Haiti Quake Efforts Were Hampered by Poor Information Sharing

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



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.”



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:


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/


Follow Real Medicine Foundation on TwitterFacebook or become a fundraiser for us at Causes.com

To contribute more information about our Haiti Earthquake Relief Efforts,

To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.


Haiti today: Lambert Santé & Public/Private Hospital Consortium

By Patrick Dupont

Now, more than 11 months after the catastrophic events of January 12 and the devastating blows to its already impoverished socio-economic state and structures, Haiti’s population is facing many other day-to-day hardships and obstacles, and two new foes:

1. An unprecedented cholera outbreak, which started in October and has already claimed more than 2,000 lives and touched roughly 92,000 Haitians while hospitalizing more than 42,000 of them [PAHO EOC situation report # 16, December 6, 2010].

The Ministry of Health, enrolling many partners amongst the already widely established primary care NGOs has responded promptly to contain and address this epidemic, implementing numerous UTCs (Units for Cholera Treatment) and CTCs (Centers for Cholera Treatment), offering almost 6,000 beds for ambulatory and hospitalization beds distributed throughout the country.

2. Ill prepared and received electoral preparations and an election process that culminated on November 28th in a public denunciation and call for annulment by twelve of the eighteen running presidential candidates, followed by a large protest march, waning only late in the evening.

While reports have varied in content and degree, it has been been commonly accepted that these presidential and legislative elections have been considerably tainted by irregularities, ranging from inability to vote due to poor organization, coercion and intimidation to electoral box stuffing. The days following these much decried elections have been marked by island wide protests, which fortunately did not affect the cholera containment and treatment efforts, and is generating a rising and potential risk for a widespread political crisis as the promised date of release of preliminary results is approaching.

Struggling to recover and re-establish some form of normalcy, the Haitian population is now faced with a raging epidemic and a boiling political situation which could significantly set back all efforts engaged and promised to the reconstruction of this Caribbean island, as most of its more gravely stricken habitants are still residing in tent cities scattered in areas touched by the earthquake, in conditions of sanitation very conducive to the propagation of more such a rampant and lethal outbreaks.

So almost at the one year anniversary of that seismic event which shook to its core the already fragile foundations of this country’s structures and institutions, the situation remains dire and uncertain as the cholera, despite best efforts is predicted to claim more lives, and overall healthcare remains minimal at best. Although massive amount of funds have been pledged and released from around the world to benefit reconstruction of health, economic and social systems, nowhere enough has been achieved.

Real Medicine Foundation, in spite of this situation, is working hard to change this outcome with two major programs: a free clinic funding, providing both primary and secondary care since June 2010 and a much larger project, targeting sustainable accessibility to quality healthcare.

1. Lambert Santé

Although treating more current medical and surgical conditions and less earthquake related injuries and complications, the free clinic at Lambert Santé Surgical facilities has continued to provide health coverage to the population of Pétion-Ville and the surrounding suburbs.

Kept open, partly through funding from Real Medicine Foundation’s partnership with this small surgical clinic, this exclusive private facility prior to the January earthquake has also relied on other organisations recent and past, to continue what the Clinic/Hospital’s owner, Dr. Margaret Degand still considers a patriotic duty. Amongst these NGOs, are found more prominently the ALIMA/Chaîne de l’Espoir foundation joint venture, AOPS/OMS and Nos Petits Frères et Soeurs.

The set up of Lambert Santé make it a more ambulatory healthcare facility, with 4 private rooms and 5 post-op beds, which have since the earthquake been converted into a public unit, providing hospital and surgical care to the patients seen through the agreements with the aforementioned organizations. Imaging space has been reconvened into a free clinic, opened to public patients day and night.

The RMF partnership with Lambert Santé is with ALIMA the only organization with human resources employment and to a greater extent than the later, continuing to insure a staff of three Nurses and three Medical Residents to assist and serve patients needs in emergency, hospitalization and postoperative care, falling mostly under the Clinic’s core competencies: Orthopaedic and reconstructive surgery.

Though not yet developed as envisioned by both parties, this partnership is striving to promote and deliver quality healthcare to the Haitian population in dire need for such basic need. During the past two months of October and November, the free clinic has been taking regular care of more than 60 patients for initial and follow-up care, resulting in more than 200 visits through RMF funding alone, with an average of 3.5 patients a day. Most of the treatments offered consisted of outpatient (82.8%) and minor surgery ambulatory (17.19%) care.

2. Public/Private Hospital Consortium project

The Public/Private Hospital Consortium project is truly the most ambitious project in RMF’s post earthquake relief effort in Haïti, this innovative concept is helping to redefine the public/private partnership in this country, envisioning a more accessible venue to quality healthcare in locally owned and operated healthcare facilities.

