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Haiti Quake Efforts Were Hampered by Poor Information Sharing

January 20, 2012 in Haiti by Jonathan White | No comments

Displaced Earthquake survivors living in temporary camps

By Dr. Martina Fuchs

Having witnessed Haiti post-earthquake firsthand, the enclosed news release provides an accurate analysis of the humanitarian efforts. The Pan American Health Organization pretty much co-managed the relief efforts with the Haitian government.

Photos in this blog posting were all taken by Real Medicine Foundation photographer, George Papuashvili and are the property of Real Medicine.

Family in a Tent Camp

PAN AMERICAN HEALTH ORGANIZATION www.paho.org

WORLD HEALTH ORGANIZATION www.who.int

News and Public Information

News Release

 

Haiti Quake Efforts Were Hampered by Poor Information Sharing

Foreign responders often ignored guidance and authority of Haitian government, says new PAHO/WHO report

Washington, D.C., January 13, 2012 (PAHO/WHO) — The massive humanitarian response that followed Haiti’s January 2010 earthquake was less effective than it could have been due to poor coordination and information sharing and widespread disregard among international groups for the authority of the Haitian government, according to a new report from the Pan American Health Organization/World Health Organization (PAHO/WHO).

To  improve future relief efforts in low-income countries, the international community should help strengthen government capacity for coordination as part of support for risk reduction and disaster preparedness, the report concludes.

The new study, Health response to the earthquake in Haiti: Lessons to be learned for the next massive sudden-onset disaster, examines the health effects of the quake and the effectiveness of national and international health relief efforts. It was released on the second anniversary of the Jan. 12, 2010, quake.

The report says Haitians themselves responded swiftly and effectively, saving many lives before foreign help could arrive. However, the domestic response was severely limited by the devastation of the country’s capital and the impact on government staff and facilities.

 

City and tent camps

The 7.0-magnitude quake (MMS scale) was among the most damaging in recent times, leaving more than 220,000 dead, over 300,000 injured, and some 1.3 million forced into temporary shelters. This catastrophic outcome was the result of both socioeconomic and seismic factors: the vulnerability of Haitian housing and construction, the shallow hypocenter of the quake (close to the earth’s surface), and its proximity to the country’s most important urban center. Rural areas in the West and South-East departments were also badly affected.

 

“Admittedly, Haiti was not prepared for any type of mass casualties. But no country or system could have had an orderly response to a disaster of this magnitude that affected the political, administrative, and economic center of the country,” the report notes.

 

For its part, the international community reacted quickly and generously, mobilizing a massive amount of resources to provide essential health services that were in urgent demand. This included valuable assistance from health authorities and facilities in the Dominican Republic and from other countries in the Caribbean, who sent assistance in the first hours after the quake.

 

However, the overall effectiveness of international efforts was undermined because many foreign actors, including most NGOs, worked with minimal coordination and with little or no regard for the authority of the Haitian government.

 

“One of the key lessons to be re-learned from the Haiti earthquake is that coordination can only be effective if the national authorities (civil protection, health, and other line ministries) are equipped and truly assume the ultimate leadership and authority for coordination,” writes PAHO Director Dr. Mirta Roses in the report’s foreword.

A critical shortcoming of the response was the lack of information sharing among different care providers. This led to lapses in follow-up care for surgical patients, including amputees, and missed opportunities for quake victims to get specialized care. For example, a dialysis center set up to treat victims with crush injuries operated at only 20 percent of its 200-patient capacity because other care providers were unaware of its existence. Compiling and disseminating a list of health facilities and the services they provide should be one of the first priorities in any future disaster, the report recommends.

 

Other lessons and recommendations include:

  • Strengthening local search-and-rescue (SAR) capacity should be a priority for disaster preparedness. Although international SAR teams reported saving 132 lives in Haiti, local people saved many more lives before foreign teams could arrive.

 

  • The “cluster” system—in which different U.N. agencies assume lead responsibility for different areas (health, water and sanitation, logistics)—should be aligned with the host government’s ministerial structure and based on a formal agreement reached prior to any disaster.

    Tent Camps and Rubble

 

  • Management of bodies—including identification and respectful burial—remains a critical area that few humanitarian organizations are equipped to address.

 

  • Although some donated medicines arrived without labels, expired, or unsorted, overall drug donations appeared to be more in line with WHO guidelines than in past disasters.

 

  • “Poaching” of national health staff by foreign groups offering higher salaries and better conditions was a problem in Haiti, as it has been in other disasters. Ministry of Health guidelines for payment of Haitian public staff by international actors were adopted by some groups but ignored by most.

