[author type="author"]Jill Lauterborn[/author][image align="right" caption="After the earthquake, Hospital Sacré Coeur went from a 73-bed to a 600-bed facility. Months after the earthquake, patient care still overflowed into soft-sided aluminum tents on the hospital grounds. (Photo courtesy of the CRUDEM Foundation.) " linkto="/web/wp-content/uploads/110304_photo01.jpg" linktype="image"]“/web/wp-content/uploads/110304_photo01.jpg” width=”246″ height=”224″[/image]
In the wake of the Jan. 12, 2010, 7.0-magnitude earthquake near Port-Au-Prince, Haiti, Project HOPE (http://www.projecthope.org/) sent doctors, nurses, technicians, and medical supplies to Haiti aboard USNS Comfort. Leading the medical response team was COL Fred Gerber (U.S. Army, Ret.), Project HOPE Country Director for Iraq and Special Projects.
Gerber turned his attention to three timeworn hospitals: the 70-bed Adventist in Diquini, Port-Au-Prince; the 130-bed Albert Schweitzer in Deschapelles, a town about 60 miles from Port-Au-Prince; and the 73-bed Sacred Heart (Hospital Sacré Coeur) in Milot, a town 12 miles south of Cap Haitien. All were overwhelmed, with their caseloads tripling in a matter of days, taxing their sanitation and electrical capacities. Each also faced dire shortages of medicine, oxygen, and potable water.
Where others might see futility, Gerber saw opportunity, drawing on more than 30 years as a medical planner and operator for the U.S. Army Medical Department. “It was a perfect opportunity to do a health facilities assessment to identify the gaps,” he explained. “I did it in the military with the Health Facilities Planning Agency [HFPA]. They would put teams together—mechanical and electrical engineers, architects, health facilities planners, … nurse critical assessors, and medical equipment repairmen and technicians from USAMMA [U.S. Army Medical Materiel Agency]—so that’s what we did.”
Gerber put together a six-member assessment team, including himself as lead, a health and facility planner, an electrical engineer, a mechanical engineer, and a structural engineer.
CW3 Terry Dover, USAMMA Technology Assessment and Requirements Analysis (TARA) Team Lead, filled the sixth slot as the team’s biomedical equipment specialist.“I went as a Project HOPE member, using my TARA and HFPA background … and applying it to what we knew,” he said.
Rebuilding Medical Infrastructure
The team wasted no time, assessing Albert Schweitzer on April 7, Sacred Heart on April 9, and Adventist on April 11, 2010, and inspecting each facility from top to bottom. Dover inventoried all usable medical equipment, as well as defunct gear to determine whether it was repairable. Gerber combined Dover’s assessment with those of the other members to provide each facility with both short-term fixes and broad, long-term solutions.
It is important we keep our heads and continue to make plans and progress in the face of all these other obstacles, and I think that’s the greatest contribution these guys made.
“We looked at several hospitals, [but] really laid out a plan to rebuild the entire medical infrastructure,” Dover said.
Tim Traynor, CRUDEM Foundation volunteer and Facility Director at Sacred Heart, was particularly impressed by the team’s assessment of his hospital’s electrical system, which had exposed wires that would short out and catch fire during surgeries.
“[The lack of] reliable electricity in Haiti is the bane of progress,” Traynor explained. “The timing was perfect, because [our systems] were under the greatest amount of physical strain and stress, and there were opportunities to take measurements and make observations unique to such stress.”[image align="left" caption="Researchers are developing the remote system’s capability to detect internal bleeding. Shown here is a negative pressure chamber used to simulate battlefield blood loss in a laboratory setting. The test subject’s legs and lower torso are slid into the tube, which is then sealed and activated to draw blood away from the upper body. (U.S. Army photo courtesy of MRMC.)" linkto="/web/wp-content/uploads/110304_photo02.jpg" linktype="image_vt"]“/wp-content/uploads/110304_photo02.jpg” width=”165″ height=”246″[/image]
The team gave Traynor a plan to rewire the entire electrical system and soon acquired all necessary wire, panels, and other parts.
The plan also addressed other problem areas, including patient capacity, air filtration, and adequate roofing. The assessment was respectfully candid about infrastructure realities in the beleaguered island nation, stating in part, “Some of what appear to be problems become less significant as the evaluators become more familiar and accepting with the realities and expectations of the Haitian people.”
“The core value of the document lies in the fact it was integrated from multiple disciplines,” Traynor said. “Things were not taken in a vacuum; they were looked at in the greatest overall picture. I was very surprised at the quality. For a group that basically went in and was very intuitive, they walked out with a picture that took me probably two and a half years to put together in my mind. They did it in a couple weeks, and that’s impressive, very impressive.”
January 2011 marked a year since the earthquake. Even before it struck, life in Haiti was below standard. The hospitals were rationing power, and the quake further taxed their electrical systems. Now the country is reeling from political upheaval while fighting a deadly cholera outbreak. Sacred Heart alone treated more than 1,000 cholera patients in November and December 2010. While funds have been pledged to assist, they have been slow to arrive.
Traynor stands in the gap at Sacred Heart and remains unperturbed. “It is important we keep our heads and continue to make plans and progress in the face of all these other obstacles, and I think that’s the greatest contribution these guys made. They were in a chaotic environment, they did perform a very valuable function, and they’ve all said whatever they can do to help, they’d like to continue. [They deserve] a lot of gratitude for that.”
- JILL LAUTERBORN is a writer for the U.S. Army Medical Research and Materiel Command. She has nearly two decades of editing and writing experience.