from Amber Lynn Munger

Three nights ago a night­mare we hadn’t imag­ined pos­si­ble began in Haiti. Like any shock­ing and hor­ri­fy­ing tragedy, we will all remem­ber and tell sto­ries of where we were when we heard about the 7.0 earth­quake that shat­tered Haiti on Jan­u­ary 12, 2010. Haiti KONPAY has been play­ing a crit­i­cal role coor­di­nat­ing a rapid response to the cri­sis in both Jacmel and Port-au-Prince. We are cur­rently coor­di­nat­ing efforts to iden­tify and assess needs and also work­ing out logis­tics to get much needed human and mate­ri­als resources onto the ground.

Through col­lab­o­ra­tion with sev­eral key part­ners in the U.S. we are work­ing with a pool of qual­i­fied med­ical pro­fes­sion­als and inter­preters pre­pared to travel to Haiti. Beyond Bor­ders is cre­at­ing a data­base of poten­tial vol­un­teers and vet­ting appli­cants. We are also receiv­ing many help­ful offers and are coor­di­nat­ing a team of vol­un­teers fol­low­ing up on the most promis­ing of these. We have out­lined a com­pre­hen­sive rapid response strat­egy and are con­tact­ing other major orga­ni­za­tions to share ideas and encour­age col­lab­o­ra­tion. We are seek­ing meet­ings with USAID, the UN, the Clin­tons and oth­ers tasked with coor­di­nat­ing inter­na­tional response to share the ideas gen­er­ated by dozens of smaller NGOs with decades of Haiti expe­ri­ence who are cur­rently work­ing together to carry out imme­di­ate response on the ground.

We are pur­su­ing two major strate­gies right now:

• Deliv­er­ing imme­di­ate sup­port to peo­ple on the ground in Jacmel and Port-au-Prince by coor­di­nat­ing the trans­port of sup­plies and vol­un­teers. Care­fully design vol­un­teer inter­ven­tions to avoid exac­er­bat­ing the devel­op­ing food and water shortages.

• Encour­ag­ing the evac­u­a­tion of Port-au-Prince and estab­lish the resources nec­es­sary to assist vic­tims when they arrive in the coun­try­side by assess­ing exist­ing resources in out­ly­ing areas and send­ing teams and equip­ment to clin­ics. Coor­di­nat­ing with Amer­i­cans liv­ing in lesser-affected areas to sup­port with trans­port vehi­cles and coor­di­na­tion of vol­un­teers in the field.

Below find reports on the efforts under­way with part­ners in Jacmel and Port-au-Prince, and two assess­ments from a team already on the ground.

JACMEL

Out today from the UN in Jacmel these are some details of the dam­age in Jacmel, which is a city of 34,000:

• 1,785 homes com­pletely destroyed
• 4410 homes par­tially destroyed
• 87 com­mer­cial busi­nesses destroyed
• 54 schools destroyed
• 24 hotels destroyed
• 26 churches destroyed
• 5730 fam­i­lies displaced
• Death count approach­ing 3,000, nearly 10% of the population

(Reported by Gwenn Mangine, www.mangine.org)

We have received a num­ber of reports list­ing major build­ings in Jacmel which col­lapsed, includ­ing: the La Tri­nite school, Inter­fa­milia school, half of the pri­mary sec­tion at the Alcib­i­ade school and cul­tural cen­ter, part of the hos­pi­tal and many other buildings.

KONPAY Co-Founder Joe Duplan is on the ground in Jacmel and is part of a coor­di­na­tion team with Guerda Placide of Fon­dasyon Limyè Lavi. FLL’s sis­ter orga­ni­za­tion is Beyond Bor­ders; Direc­tor David Diggs is work­ing closely with Melinda Miles in the U.S. Joe and Guerda spent today mak­ing a list of build­ings dam­aged, urgent needs and poten­tial sites to house vol­un­teers and set up clin­ics and tem­po­rary hous­ing. In addi­tion, they met with the Hait­ian National Police, Fire Chief and Mayor’s office to dis­cuss how to best coor­di­nate and work together to respond to imme­di­ate needs.
Obsta­cles: Jacmel is cur­rently unreach­able by land routes due to col­lapsed areas on the road to Port-au-Prince at Tomb Gateau and St. Eti­enne. Until this after­noon the run­way and air­port were filled with peo­ple who had fled the ruins of the town, but the UN peace­keep­ers report­edly have the field clear now for their planes to land, how­ever it is almost impos­si­ble for us to get clear­ance to land there.
We are fol­low­ing sev­eral promis­ing leads on get­ting boats donated in the Domini­can Repub­lic or sur­round­ing island nations that can carry our med­ical pro­fes­sion­als and sup­plies directly to Jacmel. Heli­copters are also a pos­si­bil­ity but very expensive.