RMF CEO, Dr. Martina Fuchs, and Dr. Patrick Dupont, RMF Haiti Project Coordinator

 

  • A few unruly incidents during supply distribution were overblown by the media, and the notion that disasters produce social disorder and violence was once again proven to be a myth.

 

  • Health actors’ relations with the media seemed more focused on public relations than on informing and educating the public. Practices such as embedding journalists in needs-assessment missions could benefit the affected population by better publicizing the local response and other success stories.

In addition to shortcomings in the response, the report highlights a number of successes. One example was PAHO/WHO’s deployment of the logistics and supply management system LSS/SUMA, which provided critical information and was one of the few international instruments that was directly managed by national authorities.

RMF sponsored Nurse at Lambert Sante Clinic

The report also points to some longer-term positive outcomes that are contributing to Haitian reconstruction and development. These include:

 

  • The provision of free obstetric and child care through two programs (SOG and SIG) developed by PAHO/WHO and the Ministry of Health and funded by Canada, Japan, the World Bank and the European Union.

 

  • The decentralization and strengthening of health services at the departmental and community levels.

 

  • Permanent improvements in some specialized areas of medical care, such as treatment for spinal cord injuries, thanks to the influence and resources of foreign medical groups.

 

  • The establishment of a surveillance system and strengthening of the Epidemiology Department of the Ministry of Health.

RMF's CEO Dr. Martina Fuchs, RMF Haiti's Dr. Patrick Dupont, Medical Mission International’s Program Director, Doug Kendrick, and Hospital Staff

 

  • A new focus on community-based mental health services as a complement to hospital-based care.

 

  • Greater awareness of and commitment to disaster risk reduction.

 

  • A project to incorporate the concept of “safe hospitals” into Haiti’s reconstruction efforts, funded by Denmark and the World Bank.

 

  • A new national program for attention to victims of sexual violence, led by the Ministry of Health.

 

  • Wider social acceptance of people with disabilities, following the large number of disabling injuries that affected Haitians from all walks of life.

 

“The disaster brought significant changes in mentality, behavior, and attitude,” wrote the report’s authors, Claude de Ville de Goyet, Juan Pablo Sarmiento, and François Grünewald. “It is up to the Haitians and the international community to ensure that those changes endure.”

 

LINKS:

Download the report: http://new.paho.org/disasters/index.php?option=com_content&task=view&id=1626&Itemid=1

 

PAHO/WHO program on Emergency Preparedness and Disaster Relief:

www.paho.org/disasters

Contact: Donna Eberwine-Villagran, email: eberwind@paho.org This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel. +1 202 974 3122, Knowledge Management and Communication Area, PAHO/WHO – http://www.paho.org/

 

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To contribute more information about our Haiti Earthquake Relief Efforts,

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Photos from our “Chocolatada” Christmas Party in Peru

January 6, 2012 in Events, General, Helping Children, Mission, Peru, South America by Jonathan White | Comments closed

 

On the 17th of December, our clinic staff in Peru, celebrated with an early Christmas party with some of the children and former patients of our clinic.  Thanks to the the contribution of friends and family, the party was held with gifts, food, and a musical clown show for the children.

This year the party was held at one of the local municipality community centers, and we were able to provide a total of 110 gifts for the children. 90 of these gifts were handed out to the children at the party and the remaining 20 were given at a seperate gathering for children who are patients of ours with TB (Tuberculosis) and Malnourishment in another special meeting for them.

Thank you to David Franco, who also collaborated with us, brought gifts and also a basket of food,which draw in the audience.

A great time was had by all!

Thank You For An Amazing Year!

January 4, 2012 in Africa, Armenia, Asia, Disaster Relief, Donate, Europe, General, Helping Children, India, Japan, Kenya, Mission, Mozambique, Nigeria, Pakistan, Peru, Providing Medical Support, Rebuilding Communities, South America, Sri Lanka, Sudan, Uganda, Whole Health by Jonathan White | Comments closed

Photo: Dr. Martina C. Fuchs, RMF Founder/CEO, making new friends at the Lwala, Kenya Community Hospital, October 1, 2011

We are so grateful to all our friends, supporters and teams around the world and wish everyone a fantastic 2012!

Having wrapped up another successful  we want to pause and say a huge THANK YOU to all of you who supported our work in 2011.  You have helped us achieve so much, and we give our deep thanks to everyone for your generosity and support!

In 2011 we..

