PAHO's Area on Emergency Preparedness and Disaster Relief in Haiti, which receives funding from the Canadian International Development Agency (CIDA), carries out different activities in support of the health sector, the paramedical sector, as well as the Civil Defense in Haiti. One of these activities is the organization of Mass Casualty Management courses for first responders. The Department of Sud was the setting of one of these courses that took place in July 2007. A group of twenty-six first responders were invited to participate in this training. The participants included doctors, nurses, firefighters, police officers, Haitian Red Cross volunteers, an ambulance driver and civil defense personnel. The aim of this training was to assure prompt and appropriate assistance to victims of disasters, and to achieve a rapid and permanent recovery.

Three days of theoretical training were provided in the following subjects: emergency medicine, the organization of advanced medical posts, psychosocial care, management of dead bodies, division of roles, and responsibilities and tasks of first responders. In addition, the Ministry of Health provided a presentation on contingency planning for large scale emergencies. Also, several tabletop exercises were held to better understand and put into practice the above mentioned subjects, and discussions were held on recent emergencies that have affected Haiti (flash floods in Gonaives and Mapou/Fond Verettes in 2004 where about 4,000 people lost their lives)

In order to review and exercise the skills of first responders, a “real life” simulation exercise was organized in the centre of Les Cayes, the departmental capital of Sud. A large traffic accident was simulated and 30 volunteers from the nursing school as well as members of the local scouts association were dressed with fake wounds and blood to make it all seem real. The participants were surprised with a phone call informing them that a bus filled with youth had just collided with a police truck and that many people were wounded, and dead. From that moment, the participants were given carte blanche to manage this mass casualty problem and save as many lives as possible.

Behind the scenes close coordination took place with the Haitian National Police and the Uruguayan contingent of the UN Peacekeepers in Haiti to make sure the simulation area would not be overcrowded by local spectators. This was very useful as within the audience an elderly man needed to be accompanied off site as he truly believed that so many young people were in dire need of medical help.

The evaluation of this course indicated a very high appreciation from the participants. Most of them lack proper training in Mass Casualty Management, as it is not part of their formal education for their respective professions and they do find themselves faced with these situations on a regular basis.

Briefing of volunteers before the start of the simulation.

Preliminary evaluation of needs.

Arrival of "relief personnel."

Securing the perimeter.

Evaluation of "victims."

"Victims" evacuated to treatment area.