Moving to a new phase
We are in the epicenter of the earthquake. Almost all of Léogane was destroyed: at least 80% of structures collapsed, and an estimated 10% of the population died. I think it might be even more. One in four people were injured and EVERYBODY needed shelter. I am with PAHO/WHO as the head of the Health Cluster for Léogane. When I arrived, it was worse than expected. Not one house standing on the main street.
This city is in the same province as Port-au-Prince, so even though Léogane suffered more destruction, the resources seem to have gone to Port-au-Prince first. Many of the temporary shelters still don’t have electricity, water, toilets. Access to healthcare is a little anarchic. But this was a neglected area even before the earthquake. It is far from everything, close to nothing with a dispersed population that lives in hard to reach areas five to six hours by foot or on mule. I don’t mean to say the government or international agencies aren’t trying to help here, it’s that the challenge is so large. The area is also vulnerable to flooding and cyclones, which puts even more pressure on the work we need to do.
The Health Cluster helps to coordinate the good efforts of the people who are here to help. For example, I wanted to ensure the Cuban Medical Brigades joined the cluster meetings. It is important for them to come because they are being very effective in the healthcare they are delivering. Others can learn from their experience.
We need to move to a new phase: to integrate the temporary clinics into a more permanent structure. But this strategy which seems to obvious is hard to launch because the infrastructure is not yet in place: new buildings, water, electricity, personnel. So we will reinforce the field hospitals that have started. There are three at the moment, with a capacity of about 135 patients. We should probably have about double that.
We want to reorganize the mobile clinics to they can serve as much preventive as curative medicine and to make sure that the services are better in quality and quantity, meaning good care accessible to the most possible people. PAHO/WHO coordinates with the Ministry of Health to make sure that all decisions are validated by them.
Mental health is another area that I believe should be a priority. Many people come to the mobile clinics for psychosomatic problems such as headache and stomach ache. What they really need are mental health services such as discussion groups, sports, referrals to psychiatrists in the more severe cases, but not meds.
What would be good is if out of the chaos we could help to build something better than before. This is my seventh time in Haiti. Of course I want to come back and be able to see that it is working well, even if it takes several years.