Remarks by Dr. Jon Kim Andrus, Deputy Director, Pan American Health Organization

January 13, 2009

Good afternoon, everyone, and thank you for coming.

I'd like to thank the Organization of American States for hosting this briefing. Our PAHO headquarters building has been closed due to a water main break, but I understand it will be open and operational tomorrow. But, again thanks to our hosts.

Yesterday afternoon at 4:53 pm local time, a large earth quake struck Haiti. It proved devastating.

To that end, last night and today, the Pan American Health Organization is mobilizing a rapid health response team to Haiti, through the Dominican Republic, in response to the severe earthquake that struck close to the nation's capital of Port-au-Prince, a city of two million people.

The earth quake was measured 7.2 on the Richter scale and inflicted large-scale damage, including large numbers of casualties and severe damage to hospitals and health facilities attempting to care for the injured. Damaged health facilities include the Eliazard Germain hospital in Petionville, an area of Port-au-Prince and the Petit frères et Soeurs facility.  National authorities believe there will be a serious loss of life.

Our immediate health priorities include:

• search and rescue of survivors trapped underneath rubble; 
• treatment of people with major trauma injuries; 
• preventing the infection of wounds;
• provision of clean water and sanitation and food for those in need. 
• Control of communicable diseases, such as diarrheal diseases and respiratory infections, will be another major concern in coming days.

In addition, we are deploying a 12-member team of health and logistics experts, including specialists in mass casualty management, coordination of emergency health response, and the management of dead bodies.

UN buildings, including the PAHO/WHO buildings, suffered major damage. The main force of the earthquake was felt 17 kilometres south-west of the Haitian capital, Port-au-Prince. Many homes and public buildings have collapsed. The phone system is not working and most roads in the affected area are blocked.

Neighboring countries in the region are already in the process of organizing humanitarian aid missions and assistance and search and rescue teams.  The condition of the airport is being assessed to determine how quickly humanitarian aid can reach the affected area.

To put this into perspective, this is the strongest earthquake ever recorded in Haiti along this fault line.  Haiti is the poorest country in the western hemisphere.  It ranks 154th on the United Nations Human Development Index. It is a country of extreme poverty and vulnerability.

The quake was felt as far away as the neighboring Dominican Republic, where two hospitals in Barahona and Santiago were affected.

It could not have come at a worst time. In 2008, Haiti was devastated by four major hurricanes/tropical storms: Faye, Gustav, Hanna and Ike, which wreaked havoc on physical and agricultural infrastructure.  The storms killed almost 450 people, affected a million residents and left more than 150,000 are living in shelters.

We all fear that the impact of this earthquake will be particularly devastating due to the vulnerability of Haiti's people as I mentioned.

Having said that, though, I think it is important we take the opportunity to focus and try to draw on the lessons we have learned over the decades in responding to disasters in the Americas and around the world.

In the health sector, one of the most important lessons we have learned-over and over again-is the importance of hospitals in the aftermath of a disaster.

Unfortunately, all too often hospitals become victims of disaster themselves, and are unable to provide their services precisely when they are most needed. This is exactly what has happened in Haiti.

But it is not-I repeat, it is NOT-inevitable.

We know that hospitals can be built to withstand the impact of disasters and can be planned and equipped to remain functional after disasters.

The additional cost of building hospitals to be disaster-safe is marginal, and so is the cost of retrofitting existing facilities. Most important, these costs are negligible in comparison with the cost of a failed hospital.

PAHO has detailed technical guidance on both the structural and the functional requirements to build and run safe hospitals.

We urge donors and relief organizations to keep in mind the importance of rebuilding Haiti's hospitals to be safe from disasters.

Another very important lesson from our experience with disasters is that, contrary to what is reported all too often-sometimes even by so-called health experts-dead bodies do not cause epidemics. Dead bodies are not a substantial, practical threat to the health of survivors.

This is important because misplaced fears about dead bodies often lead to mass burials, which are ill advised and violate the human rights and mental health needs of survivors.

Everyone wants to know the fate of their loved ones and to provide them with a proper burial. This is not always possible, but it should not be prevented by unfounded fears that bodies are a health threat.

Another critical lesson that we have learned is that disaster assistance from donor countries and organizations is best provided on the basis of an on-the-ground needs assessment.

PAHO's first team into Haiti has one of its major responsibilities to provide an assessment of the needs of the health sector. They will be doing so in coordination with Haitian health authorities and other U.N. agencies on the ground.

The need for field hospitals may arise as teams assess the damages to local hospitals and health facilities. Their usefulness depends on the time they become operational in the field.

In the first 48 hours, the greatest need is for emergency medical care. Search and rescue is also critically important in this first phase. After that, the need is for follow-up trauma, medical, and routine health care and emergencies.

Above all, field hospitals should be fully self-sufficient, and should not request any support from the affected community. They should complement and facilitate the work of local health services.

PAHO is helping to mobilize assistance from neighboring countries, which we know are usually in the best position to provide the earliest assistance.