PAHO Briefing on Haiti Earthquake Response - 20 January 2010

Jan 20 Press Briefing at PAHO
Dr. Jon Andrus
PAHO Deputy Director

A strong 6.1-magnitude aftershock shook Haiti today. Our Emergency Operations Center has not received any reports of additional damage or loss of life.

Today I’m going to give you a bit more detail what the Pan American Health Organization (PAHO) and the World Health Organization are doing to provide relief to Haiti.

PAHO is the regional office for the Americas of the World Health Organization (WHO). And WHO is the lead agency for health of the United Nations System.

Like the United Nations, PAHO/WHO is an organization of member countries, and Haiti is one of our members. So when we talk about Haiti, we are really talking about ourselves, we are indeed family.

As such, PAHO has a country office in Haiti that, even before the earthquake, had 52 staff in-country working full time. Our role was to support Haiti’s Ministry of Public Health with technical cooperation, that is, with advice and state-of-the-art expertise about public health issues relating to the prevention and control of infectious diseases, health policy, immunization, maternal and child health, medical technologies, and—yes—the health aspects of disasters and humanitarian relief.

Because of Haiti’s fragile institutions and infrastructure, PAHO/WHO—like a number of other U.N. agencies—prioritizes Haiti with its support. That has always been the reality. I think the government and Ministry of Health appreciate that. And, all our other member states understand that and support it.

In-country, our role has been and continues to be supportive, focused on strengthening the Haitian health sector’s ability to protect and promote the population’s health.

Areas of work that we focus on range from safe motherhood and neonatal tetanus to HIV and tuberculosis, as well as rabies, malaria, malnutrition, health services organization, and the list goes on and on.

The point here is: we were on the ground in Haiti before the earthquake, and we will be there after many relief agencies have gone.

In this crisis, PAHO/WHO—as the lead U.N. agency for health—is heading up what we call the Health Cluster in the humanitarian response there.

Our main responsibilities are to assess the health situation in the aftermath of the earthquake, to make recommendations about priority health needs and interventions, to monitor health-related relief efforts, and to coordinate the various agencies providing health-related aid.

We also provide technical guidance in specific areas, such as in the management of mass casualties, logistics and coordination, and the proper handling of dead bodies.

We have been providing special support in certain areas of disasters, such as “safe hospitals,” emphasizing the need to build hospitals and other health facilities to be able to stand up to earthquakes and other disasters and continue providing their essential services at a time of need.

We have also been emphasizing the proper management of dead bodies. We have been campaigning for years to dispel the myth that dead bodies cause epidemics and to emphasize that the identification and proper burial of bodies is an issue of human rights for the surviving family members.

We are also an important provider of medicines and medical equipment, through our PROMESS warehouse near the airport in Port-au-Prince. PROMESS functioned as Haiti’s main medical storage and distribution facility even before the earthquake, and now it is playing a critical role in purchasing as well as soliciting and receiving donations of medicines and supplies and distributing them to health facilities and agencies that are providing health services to the Haitian population.

We are also carefully monitoring the arrival of medical teams and field hospitals, and helping the Haitian authorities make recommendations on where those should be deployed to meet the most urgent needs.

Are we satisfied with the job we are doing? Definitely not. But progress is being made. Think of what we started with when the world came crashing down on Haiti. No roads, only rubble and dead bodies. No communication, only death and despair.

So the country was essentially paralyzed, but now we are seeing movement. As we go forward I think it is important to recognize that the rebuilding of the health infrastructure of Haiti will definitely require strong leadership from the Ministry of Health. To that end, we are pleased that the Ministry has formed a National Health Commission.

As one of its first actions, the National Health Commission has set the immediate priorities in the response to be:

1. Providing community-based health services using mobile teams or brigades for immediate treatment and triage of injuries, and for some post-operative follow-up;
2. Establishing fixed health posts to be created where people are congregating in open areas, and where members of the community can go to receive care; and 
3. Supporting hospitals with surgical capability. These include hospitals already there and operating, as well as field hospitals that are being set up.

All services are being provided free of charge. As I mentioned yesterday, this strategy will take some of the pressure off overburdened hospitals by providing services in the community, in the neighborhoods, themselves.

We are also convening meetings of representatives of organizations, countries, and agencies that are providing health services as part of the massive international relief effort, to be sure that we and they—among themselves—are aware of what they are doing, what their needs are, and how we can all work together in a coordinated fashion to meet the needs of the Haitian people.

Support to Haiti must be coordinated through partnerships. Many countries and many organizations are sending aid and personnel to Haiti.

They range from U.S. counties, such as nearby Fairfax County, sending search-and-rescue teams, to countries such as Israel sending turnkey field hospitals.

It has been an enormous challenge to absorb this relief aid, which of course is urgently needed by the population. But gradually—and obviously not always as fast as we would like—as roads open, as channels of communication become installed and managed, resources are getting to where they are needed most. Again, are we satisfied? Definitely not. So much more needs to be done and we need to understand exactly what those needs are.

