HAITI ONE YEAR AFTER - Medecins Sans Frontieres

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HAITI ONE YEAR AFTER

F e b r u a r y M a r c

h A p r i l M a y J u n e J u l y A u g u s t S e p t e m b e r O c t o b e r N o v e m b e r D e c e m b e r

J a n u a r y 1 2

2 0 1 0 J a n u a r y 1 2

2 0 1 1

A REVIEW OF MEDECINS SANS FRONTIERES' HUMANITARIAN AID OPERATIONS

PUBLISHED JANUARY 10, 2011

© Kadir van Lohuizen / NOOR



Prec

O

my eet isit to Haiti, the deastatio ased by

the eathqae that hit oe yea ago i Jaay was

still ey isible. I was shoed by the magitde o the

atastophe ad at the same time ey impessed with the extaodiay esiliee demostated by the Haitia people.

This has bee the lagest emegey espose i the 40yea

histoy o Médeis Sas Fotièes/Dotos Withot Bodes

(MSF). We hae bee stethed to the limits by the gey

ad extet o medial eeds i the immediate atemath o the

qae ad beyod. Bt the wo doe by the MSF teams has

bee otstadig. Thas to the geeosity o MSF doos

woldwide, we wee able to qily eat to the medial ad

hmaitaia eeds o Haitias ollowig the eathqae ad,

moe eetly, dig the astmoig holea otbea that hasow illed moe tha 3,000 people.

Oe yea ate the atastophe, it’s impotat to loo ba o

what has bee doe ad ahieed ad to eiew the hoies

that wee made. We mst also be eady to tale emaiig

halleges, omlate eessay stategies, ad lea lessos

that will impoe o emegey esposes i the te.

Iteatioal ageies mst lie p to the ommitmets they

hae made to the Haitia people ad to thei doos. As hma

itaia atos, we hae to be aotable o o opeatioalhoies ad taspaet abot o expedites. MSF has do

meted its expeiee i Haiti last yea i a itial way, ad I

iite yo to ead this epot.

Moe tha oe millio people emai homeless i Haiti today.

Ee beoe the eathqae, hdeds o thosads o Haitias

lied i peaios oditios, patilaly i the apital’s his

toially magialised slms, whee ew aid ogaizatios ae

poidig assistae. Thei immediate eeds mst emai at the

oeot o the hmaitaia atio i Haiti.

Lastly, I wold lie to tha the moe tha 8,000 MSF peso

el who hae woed tielessly to espod to the eeds o the

Haitia people. We ae also gatel to the Haitia people o

welomig s ad sppotig o atios. Ad, oe yea o, we

emembe ad miss the MSF sta, patiets ad amily membes

who lost thei lies i the eathqae.

Dr. Unni Karunakara

Iteatioal PesidetMédeis Sas Fotièes



InTrODucTIOn

1 IAn OvErvIEW OF MSF’S rESPOnSE: ChoiCes, Challenges AnD lessons learned

1.1 I EMErGEncY PHASE Juy 12 – ap 30, 2010

Triaging the Wounded

Dwindling Medical Supplies

Establishing Field Hospitals

The Challenge o Rebuilding Hospital Capacity

Treating “Crush Syndrome”

Medical Challenges: Managing a Massive Surgical Caseload

Bolstering Post-Operative Care

Providing PhysiotherapyEmergency Psychosocial Care

Psychiatric Care

Basic Healthcare or Displaced Persons

Chronic and Acute Medical Conditions

Emergency Obstetrical Care

Burn Care

Non-Medical Assistance

Water and Sanitation

Human Resources

1.2 I POSTEMErGEncY PHASE My 1 – octb 21, 2010

Reorganisation o Medical Activities

Tents and Drinking Water

Hurricane Season

1.3 I cHOLErA EMErGEncY rESPOnSE octb 22 – Pt

Current situation

2 I FInAncIAL AccOunTABILITY

Categories o spending

3 I LOOkInG AHEAD - PLAnS AnD PErSPEcTIvES

Planned Projects

Emergency Obstetrics

La Fondation Sant Se Ae Pam

Tabarre Container Hospital

cOncLuSIOn

Table ctt



Introuct

Haiti One Year after


h A p r i l M a y O c t o b e r J u n e J u l y A u g u

s t S e p t e m b e r

N o v e m b e r D e c e m b e r

J a n u a r y 1 2

2 0 1 0J a n u a r y 1 2

2 0 1 1

T u up tu pp v ty- um tt w uy but ccb by mu w tt w vy . ecmc pptut w w, umpymt w wp, t w w ccutm t pm vc ptc

upv. it w u t t tk ck cc t t c t tmttt utbk vc tt MsF cm t wk t cuty t t pc y 20 y .

F mt ht, v bc t c w ut c, c by t pubc pvt t -

ct m tm ub. Pubc pt cc w t pu by mmt pbm tk, t t, u, mc upp. Ptt cu b tu wy bcu t ptw u, ty wu v t b ttmt w ty ut my. gv bt w t k;ht’ mt mtty t w 630 t p 100,000, t t t mp, 50 tm t t t Ut stt xt .

i Pt-u-Pc, my t p w y pt MsF’ mcy vc. a mj mc umt zt tt’ b pt ht c 1991, MsF w t w ht’ pp xp t -tt u ct v w vc w mut. T cuty cu y vb w-pc t wt t u t m tt tu cttp wu pc tmc uc.

it w t t bckp tt t Juy 12 tquk t wt m t u pw t tw ht t p tum tt wt by yt v t mt bu t kw.

Haïtians aced the adversities o lie on a daily basis even

beore a devastating earthquake struck on January 12, 2010.

© Bruno Stevens/Cosmos



Introuct






J a n u a r y 1 2

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2 0 1 1 F e b r

u a r y M a r c h M a y O c t o

b e r J u n e J u l y A u g u s t

S e p t e m b

e r N o v e

m b e r D e c e

m b e r

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2

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Figures at a Glance

T u bw ct t vu ctvt utk by MsF t 10 mt t t t-quk tuck ht. T c cum ccut t t cp ctvt c ut by MsF m

Juy 12 tu octb 31, t tt t wc cumutv u vb ( m

t umb ptt tt c, wc t t 91,000 Juy 2, 2011).

Year to date January 12 - October 31

Human ressources

Haitia sta 2,844

Iteatioal sta 260

Medical facilities

Opeatig theates 15

nmbe o beds 1,121

Hospitals ehabilitated 10

new costtio 6

nmbe o xed sites (maximm o peiod) 12

nmbe o mobile liis 3

cholea Teatmet cetes bilt (Ot. 22 – De. 12) 47

Medical activities

Patiets teated 358,758

Sgial opeatios 16,578

Patiets teated: post opeatie ae 10,939

Patiets teated: ioleeelated tama 7,110

Patiets teated: othe tama 38,534

Patiets teated: holea 91,000

Patiets teated: psyho soial ad metal health 177,212

Patiets teated: delieies 15,105

Patiets teated: sexal iolee 696

Logistical equipment

relie its distibted (as o May 12) 85, 000

Tets distibted 45,940

Lites o wate distibted pe day as o Otobe 31 516,000

Laties bilt 823

Showes bilt 302




An Overview o MsF’ rp F e b r



S e p t e m b

e r N o v e

m b e r D e c e

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At the time o the eathqae, MSF was ig thee seoday leel health ae sttes i

PotaPie: a emegey health ete i the Matissat slm; a emegey hospital o tama ad

othopedi sgey whih also had a itesie ae it o bs ad a ehabilitatio ete, i the Paot

eighbohood; ad a emegey obsteti ae hospital with ateatal ae liis i the Delmas aea. These ai

lities wee desiged to addess the medial eeds o poplatios liig i ey poo, ioleeplaged ba om

mities.

