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HEALING A WOUNDED COUNTRY - Par : Paul McPhun and Kevin Coppock, in Policy Options

mardi 6 avril 2010 par William Toussaint

The independent medical humanitarian organization Médecins Sans Frontières/
Doctors Without Borders has been providing health care in Haiti for 19 years. After
the earthquake hit, its regular cadre of 800 field staff in Port-au-Prince quickly
expanded to 3,400 people working in 26 hospitals and clinics. Two representatives
from the organization explain why restoring Haiti’s health care system to what it was
before the quake would be a travesty — because Haitians deserve so much better.
Paul McPhun and Kevin Coppock offer some ideas for how to get it right this time.

Il y a maintenant 19 ans que l’organisme humanitaire indépendant Médecins sans
frontières fournit des soins médicaux en Haïti. Au lendemain du séisme, il a
rapidement augmenté son effectif de terrain de 800 à 3 400 personnes, qui
travaillent actuellement dans 26 cliniques et hôpitaux de Port-au-Prince. Deux de
ses représentants expliquent ici qu’il serait dérisoire de rétablir le système de santé
tel qu’il l’était avant le séisme, puisque les Haïtiens méritent beaucoup mieux. Paul
McPhun et Kevin Coppock proposent quelques idées visant à créer cette fois un
système de santé digne de ce nom.

The immediate emergency phase may be over, but the
long-term work is just beginning, and it’s no less an
emergency,” warned Karline Kleijer, Médecins Sans
Frontières (MSF) head of mission, a mere seven weeks after
the January 12 earthquake. The future remains uncertain for
essential health care in the affected region of Haiti.

Before the catastrophe, more than half of the Haitian
population could not afford health care. More than 70 percent
of them were reported to be living on less than US$2
per day. The capital, Port-au-Prince, a city of 3.5 million
people, with many living in slums, had 21 public health
facilities and only four hospitals. These fee-for-service facilities
lacked medical staff, equipment and supplies. Haiti’s
health care system before the earthquake was insufficient to
address the basic medical needs of the population in Portau-
Prince. Now, in the aftermath of the earthquake, the
level of medical need has increased dramatically.

As we write this Policy Options article, more than two
months after the cataclysm, many of the smaller medical
organizations have left or are leaving. MSF sees a limited,
and certainly inadequate, response to providing basic shelter
to the displaced. Reflecting back on the aftermath of previous
natural disasters in Haiti leaves us far less convinced
than others who see the outpouring of global compassion
for earthquake victims as an indicator that everything will
turn out for the better in the end.

Will there be sufficient medical capacity to deal with
the large numbers of patients requiring postoperative care, specifically rehabilitative and psychological care, over a
longer period ? How many Haitians will suffer from living in
inhumane, undignified living conditions in overcrowded
and violent camps without access to adequate shelter and
sanitation ? Will many of Haiti’s displaced experience a second
traumatic displacement when the hurricane season
slams them in June ? Will there be enough medical capacity,
after six months to one year, to deal with the normal levels
of medical emergencies experienced by cities of this size ?

MSF medical teams already in Haiti on the night of the
earthquake faced extreme conditions : severe injuries, small
fires burning, corpses on the streets, frantic crowds searching
desperately for buried loved ones and widespread levels
of physical devastation. The wounded poured into MSF’s
makeshift hospitals on the streets. Our staff struggled to
treat the influx, while at the same time trying to locate their
own colleagues and families, many trapped in rubble.

The first phase of the medical response with mass casualties
lasted about 10 to 14 days. Several MSF hospitals
were severely damaged. Survivors pulled patients and other
staff — both dead and wounded — from the rubble. La Trinité
trauma centre collapsed with patients and staff inside, including
our most senior surgeon, Erick Edouard, who was one of
the seven MSF employees killed in the quake. The Maternité
Solidarité emergency obstetrics hospital managed by MSF
Canada was rapidly evacuated as it was on the brink of collapse.
Babies don’t stop being born when disaster hits, and more than a few were delivered outside that night amid the chaos.

Read more : click here

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6 avril 2010
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