PORT-AU-PRINCE

The sit­u­a­tion in PAP is grow­ing more des­per­ate by the moment. We are work­ing with Amber Munger who is head­quar­tered at the Matthew 25 Guest House in Del­mas 33, where a triage hos­pi­tal has been set up on the soc­cer field. In addi­tion, Reed Lind­say, jour­nal­ist with TeleSur and head of the Honor and Respect Foun­da­tion, is on the ground and will be join­ing Amber tomor­row. Also about to be part of the team are Sasha Kramer of SOIL and Cather­ine Lainé of Appro­pri­ate Infra­struc­ture Devel­op­ment Group (AIDG). AIDG also has struc­tural engi­neers on the way.

This team will be coor­di­nat­ing the response in PAP. They will help us get resources – human, mate­r­ial and finan­cial – to where they are needed most. They have imme­di­ate needs such as diesel for gen­er­a­tors and cash to keep buy­ing food, and in the short-term they need med­ical sup­plies, food and other equip­ment. There is also a need to start dig­ging trenches for tem­po­rary bur­ial in the imme­di­ate neighborhood.

Reed Lindsay’s text Thurs­day night:

“The worst may yet to come, if we do not act fast. Peo­ple are already thirsty, and water, is dif­fi­cult to find, even to buy. I drove through the entire city today and didn’t see a sin­gle aid dis­tri­b­u­tion. Al Jazeera news team told me the same. Streets are nor­mally lined with street food mer­chants. Now dif­fi­cult to find any food and it will get worse. Sit­u­a­tion des­per­ate but could get cat­a­strophic soon. Thou­sands are dead, prob­a­bly tens of thou­sands. Bod­ies hauled off in trucks to  be buried in com­mon graves, but many bod­ies still lying on the street  and many more in wreck­age. It is too late for them. But for those who sur­vived, time is run­ning out. Com­mu­ni­ties are start­ing to orga­nize.  But they have no resources. Every­one sleep­ing in streets and plazas parks. They have set up their own refugee camps. Thou­sands have fled for coun­try­side. But most have nowhere to go.”

Amber Munger, work­ing with KONPAY, reported yesterday:

“In my thir­teen years of work­ing in Haiti, not once before have I seen such mas­sive destruc­tion as we are expe­ri­enc­ing now.  Nor have I seen such moti­va­tion, deter­mi­na­tion, com­pas­sion, and sol­i­dar­ity among peo­ple.  When we entered por­to­prens after the quake struck, the city had fallen and was con­tin­u­ing to fall as a result of con­tin­u­ous after­shocks.  The streets were full of peo­ple sit­ting together.  Every­one was sit­ting in the mid­dle of the roads for fear that the houses would con­tinue to fall on them. They were singing.  The whole city was singing.  They were singing songs of sol­i­dar­ity.  They were singing songs of thanks and praise that they were still able to sing and to be together.  These peo­ple have lost every­thing.  The city is now a city of refugees.  But they are putting their voices together to be thankful.”

Major obsta­cles are trans­porta­tion of dona­tions and vol­un­teers. We are work­ing on sev­eral angles right now to get sup­plies either via land from the Domini­can Repub­lic, on planes into PAP or on cargo ships pos­si­bly via the St. Marc port. Com­mu­ni­ca­tion remains a seri­ous obsta­cle to coor­di­nat­ing with other groups on the ground, but Amber is step­ping up her efforts to be in touch with other groups offer­ing emer­gency relief and hopes to move to the new MINUSTAH (UN Peace­keep­ing Mis­sion) cen­ter for NGOs once it is set up.

Two reports from Johns Hop­kins Uni­ver­sity teams that are in PAP with Amber now:

1. Rapid Assess­ment Sur­vey: Del­mas 31

Loca­tion: Com­mune of Del­mas, area Del­mas 31 (28SqKm)

Sur­vey­ors: Remle Stubbs-Dame and Lenka Heller

Infra­struc­ture: 50–75% houses collapsed

Demo­graph­ics: 834 indi­vid­u­als sur­veyed (296 children).

Total Pop­u­la­tion prior to earth­quake: 341,791 (IHSI, 2007)

Deaths: 10% death rate among pop­u­la­tion surveyed

Injuries: 5%-10% of pop­u­la­tion sur­veyed is crit­i­cally injured and not receiv­ing med­ical care

Imme­di­ate Needs: (Pop­u­la­tion will run out of food and water within 24–48 hours)

• Removal of deceased from streets
• Potable water
• Med­ical treat­ment of super­fi­cial wounds (alco­hol, gauze, antibi­otics, betadine)
• High-calorie food
• Sanitation/waste man­age­ment

Sta­tus of pop­u­la­tion: At time of sur­vey, major­ity of pop­u­la­tion was calm, under­stand­ing, and patient. Ten­sion is ris­ing quickly in set­tle­ments since most of them lack all imme­di­ate needs.

NGOs: Encoun­tered two aid work­ers with lim­ited sup­plies who were based in the community

• Chap­pelle Evan­gelique of Del­mas 9 and Del­mas 11 – oper­at­ing a clinic but leav­ing on 1/15/10.