MSF sttes ad sta wee hit had by the qae. It too days to aot o eeyoe. Sadly, 12 Haitia MSF sta membes wee illed i the eathqae, as wee some patiets ad aetaes who wee iside bildigs that ol

lapsed. Othe MSF sta membes wee ijed o lost amily membes ad ieds, while still othes lost eeythig

they owed ad wee edeed homeless.

Despite the temedos pesoal losses sstaied by may

atioal sta membes, ad despite the haos that ollowed

the eathqae, the majoity o MSF’s siig Haitia sta

immediately set to wo helpig thei otyme ad otied

to do so thoghot this dilt peiod.

The MSF obstetial ad tama hospitals wee destoyed bythe eathqae. Oly the Matissat emegey aility was still

opeatioal, bt it was qily oewhelmed by the ijed ad

dyig people who lled the hospital gods. Matissat had the

apaity to eeie a maximm o 50 asalties. Bt i the hos

i v t cm t wk bcut t t my

bu. i pp m t cut c k t v cm t cu pp, m, ht,

i mut t m.

MSF soial woe chales Joseph,

who lost his home i the eathqae.

“

“

© Julie Rémy




An Overview o MsF’ rp F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

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a r y 1 2

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S e p t e m b

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ate the eath shoo, sta thee had to ae o moe tha 400 itially ijed ad dyig patiets who aied

almost all at oe.

Patiets aied at othe MSF medial ailities ad admiistatie oes with mltiple ad ope ates, shed

limbs, sll ates, spial od ijies, ad lietheateig bs. Teams oetated o wod leaig, de

bidemet ad dessig, ad ate stabilisatio. I the st days, the immediate ad highest pioity o MSF was

to stabilise ad maage ae o the woded, to ogaise tiage, ad to poide immediate liesaig sgey ad

edolieae.

Althogh mh o its health ae iastte was destoyed,

MSF still had the taied sta ad the spplies—stos o mediies, medial mateial, sgial eqipmet ad logistial ma

teial—to espod. MSF sta adapted to the immediate odi

tios o the god while logistial pesoel qily ogaised

themseles to impoe the eiomet o teatig ad aig

o patiets.

Teams woig at the Matissat health ete osed pimaily

o mio wod dessigs o ijed pesos. At the MSF

ehabilitatio ete i Paot, oly oe opeatig table was

aailable o mio opeatios. I ad aod the ollapsed La

Tiité Hospital, sgey was poided i maeshit tets ad,ate a ew days, i a shippig otaie that was oeted ito

a opeatig theate. La Tiité Hospital had eight speialised

Haitia sgeos, who, togethe with the est o the sta, ad

despite thei ow losses, poided ae with the limited esoes

aailable to them.

MSF logistial sta tasomed La Tiité Hospital’s phamay

ito a sgial opeatig oom as well. Fthemoe, withi ap

poximately 48 hos, MSF idetied aailable ooms ad a des

sig statio at the Miisty o Health’s chosal Hospital ad ma

aged to stat sgial atiities thee i two opeatig theates.Othe patiets wee teded to at a MSF oe. By Jaay 15,

majo sgey was also beig poided i tets aod the MSF

sppoted caeo Hospital.

Fv mut t t quk, pp w b u p. Wt w u,

t w u pp uy.

D. Jeae cabeza, medial oodiato o

MSF’s opeatios i Haiti, who was at MSF’s

ehabilitatio ete i the Paot eighbo

hood ad had, lie some o he olleages,

sstaied mio ijies.

“

“

© Julie Rémy




h M a y O c t o b e r J u n e J u l y A u g u

s t S e p t

e m b e r

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r D e c e

m b e r

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9


Emergency p F e b r



S e p t e m b

e r N o v e

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Triaging the Wounded

Tiage is the poess by whih medial sta detemies whihpatiets ae i the most seee oditio ad whih teatmets

shold be pioitised. Eetie tiage eses that aailable e

soes ae sed to sae the maximm mbe o lies ad to e

de mobidity. I the best o imstaes, tiage a iole

dilt hoies. I the immediate atemath o the eathqae

i Haiti, howee, it was ot possible o MSF teams i some loa

tios to ay ot systemati tiage de to the massie mbes

o woded people foodig hospital gods. The exeptioal

imstaes ad eomos woload eqied ey dilt

deisios to be made. The tiage stategy sta adopted was to

pioitise patiets with the highest hae o sial.

ultimately, MSF was oe o the majo atos i emegey s

gial ae amog the 30 oeig eld hospitals deployed dig

this st theemoth emegey phase. MSF sgeos peo

med 5,707 majo sgial poedes, 150 o whih ioled am

ptatios.

A emegey sgial stategy mst be adapted to aailable e

soes ad eeds; it eeds to be deeloped ad otiosly

eassessed by the most expeieed sgeos i ollaboatio

with othe olleages. This was ot systematially doe dig

the st days ollowig the eathqae de to the massie ifxo woded; thee was o let p i the wo ad ths o time

o efetio ad plaig, oly espodig. Oe o the lessos

leaed o MSF is to the stegthe its expetise with moe

expeieed sgial oodiatos to ll this gap i the te.

T w but wu.

Ty w py ct t t u y, w ppw t b but ut. T

uy ’t vy cmpx, but t’ mt pmtv but uy

mv m tu mputt mb. T

c yu v t tk ucy wt yu c pv tt mb

wt t mut b mv. it cb vy fcut c t tm

mputt cy t t t yu wt t tu t. But w p b cu y

bu, t tu v bvy m, t t

vwm ct ptc ck tt .

MSF Sgeo D. Pal MMaste

who eahed Haiti less tha a wee ate

the eathqae st.

“

“

© Julie Rémy




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

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© Julie Rémy

This also delies the eed to otlie a appoah o espo

se to mass asalty eets thogh tiage, stabilisatio, eeal

systems, ad edolie ae. Lessos leaed ae eablig MSF

to impoe its apaity ad expetise to ogaise tiage, eme

gey seies ad itesie ae its i peaios emegey

oditios.

it’ tu tt t ct

vyt pb t p m v my tw . at m t t

y, wt ct tt , tw t pt but t mputt

my . Ty k m ty vm t mc . i t

yt, but i t t b .

23yeaold woma who was teated by MSF

ate the eathqae.

“

“




Emergency p F e b r



S e p t e m b

e r N o v e

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Dwindling Medical Supplies

As medial teams got to wo, logistial teams seahed damaged MSF hospitals o eqipmet, mateial, ad dgs.

cotigey stos wee ept speially o emegey pepaedess seaios sh as foods, ladslides, ad epi

demis. residal emegey spplies om MSF’s iteetio ollowig the 2008 foods i Goaies wee still i the

oty, as wee be stos o spplies to maitai ogoig tama, othopedi, ad b teatmet, ad obste

tial ae pogams.

Fotately the sixmoth spply ode o the Matissat emegey ete had jst aied ad old be sed o

the emegey espose i Matissat. MSF teams edistibted existig spplies amog the aios hospitals, bt

the itese pesse ad the la o mobility i those ealy days peeted the establishmet o a tightly oodia

ted spply hai o the medial spplies that wee aleady i the oty. Iomig spplies ad doatios made

thogh the cetal Medial Stoes PrOMESS, whih was sppoted by the Wold Health Ogaizatio (WHO) ad its

egioal am, the Pa Ameia Health Ogaizatio (PAHO), helped oeome itial ealy shotages.