  • In Japan, post-earthquake and tsunami, RMF reached over 33,000 people in Ishinomaki City with supplies, debris/sludge cleanup, and community center support.
  • In India, in RMF’s Malnutrition Eradication Program, our field staff of 75 Community Nutrition Educators diagnosed and treated 85,016 cases of Acute Malnutrition in more than 600 villages since our program started in 2010.
  • In Uganda, we provided healthcare, education and vocational training support to 55,000 refugees at the Kiryandongo Refugee Settlement.
  • In South Sudan, 40 Nurses and Midwives at the RMF sponsored first-ever accredited Nursing and Midwifery College in Juba, are beginning their 2nd year of training.
  • In Pakistan, RMF treated more than 25,000 flood victims at our free medical camps, 32,000 patients at our clinic in Gulbella and provided healthcare in Talhatta for more than 150,000.
  • In Haiti, our free clinic at Hôpital Lambert Santé provided public access to 24-hour emergency and general healthcare to a community that is home to more than 100,000 displaced persons.
  • In Kenya, we upgraded the only hospital for 1,000,000 people in Lodwar, Turkana, starting with the pediatric ward and also continued to provide medical support, food and water to thousands through mobile and stationary clinics in the poorest and most drought ravaged regions in Kenya.
  • Closer to home, in South Los Angeles, RMF provided 70 children with new backpacks filled with school supplies and personal products, and just threw a Holiday Party for these children on December 17th.

From all of us at RMF: Have a Happy, Healthy and Prosperous 2012!

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Voices from the field: Señora Maria by Jana Siu

August 3, 2011 in Jana Siu, Peru, South America, Voices from the Field by Jonathan White | Comments closed

by Jana Siu

I got to know Señora Maria over her prescribed 5 day course of antibiotics. Everyday she’d shuffle in around 2pm, hand over her prescription and give one large sigh before I gave her an injection into her hip. Afterwards, we’d have a little chat about the importance of getting the whole course of antibiotics. I always fear that patients won’t come back because of the pain. On the contrary, I’ve found the patients here to be very diligent on coming in day after day, whether for an injection or excruciating wound care. When I asked her about this, she told me that in spite of the pain, she was very grateful for the attentive care she was receiving from Dr. Erika and the staff. Prior to the Policlinico, her healthcare consisted of rare visits to “la posta”, the government funded clinics for the underserved and the poor. Her disheartening response to what was problematic about it said it all, “They treat me badly.”

On her last day of antibiotics, Señora Maria was disappointed to hear that my stay here was coming to an end. And in good Peruvian fashion, she asked whether or not I had tried the 20 or so Peruvian dishes that she rattled off. I thought I had done well, but she was still shocked at the few I had not tried. She rubbed her injection site and clucked her disapproval as she shuffled out the door.

The following Monday, Señora Maria arrived with her daughter bearing two bags containing “arroz con seco de pollo” for the entire staff. We were over the moon; a piping-hot home-made delivered meal! She chuckled when I thanked her for helping me complete my Peruvian culinary experience. I was moved by Señora Maria´s gesture of appreciation and felt very proud of our staff that made her feel cared for…and then got distracted by the delicious food.

More information and reporting about our clinic in Peru can be found here.

Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com

To help us continue to purchase medicine, supplies and fund the staff at the clinic you can contribute to this initiative by clicking on the Donate button below or visit our website at www.realmedicinefoundation.org/donors.

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Voices from the field: Preventative Health Campaign Outreach in Cleto Rojas, Peru

July 26, 2011 in Jana Siu, Peru, Providing Medical Support, Rebuilding Communities, South America, Voices from the Field, Whole Health by Jonathan White | Comments closed

by Jana Siu

Vicki the pharmacist described to me the neighborhood of Cleto Rojas in San Clemente as rustic. I found “rustic” to be an understatement. This area increased dramatically in size after the earthquake. Houses are constructed of wooden poles and mats of weaved reed stalks as roofs and walls. Plastic sheeting, some that have the emblem of medical relief organizations long gone, insulate these homes. It’s a very dusty, windy, dry part of town. We chose Cleto Rojas as the location to do our preventative health campaign.

Tumbling out of our cramped motos with our supplies and anticipation, we were slightly disappointed to see all of 5 people sitting outside. But knowing that information spreads pretty quickly through paper-thin walls (literally), we soon found ourselves in a crowd of 60.

One of the major problems found here is a significant parasite infection rate. There is no running water so the municipal district fills these above-ground concrete wells shared by groups of neighbors. Water gets contaminated quickly. Add in all the stray dogs, close bathroom quarters, and poor hygiene practices, people get sick.

Hand washing for hygience demonstration

First things first, each child was given an anti-parasitic. Next, our staff gave a presentation on proper hygiene, food preparation, and basic parasitology. We concluded with a hand-washing demonstration. Our audience was engaging, participatory, and it was a fun and interactive experience for everyone.

