Questions in Haiti

We're all following the updates from the 7.0 earthquake that struck Haiti just 48 hours ago.  Our brothers and sisters have been mobilized to assist and there is a pouring out of support in the form of food drives and monetary donations all over the internets.  Before I get into my points to think about, please remember to donate to established organizations.  The American Red Cross is just such an organization that can use the money well, as opposed to your local corner Girl Scout Troop who may have to pay to have things sent over, and even then it may not arrive in time.

In time for what Happy?  Oh I think you know.

Our brothers and sisters mobilized for the search and rescue effort are facing a task they may not be ready for.  They are trained professionals in search, rescue, recovery, everything first response, but there is, by all accounts so far, no framework to support their efforts.  I don't just mean a place to land, restock and camp, I'm talking about basic disaster concerns.  These folks can get in and get setup, do their thing like no other.

Let's think this through for a moment.  Estimates show 9 million people in Haiti and at least 1/3 of the country may be injured.  3 million injuries.  From scratches and scrapes to fractures to crush syndrome and major systems trauma.  Many may not survive the night because of their injuries, but let's look past that.

When the USAR teams use their tech, tools and smarts to rescue the injured, where will they go?  Who will come to transport them to the hospital?  Where are the hospitals?  In rubble.  Each and every resource that can assist in this event will need to be brought in from without.  How long will it take to set up triage and treatment centers to help the ambulatory?  Then the injured but invalid? And finally to the traumatic injuries.  The hospital does not just need electricity, or staff, or supplies, they need everything, including walls.

On all 4 networks I have seen different footage, all of one ambulance traveling the rubble strewn roads.

The honest answer is that definitive care for most of those injured will not arrive within 72 hours of their injury.

Do we remember what happens to internal injuries that go untreated?
I had an image of three survivors still trapped in the rubble set for this post, but have deleted it.  You can see it here, it's photo number 2.  When these folks are rescued...then what?



What is the plan for when the almost 100,000 estimated dead are still in the streets in 96 hours?  Will they have an adverse effect on what little sanitation remains, what little clean water there may be?  What will happen to those sleeping in the open near the bodies?

I do not  envy the person who must choose how to deploy resources, but it makes me think about my own City when, not if, but when our big one hits.  We will have plans, resources from afar.  We have volunteers trained to help, we have disaster supplies ready to go.  We have folks with phones that can make calls without cell towers, buildings that can generate electricity when the sun shines.

Those things are not common in Haiti.  Cell phones, the ones that still have a signal, will have dead batteries soon.  Gasoline for generators will be running low.  People will become desperate for help.

What do we do then?

I don't have an answer, nor am I posing these questions in a political framework, just trying to get us all thinking ahead.

If it looks bad now, just be ready for when decomp begins and things get worse.  And each person rescued is another that will need advanced care, food, water, medicine.  Each reporter that arrives needs water, food and shelter that could be used at a temporary hospital.

I challenge each and every news network to pull your crew out of the disaster area and donate what you would have used on your people to the relief effort.

If anyone has a link to updates directly from teams at the site, let me know.

HM

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This post was mentioned on Twitter by theHappyMedic: New blog post: Questions in Haiti http://happymedic.com/2010/01/13/questions-in-haiti/...
dcimedic said…
You read my mind. Our news has been covering many Haitian churches etc and they all say that they are mobilizing to go down and help. They are asking for donations of money, food and clothing. We all know that the best thing to do is donate money to the ARC or Doctors without boarders who have stock piles of supplies, and not add more persons to consume already limited valuable resources. My only hope is that the someones military can act as a gate keeper to keep out all the well meaning but ill prepared groups.
Fire Daily said…
Great points on the immense scope of this disaster, which has been described as unimaginable.

And it has no end in sight.

Without infrastructure, communication, energy, transportation- this event will continue to evolve with new (yet unknown) tangents sprouting up as the days and weeks go on.

Almost all of Haiti depends on Port Au Prince as a distribution center for food, gasoline, etc., so even areas initially "unaffected" by the original quake will suffer dire consequences due to the destruction of the city.

As horrific as this nightmare is now, this is only the beginning.
Mark Wheatley said…
USNS Comfort is being sent to Hati. http://en.wikipedia.org/wiki/USNS_Comfort_%28T-...
* Patient Capacity:
o Intensive care wards: 80 beds
o Recovery wards: 20 beds
o Intermediate care wards: 280 beds
o Light care wards: 120 beds
o Limited care wards: 500 beds
o Total Patient Capacity: 1000 beds
o Operating Rooms: 12
* Departments and Facilities:
o Casualty reception
o Intensive care unit
o Radiological services
o Main laboratory plus satellite lab
o Central sterile receiving
o Medical supply/pharmacy
o Physical therapy and burn care
o Dental services
o Optometry/lens lab
o Morgue
o Laundry
o Oxygen producing plants (two)
o Medical Photography
o Four distilling plants to make drinking water from sea water (300,000 gallons per day)
o Flight deck can handle world's largest military helicopters (CH-53D, CH-53E, MH-53E, Mi-17)

Also being sent is the USS Carl Vinson (CVN-70) which can provide 400,000 gallons of drinking water daily.
Anonymous said…
You read my mind. Our news has been covering many Haitian churches etc and they all say that they are mobilizing to go down and help. They are asking for donations of money, food and clothing. We all know that the best thing to do is donate money to the ARC or Doctors without boarders who have stock piles of supplies, and not add more persons to consume already limited valuable resources. My only hope is that the someones military can act as a gate keeper to keep out all the well meaning but ill prepared groups.
Fire Daily said…
Great points on the immense scope of this disaster, which has been described as unimaginable.