MSF maitais a emegey spply base i Paama, whih allowed s to get spplies ito PotaPie beoe

the aipot way was jammed with iomig elie ad diplomati fights. The mai gaps i majo sgial mateial,

howee, old ot be lled by these maily omedial elie spplies.

MSF theeoe expeded sigiat eot to see diet ladig aess o essetial medial ad omedial

spplies i PotaPie. This ilded establishig otat with oials om the Haitia goemet, the un,

ad the uited States who wee dietig iomig ai ta i ode to see ladig slots o MSF ago fights.Howee, may fights ayig spplies ad disaste expets wee dieted to the Domiia repbli bease the

Haitia apital’s small aipot was damaged, oeloaded with fights ompetig to lad, ad beset by lea ai

ta pioities.

Betwee Jaay 14 ad Jaay 18, e spplylade MSF plaes wee dieted om PotaPie to the Domii

a repbli. These plaes aied a total o 85 tos o medial ad elie spplies, ildig the mateial to bild a

100bed ifatable tet hospital to eplae the destoyed Tiité Hospital. MSF spoe ot abot the la o pioitisa

tio o medial spplies thogh old ad ew media otlets.

I the ed, most MSF spplies wee oted thogh the Domi

ia repbli, ad MSF established a spply base i Sato Domigo. Ee thogh this meat taig a loge ote ito Haiti, it

poided a moe stable ad eliable optio o the iitial moths,

as Haiti’s aipot ad seapot, while ope, emaied oebde

ed.

Seeal ogaisatios oeed thei seies to sppot MSF’s

wo ollowig the eathqae. Fo example, the eiometal

ogaisatio Geepeae geeosly doated the se o its ship,

Espeaza, to assist MSF with its emegey espose i Haiti.

This doatio eabled MSF to taspot its most get liesa

ig medial spplies as qily as possible by ai, while Espeaza made the slowe joey to PotaPie ayig less

get, thogh essetial, spplies sh as blaets, bets, ad

soap. The ship also aied a eight o thosads o lites o el,

a ommodity i shot spply i Haiti i the immediate atemath o the eathqae.

it k wk

w tut. W ’t v y m mp t m p u ptt. W ct ccpt tt p cy v mc

upp qupmt ctu t

b tu wy wu ptt . Pty mut b

v t mcuppt t cuty.

rosa cestai, MSF medial oodiato.

“

“




Emergency p F e b r



S e p t e m b

e r N o v e

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Establishing Field Hospitals

The MSF logisti teams mobilised qily to set p tempoay iastte ad to epai ad expad existig i

astte. Spplies o wate ad eletiity wee established, saitatio poedes pt ito plae, ad, late o,

medial ailities wee istalled.

Yet i the wees ate the qae, sta ad the poplatio alie wee eed by eqet ateshos, ildig

a patilaly powel oe o Jaay 20. Ee i hospitals ad bildigs that had withstood the eathqae, the

Haitia sta ad patiets esed to stay iside oete sttes ot o ea that they wold eetally ollapse, as

so may othes had. I some istaes, theeoe, patiets wee hospitalized, ad some opeatios wee odted,

de tets.

Emegey eld hospitals wee set p sig existig Miisty o Health sttes, MSF sttes, o othe piate

sttes—a detist lii at Bieteaie, a shool i caeo, semipemaet bildigs i Léogae, ad the i

fatable hospital, whih, oe it aied, was eeted o a ootball eld i the Delmas 30 distit.

The ifatable hospital was employed to eplae the destoyed La Tiité Hospital, whih poided tama ad otho

pedi sgial ae, ad to qily establish the apaity to poide highqality emegey medial ae to om

plimet atiities at othe eld hospitals aleady established by MSF medial teams. Despite the at that the plaesayig it wee dieted to the Domiia repbli, the ifatable hospital—whih ame to be ow as Sait Lois

Hospital—was tioal ad eeiig patiets jst 10 days ate the eathqae.

© Nicola Vigilanti




Emergency p F e b r



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The Challenge o Rebuilding Hospital Capacity

To ese pope oditios o emegey sgial atiities ollowig the iitial emegey phase, MSF sed bil

digs that wee deemed saitay ad sae—i.e. ot sttally ompomised by the eathqae—ad also eeted

hospitals made o peabiated otaie modles. A ompliatig ato was that may patiets still esed to be

hospitalised iside ay oete stte ad peeed to oalese i tets.

Fom the otset, the ogaisatio osed o estoig ad stegtheig seoday leel hospital apaity o eme

gey ae. Fo example, MSF ashioed a dediated postopeatie ae pogam, omplete with a ll sgial it,

i a ome waehose. MSF also hose to se loal owhow ad eadily aailable mateials—oete odatios,

timbe wood o the ame ad the walls, io sheetig o the oo—to bild semipemaet sttes that old

late be made pemaet.

MSF eeded to get its sgial its opeatioal as soo as possible i ode to gaatee asepti oditios ad to

eplae the impoised opeai set ps. Sppotig sgial atiities i existig ailities oeed the best asepti

oditios, bt may o these sttes wee ot tioal o sttally sod, o else they had bee oewhel

med with patiets ate the eathqae. Alteaties ilded tasomig osaitay bildigs sh as shools, a

soda atoy, ad a hild ae ete ito eld hospitals with sgial its iside. The tehial soltios applied by

the teams wee siet to peet ay majo otbeas o ietios dig the st moths o the iteetio.

Treating “Crush Syndrome”A MSFailitated real Disaste relie Tas Foe that eglaly wos with MSF i eathqae emegeies ma

aged to estat the idey dialysis i the uiesity Hospital to teat crush syndrome1 patiets with ate idey

ijies (as well as patiets with peexistig hoi idey disease) i less tha a wee.

The whole iteetio at uiesity Hospital lasted exatly two moths ad eqied osideable esoes. Twe

ty ephologists, ses, ad haemodialysis tehiias wee dispathed to Haiti om aios oties. This team

peomed the eqialet o 316 dialysis teatmet days. Bt the oeage ad otpt a be osideed limited gi

e the low mbe o patiets who eeied this speialised ae set agaist the moe tha 300,000 ijed people,

may o whom wee liely “shed” by ollapsig bildigs ad walls.

This is lagely de to a la o detetio o patiets with sh sydome. The iteetio beetted om the s

essl itodtio o a MSFspplied poitoae deie that allowed o immediate detemiatio o the most

itial biohemial tests ad aste deisiomaig o the maagemet o sh sydome patiets. The mai les

so leaed is the eed o moe emphasis o ealy detetio o sh sydome patiets at the eld hospital leel to

peet ate eal aile ad ailitate thei timely tase o idey dialysis.

1. Cu ym ct wc muc tu m by v t juy mv qutt tx t t b, t ky u.

lt utt, cu ym c b t.




Emergency p F e b r



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Medical Challenges: Managing a Massive Surgical Caseload

De to the eomos aseload o sgial patiets admitted to MSF ailities, eeals om othe healthae aili

ties, ad patiets let behid by tempoay iteetio teams om goemets o smalle sale ogaisatios, MSF

qily ieased its iitial postopeatie ad ehabilitatie ae apaity. Most MSF ailities had the apaity o

sgey ad itegated physiotheapy ad metal health ae.