Luisa giving dental cleaning demonstration

Luisa, our volunteer dentist pulled out her dental model to everyone’s delight, and talked about dental hygiene. “What else do we brush besides our teeth?” Luisa asked. “Our tongues!!” chimed the kids in a loud chorus.  I have no doubt that her lesson stuck. The children squealed in delight over their new toothbrushes that we passed out and got a helping of fluoride, although they admitted to liking the taste of toothpaste much better, so we passed those out too.

Our lecture on women’s health created so much input from the women that we had to institute the “raise your hand before you speak” rule. This was one of the few times that I was happy that people couldn’t wait their turn to talk.

2 hours later, after questions were answered, teeth were made a little stronger, and free gifts were passed out, people trickled back home. I find that you can never over-do preventative health. And unless vaccinations are involved, everybody has a good time and learns something new. If we happen to lose a few clinic appointments due to proper hand-washing then…hooray!

Children with new toothbrushes

More information and reporting about our clinic in Peru can be found here.

Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com

To help us continue to purchase medicine, supplies and fund the staff at the clinic you can contribute to this initiative by clicking on the Donate button below or visit our website at www.realmedicinefoundation.org/donors.

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Voices From The Field: Busy Monday at the Clinic by Jana Siu

July 19, 2011 in Disaster Relief, Jana Siu, Peru, Providing Medical Support, South America by Jonathan White | Comments closed

The guest contributor to our Blog today is Jana Siu, a Registered Nurse from California who has volunteered for us before in India.  Jana is spending time volunteering at our clinic the  “Policlínico Peruano-Americano” in San Clemente, Peru and just sent this first dispatch from the field.

 

Jana treating patient

by Jana Siu

I was warned about Mondays here at Policlinico Peruano Americano. It’s not even 11am and the patient log is at 62. Out in the crowded waiting room, seated on long wooden benches, there are coughing and crying children, stoic men, breastfeeding mothers and their babies, and the quiet elderly waiting with their caregivers. There is a strict organization in trying to get all these patients seen which is made all the calmer by the patience of those that need medical care. For these people, Policlinico Peruano Americano is the only option to meet their health needs.

Blanca and Leila at the clinic

It is nearing the 4th anniversary of the devastating earthquake that struck the Southern Coast of Peru and everywhere I look, there is sobering reminders: piles and piles of cleared rubble, homes that have half crumbled away, empty lots where houses and buildings once stood. And the stories that stay with these people. It is all very sad but despite it all, rebuilding continues, “poco a poco”.

Pisco

Here at the clinic, there is very little time to think about the past. It is fast-paced, and although the staff is very serious about the work, they remain compassionate. The one nurse, Leila and the voluntary nurse techs do an impressive job of managing patient flow. Their rusty file cabinets are bursting at the seams, none of which have tracks and they hold close to 13,000 charts. Although days can be exhausting, the staff maintains their humor and make sure procedures are explained and questions answered. I see very little of the 2 doctors here since they are just bombarded with patient exams. The lovely pharmacist, Vicki and I quickly became friends over nebulizer kits that were donated from different organizations manufactured by different companies. We were able to make most of the kits work by throwing a few pieces out the window and taping others together.

San Andres

My month here providing medical support should be interesting. Leila and I compare and swap different nursing tips, techniques, and procedures. There´s a lot of: “Really?! Hmmm…okay.” While giving an intravenous medication to a patient, she asked me what our tourniquets are like. When I told her we use single-use tourniquets, in between a giggle, she replied, ¨We´ve had this one for two years!”

More information and reporting about our clinic in Peru can be found here.

Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com

To help us continue to purchase medicine, supplies and fund the staff at the clinic you can contribute to this initiative by clicking on the Donate button below or visit our website at www.realmedicinefoundation.org/donors.

 

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Haiti Situation Report from United Nations

June 14, 2011 in Haiti by Jonathan White | Comments closed

 

The orange alert has been lifted on 9 June by the Direction de la protection civile (DPC). River water levels have started to recede in affected areas of the Nippes, West, Artibonite and Centre departments.

According to final estimates by the DPC, 28 people died, 6 have been injured and 6 are still reported missing. The West department, including Port-au-Prince metropolitan area, has the highest fatality rate with 22 deaths.

CAMP COORDINATION/MANAGEMENT (CCCM)

Needs: A total 213 vulnerable sites were assessed by telephone between 6 and 7 June. Needs assessment teams, deployed by the International Organization for Migration (IOM) in 91 of those camps, reported that tenwere severely flooded. Of those 91 camps, 29 are large sites hosting more than 1,000 households.