• Amer­i­can school­teacher has build­ing for safety, feed­ing, and lim­ited med­ical sup­plies for basic wounds: Sher­rill E. Fausey (Chris­t­ian Light Min­istries foun­da­tion) fausianno@yahoo.com)

Gen­eral Assess­ment: The com­mune is pre­dom­i­nately low class with a small share of mid­dle class and slum set­tle­ments.  An esti­mated 50–75% of struc­tures have col­lapsed com­pletely.  About 50 peo­ple are still trapped under the rub­ble; the major­ity are con­firmed deceased.  There are approx­i­mately 25 small set­tle­ments (100–300 peo­ple) in the area.  There are also at least 2–5 larger make-shift camps in parks of approx­i­mately 1,000–3,000 peo­ple. Those who still have homes are sleep­ing on the street at night for safety. We sur­veyed a densely pop­u­lated sec­tion of Delma 31.   The dam­age var­ied from from street to street, from 25% — 75% of the houses had fallen par­tially or com­pletely, and an addi­tional 10–15% were struc­turally inhab­it­able.  Dur­ing the visual sur­vey, which cov­ered an area of approx­i­mately 500 square meters, observers noted one func­tion­ing mar­ket and one mar­ket that was run­ning out of food.   Out of approx­i­mately six water stores passed, only one was open and still dis­trib­ut­ing water, albeit slowly to the large line which had con­gre­gated.  Sur­veyed par­tic­i­pants reported that on the morn­ing of the 13^th water ven­dors had been walk­ing along the road, but since 12pm no water was being sold by individuals.

Camp and Small Set­tle­ment Vis­its: Delma 31

• Camp 1: 5,000–13,000 inhab­i­tants.  45% chil­dren.  Food ven­dors set up on either side, and at least one day’s sup­ply of water for most inhab­i­tants.  One med­ical team oper­at­ing,  but leav­ing PaP tomor­row.  No one run­ning the camp.
• Camp 2: 2000 inhab­i­tants.  424 hurt, 44 gravely injured.  No food, less than one day of water.  No med­ical care.  Con­tact: Lieu Parc Maguana Del­mas 31, Rue Maguana, Tel 509‑3400-7908, 3944–9594.  In charge:  Patrick Eti­enne, Psychologist.
• Set­tle­ment 1: 300–350 inhab­i­tants. Mostly minor injuries. No food, water, med­ical care. Rue De Mabwa # 3 (empty lot).
• Camp 3: 2,000 inhab­i­tants. 20% crit­i­cally injured. 24 hour sup­ply of food, no water, no med­ical care. Rue Saint Phare

2. Med­ical Report: Bour­don Valley

1/14/10

Over the last two days our team has pro­vided med­ical care in the Bour­don Val­ley com­mu­nity. We saw patients with injuries rang­ing from super­fi­cial abra­sions, burns, crushed limbs, and many infected and gan­grenous wounds scrap­ing down to mus­cle and bone. Yes­ter­day and the day before, we passed through smaller groups of peo­ple hud­dled together seek­ing refuge away from their houses with a range of injuries. Today we trav­eled to the prime minister’s house with peo­ple camp­ing on the grass since the earth­quake. There are hun­dreds maybe thou­sands of peo­ple camp­ing there. We worked along­side a team of Hait­ian doc­tors and nurses along with a team of med­ical work­ers from China. Most of the injured peo­ple here had already received some type of rudi­men­tary treat­ment, and with sev­eral of them there was noth­ing fur­ther that could be done besides wait­ing for appro­pri­ate antibi­otics and sur­gi­cal care that was needed. We redressed many wounds. We are a team of two doc­tors and two med­ical stu­dents and our skills and resources only allow for sub­op­ti­mal pal­lia­tive care. Giv­ing a girl max­i­mum strength ibupro­fen after her leg has been shat­tered and is now necros­ing is not ideal to say the least. Many peo­ple needed urgent surgery at this stage. Peo­ple need ortho­pe­dists, trauma sur­geons, and anes­the­si­ol­o­gists. Other spe­cial­ists that would be use­ful: oph­thal­mol­o­gists, pri­mary care.

A list of key sup­plies we came up through our expe­ri­ence and the request of another Hait­ian doctor:

Med­ica­tions:

Pain con­trol (Aceta­minophen, Ibupro­fen, mor­phine, tra­madol, lido­caine, lido­caine cream)

Wound clean­ing (hydro­gen per­ox­ide, gauze, swabs, iodine, ace ban­dages, gloves, plas­tic bags, masks, tweez­ers, tape, alco­hol wipes, triple antibi­otic cream, ster­ile water)

Antibi­otics (IV antibi­otics, co-trimoxazole, amox­i­cillin, tetanus vac­ci­na­tions with cold chain, ciprofloxacin, clin­damycin, metron­ida­zole, eyedrops)

Chronic med­ica­tions (glu­cose checker, met­formin, insulin, anti­hy­per­ten­sives – hydrochlor­thi­azide and ACE inhibitors)

Oral rehy­dra­tion therapy