I oe MSF aility, 807 ases wee epoted dig the st thee days, bt, sie data olletio was ot a pioity

i these ealy momets, the type ad seeity o ijies emais ow. By the ed o the st wee, thogh,

MSF estimated it had teated moe tha 3,000 woded people i the Haitia apital ad peomed moe tha 400

sgeies.

This atal disaste dieed om othes i two sigiat ways. Fistly, it dietly aeted the iastte o a

ba apital ad, oseqetly, the apaities o all goemetal, un, ogoemetal, ad piate ageies to

espod. Seodly, the sale o the immediate medial eed amog those ijed was the agmeted bease

the eathqae impated desely poplated aeas o pooly plaed ad eglated settlemets withi the apital.

These atos ombied both to eate a hge eed ad also to hide the ability o ogaizatios to espod to that

eed.

Eah MSF hospital was ooted with speial ases, sh as eologial tama ijies, whih they did ot hae

the apaity to teat. reeals, howee, wee dilt to poide de to a la o awaeess ad ommiatio

abot what othe apaities wee aailable i Haiti, ildig at othe MSF ailities. Thee was o etal hb thathad a oeiew o aailable seies. Dieet stategies wee gadally deeloped to deal with eeals. Some pa

tiets wee eeed to Sato Domigo o adaed teatmet. Some seee b ijies wee eeed to the uSS

comot ship doed o the mai pot. Bt this eqied extesie logistis. It was ot til late i Febay that MSF

maaged to eate a moe adaed, etalised ae o b ijies.

Bolstering Post-Operative Care

Beig ooted with sh a hge aseload o sgial patiets ad haig leaed om peios eathqae i

teetios, MSF deeloped a sigiat ipatiet ad otpatiet postopeatie ae apaity. I additio to post

opeatie ae ailities attahed to o itegated withi the hospitals, by the ed o Jaay, MSF opeed speipostopeatie ae etes to deal with the oeload o patiets eqiig pologed ipatiet ad amblatoy

postopeatie ae.

May o these ases wee eeed om MSFmaaged o sppoted health ae sttes. Othes wee om militay

o iilia emegey atos who depated ate the st wees o the iteetio, leaig behid may patiets

who still had dessigs, asts, o exteal xatio that eeded attetio. Almost all o the postopeatie ae etes

had to itegate majo sgial seies i ode to poide eessay ollowp wod ae ad othopedi sgey

(debidemet, ietios, iteal ad exteal xatio) ad eosttie sgey.

Fom Jaay 12 thogh the ed o Apil, MSF ogaised ipatiet postopeatie ae o 2,604 patiets ad amb

latoy postopeatie ae o a dometed aseload o patiets.

I Febay, MSF opeed a postopeatie ae ete i a oeted sot di atoy i the Sathe eighbohood o

the apital. With a apaity o p to 300 beds, patiets old eeie wod ae ad moe speialised othopedi o

eosttie sgey. Hadiap Iteatioal physiotheapists woed alogside MSF to help patiets ehabilitate

ad adapt to posthetis.




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

I total, MSF established some 2,000 postopeatie ae beds i PotaPie withi e wees o the eathqae.

While it is bette to hae too mh apaity tha ot eogh, MSF did eate moe postopeatie ae apaity tha

it ltimately tilised i the emegey phase. MSF sgial speialists ad emegey maages ae etly ea

latig meas to ese the geate oodiatio ad moe peise pojetios o eeds i ode to peet, to the

degee that is possible, a oese o hma ad aial esoes aod establishmet o postopeatie ae

apaity i massasalty atal ad mamade disastes.

Providing Physiotherapy

Gie the high popotio o sgial ases, may o whih ioled othopaedi ijies, MSF ehaed its ability to poide

physiotheapy. These seies wee eithe itegated ito MSF’s

emegey hospitals o oeed thogh postopeatie ae a

ilities. The woload o MSF teams was ey high. I oe MSF

hospital, at the pea o physiotheapy atiities i Febay ad

Mah, a aeage o 200 patiets wee eeiig ae i appoxi

mately 1,000 sessios pe wee. MSF pateed with Hadiap

Iteatioal i seeal ailities ad displaed pesos amps to

impoe the qality ad aailability o postheses ad physial

ehabilitatie ae.

© Benoît Fink / MSF

Ty v b tu

muc but v t tttu.i w 30-y- mw b mputt m

t m w wk up, w t cmpt .

T w m t m,‘i’m t mk t.

niole Deis, a MSF se, who woed

eathqae ijies.

“

“




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

Emergency Psychosocial Care

Fom the stat o the emegey espose, MSF mobilised ew metal health ae teams, o eioed existig oes,

with iteatioal sta ad ewlyeited atioal sta. These teams osed o the atioal sta, may o whom

had lost elaties ad homes bt oetheless otied to wo despite axieties abot the peset ad e

taities abot the te. They also poided osltatios o seeely ijed patiets ad thei amily membes i

postopeatie ae. As o ealy Febay, metal health ae atiities—psyhoedatie gop sessios, idiidal

osltatios, ad mtal sppot gops—expaded to otpatiet seies ad late ito the ommities o cité

Soleil, caeo Feille, ad Tapis roge; the iteally displaed pesos amps aod Jamel ad Léogâe; ad

the Gae, Pétioille Gol clb, ad Aiatio IDP amps as well.

Psychiatric Care

Psyhiati ae was ogaised at Sait Lois Hospital ad its attahed otpatiet depatmet o all those patiets

who eqied the seies ad who old be eeed om othe MSF pogams o othe atos.

All told, moe tha 40,000 people eeied psyhosoial o psyhiati sppot om MSF sta dig the iitial eme

gey phase.

Basic Healthcare or Displaced PersonsBy the ed o the st moth, i ode to espod to the pessig eeds o basi health ae o displaed people i

PotaPie who had od some type o shelte ea MSF sgial ailities, MSF teams set p otpatiet seies

lied to o itegated withi the emegey hospitals ad postopeatie ae etes. The otpatiet depatmets

o the hospitals o chosal ad Jamel, howee, emaied de the maagemet o the Miisty o Health, with the

assistae o othe ogaisatios.

Soo atewads, MSF also set p xed o mobile OPD seies i seeal IDP amps ad sppoted existig liis

at othe amps i PotaPie—Delmas 24/Fot natioal, champs de Mas, Gae camp, Shiia lii, Petioille

Gol clb, Aiatio amps, caeo Feille ad Tapis roge—ad otside the apital i Jamel ad Léogâe.

Depedig o the loatio ad the eidet eeds, these otpatiet seies poided osltatios, amblatoy

dessigs ad postopeatie ae, metal health seies, ateatal ad postatal osltatios, ae o itims o

sexal iolee, ad aiatios (iitially agaist tetas, ad late to ilde aiatios oeig the ll sope o

the Expaded Pogamme o Immisatios seies).




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

Chronic and Acute Medical Conditions

MSF has deeloped a geat deal o teatmet expeiee o ietios diseases sh as HIv/AIDS ad tbelosis.

Howee i Haiti, MSF lagely elied o othe ogaizatios that wee aleady poidig teatmet o these odi

tios to otie the wo. Gie the iedible olme o patiets de its ae, MSF teams wee ot able to ade

qately assess whethe these ogaisatios—both Haitia ad iteatioal nGOs—wee atally able to meet the

eeds o patiets eqiig HIv/AIDS o TB teatmet.