Response: The Direction de la protection civile (DPC) and CCCM partners are currently providing

assistance to 10 sites hosting internally displaced people (IDPs) in earthquake affected communes. Mitigation activities are ongoing in six of the large camps hosting more than 1,000 families and around 200 tents will be distributed. Assistance is being provided to help IDPs drain the water and remove the mud and rubbles in and around camps.

Gaps & Constraints: Water canals near camps are blocked and need to be cleared to prevent further flooding and landslide. Additional tents and tarps are urgently needed, stresses the CCCM Cluster.

WATER SANITATION HYGIENE (WASH)

Needs: Latrines and showers are damaged, mostly in camps with no WASH actors, reports the Cluster. Dispersion of fecal matters is reported in some camps. A deterioration of residual chlorine levels has also been observed in water distribution systems.

Response: WASH partners are conducting drainage activities in camps although water levels have started to recede. Distribution of WASH items is ongoing. The Direction de l’eau et de l’assainissement (DINEPA) is scaling up its monitoring of residual chlorine water levels of community water distribution stations.

Gaps & Constraints: Desludging and repair of latrines are urgent. Additional Aquatabs and jerricans are needed to prevent further cholera outbreaks. More rakes, wheel barrows and shovels are needed to clearmud and stagnating water. Due to a lack of latrines and showers in Grande Saline in the Artibonite department, affected population use water canals.

HEALTH/NUTRITION

Needs: The increase in the number of new cholera cases seems to stabilize in Port-au-Prince with 1,938 occupied beds on 9 June compared to 1,885 beds on 8 June and 1, 773 on 7 June. Outbreaks of cholera continue to be reported, particularly in the communes of Peredo and Saint Michel in the South department and in Mapu, Bayonnais, and Dessaline, in the Artibonite department, which was totally flooded when the Artibonite River over flown its banks. Cholera numbers have been on a stable high, and went up over the past two days in Léogâne/Gressier of the Palmes region.

Response: In cooperation with the CCCM Cluster, PAHO has set up a surveillance alert system in camps. An important awareness campaign, organized by the Direction sanitaire de l’Ouest (DSO), in partnership with health partners, will be launched in Carrefour and Martissant which were among hard hit areas of Port-au- Prince metropolitan area. Additional medical supplies (catheters, doxicicline, érythromycine and sirop) have been made available.

Gaps & Constraints: The CTC of Baradères in the Nippes department has run out of fund. As a result, the 27 staff members have not been paid since February and are threatening to go on strike. Under reporting of cholera cases in the South department remains an issue. Drouin UTC in Grande Saline commune has been cut off by flooding and can only provide medical assistance to cholera patients in the immediate vicinity.

EMERGENCY SHELTER

Needs: According to a joint assessment mission between departmental, local authorities and humanitarian partners in the commune of Grande Saline in the Artibonite department, 4, 629 people have been affected (16, 5 per cent of the population).

Response: La Tapie Shelter in Grande Saline is hosting 135 people while 3, 675 others have moved with host families.

Gaps & Constraints: The provision of assistance to affected population and host families is needed.

EDUCATION

Needs: Some schools in Baradères have been flooded, according to the Education Director of the Nippes Department. In Artibonite, one school is hosting 200 people affected by the flooded River Artibonite. In the West department, three schools have been confirmed to be flooded in Port-au-Prince. The five unused classrooms in Thomazeau affected by water rising levels of Lake Azuei continue to be occupied as one of three collective centers.

Response: Cleaning of Port-au-Prince affected schools was done immediately after the rain and no disruption of classes have been observed.

FOOD SECURITY/AGRICULTURE

Needs: the flooding of agricultural fields has resulted in the loss of manioc, sweet potatoes, rice, and tomato crops in Grande Saline, according to a joint assessment between departmental, local authorities and humanitarian partners.

Response: provision of agricultural tools and seeds, distribution of food and kitchen kits are scheduled to take place in the coming days.

LOGISTICS

Response: An integrated mission with departmental and local authorities, the Direction de l’eau et del’assainissement (DINEPA), the National Haitian police (PNH), MINUSTAH and the Office for the Coordination of Humanitarian Affairs (OCHA) was conducted on 9 June in Baradères in the Nippes department in response to heavy flooding. Two areas suitable for helicopter landing were identified for an emergency response should the city be cut off by flooding in the future. Two trucks were deployed on 9 June by the Ministère des travaux publics, transport et communication (MTPCT) and the Direction sanitaire des Nippes (DSNI) to deliver food rations on 9 June in the commune of Baradères. Global Mapping of Emergency Stockpiles, a collaborative initiative between the Global Logistics Cluster Support Cell and OCHA, provides a pre-selection of what is accessible in the country. It is accessible at:

http://www.humanitarianinfo.org/stockmap.

