On January 12th at 4:53 pm local time (21:53:09 UTC) a 7.2 Richter scale earthquake hit near Leogane Haiti 17-km west of Port-au-Prince (PAP).  The impact of the earthquake on already vulnerable communities and fragile infrastructure resulted in 212,000 deaths and 300,000 injuries. Over 1.2 million people have been displaced and are in need of basic services (i.e., shelter, water, food and healthcare)

Unique to earthquake disasters, the immediate medical needs after January 12th 2010 were significant.  After search and rescue teams gained access to affected people, the need for acute trauma and orthopedic services was immense.  The outpouring of response from the public through monetary and in-kind donations swelled and medical professionals sought avenues to provide clinical support.

The Northwestern Department of Emergency Medicine worked with Dr. Jennifer Chan, an international emergency medicine faculty member with specialized skill sets in humanitarian disasters, to respond to the Haiti earthquake and build knowledge around how Emergency Medicine can interface with the humanitarian response activities.

Response to the 2010 Earthquake in Haiti

• Collaboration with the Center for Global Health at the Feinberg School of Medicine to deploy Dr. Lucenti to provide clinical services with International Medical Corps at Hospital Universitaire de l’Etat Haitien also known as “HUEH.”
• Dr. Chan acts as deputy of operations for the Harvard Humanitarian Initiative supported  “Love a Child Disaster Recovery Center”-- the largest acute phase rehabilitation hospital in Haiti.

Building Knowledge Around Disasters and Humanitarian Emergencies

• Using the Haiti Earthquake as a springboard for education: daily, weekly, and bi-weekly situation reports to help educate the Department on key humanitarian principles.
• Dr. Chan attended the Northwestern University symposium on the medical response to the Haiti earthquake sharing her experiences and lessons learned that occurred on April 28, 2010.
• Future training opportunities are available for humanitarian training for Northwestern EM Faculty and Residents interested in International Emergency Medicine and Humanitarian Response through the Humanitarian Studies Course in Boston.
• Planned future rotations for our residents include the countries of Ghana, Nigeria, and Guatemala. 

First Hand Accounts

Jennifer Chan, MD

May 3 – Gotta love technology….

Tonight I received a text from a friend in Haiti urgently looking for Diptheria Antitoxin. From Chicago I texted my colleagues at Love a Child Disaster Recovery Center in Fond Parisien and also Mark Courtney at HUEH.  Mark, already networked well at HUEH, referred me to an ID physician from PIH (Partners in Health).

Mobile technologies are amazing assets in global health; and when networks are up and running they can be very helpful in providing health care services in disaster or post disaster settings. 

Information Communication technology (ICT) has the potential to improve humanitarian response. Check out Ushahidi's work in Haiti.

.....My friend was already connected with Mark's contact at PIH..... they are transporting the Diphtheria Antitoxin back to the IDP (internally displaced persons) camp at this very moment..... 

Mark Courtney, MD

"Starting day three.” Yesterday worked triage. This was challenging. Due to the very limited resources you really have to figure out if you should bring people back. They almost have to be in some respiratory distress, AMS, or high fever. Almost all else gets sent out or Rxd in a triage chair. Seeing lots of cerebral malaria. They get better quick c iv quinine."

Things here are a world of difference from anything that resembles US medical care. Worked 7am-5pm. Surprises:  the nurses and doctors on our team are outstanding. We got orientated and lead by the most senior doctor during our shift—a guy who looks and acts like Kramer from the television show “Seinfeld.”  He had been here a whopping 24 hours prior to our arrival.

We arrived and transported a septic neonate. Then a baby was delivered without complication. Then I sewed up a patient hit with a machete and had to serial exam him to decide when to let him go "home" (aka tent). There is no CT. Chest X-rays are near possible to get. However we can get bedside HIV tests, bedside malaria tests, and some stat labs. We've treated cerebral malaria, burn wounds from Sterno-cooking fuel, TB, HTN CVA.  

There is a new EM MD who arrived today and some new nurses.  The team volunteerism is amazing. We are no longer the most junior people which is also interesting.