As Haitians waited for international aid to arrive, their shock turned to desperation in the absence of food and medical care. After many logistical hurdles in the days immediately following the earthquake, international aid groups began arriving in Haiti over the weekend – ranging from search-and-rescue teams with large equipment for digging through the rubble to health organizations that are setting up field hospitals and distributing food.
However, many food-distribution efforts turned to chaos in the absence of an organized security force, as mobs of people fought for food. Reports of looting and violence are increasing. The local police force has been decimated, either injured, killed, or simply not reporting to work because of their own desperate situations. Nine thousand UN troops are in Haiti. Monday morning, 2,200 US Marines arrived in Haiti, and 10,000 total are being deployed. President Obama has called up reserve military personnel and ordered a Coast Guard unit to head to Haiti to provide support in several areas, including security.
After heavy equipment arrived, search-and-rescue teams began digging through rubble and, miraculously, found survivors who had been trapped for four to six days. US Ambassador Kenneth Merten reported that, as of Monday afternoon, 75 people had been rescued, and rescue crews continue to dig for both the living and the dead. Paul Antoine Bien-Aime, Haiti's interior minister, told Reuters that around 50,000 dead bodies have been collected. He expects the death toll to be between 100,000 and 200,000 people, while admitting that they will never know the exact amount. With much of the media focused on the devastation in Port-Au-Prince, little attention has been given to other parts of Haiti affected by the earthquake. Haiti's Ministry of Interior and Civil Protection is reporting that approximately 10,000 people were killed in the towns surrounding the capital city. And 80% and 90% of the homes were destroyed in the towns of Gressier and Leogane, respectively.
Health Concerns Increasing In terms of health issues, the World Health Organization (WHO) has been submitting daily status updates. Scarcity of basic provisions, such as food and water, remains the biggest challenge, and a major concern is the sheer overwhelming numbers of the injured and the lack of facilities and medical supplies to treat them. The WHO is reporting that at least eight hospitals were destroyed or severely damaged in the earthquake. At least five are functioning in some capacity. According to the WHO, "Untreated trauma wounds and infection of wounds are major health concerns that need priority attention." Similarly, Doctors Without Borders (Medicins Sans Frontieres) is reporting that, because of limited treatment capacity, injuries that were minor three days ago are now life-threatening due to infections that come from the lack of immediate medical attention.
Groups from all over the world are in or are headed to Haiti to set up field hospitals. Teams from the US, Israel, Colombia, France, Canada, Indonesia, Russia, and more have arrived or are on the way to set up hospitals or provide medical care in existing hospitals. Supplies are coming in by the ton; however, there is no organized distribution process or method of tracking what is actually in each shipment. As a result, surgical supplies are ending up in places that aren’t equipped to use them, when that same field hospital is lacking basic items such as splints and sterile bandages.
Another issue that is beginning to take shape is the potential stress that this disaster is putting on the health of the Dominican Republic's population. Because of the influx of patients from Haiti, hospitals in the surrounding countryside and border towns of the Dominican Republic are overflowing, denying those sick from normal illnesses (unrelated to the earthquake) the access to medical care. For example, a 20-bed hospital in the Dominican Republic border city of Jimani saw 2,000 people on Saturday and conducted 200 major surgeries. The overflow from that hospital is being sent on to Santo Domingo.
Many ongoing medical efforts in Haiti are being severely disrupted. Around 70,000 babies are born annually in the country, and the overwhelmed health centers and hospitals are focusing on trauma injuries from the earthquake instead of obstetric care. Furthermore, the Haitian Health Organization (HHO) normally runs an obstetrical transport ambulance that performs around 20 emergency evacuations of pregnant women every month. Expecting mothers use cell phones to call the ambulance when they need help. The HHO is reporting that this service has been halted because all cell towers have been knocked out by the quake, and there is no way to communicate with the pregnant women.
As reported in our Friday blog post, Haiti's numerous existing health issues – tuberculosis, HIV/Aids, malaria, respiratory diseases, diarrhea, disease associated with intestinal worms, dengue fever – will only be escalated by the disaster. Furthermore, as masses of people flee the dangers and chaos of Port-Au-Prince and crowd into other towns and tent cities, other health concerns will arise. "Displaced people are at high risk from outbreaks of water-, sanitation-, and hygiene-related diseases, as well as foodborne diseases, due to reduced access to safe water and sanitation systems. Salmonella typhi (causing typhoid fever), hepatitis A and hepatitis E are present and have epidemic potential," the WHO reports on its website. "Population displacement can result in overcrowding in resettlement areas, raising the risk of transmission of certain communicable diseases spread from person-to-person, such as measles, tetanus, and diphtheria." Other concerns include malnutrition, skin infections, reproductive health, and even non-communicable diseases such as cancer, diabetes, and cardiovascular issues.