Fthemoe, MSF did ot hae the appopiate mediies o had i the emegey phase to ae o patiets s

eig om oommiable oditios sh as hypetesio, diabetes, ad epilepsy. O 850 patiets teated i

oe loatio betwee Mah ad Septembe, thee wee 72 ases o hypetesio. reogisig this shotall i the

paage o aailable ae i some MSF medial sttes, the ogaisatio is aleady ealatig the easibility o

ildig hoi disease its i the emegey pepaedess stos it maitais i dieet oties.

Emergency Obstetrical Care

With the desttio o MSF’s emegey obsteti hospital,

MSF stated oeig hma esoes, dgs, ad obstetis ex

petise to sppot to the Miisty o Health mateity hospital,

Isaïe Jeaty, whih had ot bee damaged i the eathqae.

The hospital teats pegat wome with medial ompliatiossh as elampsia ad malaia ad poides eoatal ad post

atal seies ad a blood ba.

W’v v my

pmtu bb ut tum. Wm cm t uwt p-cmp cmp

-- u ct xcbt by t. Tu ht xtmy

t cmp bt tquk,

t mv t t t pbby ut

vt t ct.

Ea de Plee, a MSF midwie

at Isaie Jeaty mateity hospital.

“

“

© Julie Rémy




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

Burn Care

Whe La Tiité Hospital was destoyed, Haiti lost its oly speialised teatmet it o seee bs. reestablishig

this it beame a pioity, espeially gie the dageos liig oditios aed by eathqae sios.

By late Mah, a ew dediated it had bee set p de aas withi the Sait Lois Hospital ompod. The

it poided thee tets ad 30 beds o seee b patiets, both hilde ad adlts.

Bu cy qut v w bcu t pp v v m u ct.

a pct my tk pc jut , t vy cmp pc: my mmbp, py ck t m .

Wm c t bu bcu pt b wt tp v, c t t bkt.

M mty bu w mmb puct, pmy u ct. F

vctm v bu, t 24 u w t cct cuc.

emcy uy mut b pm wt x u t cct pp ty qu vy u c t wk t mt.

D. rémy Zilliox, a MSF plasti sgeo ad b speialist.

“

“

© Nicola Vigilanti




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

Non-Medical Assistance

Jst days ate the eathqae, MSF teams aied ot assessmets o the eeds otside PotaPie ad iitiated

mobile liis i ommities sh as Petit Goae, Gad Goae ad Léogâe, all o whih ae sitated ey ea the

epiete o the eathqae, ad i Jamel to the soth. By the ed o the moth, MSF was edeaoig to the

aid these ad othe hadhit ommities by establishig xed ad mobile liis ad ogaisig spplies o wate

ad the osttio o hygiee ad saitatio ailities.

Qily, it beame lea that hdeds o thosads o people

eeded shelte—ad that the la o shelte was haig medial oseqees—bt wee ot eeiig mh assistae i

that egad. I late Jaay, MSF bega distibtig plasti shee

tig, tets, ad othe elie items, salig p these eots the ol

lowig moth oe it beame lea that ew o the ogaisatios

expeted to addess these eeds wee atally doig so.

Seeal gops expessed oes oe seity, whih wee ot

etiely oded. Axiety ad despeatio was peasie ate

the eathqae, whih i some istaes eated est ad at

times age amogst people awaitig assistae. MSF’s st dis

tibtios i the al aeas otside o PotaPie te days

ate the eathqae wee hampeed by owd otol isses.

MSF ths deided to miimize seity iss by exetig qi,

lagesale ealy moig distibtios, sig bses to taspot

beeiaies i small gops to moig distibtio poits, ad

distibtig items thogh hhes ad othe ommity oga

izatios.

By the ed o Je, MSF had distibted lose to 85,000 elie

spply its made p o items sh as ooig tesils, hygiee

items ad blaets, appoximately 2,800 olls o plasti sheetig

ad moe tha 28,640 tets. I Léogâe, o example, MSF madedistibtios to 3,000 amilies. MSF eetally spet €11.7 mil

lio (uS$15 millio) i shelte ad oood item distibtio.

T mm tm t, y, bc v

ct t b mt.

F t , w v tt ttbut 26,000 tt wc w

pv t t u 100,000

pp. abut 7,000 v y b tbut tbut

t t t mmt. MsF

tbut ck ut,y kt—p, b, tw,

tc.—bkt mqut t t m umb pp. hwv,

t tbut w t bu. humt t

mut w t m, t wy.

chistophe Stoes,Geeal Dieto o MSFBelgim

“

“




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

at t vy b, w v t c tt w cv tt y qupmt. it w Juy, t wt w cmt, wt . W

tut w’ b t jut cup mt. My u b cmpty ty. i cm wt my my u t t cmp bcu t w t t t my pvum. W cv b tt, bkt, y ktc qupmt, v m .

W w vy ppy. But w t’ m t v mt c t tquk pp. Ttt t u – t y bk m pc – w t

uc p. i yu v tm, i vt yu t cm p .Yu w .

34yeaold Haïtia ma, leaig i IDP amp i PotaPie

“

“

© Kadir van Lohuizen/NOOR




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

Water and Sanitation

Mh o MSF’s wate ad saitatio wo osed o eatig the appopiate hygiee oditios to ay ot medi

al ad sgial pogams ad to stem the spead o disease. MSF teams poided sae wate, ostted o ehabi

litated laties ad esed the eaatio o waste wate ad solid ad medial waste at the 26 ailities opeated

dig this emegey phase.

Wate poisio atiities wee also established o poplatios shelteig ea MSF medial ailities, ad watead

saitatio teams stated hygiee pogams i the amps whee MSF had medial atiities ad whee eeds wee

still ot oeed by othe atos. This ilded tyig to ese aess to laties, showes, ad lady zoes, as well

as hygiee pomotio ampaigs.

Almost all o the iomal displaemet amps elied o di

ig wate that was ted i ad teated osite. Most sites had

isiet wate o spae o bathig piately, whih amo

ted to a hygiee isse as well as a seity isse, patilaly o

wome. Laties wee badly ad widely eeded. De to la o

spae, a elatiely high wate table i some loatios, ad the

ate o the soil i the ity, howee, it was dilt to ahiee

the aeptable stadads o laties i some amps.

h t cmp,w ’t v u t,

w t t ut t t wt u t t ck

tbut pt. at t vy b, t w

, bcu t w t t pp, but w t’ k

v wt t cty.

A 22yeaold woma,

i the caeo Feille IDP amp.

“

“

© Ron Haviv / VII




Emergency p F e b r



S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1A p r i

l 3 0

cosideig how may people had bee displaed, MSF’s oeall wate ad saitatio eot was qite modest. This

was lagely a tio o the deisio to pioitise medial isses, the pesee o othe atos woig i this aea,

ad patial ostaits.

A additioal isse o MSF’s opeatios, i tems o saitatio, was the la o a sae disposal site o medial waste i

PotaPie, whih otied to pose a poblem late o i the yea with egads to the massie holea otbea.

I the absee, MSF has istalled iieatos to poess the waste om its ailities.

Human Resources

A ommo eate o disastes is that ogaisatios qily ome to ely heaily o thei most expeieed ad qa

lied loallyhied sta—bt the mst qily hie ad tai additioal loal sta.