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UN Haiti situation report: Humanitarian Bulletin

June 6, 2011 in Haiti by Jonathan White | Comments closed

Cholera alerts on the rise

The number of weekly hospitalizations nationwide has increased from an average 1,700 to 2,600, reports PAHO in its latest bulletin dated May 27. The South-East, Grande Anse, South and West are the departments most affected by outbreaks of cholera with a surge over the past three weeks inthe number of daily alerts received from partners in the field. In the South-East department, the number of hospitalization has tripled over the past two weeks, with some of the cases coming however from neighboring West Department. From 21-23 May, a significant increase of cases in Port-au-Prince metropolitan area has also been reported. As of 2 June, close to 2,000 cases and 13 deaths had been reported. Some donors including ECHO and USAID have indicated the availability of new funds to respond to further cholera outbreaks.

PAHO is noting that it is too early to say whether there is a change in the tendency of the epidemic. The rise in the number of alerts might be due to the closure of Cholera Treatment Units (CTUs) and Centers (CTCs), resulting in the accumulation of cases in other health infrastructures still open. Given the early detection of alerts, a prompt response has been implemented. PAHO/WHO is coordinating the response through the Preparedness Emergency and Disaster Relief (PED) teams deployed at the departmental level. Those teams are tasked with distributing prepositioned emergency stocks, coordinating with the Ministry of Public Health (MSPP), and deploying rapid response teams, in collaboration with several NGOs, for initial control of the health situation and epidemiological surveillance. In coordination with UNICEF, PAHO/WHO is supporting the installation of oral rehydration points, particularly in Port-au-Prince.

 As of 22 May:

  • 1.7% mortality rates nationwide
  • 314,539 cumulative cholera cases
  • 5,332 number of deaths

 

CONTINGENCY PLANNING

Awareness campaign on seismic and tsunami risks continues The awareness raising campaign on seismic and tsunami risks reduction, which started last February under the leadership of the Direction de la protection civile (DPC), moved to the North, North-East and Nippes departments. From 7 to 13 May, hundreds of school children and individuals from major cities, including Cap Haïtien, Ouanaminthe and Fort Liberté, attended conferences and public debates with the participation of specialists from the Bureau des mines et de l’énergie (BME) and the Service maritime de la navigation d’Haïti (SENAMAH). Public screenings of documentaries

were also conducted at Place Notre Dame in Cap Haïtien. These activities were organized by the Thematic Committee on Education and Public awareness, in coordination with local authorities. May 7th coincided with the commemoration of the 159th anniversary of the 1842 earthquake and tsunami which destroyed the city of Cap Haïtien. The earthquake killed 5,000 people, and the tsunami 300 individuals. In the Nippes department, about 150 young volunteers marched through Miragoâne on 18 May.This third consecutive edition of the event was also attended by delegations of students and volunteers from the Ministry of Youth, Sports and Civil Service. Professor Eric Calais of Purdue University, commissioned by the United Nations Development Program (UNDP) since July 2010 to provide technical support to the Haitian Government on seismic risks, and engineer Gerard Métayer, held a panel discussion onearthquake and tsunami risks on 17 May. These activities were conducted with the support of UNDP, Plan Haiti, and the participation of the National Haitian Police (PNH) and the Alliance pour la gestion des risques et la continuité des activités (AGERCA).

FOOD

Survival strategies of vulnerable population exhausted in some areas The cumulative and simultaneous impact of the price increase, financial pressure on households due to school tuition since October, and the reduction of humanitarian aid over the past nine months have contributed to higher levels of poverty of vulnerable households, according to a study conducted from 4 to 6 and 11 to 13 May. The study was led by WFP, FAO, OXFAM, ACF, in support of the National Coordination for Food Security (CNSA), in the Port-au-Prince neighborhoods of Carrefour Feuilles, Croix-des Bouquets and Camp Aviation, in two villages of Anse Rouge, one village of Saline.

