti since 1991.

Haiti: Five years later, healthcare is

under-prioritized in post-quake
reconstruction

MSF staff and patients in a makeshift surgery area outside the Carrefour hospital in Haiti
following the earthquake that destroyed many parts of the country in 2010. Oliver Schulz,
MSF's current country director for Haiti, says that healthcare needs to be a higher priority in
Haiti five years after the quake than it currently is.

January 09, 2015

Five years have passed since a truly devastating earthquake
shook Haiti, affecting approximately three million people and killing
220,000, according to government estimates. What is the situation
in Haiti now after five years of reconstruction efforts, and what

healthcare does Mdecins Sans Frontires / Doctors Without Borders

(MSF) still provide in the country? MSFs Haiti country director
Oliver Schulz discusses.

What is the overall medical and humanitarian situation in Haiti five years
after the earthquake?
Before any sort of assessment of where we are now, we should remember
that on January 12 2010, 60 per cent of an already dysfunctional health
system was destroyed in an instant. Furthermore, 10 per cent of Haitis
medical staff were either killed or subsequently left the country. This was
quite simply catastrophic. MSF had to relocate services to other facilities,
build container hospitals, work under temporary shelters, and even set up
an inflatable hospital. We had already been present in Haiti for the previous
19 years, filling pre-existing healthcare gaps; we knew that most health
systems would struggle with a cataclysmic event such as this, let alone one
that was already struggling under normal circumstances.
Fundamentally, the vast majority of the Haitian people still struggle to
access the healthcare they need. For example, the HUEH (Hpital de
lUniversit dEtat dHaiti), the only public hospital offering orthopedic
surgical care in the country, has still not been fully rehabilitated and so
cannot run at full capacity. Furthermore, while money has been spent on
building hospitals, quite a few, such as one built in Carrefour, currently
stand as empty shells because of inadequate planning to ensure properly
trained staff, sufficient drugs, money, guaranteed maintenance and medical
material to run them.

Fundamentally, the vast majority of the Haitian people still

struggle to access the healthcare they need
Has donor money improved the situation?
While progress has been made, we are not in a position to track the
outcomes of the huge influx of donor funding into the country following the
earthquake. It is clear, however, that the money that followed the
earthquake in an effort to build back better in Haiti has not given

adequate priority to healthcare. In part due to the presence of other actors

and the reconstruction effort, it is true that MSF has transitioned away from
running activities directly related to the earthquake response. But we still
find ourselves filling important gaps in the Haitian healthcare system, gaps
that perhaps would not be present if some of these reconstruction projects
had been better planned.

What are MSFs priorities in Haiti?

MSF continues to manage four hospitals in the earthquake-affected areas of
Port-au-Prince and Logne, providing emergency trauma and obstetrical
care, neonatal emergency healthcare and treatment of severe burns.
Despite the widespread urban violence and frequent intense traffic
accidents, and a dramatic increase in the number of deaths from trauma
from approximately one per 20,000 in 2002 to almost one per 10,000 in
2012, traumatology services are almost inexistent. In 2014, in its hospital in
Tabarre alone, MSF treated 1,325 violent trauma cases and almost 6,500
accidental trauma cases, performing on average 130 surgical interventions
a month. And despite high burns risk resulting from precarious living
conditions and families living in single rooms, MSF runs the only major
burns unit in the country.
Beyond these activities, until such a time as the Haitian Ministry of Health
can take over, the other major priority remains cholera. Here, four years on
from the diseases reappearance in the country after a 150-year absence,
the emergency response remains inadequate.

Haiti: Despite increasing needs, too few beds to treat patients with

cholera

It should be clear to the Haitian government and its donor partners that
cholera outbreaks will continue at least for the medium-term. Despite this,
during an outbreak from September to December in 2014, the response

system quickly stalled as funding was not released fast enough. MSF had to
step in again and set up its own cholera treatment centres as well as give
financial support to the Ministry of Healths efforts to treat patients. Overall
last year, MSF treated over 5,600 patients with symptoms of cholera, more
than half of whom came in a single peak from mid-October to midNovember.
There is no adequate system in place to provide urgent care, despite the
existence of a National Plan for the Elimination of Cholera. The Haitian
authorities, in collaboration with their international partners, must activate
an emergency response and quickly integrate cholera case management
into their health structures.

What more needs to be done in Haiti?

Healthcare needs to be a much higher priority for the authorities and their
international partners than it is right now. The health budget is low, and in
general we are seeing a transition away from an emergency humanitarianbased response towards a development-based one. While this is crucial for
building a proper and functional healthcare system, it must not come at the
expense of capacity to respond to emergencies in the present. Funding
mechanisms must be capable of releasing money in a timely fashion in
emergency situations such as cholera outbreaks. In addition, we need more
coherent planning from those involved in the reconstruction effort so that
we do not have situations where hospitals are constructed without
adequate thought given to how to staff them, finance them, and stock them
so that they can actually function, which has been the case in some
facilities up until now.

Over the 10 months following the devastating 2010 earthquake in Haiti,

MSF treated 360,000 patients, performed over 15,000 surgeries, and
distributed over 50,000 tents and half a million square litres of water per
day. MSF currently manages four hospitals providing emergency trauma and
obstetrical care, neonatal emergency healthcare and treatment of severe
burns, and has additionally treated more than 204,000 victims of cholera

since 2010, with a mortality rate less than one percent. MSF has worked in
Haiti since 1991.
Posted by Thavam