MSF maaged to mobilise a peedeted mbe o sta om aod the wold bt stggled ate the iitial

stage o the emegey to spply the eessay iteatioal aid woes with the expetise o a disaste o this

id. Seio maages ad oodiatos ted to toe at a high ate i the ealy moths o emegeies, ad its

eessay to otate people i both to eep sta membes esh ad eetie ad also to allow them time to est a

te what is ieitably a extemely itese, extemely taxig expeiee. The high demad o sta i Haiti ate the

eathqae—ad, late i the yea, i Paista dig the histoi foods—plaed seee pesse o MSF i some

loatios to maitai stag leels i eld pojets.

Aothe ey lesso leaed is the itial impotae o etai oles i this day ad age. These ilde Iteet ad

teleommiatios expets; biomedial eqipmet tehiias to istall ad maitai adiology ad adiosopy

eqipmets, hoizotal steilisatio its, ad bloodba, oldhai, ad speial aesthesia eqipmet; eleti

ias; ad sttal ad osttio egiees to assess the saety o medial bildigs, oes, sta hoses, ad

waehoses.




Post-emergency p F e b r

u a r y M a r c h A p r i l J u n e J u l y A u g u

s t S e p t

e m b e r

N o v e m b e

r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1 O c t o

b e r 2 1

M a y 1

gey medial opeatios, losig some medial ae ailities, ad edig atiities i seeal displaed pesos

amps i the apital, whih wee by the beig well seed by othe ogoemetal ogaisatios. As it happe

ed, i at, the histoially magialised slms, whih wee less see bt wee ot by ad lage see by istittio

al doos as haig bee hit had by the eathqae, eeied a less adeqate assistae tha did the amps. MSF

theeoe hose to maitai its medial ailities i ommities sh as cité Soleil ad Matissat.

Additioally, MSF ageed to bild a geeal hospital i Léogâe, a emegey obsteti hospital i Delmas 33 o

PotaPie, a speialised tama hospital i Tabae, o the otheaste otsits o PotaPie, ad a gee

al hospital i Doillad, o the apital’s peiphey, jst otside the cité Soleil slm.

MSF did ae some dilties dig this logetem plaig phase. restitios o the amot o aailable lad

ompliated the poess o iitiatig ew osttio whe it was eessay. Ad the plaig o the hospital i

Delmas 33 was hampeed by isiet ommiatio betwee MSF ad the Haitia Miisty o Health ad othe

eglatoy obstales. This lead to a sbstatial delay i the pojet, ad ths a sbstatial delay i the poisio o

timely teatmet to the people o the ommity, patilaly pegat wome i eed o emegey obstetial

ae. (costtio was eetally ompleted, howee, ad the aility poed espeially alable last all, whe it

was sed as a holea teatmet ete ate the holea otbea spead to the apital.)

Additioally, i Otobe MSF opeed a 120bed hospital i Léogâe desiged to os o obsteti, tama, ad pe

diati emegeies ad iteded to allow MSF to phase ot the teted hospital it established o the gods o the

Miisty o Health hospital i the ity jst ate the eathqae.

© Ron Haviv / VII




Post-emergency p F e b r

u a r y M a r c h A p r i l J u n e J u l y A u g u

s t S e p t

e m b e r

N o v e m b e

r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0J a n u

a r y 1 2

2 0 1 1 O c t o

b e r 2 1

M a y 1


h A p r i l M a y J u n e J u l y A u g u s t

S e p t e m b

e r N o v e

m b e r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0 J a n u

a r y 1 2

2 0 1 1 O c t o

b e r 2 2

Tents and Drinking Water

By May, MSF had ompleted its distibtios o tets, bt the ogaisatio otied to distibte basi eessities

sh as ithe tesils ad hygiee its i a host o loatios both iside ad otside o the apital. At this poit

moe tha 28, 000 tets had bee distibted. Tets ad basi eessities wee also distibted to abot 200 amilies

i emote illages o Léogâe egio,

Dig this seod phase, the ogaisatio eded the amot o wate it was distibtig om a high o 870,000

lites pe day dig the emegey phase to 713,000 lites o wate pe day, oghly eogh o 71,000 people.

Hurricane Season

The hiae seaso was a majo peopatio oe the smme bease so may people wee (ad still ae) liig

i peaios oditios ad bease may MSF patiets, eaig aothe eathqae, wee still way o stayig i

doos o ay exteded peiod o time. Fo this easo, may MSF ailities still sed massie tets to elose hospital

wads.

Fotately, the ais ad wids wee ot as deastatig as so may had eaed they wold be. MSF did poide a

emegey spply o tets to ewly esettled amilies ollowig a Jly stom that aeted the coaille amp ad a

a shelte epai pogam i the Petioille Gol clb ad othe amps.

From January 12 to October 31, MSF treated more than 358,000 people, perormed more than 16,570 surgeries,

and delivered more than 15,100 babies. MSF also uses mobile and xed-point clinics to provide primary medical

care and relie supplies to displaced persons living in various camps in Port-au-Prince. The organisation carried

out water-and-sanitation services to displaced persons in the Cité Soleil slum and Carreour.

MSF was operating seven private, ree-o-charge, secondary-level care hospitals and supporting two Ministry

o Health structures in Port-au-Prince, accounting or nearly 1,000 hospital beds in the capital by the middle

o October. These acilities provided emergency, trauma, obstetrical, pediatric, maternal, and orthopedic care

services. Mental health care and treatment and counseling or victims o sexual violence are also provided by MSF. Outside the capital, MSF supported Ministry o Health hospitals in Jacmel with nearly 100 beds o patient

capacity and runs a private, 120-bed container hospital in Léogâne that opened in October.




Cholera emergency p F e b r

u a r y M a r c h A p r i l M a y J u n e J u l y A u g u

s t S e p t

e m b e r

N o v e m b e

r D e c e

m b e r

J a n u a r y 1

2

2 0 1 0 J a n u

a r y 1 2

2 0 1 1 O c t o

b e r 2 2

At this poit, it was lea to MSF’s eld maages that the

holea otbea was goig to be a hge isse that e

qied a lagesale espose aoss seeal setos. O

Otobe 31, lage mbes o patiets bega omig to

MSFsppoted hospitals i the PotaPie’s cité So

leil slm with the symptoms o holea.

It’s a really

worrying situation or us at the moment.

All o the hospitals in Port-au-Princeare overowing with patients and we’re

seeing seven times the total amount o cases

we had three days ago.

Steao Zaii , MSF’s head o missio i Haiti,ommetig o the otbea o holea i the apital.

cosess was that holea was ey liely to spead wi

dely i a oty whee most people laed aess to

lea diig wate o saitatio, whee the poplatio

was amilia with the eessay peetio meases,ad whee atioal health sta, too, had o expeiee

with the disease po whih to daw. Bt the tasmis

sio dyamis wee dilt to pedit, bease the oly

peedets wee seeal deades old.

The poplatio’s axiety was heighteed by the PAHO

epidemi pojetios. At o poit did PAHO’s epidemi

modelig lead to a eetie aid deploymet. O the

otay: hge amots o aid wee oetated i

PotaPie while isiet sppot was poided to

the iexpeieed health woes battlig the disease’s

aggessie spead i al aeas. MSF teams od

some health etes aig shotages o liesaig oal

ehydatio soltio ad othes that had simply bee

shtteed.