This project of private hospital networking is initially comprising three of the most prominent and modern institutions in Haiti: Canapé-Vert, Community and Lambert Santé hospitals, which will offer a vast array of care and services spanning from internal medicine, urology, obstetrics and gynaecology, paediatrics, endoscopy, conventional and laparoscopic surgery, orthopaedic and reconstructive surgery among their numerous competencies.

Through employed professionals in a vast array of medical and paramedical personnel and subsidized patient care, the Consortium goals will address some of Haiti’s healthcare system’s most crucial problems: Accessibility and sustainability while promoting and establishing accountability and scalability.

In its final phase of preliminary preparations, this project is currently pulling together all resources and partnerships to implement a launching in the first trimester of 2011. Already registered with Haiti’s Ministry of Health and endorsed by the Interim Haitian Reconstruction Committee, the Consortium project will soon materialize a new, more participative and efficient public partnership model in Haiti’s newly redefined healthcare panorama.

Follow us on TwitterFacebook or become a fundraiser for us at Causes.com

To contribute more information about our Haiti Earthquake Relief Efforts,

To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.

UN appeals for funding to fight Cholera in Haiti

As we continue to follow the Cholera outbreak in Haiti:

“The UN has appealed for nearly $164m (£102m) to fight a cholera outbreak in Haiti which has now claimed 724 lives.

UN spokeswoman Elisabeth Byrs said that unless funds were provided, “all our efforts can be outrun by the epidemic”. (BBCNews)

For more on this follow the link: http://www.bbc.co.uk/news/world-latin-america-11743629

To contribute to our Haiti Earthquake Relief Efforts, please click the Donate button below or through our website at realmedicinefoundation.org.

Folllow us on Twitter or Facebook

Haiti racing to stem Cholera epidemic

BBC news reporting that while Haiti missed the brunt of the Hurricane Tomas storm, the flooding that followed the heavy rains has greatly increased the risk of a large cholera outbreak in the capital, with more than 70 cases reported in Port-au-Prince, and more than 540 people killed in the areas outside of the capital that were first affected.


To contribute to our Haiti Earthquake Relief Efforts, please click the Donate button below or through our website at realmedicinefoundation.org.

Folllow us on Twitter or Facebook

Haiti bracing for the storm

by Jonathan White

Our staff and friends in Haiti are all bracing for the heavy rains and wind later today and hoping that the massive tent camps don’t turn into a worse situation than they already are.  The Port-au-Prince area is already a very fragile situation with the recent Cholera outbreak and the continued lack of real development funding from the international community.  Most living in the tent camps are reluctant to leave the little they have as they are worried they won’t be able to return or will lose what little they have.  Little has changed for the Haitians since we marked the 6 month anniversary of the earthquake back in July.

Our initiative in Port au Prince is preparing for the aftermath of this storm and continues to work to find ways to build longer term sustainable efforts.

More about the storm

Hurricane Tomas is expected to pass near western Haiti later today Tomas will likely now maintain high end category one hurricane status as the storm center transits between Cuba and Haiti later this morning.

Sustained winds will be in the 80-90 mph range with mountain top gusts approaching 100 mph + (winds are always stronger higher up in the atmosphere).  Rain totals may approach locally 6″-12″ – flash flooding remains a big concern and wind gusts will be strong enough even though the center of the hurricane is expected to stay out over water —> to bring down weaker materials in the shelter zones.
Reports are this morning that despite warnings to leave – many chose not to citing the shelters are all they have left and don’t want to risk losing what little possessions that remain.  A truly awful and sad situation.
Here’s the latest path update from the National Hurricane Center:

To contribute to our Haiti Earthquake Relief Efforts, please click the Donate button below or through our website at realmedicinefoundation.org.

Folllow us on Twitter or Facebook

“UN condemned over ‘appalling’ Haiti earthquake camps” (BBC news)

Just in case people have forgotten that very little has actually been done to resolve enormous tent city/homeless situation in Port au Prince, or the fact that the  $1 Billion the US promised has yet to materialize due to political games being played in the US Senate….the BBC has checked back in on the situation in Haiti and reviewed a recent report published by Refugees International and is not impressed, here is their not so uplifting update:


In addition to RMF supporting a team of nurses in one of the few remaining small hospitals in Port au Prince, we are continuing to push for a much larger scale health care capacity building project, but as with most initiatives down there dealing with immense funding challenges with very little promised money actually being delivered.

To contribute to our Haiti Earthquake Relief Efforts, please click the Donate button below or through our website at realmedicinefoundation.org.

Folllow us on Twitter or Facebook