HAITI 2010 : Earthquake Feedback Experience of the
French Caribean rescue team
Eric FONTANILLE (Emergency MD)French West indies Defense Force coordinator
University hospital of Fort de [email protected]
14 th Health Disaster Coordinators Meeting
MARTINIQUE AND GUADELOUPE ISLANDS
– Two French islands– Distance from HAITI: 1400 km – Population: 1 Million / 2 islands– French military base…– Fire Figthers with a special rescue
desaster team– Health Equipment
• 2 University hospitals (EMS)– High level of competence– 700 beds for each
• 2 X 10 General hospitals
January 12th at 8 pm The Martinique Emergency Medical Service (EMS) mobilizes :
3 Doctors . 2 Nurses The EMS Guadeloupe and French Guyane is alerted
The French Embassy sent a SOS to the regional governement disaster office
The local Radio…
The EMS integrates the FWI DICA : 84 Staffs: Military + Fire fighters specialized in desasters and a emergency medical staff (9) + 2 rescue dogs
Equipment: 2 medical devices dedicated to disasters (100 victims)
French Guyana team..
In the plane: Two missionsIn the plane: Two missions
- Rescue : search for buried victims- Medical : care to the populations
The 13 th january at 7pm the FWI Rescue team arrives in Haiti: The First? Ambassador: 4 PRIORITY
MEDICAL CARESEARCH RESCUE
1/ RESCUE AND EXCAVATION
THEY BEGIN IMMEDIATLY.
3 saved victims (Total 17) !
Dangerous site: In the night...
RESCUE EXCAVATION: ANALYSIS
Why the luxury Montana hotel choice ? We try to find local health and security
leaders to restore the chain of command
We have not lots of doctors and they are PARALIZED for a long time,What For? 3 Survivors for 78 rescuers/12 days
-A medical "Specialists' affair
First choice: The MONTANA HOTEL
2/ THE MEDICAL ACTION
• THE FIRST LEVEL1/ To manage the French nationals2/ To restore the health care capacity3/ To organize the air medical evacuation
• THE SECOND LEVEL• Medical security for the rescuers and excavation victims• Deads identification• Orphans management
French Ambassador priority !
- it decides to gather them in the Embassy near the rescuers…
- Jannuary 13 th, at 3 AM : - First Evacuation of 20 French nationals
and 6 french wounded to Fort de France
1 / THE FRENCH NATIONAL EVACUATION
Lots of French in Haïti !
EVACUATION of NATIONALS:ANALYSIS
A Ambassador PriorityWhere are they ? How many?
- They impacted the medical action and evacuation
- In Martinique they had a medical and a psychological exam if they needed
• Total 1300 people were evacuated to Martinique in 6 days
2/ EVALUATION OF THE HEALTH CARE CAPACITY
• The Medical Director did a medical and technical evaluation of 6 Health care establishments recommended by the French Embassy MD
• Objectives– To find the french wounded– Evaluate the accomodation capacity of
the hospital– Make a medical and technical choice
for 4 safe hospitals where the french medical team could work effectively on security
THE EVALUATION WILL LEAD TO A PERENNIAL MEDICAL STRATEGY
1/To identify a « referal hospital for the EMS »: The CDTI hospital or « sacré cœur »– To accomodate the seriously injured coming from the clearing sites – Triage and stabilization of the casualties before their medical
evacuation– Organize and control of pharmacy for the medical teams
2/ To expand to 3 others Hospitals with medical team coming from France (140 people)...
3/ To prepare the French military health mission.
PRINCIPAL STAGES OF THE MEDICAL ACTION IN EACH HOSPITAL
3/To begin the care and the post operative care
2/TRIAGE ! Alive or death …...
1/ Evaluation
THE HEALTH CARE CAPACITY After 3 days
…
The « French » were working in 4 «referral » hospitals
- A surgical team from Martinique and Haïti work together …. Every 3 days the team change
- A Tent hospital allows post operative care
THE HEALTH CARE CAPACITY HAS BEEN COMPLETED BY THE FRENCH ARMY
Started the18 and the 26 of january
MEDICAL AND SURGICAL SUPPORT 1/1/The The ESCRIM:ESCRIM: A A TentTent surgicalsurgical HospitalHospital..
-- 2174 consultations 2174 consultations -- 209 209 surgeriessurgeries--1389 hospitalisations1389 hospitalisations
2/ 2/ The The ““ SirocoSiroco ””: NAVY : NAVY hospitalhospital BOAT,BOAT,
3/ 3/ HelicoptersHelicopters
: :
THE HEALTH CARE CAPACITY : ANALYSIS
• Many request… Only 4 Hospital…
• Recurrent earthquake: Stop the activity and need new evaluation to start again...