The mbe o si patiets was gowig. I the api

tal, the mbe o people seeig teatmet at MSF

ad sppoted medial sttes jmped om 350 o

the wee edig noembe 7 to 2,250 ases the wee

edig noembe 14. I the noth, MSF teams logged

280 ases dig the wee edig noembe 7, bt that

mbe jmped to 1,200 o the wee edig noem

be 14. They otied to gow ate that.

MSF was able to otie woig thoghot seeal

bots o iolee i the oty. Dig iots i the othe ity o cap Haitie, MSF teams still maaged to

ope ew cTcs ad tael thoghot the ity to poi

de teatmet seies. I ealy Deembe, ollowig the

oty’s eletios, MSF was still able to poide teat

met i its etwo o cTcs i the apital whe iotig

hit PotaPie.

Despite the hge pesee o iteatioal ogaisatios

i Haiti, the holea espose had bee iadeqate i

meetig the eeds o the poplatio. MSF issed epeated

pbli statemets poitig ot that itial shotalls ithe deploymet o wellestablished meases to otai

holea epidemis ae demiig eots to stem the

ogoig otbea i Haiti. O noembe 18, MSF issed

a pess elease allig o othe aid atos to do moe, to

sale p thei esposes ad to do it qily.

MSF otlied a seies o meases that eeded to be ta

e immediately to ty to get the epidemi de otol.

These eeds wee shaed with goemet oials, the

un leadeship ad hmaitaia elie oodiato, ad

othe nGOs

“

“

Cholera is an easily preventable disease. It may be new to Haiti,

but the ways to prevent and treat it are long established.

Without an immediate scale-up o necessary measures by international agencies

and the government o Haiti, we alone cannot contain this outbreak.

caolie Segi, MSF emegey medial oodiato.

“

“



29




s t S e p t

e m b e r

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Current situation

At peset, MSF is still salig p atiities, osig o

maig moe beds aailable ad o ase maagemet,

while maig se that oholea atiities otie

omally. By late Deembe, the ases i the noth, no

thwest, ad the Sotheast depatmets, the Atiboite

egio, ad the aea jst west o PotaPie wee all

seeig ases deease. Howee, MSF admitted 8,450

ew ases i its cTcs atiowide i the wee edig De

embe 26. Thee seems to be a widespead belie that

the holea espose i the apital will hae to last seeal moe moths, thogh ealy 2011, at the ey least.

I a smalle otbea, MSF wold be as osed o tyig

to bea tasmissio as it is o teatmet, ayig ot

ommity awaeess ad edatio eots, distib

tig wate, ad so oth. I this sitatio, thogh, it has

bee eessay to deide how the ogaisatio a be

most eetie gie the esoes it has. The ogaisa

tio has doe some o the aoemetioed peetio

atiities, bt it maily has osed o seig the most

seee ases, o saig lies, essetially, while hopig

ad pshig othe atos will ll i the gaps elsewhee.

Besides MSF, cba medial bigades hae bee themost atie ato i the aea o teatmet o holea a

ses. Moe tha 3,300 people had died om this lagely

peetable ad teatable oditio by Deembe 26.

These included:

reassig a poplatio ighteed by a disease that

is ompletely ow i the oty, ommiatig

the low is ad positie beets o haig popely

holea teatmet etes i lose poximity to omm

ities;

Poidig sae, hloiated wate to aeted ad atis

ommities atiowide, i additio to blaet disti

btios o soap;

Bildig laties ad saely emoig waste o a eg

la basis;

Esig waste maagemet ad emoal at medial

ailities, i ode to peet otamiatio;

Establishig waste disposal sites lose to ba aeas i

appopiate ad otolled eiomets;

Establishig adeqate oal ehydatio poits i aeas

whee holea ases ae appeaig;

Maitaiig a sae ad eiet etwo o eeal o

seee ases to holea teatmet etes;

Esig sae emoal ad bial o dead bodies.

© François Servranck / MSF






s t S e p t

e m b e r

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J a n u a r y 1 2

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MsF w mb c mcy p c vy mttv ptmt ht.

By dcmb 26, t Mty ht pt 150,000 c m t 3,300 t c t

cuty. at t m tm, Juy 2, 2011 m t 91,000 c c b tt by MsF

mc tm 47 c ttmt ct tuut t cuty. (T ccut ppxmty 60

pct c tt t t cuty.) MsF tb v 4,000 b ptt cp-

cty t c utbk b b t mt t c tty t t 2 pct t

ct.

M t 1,000 t mc tc upp v b but t t cuty, MsF m

t 5,500 ht tt t ct t c ttmt.

MsF tmt t w p ppxmty €10.8 m ($14.2 m) c mcy pm

2010. at €7.5 m ($9.9 m) pjct t b qu t ctu c-t ctvt

ht 2011.

© Gregory Vandendaelen / MSF




h A p r i l M a y J u n e J u l y A u g u s t

S e p t e m b

e r N o v e

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31

Financial accutbty






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MSF eeied massie aial sppot o the Haiti emegey om hdeds o thosads o doos

aod the wold. By the ed o 2010, MSF has estimated it will hae spet all o the €104 millio 2 ($138

millio) doated by piate sppotes o Haiti.

MSF estimates that it will hae spet a total o €94 millio ($124 millio) o the eathqae elie eot i 2010. The

emaiig piate estited ds aised o Haiti (appoximately €10 millio o $13.2 millio) will hae bee sed to

mobilise MSF’s holea espose.

As o Otobe 31, MSF had spet 76 peet—some €79 millio ($104 millio)—o these estited ds i the st

10 moths ollowig the disaste.

Major Operational Spending Categories January 12 to October 31, 2010

2. T mut t v b cvt t eu u t v mty t cuc wc t u w y t. a Us u

t pt v b ccut b eu t Us d v xc t m Juy 1, 2010 t octb 31, 2010 (1.32 Usd t 1 eu)

Category Euros US Dollars Percentage

National Staf 18,571,604 24,514,517 23%

International staf 12,622,519 16,661,725 16%

Medical 12,271,641 16,198,567 15%

Logistics 18,395,034 24,281,445 23%

Transport & Freight 14,964,735 19,753,450 19%

Running costs 2,114,144 2,790,670 3%

Training 102,269 134,995 0,13%

Consultants 305,999 403,919 0,38%

Other 180,674 238,490 0,23%

TOTAL 79,528,620 104,977,779



Financial accutbty






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Use o expenses through October 31st 2010

TOTAL: € 79.5 MILLION

Opeatig sh lagesale emegey health pogams eqies a age o iestmets. Gie the deastatio i

PotaPie ad beyod, ildig the eatotal desttio o may health etes ad hospitals, oe 20 pe

et o MSF’s expedites as o Otobe 31 wee deoted to logistis, sh as the ehabilitatio o osttio o

medial ailities as well as the distibtio o shelte mateials ad the bildig o laties. Withot this iestmet,

medial sta wold ot be able to opeate ad patiets wold ot eeie the sope ad qality o teatmet MSF

oes.

A the 15 peet o MSF’s expedites wee attibted to the medial ategoy. This ildes medial spplies

ad eqipmet sh as dgs, aies, sgial its, hospital eqipmet ad mateity health spplies.

Gie the medial ate o the iteetio ad the peedeted leel o deploymet o atioal ad iteatio

al sta, both sta ategoies aot o a sigiat amot o the expedite (almost €32 millio). They ilde

all the elated expeses o the moe tha 8,000 (maily medial ad logistis) sta that hae patiipated i the

iteetio.

Bease ast amots o elie goods had to be boght ito Haiti, taspot ad eight aoted o 19 peet o

the total spedig thogh Otobe 31. rig osts ildes expeses elated to all MSF oes i Haiti.

