19 Jul 2010 | Interview

 

 

Michèle Beck is a nurse with MSF. She has just returned from a three-month mission in Haiti, where she coordinated MSF's medical, logistics and administrative activities at the Saint-Louis hospital in Port-au-Prince's Delmas 31 district.

 

Saint-Louis is a hospital inside inflatable tents. The order for it was placed the day after the January 12 earthquake. It involved a huge, around-the-clock logistical effort to get it here, set it up and then operate on the first patient on 25th January.

 

I had already seen a similar MSF field hospital when I was on a mission in the Gaza Strip. That one involved two tents. But Saint-Louis is even more impressive! It's a 'turn-key' hospital with 14 inflatable tents housing 236 hospital beds, three operating rooms, two surgical dressing rooms, two orthopedic and general surgery units, an intensive care unit, a major burn unit and a medical emergency unit. It is fully-supplied with the latest equipment. It also has a laboratory and an integrated waste treatment and sterilization system.

 

The Saint-Louis team is composed of 16 international staff and more than 500 Haitians. They include logisticians, nurses, doctors, surgeons, anesthetists, stretcher-bearers, hygienists and administrators. Every week, the hospital admits an average of 100 patients and our teams hold approximately 300 consultations, both surgical and medical. We manage the most urgent cases – the patients who need to be hospitalized. The others are treated on an outpatient basis or referred to other MSF health facilities or clinics.

 

Although we're seeing fewer earthquake victims now, the volume of our work hasn't declined and we haven't been able to reduce the number of beds as we'd expected. The post-earthquake patients we treat today did not have access to medical care during the emergency. They may have suffered a broken bone that was not set properly, so they need non-emergency or revision surgery. But there aren't many of them. We see a lot of people who have accidents on the street, domestic accidents, victims of violence (bullets, knives, sexual violence) and patients with chronic illnesses who need to be stabilized. In a way, these patients' medical needs are still related to the earthquake and its impacts. The streets are in very poor condition, littered with piles of rubble that you have to avoid. The sidewalks are unwalkable. These are all risk factors that lead to accidents on roads and streets. The living conditions of the homeless -- the people living in tents -- can cause domestic accidents. As a result, approximately 80% of our patients in the major burn unit are children. On the other hand, the number of victims of violence has not increased.

 

The hospital was working at full steam during the three months of my mission – from operations to physical therapy, dressings, skin grafts for burn victims and mental health care for everyone who needed it. The only time our admissions slowed was when the rainy season began. The periods of rain are short but torrential. We had to elevate the hospital tents. Surgeries had to be postponed for a week and non-emergency patients were referred to other MSF facilities. We also had to dig drainage ditches, lay gravel and prepare the site.

 

MSF responded quickly and comprehensively to the earthquake, thanks, above all, to the Haitian staff and, in particular, to those with whom MSF was already working before the quake. They were already at work in the first hours after the catastrophe. I especially admire them because most had lost a member of their own family, a close friend or their own house. The day of the earthquake, the teams already working in Haiti triaged the wounded in the street and performed surgery in the courtyard of MSF's office at La Trinité hospital in Delmas 19, and then in containers. The Haitian staff remains very involved and very committed today. And many of them are still living in tents.

 

Six months after the earthquake, most of the affected populations are still gathered in camps in makeshift shelters. Most of these sites are in Port-au-Prince. Some families have gone back to live in front of what remains of their house. They can't bear to abandon their former home. There is humanitarian aid and food and supplies being distributed in the camps. However, it's not clear who is supposed to be doing what and the aid actors are having a hard time organizing themselves.

 

I didn't see visible signs of reconstruction the entire time I was in Port-au-Prince. Everyone is affected by unemployment and popular discontent is growing. Demonstrations are occurring more frequently and tensions are mounting. Now that it's the rainy season, the homeless are slogging through the mud. Their living conditions have deteriorated further, although the earthquake victims in the camps have set up committees to deal with certain problems, such as handling waste. For now, the rain has not caused health problems, but crowding and the unhealthy conditions could create problems in the long-term. Illnesses such as diarrhea and respiratory infections can spread.