And it has no end in sight.

Without infrastructure, communication, energy, transportation- this event will continue to evolve with new (yet unknown) tangents sprouting up as the days and weeks go on.

Almost all of Haiti depends on Port Au Prince as a distribution center for food, gasoline, etc., so even areas initially "unaffected" by the original quake will suffer dire consequences due to the destruction of the city.

As horrific as this nightmare is now, this is only the beginning.
Ann T. Hathaway said…
I am not an emergency responder but in international affairs. These were also exactly my questions. I do not think this is a gig for amateurs, that's for sure. it's going to be hard enough for people with skills.

Really great post and great comments too.
Mark Wheatley said…
USNS Comfort is being sent to Hati. http://en.wikipedia.org/wiki/USNS_Comfort_%28T-AH-20%29
* Patient Capacity:
o Intensive care wards: 80 beds
o Recovery wards: 20 beds
o Intermediate care wards: 280 beds
o Light care wards: 120 beds
o Limited care wards: 500 beds
o Total Patient Capacity: 1000 beds
o Operating Rooms: 12
* Departments and Facilities:
o Casualty reception
o Intensive care unit
o Radiological services
o Main laboratory plus satellite lab
o Central sterile receiving
o Medical supply/pharmacy
o Physical therapy and burn care
o Dental services
o Optometry/lens lab
o Morgue
o Laundry
o Oxygen producing plants (two)
o Medical Photography
o Four distilling plants to make drinking water from sea water (300,000 gallons per day)
o Flight deck can handle world's largest military helicopters (CH-53D, CH-53E, MH-53E, Mi-17)

Also being sent is the USS Carl Vinson (CVN-70) which can provide 400,000 gallons of drinking water daily.
topv7051 said…
Besides the Comfort and the Vinson, an amphibious ready group with 2000 Marines and about 20 helos is leaving NC for Port au Prince. The smartest thing they can do with them will be to get the port in operation and make it secure.
My reserve unit is built for disaster relief-everything to run an airfield, from MPs and firefighters to cooks, water purification units, showers, laundry, generators, lights, and a hefty engineer detachment. Yet we never get used for these things. Our HQ is in New Orleans but we only sent 50 guys there. Instead we will send thousands of infantrymen to stand on top of the pile for CNN.
[...] This post was mentioned on Twitter by Thaddeus Setla, Happy Medic, FireDaily.com, Chris Kaiser, Shelly Wilcoxson and others. Shelly Wilcoxson said: RT @TheRoadDoctor: RT @theHappyMedic: New blog post: Questions in Haiti http://bit.ly/7aEL4u ^thought provoking stuff, Happy... [...]
Ann T. Hathaway said…
I am not an emergency responder but in international affairs. These were also exactly my questions. I do not think this is a gig for amateurs, that's for sure. it's going to be hard enough for people with skills.

Really great post and great comments too.
topv7051 said…
Besides the Comfort and the Vinson, an amphibious ready group with 2000 Marines and about 20 helos is leaving NC for Port au Prince. The smartest thing they can do with them will be to get the port in operation and make it secure.
My reserve unit is built for disaster relief-everything to run an airfield, from MPs and firefighters to cooks, water purification units, showers, laundry, generators, lights, and a hefty engineer detachment. Yet we never get used for these things. Our HQ is in New Orleans but we only sent 50 guys there. Instead we will send thousands of infantrymen to stand on top of the pile for CNN.
Billy said…
And I hate to say this but from talking to several of the missionaries from our church, crime is bad in Port au Prince when everything is going good. There will be a need for security so that the deployed teams can sleep, eat and decon in safety without there gear walking off or other things happening. Any time there is a disaster there are people more than willing to use it as a opportunity to do bad.
Anonymous said…
Besides the Comfort and the Vinson, an amphibious ready group with 2000 Marines and about 20 helos is leaving NC for Port au Prince. The smartest thing they can do with them will be to get the port in operation and make it secure.
My reserve unit is built for disaster relief-everything to run an airfield, from MPs and firefighters to cooks, water purification units, showers, laundry, generators, lights, and a hefty engineer detachment. Yet we never get used for these things. Our HQ is in New Orleans but we only sent 50 guys there. Instead we will send thousands of infantrymen to stand on top of the pile for CNN.
Billy said…
And I hate to say this but from talking to several of the missionaries from our church, crime is bad in Port au Prince when everything is going good. There will be a need for security so that the deployed teams can sleep, eat and decon in safety without there gear walking off or other things happening. Any time there is a disaster there are people more than willing to use it as a opportunity to do bad.
Billy said…
And I hate to say this but from talking to several of the missionaries from our church, crime is bad in Port au Prince when everything is going good. There will be a need for security so that the deployed teams can sleep, eat and decon in safety without there gear walking off or other things happening. Any time there is a disaster there are people more than willing to use it as a opportunity to do bad.
Billy said…
And I hate to say this but from talking to several of the missionaries from our church, crime is bad in Port au Prince when everything is going good. There will be a need for security so that the deployed teams can sleep, eat and decon in safety without there gear walking off or other things happening. Any time there is a disaster there are people more than willing to use it as a opportunity to do bad.
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