All these expedite lies otibted to ahiee a mbe o emegey assistae atiities. To gie some exam

ples, the amot dediated to sgial ad postopeatie ae amoted to €17.2 millio ($22.7 millio) thogh

Otobe 31, while €10.1 millio ($13.3 millio) wee dediated to mateal health ad €11.7 millio ($15.4 millio) tothe distibtio o shelte ad oood items.

National staf Logistics

Transport & Freight

International staf

Medical

Running costs

Consultants

Other

Training

3%

15%

16%

23%

23%

19%



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wold eate a pblipiate hospital i the apital i

the yeas ahead. Aothe €7.5 millio ($9.9 millio) is

pojeted to be eqied to otie holeaelated a

tiities i Haiti i 2011. Beyod these pojeted atiities,

MSF will emai eady to espod to ew emegeies i

the oty—as it does i all o the ealy 70 oties it

opeates i today.

MSF had aleady bee peset ad atie i the oty

o the past 19 yeas. It was theeoe eady to espod

whe the disaste st. Ad it is ow pepaed to dothe wo that will emai i the days, moths, ad yeas

to ome.

Planned Projects

MSF will os its esoes o the otied poisio

o emegey ae o tama, othopedi ad iseal

sgey, as well as pediati emegeies:

Lad is beig phased o the osttio o a ew

hospital i the idstial aea o Tabae. It will hae 110

bed apaity ad will at as a eeal stte o eme

gey ases i the cité Soleil ad Matissat slms, po

idig pediati, othopedi, ehabilitatio, ad metal

healthae seies as well.

The et medial ailities i Matissat, chosal, ad

Bieteaie ae to poide teatmet, stabilisatio, ad

tase o emegey ases.

The MSF otaie hospital i Léogâe will otie its

os o obsteti, tama, ad paediati emegeies.As othe nGOs moe i with pimay health ae ati

ities, the hospital’s otpatiet depatmet will lose

dow o oetate o speialised osltatios. The

goal is to d a solid pate who a tae oe the hos

pital i de time.

By Jaay 2011, the ifatable hospital at SaitLois

will be defated, ad the medial pogam—ebilt with

otaies—a moe to a moe pemaet stte

o 120 beds i Doillad.

MSF will t oe ll esposibility o the Jamel hos

pital to the Miisty o Health i Jaay 2011.

Bieteaie Hospital, a 80bed aility i a stoe

stte, will otie its atiities with a os o

emegey ad pediati ae til at least the ed o

2011.

Emergency Obstetrics

Emegey obstetis ad eoatal ae will estat i

the ewly ostted otaie hospital i Delmas 33

that eplaed the ollapsed Hôpital Mateité Solidaité.

This 135bed mateity hospital ow meets eathqaead hiae esistae stadads. The ew aility will

poide aess 24/7 to ee ad highqality emegey

obsteti ae o ompliated pegaies ad delie

ies.

MSF will poide aess to peatal osltatios ad ol

lowps to patiets with poblems elated to pegay,

sh as elampsia, peelampsia, pegayelated

hypetesio, ad peexistig hypetesio. Thee will

be postatal osltatios ad ollowps o patiets

who delieed i the mateity hospital.

MSF will oe oltay oselig ad testig o HIv

to all wome admitted to the Delmas 33 Hospital o the

basis o thei seologi ad imme stats, while esta

blishig a eeal system o those who test positie.

All ewbos who ae ill ad/o bo pemate at the

Delmas 33 Hospital will eeie eoatal ae. MSF will

hie moe tha 155 Haitia sta to the hospital ad

exted taiig oppotities o medial esidets om

i PotaPie.

La Fondation Sant Se Ae Pam

MSF is also woig o a ew poposal o a geeal

hospital with a apaity o 212 beds, a taiig pogam

o medial stdets ad speialist dotos, ad a log

tem tasitio pla. With this i mid, MSF has set p a

odatio whih will iole pates om Haitia iil

soiety, iesities, ad othe sposos.

Medial speialties will ilde othopedis, geeal s

gey, b ae, maagemet o hoi pathologies ithe ate phase—asthma, diabetes ad hypetesio,

i patila—ad tioal ehabilitatio. Most o the

sta woig i the hospital will be eited i Haiti a

odig to the sills ad qalities eessay o the po

pe tioig o medial atiities.



35

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The maagemet steeig ommittee will be gadally

appoited om sta eited at the begiig o the

pojet. To do this, they will eeie appopiate taiig

sppoted by MSF i ollaboatio with othe pates.

MSF will gide ad aially sppot the statp pha

se o this stadaloe Haitia odatio with the aim o

leaig it to loal maagemet oe it is sstaiable.

Tabarre Container Hospital

Followig the Jaay 2010 eathqae, the espose

by aios atos ote (ad destadably) osed

o pimay athe tha seoday health ae. Howee,

tama ijies ae oe o the majo ases o mobidity

ad motality i Haiti.

Sgey apabilities ae eeded, as ae pemaet st

tes i whih to ay them ot. MSF ths deided to

eate a otaie hospital that wold bidge the gap

betwee the emegey espose ad the logetem

espose ad wold poide a aiety o essetial s

gey seies i a site that old be sed by the ity.

I seod hal o 2011, MSF will ope a 110bed otai

e hospital i Tabae, PotaPie, with the aim o

tig it ito a tama sgial ete o the ity able

to ay ot 150 sgeies a moth. Tamatology, o

thopedi, ad iseal sgey will be poided, alog

with emegey pediati sgey ad patiet ehabilitatio.

This will allow a apid espose to the eeds existig

i the time iteal betwee emegey espose

ad logtem aswe. (util the ew stte opes,

Sathe Hospital is beig sed as a eeee tama

ete.)



Concu






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MSF wishes to acknowledge the sufering o the Haitian people, who have endured so much during and ater

the earthquake. However, much o the afected Haitian population continues to live in very precarious

circumstances. With the continued support o our donors and staf, MSF remains committed to addressing

the needs in Haiti to the best o our ability in the coming years.

The earthquake in Haiti was an unprecedented disaster or the Haitian people and created enormous medical and

non-medical needs. The aid response has been unable to ully meet these needs; throughout the year the assistance

provided, whether or shelter, clean drinking water or cholera treatment, was not enough.

There is much about the international aid system that can be improved, and MSF also recognises that there are areas

in which we ourselves can improve in terms o deploying our own resources, especially regarding shelter and prepa-

ring or mass casualities, as well as in voicing our concerns and engaging with others to improve the aid response.

With the ongoing generous support o our donors and commitment o our staf, MSF is dedicated to using our expe-

rience in Haiti to prepare our actions in uture emergencies.

Over the past year, MSF attempted to meet the most critical medical needs in Haiti. As in every context, we had to

make choices on how we could best employ our expertise and resources, keeping in mind other critical needs and

emergencies elsewhere in the world in 2010.

In the rst phase, this was through trauma surgery and other emergency medical activities, along with shelter and

water and sanitation activities. In the second phase, this was through post-operative, mental health, and primary

and secondary health care services. When cholera broke out in October, we reoriented our activities to respond as

robustly as possible to treat those afected, while keeping up our other programs as well.

In 2011, we will ocus on running six hospitals and supporting two Ministry o Health hospitals. Unortunately, more

© Nicola Vigilanti

HAITI ONE YEAR AFTER - Medecins Sans Frontieres

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