Stefano Zannini, the head of mission for Doctors Without Borders (Medecins Sans Fronteres / MSF) in Haiti, spoke to reporters this morning about the organization's operations in response to the catastrophic earthquake. Following are my notes from this call, and from related emails with MSF staff. Here's a link for online donations to MSF.
• All 3 MSF medical facilities in Port-au-Prince, the capital city, were damaged in the quake: a health center in Martissant slum, the Trinity trauma centre (60 beds), and the Solidarité maternity hospital (a 75 bed emergency obstetric facility). Two new operating facilities will be set up in the next 48 hours, including an emergency inflatable hospital due to arrive in Haiti on Saturday (like the one in the photo above — Maggie blogged about this earlier on Boing Boing).
• MSF staff have scavenged equipment from damaged hospitals and medical centers to augment resources at the Choscal hospital in the Cité Soleil district where operations are centered. Materials and surgical equipment have also been salvaged from a free maternity hospital normally operated by MSF. They are continuing to deliver babies, also. The two other obstetric hospitals in the area were destroyed in the earthquake.
• MSF staff in Haiti have been working shifts of up to 24 hours straight since the quake hit 3 days ago. They are exhausted. The first MSF planes with supplies are now arriving in Port-au-Prince, bringing goods and reinforcement staff. Some 40 tons of surgical equipment and sanitation treatment supplies to ensure clean drinking water are on the way.
• Many thousands of survivors are now homeless, or afraid to return to quake-damaged homes. Everyone is seeking shelter. People are sleeping in the streets, protecting themselves with blankets, or if they do not have blankets, covering themselves with plastic bags.
• The immediate focus for MSF teams is on expanding the ability to perform surgery for trauma victims, and responding to the incoming flood of victims who need immediate first aid for wounds. MSF priorities in days to come: stabilizing wounded, referring more complicated cases to specialists, reinforcing staff teams, restarting obstetric care, and addressing mental health needs of survivors. Also monitoring the need for food, clean water, and shelter.
MSF: "It is a race against time because infected wounds need rapid interventions. Inflatable operating theatres, with more surgical specialists are en route. But there are major issues of access and transport, with the staff delayed in the air and on the roads. "
• Survivors are trying to rescue their personal effects from their houses. During the daytime, streets are crowded with people looking for help and trying to find their families. Zannini: "I can see thousands of them walking in the streets, asking for help, asking for everything. Trying to stop every car they see in order to get something to go on."
• People are transporting patients on doors which are being used like stretchers. Also transporting patients by car, truck and moped. A few hospitals were not completely destroyed by the earthquake.
• Zannini: "In our hospitals, there are thousands of people waiting for surgery."
• Lots of survivors with open fractures needing surgery. First surgery last night was a complicated delivery of a baby. Zannini: "I am very proud to share with you that we were able to save the life both of the baby and the mother."
• Three things survivors need most right now: medical attention (including surgery), food, safe drinking water.
• Zannini: there were hundreds of dead bodies at MSF facilities. "Trucks from the Haitian government have come to retrieve them. We have protocols about treating the bodies with disinfectants to limit the risk of infection spreading. We do whatever we have to do… our primary role is looking after the [living] wounded."
• Currently MSF's teams are operating out of medical facilities that survived the earthquake. The inflatable hospital structures should be arriving today, and will be set up as fast as possible. These structures will include a surgery operating theater.
• Government trucks are going around the capital collecting dead bodies. A reporter on the conference call asks about dead bodies and the spread of disease. Zannini replies that MSF is focused primarily on surgical care: "Thousands of people need immediate surgical intervention."
• How concerned is MSF team about the spread of disease from corpses? Avril Benoit, director of communications for MSF Canada: "We get qustions like that all the time after a disaster. In our experience as a medical organization, we have rarely seen disease spread. We are always concerned about it, keeping an eye on it. After the hurricane in Gonaives [Haiti], the major priority was clean drinking water… water and sanitation experts are on the way to Haiti now and will be working on that from MSF side and from other organizations… there is no question that clean drinking water is a priority right now, but risks of disease spreading are seldom seen."
• Dr Mego Terzian, from an MSF emergency cell: "Triage, stabilisation of the wounded and referrals for surgical needs are the medical priorities. The dead bodies represent a medical issue in the sense that it's a factor of stress for the survivors. But in this context, as the cause of the death is not an infectious factor, there is no risk of epidemics linked to bodies."
• Asked how operational the Haitian government is, Zannini replies: "We speak with other actors, we meet with them, but our priority now is on the patients." Asked about coordinating with the UN or other NGOS, Zannini replies, "We are focused around our teams."
• 40 tons of supplies are on the way. On Thursday, MSF team in Haiti received medical supplies including medicines/drugs via airplane. The biggest needs at first were antibiotics, blankets, medical equipment. "At the moment we have enough supplies." More supplies coming in. "Most common problem is open fractures."
• What materials are needed most in the field? "Equipment, drugs to stabilize patients." Avril Benoit: "We have also been able to recover some of the material from our damaged hospitals. One cargo plane is due to arrive from Bordeaux, France, and another from MSF base in Panamá."
• MSF has been operating 24 hours a day. Staff have been working up to 24 hour shifts at a time in the immediate days following quake, but goal is to rotate staff in 12-hour shifts. Staff has drinking water and food, they are exhausted but coping as best they can. MSF: "25 new staff are expected to have joined the teams in Port au Prince by the end of today."
• Psychologists are arriving soon to help with mental health needs of Haitian victims, and with the mental health needs of MSF staff. But surgical activities are top priority right now.
• Zannini still expects more survivors to be rescued alive from damaged structures. "It is impossible for me at the moment to know" how many more survivors may be recovered in coming days.
• Asked "When will it get better?" Zannini replies, "It became better when we started surgical activity… we are full of patients… but as far as we are able to treat and stabilize and operate, things will [continue to] improve."
(Special thanks to Pete Masters from MSF. Photo: Inflatable medical village Doctors Without Borders set up in Mansehra, Pakistan. Credit: Remi Vallet, via Discovery News. )