• Environmental health: The last action but…
• 314 Health organisations on Haiti…– Who’s the Boss, who does what ?– But Thank you NGO and more…
• What’s happen for the patients after surgery ? Tents are not so bad
• French Pharmacy limited,The difficult transportation…
3/ AIR MEDICAL EVACUATION: 2 phases
No health organization« Caribean Fraternity »Other regional possibilities are limited?Airport is not on control…The French government PRIORITY…
Every day ,5 Military planes with doctors go and return to Martinique and Guadeloupe with Haiti victimsBut: No schedule, what kind of patients?…
Day 1 to 5: PHASE 1
DAY 5: AIR MEDICAL EVACUATION IS WELL ORGANIZED
PHASE 2: After 5 days
The local surgical capacity is correct.The tritement on the spot is to be supported
• The medical transportation are made according to the capacities of the Martinique and Guadeloupe hospitals
• 10 victims are sent to Martinique and Guadeloupe one day alternately
Hôpital DiquiniHôpital Diquini
Moyens :Moyens :DSC : 24 DSC : 24 ééquipes quipes
mméédicalesdicales
ActivitActivitéé JournaliJournalièèrere216 Cs216 Cs
ActivitActivitéé cumulcumuléée :e :1484 Cs1484 Cs
To summarize afterafter one one weekweek, the French , the French medicalmedical organizationorganization
Hôpital du SacrHôpital du Sacréé--CoeurCoeur
Moyens :Moyens :DSC : 6 DSC : 6 ééqu mqu méédd
SAMU : 3 SAMU : 3 ééqu mqu méédd
ActivitActivitéé JournaliJournalièèrere135 Cs135 Cs
ActivitActivitéé cumulcumuléée :e :1119 Cs1119 Cs
Hôpital du canapHôpital du canapéé vertvert
Moyens :Moyens :DSC : 8 DSC : 8 ééquipes quipes
mméédicales.dicales.
ActivitActivitéé JournaliJournalièèrere93 Cs93 Cs
ActivitActivitéé cumulcumuléée :e :1015 Cs1015 Cs
Hôpital de la Hôpital de la communautcommunautéé haitiennehaitienne
Moyens :Moyens :DSC : 3 DSC : 3 ééquipes quipes
mméédicales.dicales.
ActivitActivitéé JournaliJournalièèrere93Cs93Cs
ActivitActivitéé cumulcumuléée :e :645Cs645Cs
ESCRIMESCRIM
A.M.C.A.A.M.C.A.«« SirocoSiroco »»
TRIAGE & LITTLE CARETRIAGE & LITTLE CARE
SURGERIESURGERIE
HospitalisationHospitalisation
AéroportHôpitauxAntilles
Mission reconnaissanceMission reconnaissanceMAEMAE
Moyens :Moyens :DSC : 1 DSC : 1 ééquipe mquipe méédicaledicale
SAMU : 0 SAMU : 0 ééquipe mquipe méédicaledicale
Mission RMission RéégulationgulationEVASAN et transfert EVASAN et transfert
interhospitaliersinterhospitaliersMoyens :Moyens :
DSC : 1 DSC : 1 ééquipe mquipe méédicaledicaleSAMU : 1 SAMU : 1 ééquipe mquipe méédicaledicale
équ. méd. = équipes médicales
Cs = Consulations
AmbulanceHélico
Avion
OTHER « MEDICAL » MISSIONS
1 / MANAGEMENT of DEAD BODIES
2 / ORPHANS
FRENCH DEAD BODIES MANAGEMENT
A Forensic MD WITH THE FIRST TEAM….
Police & Technical expertise…. The french death can go back to france…
Expert near the autorities
Les ressortissants franLes ressortissants franççais !ais !500 ORPHANS TRANSFERED IN MARTINIQUE
A doctor and psychologist….. On plane reserved ...
A quick Police investigation ? Good for the rescuers brain
Day12 : THIS IS THE END OF THE FRENCH CARIBEAN FIRST RESCUE TEAM.
900 Organization
900 French RescuersFFEMS Paris
All the world is here
RESULTS
• FROM THE 13 TO THE 21 JANUARY THE FRENCH CARIBEEN FIRST RESCUE TEAM MADE:
• CONSULTATIONS : +/_4000• SURGICAL INTERVENTIONS : 300
• AIR MEDICAL EVACUATIONS: 136 X 2
CONCLUSIONS What was wrong?
Where and how to begin?
-A difficult coordination with the other health organizations and international rescue ..
-Difficult transmission (phone?) between Haiti and Martinique
A MAJOR DISASTER: « a big moment of solitude for the first rescue team » It’s not like in the plan, or in simulation exercices
The embarrasment?
« I CUT OR YOU DIE » !
What can i do?
We are Caribean !
CONCLUSIONS Positives
• A rapid and a good response by the French Caribean hospitals because of their proximity and « creole fraternity »
- For the first time the regional EMS work together
• Technical and complete surgical team is important at the begining of the rescue phase
• The French Caribean team prepare the 6 weeks French action
• Working with other Caribean countries or organization is absolutely necessary if we want to be effective.
THANK YOU AND
TOTAL RESPECT FOR MY HAITIEN FRIENDS…
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