OCHA Haiti Humanitarian Bulletin

May. 2011 Office for the Coordination of Humanitarian Affairs – http://ochaonline.un.org | 5 neighborhood of Gande Rabuteau in Gonaïves in the Artibonite Department. All survival strategies to cope with rising prices have been exhausted, notes the study. Incomes of most households surveyed, the majority headed by women with children, have fallen sharply and this trend continues. With rising prices and declining purchasing power, small businesses have become much less profitable, forcing women to buy food on credit or beg to feed their children. In Gonaïves, job opportunities in the salt marches have also fallen sharply following hurricane Tomas. In Anse Rouge, rural households experiencing lower poverty levels, and whose main source of income is agriculture, have also seen a drop in income due to higher prices of agricultural inputs, fuel and labor.

School fees and contingencies

Therefore, households’ nutritional status has worsened, the poorest having reduced their number of daily meals from three to two. For the poorest of the poorest, the daily consumption of food has been cut down to one meal a day. The consumption of meat and rice was significantly reduced and replaced by less nutritious food such as “arbre véritable” and sweet potato. Mothers report that their children are thinner and complain of headaches and stomachaches, which are potential signs of hunger, malnutrition and micronutrient deficiency. Some school principals have observed cases of fainting and reduced attention in class. Those households go to health centers as a last resort because they can no longer afford to buy drugs in pharmacies.

With rising prices, poor households also experience difficulties in meeting school tuition. As a result, a significant number of children were taken out of school since last December. In some classes the number of school children has dropped by half. Almost half of the women surveyed In Rabuteau have taken their children out of school. Some families cannot not even afford to keep children in community schools where tuition are very low, from 50 to 200 Gourdes per year (1 to 5 US$).

With rising prices, poor households also experience difficulties in meeting school tuition. As a result, a significant number of children were taken out of school since last December. In some classes the number of school children has dropped by half. Almost half of the women surveyed In Rabuteau have taken their children out of school. Some families cannot not even afford to keep children in community schools where tuition are very low, from 50 to 200 Gourdes per year (1 to 5 US$).

Haiti Health Cluster Bulletin Update

April 18, 2011 in Disaster Relief, Haiti, Helping Children, Providing Medical Support by Jonathan White | Comments closed

Haiti Health Cluster Bulletin:

Cholera and Post-Earthquake Response in Haiti: April 15th, 2011

The following report was compiled by the The Ministère de la Santé Publique et de la Population (MSPP) and PAHO, the Regional Office of the World Health Organization (WHO) for the Americas,coordinate the Health Cluster. MSPP Cluster Contacts: Dr. Claude Surena; Dr. Jean Hugues Henrys; PAHO/WHO Contacts: Dr. Juan Carlos Gustavo Alonso and Dr. Josep Vargas.

Highlights

  • The number of cholera cases nationwide continues to decrease. The number of cases in Northeast, Centre, Port-au-Prince, North, Northwest, Artibonite, West (except Leogane-Gressier), South, Grande Anse and Southeast departments are stable or decreasing. However, cases in Nippes and West (Leogane-Gressier) are increasing (although only slightly in the West).
  • The continued decrease of cholera cases together with the phasing out of health actors from cholera treatment facilities has raised concerns about the capacity to cope with a potential increase in cases during the upcoming rainy season. The impact on the health sector is important given that the management of the cholera outbreak has been highly dependent on the support of foreign health organizations. A gap analysis is underway to identify potential risk areas and to sensitize donors to maintain their support to the cholera response.
  • An independent evaluation mission has arrived in Haiti to assess the efficiency and effectiveness of the coordinated national and international response to cholera, both in terms of immediate and medium term impact. The results will assist the MSPP and its international and national partners to draw lessons from successes and shortcomings, and improve the joint response in case of a possible recurrence of the epidemic especially due to the upcoming rainy season.

Situation Overview

  • 4 April 2011, the cumulative number of reported cholera cases was 274,418, including 4,787 deaths. The observed cumulative incidence of cholera cases since the beginning of the outbreak was of 26.2 per 1,000 inhabitants, ranging from 4.9 per 1,000 in the Department of South-East to 40.3 per 1,000 in the Department of Artibonite.
  • Overall, the number of medical staff from health partners has been reduced in most CTCs and CTUs. Medical staff has been trained and is currently employed in the CTUs established in health centers. NGOs are mostly phasing out due to the decrease in cholera cases or due to the lack of funding. However, health partners continue to provide support to maintain regular training and refreshment courses for local medical staff, and maintain a surveillance system to monitor the evolution and assessment of the potential need to reactivate their response.
  • Apart from the essential work of the NGOs, it is important to mention the role of the Cuban Medical Brigade (CMB) as well. The CMB treated a high percentage of cholera and diarrhea cases during the epidemics through a network of CTCs and CTUs. They built up belts of community workers around each CTC and CTU, thus ensuring prevention and health promotion activities that accompanied the efforts to save lives at the treatment centers. The CMB also deployed active research brigades, who go to the difficult to reach sub-communes to investigate and treat cholera cases, thereby diminishing the “silent zones”.
  • The criteria for closing down cholera facilities and for phasing out NGOs from cholera facilities are well established, and there is an effort to maintain sufficient supplies and medical materials at the cholera centers. Nevertheless, lack of sufficient supervision and irregular payment of salaries to local health staff represent major risks that can jeopardize the response capacity at local and departmental level in case of sudden increase in the number of cholera cases, or any other major outbreak.
  • The WASH sector remains of paramount importance. The chlorination of water systems and water trucks delivering water to the metropolitan areas has been a huge progress, despite the challenges that this method still faces. Attention needs to be paid to the private companies and the alternative treatment systems being used so as not to have resurgence within the urban areas. In rural areas, the treatment of water remains a difficult challenge