To that end, our Director, Dr. Mirta Roses, is traveling tomorrow to Haiti to get a first-hand look. Dr. Roses has >30 years of public health field experience. She is tireless worker for the cause of the underserved. Her assessment comes at a critical time as relief and rescue efforts transition toward more long-term, big-picture recovery and development of a country and its people.

Some of the good news coming out of Haiti includes the rescue efforts.

We know that to date, 121 people have been saved by rescue teams—a record for the number of people rescued after an earthquake—and countless more have been rescued by Haitians working with no equipment at all.
There are now 43 teams made up of 1,820 rescue workers and 175 dogs searching for survivors in affected areas. 

We greatly appreciate the tremendous amount of work and courage demonstrated by members of the rescue teams.

We know, though, that getting food and water and other necessary supplies to the surviving population, and medical care to injured survivors, is proving in many ways to be more difficult than digging through damaged buildings to rescue people who were trapped in the ruins and the rubble.

One of the main reasons, of course, is that the numbers of survivors is so much greater. There is enormous human need following this disaster.

Another reason is the diversity of aid-sending organizations: although the United Nations is working to coordinate the response, relief aid is coming from different countries around the world, from different agencies of the same country, from individual communities (as I mentioned), from nongovernmental organizations, and from different agencies of the U.N.

And on top of all this there are concerns about security.

These problems have been increasingly resolved. But others have arisen. One of them is the sheer volume of relief aid pouring into the country from so many different agencies.

We know, for example, that the Haitian airport has so far handled more than 600 aircraft in the last week. Hundreds of planes are still waiting for landing slots. Planes bringing essential water, food and medical aid are being prioritized but the system is extremely congested.

Another is the fact that some donors—whose aid is urgently needed—have not made advance arrangements for the unloading, storage, and distribution of aid.

Similarly, some aid teams have arrived without adequate preparation of their own food, lodging, and transportation-- putting stress on services that are already stretched and in short supply for Haitians themselves.

I think if we start with acknowledging the fact that this response cannot be about any one country or agency, it cannot be about turf or issues of jealousy or who gets what, it is about supporting the government through partnership that at end of the day will save lives and ensure a platform for reconstruction of a devastated country. It’s about the whole of Haiti.

We have reports just today of excellent progress in the coordination of efforts. The U.N. Logistics Cluster is working jointly with the U.S. Armed Forces and U.N. stabilization forces to establish additional lines of communication, to facilitate air traffic control and to ensure the efficient use of military resources.

The World Food Program is bringing additional warehouse capacity for emergency supplies.

The road to the south pier at Haiti’s main port has been repaired and is now fit for heavy machinery.

The port of Barahona in the Dominican Republic is being used to relieve congestion at the airport in Port-au-Prince. This base in Barahona will be used to transport supplies to the southern Haitian coast, where several towns we know of that were struck hard by the earthquake.

The U.N. Logistics Cluster is setting up temporary accommodation for another 200 humanitarian personnel. The fuel situation is improving: 10,000 gallons of fuel is expected to be delivered to the U.N. logistics base today.  PAHO will be able to deliver 1,300 gallons of fuel to Haiti’s University Hospital for its generator.

You can see from these kinds of examples the challenges that are being overcome.

Let me give you some additional updates on the health situation on the ground in Haiti.

The main hospitals have been damaged but are able to function at various levels, albeit with difficulty due to the lack of water and electricity. The facilities that appear to be more operational are generally the ones run by international nongovernmental organizations. The Red Cross is running mobile medical units and other NGOs are working out of hospitals.

There are now 18 permanent health facilities and temporary field hospitals functioning, with multiple other health facilities heading to Haiti.

We have learned that the USNS medical ship Comfort, with a 1000-bed capacity, arrived in Haiti this morning. This is excellent news.

Here is what we know about field hospitals:

• The Israeli mobile field hospital is fully operational and is being used as a referral hospital.
• A Russian military hospital is functioning
• A Nicaraguan military hospital being established
• Additional field hospitals are arriving from Mexico, Indonesia, Turkey, France, Doctors without Borders, Indonesia, and the USA.

Makeshift health and triage facilities have been set up at different locations. Patients are being evacuated to Martinique, Miami and the Dominican Republic. Dominican hospitals located near the border with Haiti are now overwhelmed and running out of specialized medical supplies.

We continue to monitor these developments and help to fill the gaps, and we have requested additional assistance from donors to support health action in five top priority areas:

• Coordination, including continuing needs assessment, monitoring and evaluation Prevention of disease outbreaks
• Providing safe water and sanitation
• Reestoring basic health infrastructure and basic healthcare services, and Ensuring the availability of essential drugs.

I will stop there. I am happy to entertain any questions, and again thank you all for coming and supporting our efforts.