Wash (Environmental Health)

PAHO/WHO continues to support the MSPP in identifying needs and priorities for the improvement of sanitary conditions of the health centers in several departments through water sanitation networks and

waste management. Environmental health is an essential part of the long term fight against the spread of cholera and other diseases related to water and sanitation management. The financial resources of numerous NGOs that ensured drinking water distribution and removal of excrement from latrines and septic tanks in Port-au-Prince are running out or have been exhausted.  Transition strategies offer only a limited solution, and serious concerns exist with regard to access to drinking water and adequate public health conditions.

Mental Health

The working group that formulates the Mental Health Policy and the National Plan continues to be dynamic. This group consists of the MSPP, PAHO/WHO, national and international mental health actors and several experts from universities (Toronto, and Montreal). The drafting of the national policy document is currently being finalized.

The list of essential psychotropic drugs for the country is in its final stages of development and the proposal will be submitted to the MSPP by mid-April. The WHO-AIMS is in its final phase, consisting of the compilation of data and development of the evaluation report.

Health Promotion

The final version of The Ways of Working (WOW) document on hygiene promotion will be circulated starting 6 April. It systemizes the lessons learned formulated during the Hygiene and Sanitation Promotion Workshop (Haiti 2010) held at Moulin Sur Mer on 11-12 March.

Nutrition

To continue to reinforce MSPP capacity, PAHO/WHO has provided support for the development and reproduction of 500 copies of the Global Acute Malnutrition (GAM) management protocols that were provided to the MSPP in September 2010. With the cholera outbreak, PAHO/WHO has provided support to the MSPP to update the Protocol, taking into account the care of malnourished children suffering from

cholera.

New growth standards: In May 2010, PAHO/WHO took the lead in MSPP adopting new growth standards, and later by professional associations and partners. Based on these new standards, PAHO/WHO has supported the MSPP in the review of the “chemen lasante” map, thereby creating the opportunity to dispose of a draft of a child nutrition and health booklet since February 2011.

Revision of the IMCI: In order to make the necessary adjustments based on new WHO

recommendations and on the new national protocol for GAM management, PAHO/WHO is offering support for the review of current IMCI standards. The review of the national nutrition policy is underway.

Fortification: In order to prevent micronutrient deficiencies, the technical nutrition committee that support to the MSPP is currently conducting discussions on fortification of wheat flour with micronutrients.

Post Earthquake Health Surveillance

World TB Day, which took place on March 24th 2011, is designed to build public awareness that tuberculosis remains an epidemic, causing several million deaths each year, mostly in developing countries.

This year, Haiti’s National TB Program of the Ministry of Health commemorated the World TB Day by organizing a Ceremony to launch the Reconstruction of the TB Hospital of Leogane, which was totally destroyed by the 2010 Earthquake. The Leogane center received the most significant number of TB cases in the country, and its loss resulted in an enormous challenge for TB services.

The meeting was aired on Haitian National Television and was attended by all national and international TB partners. The reconstruction will be done by Italian NGO INTERSOS, with technical support by PAHO/WHO and additional support by the Japanese Embassy.

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Inauguration of new clinic location in Peru

March 2, 2011 in General, Peru, Providing Medical Support, Rebuilding Communities, South America, Strategies for the Future, Whole Health by Jonathan White | Comments closed

Our clinic has moved to a new building with the sponsorship of the local authorities in San Clemente.  This will new location will cost less for us to rent and manage, and brings us closer in partnership with the local health and political representatives.

Below are a collection of photographs from the official inauguration with the local mayor and other dignitaries present for the ribbon cutting ceremony.  More photos to come as we get settled into our new location.

For more information about our clinic in Peru, please visit our website: http://www.realmedicinefoundation.org/initiative/policlinico-peruano-americano

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