Thousands of amputees need post-operative care and rehabilitation
Two weeks after Haiti’s Jan. 12 earthquake, the need for emergency health care has declined dramatically, but many quake survivors urgently need post-operative care that is now in short supply, say experts at the Pan American Health Organization/World Health Organization (PAHO/WHO).
"During the first 10 days, search-and-rescue was the priority, along with traumatic and orthopedic injuries, wounds and burns, internal injuries, and trying to prevent wound infections," said PAHO/WHO Director Dr. Mirta Roses during a joint press briefing with officials of Haiti's Ministry of Public Health in Port-au-Prince. “Now the priorities are changing, and there are more needs for post-operative care and follow-up. But there is still little capacity to help patients who need that follow-up care.”
Among the most urgent needs are those of thousands of Haitians who had amputations as a result of earthquake injuries.
“Some hospitals were performing 30 amputations per day, others 100 a day,” said Dr. Roses. “These people will need physical rehabilitation as well as mental health services. That means more nursing and mental health personnel and more physical therapists, and of course the right equipment for these kinds of programs.”
Rehabilitation, and especially physical therapy, is critical to prevent or minimize long-term disability due to earthquake injuries. This is especially important because disabilities can cause significant economic and mental health problems for earthquake survivors in the long term.
“Some fractures and wounds will produce disabilities,” said Dr. Ciro Ugarte, a top PAHO disaster expert. “But the severity of disability also depends on the treatment and follow-up patients receive. A lot of disability can be minimized if people get the right care, including physical therapy.”
Ugarte added that Haiti had a shortage of rehabilitation personnel and services even before the quake. Now the demand for such services will be much higher due to the thousands of injured survivors.
As the emergency phase of the disaster winds down, there is already a mismatch between medical relief personnel and the immediate health needs of the population.
“What we are seeing on the ground are a lot of medical doctors and paramedics, but not enough nurses,” he said. “Several medical teams that came 10 days ago are ready to go back home. We need to replace them and to re-establish the health services network.”
PAHO experts say the most pressing need now is for mobile and community-based clinics that can provide such services as maternity care, post-operative care, and treatment for chronic health problems including diabetes, heart disease, HIV, and tuberculosis, which is a significant public health problem in Haiti.
Also important is establishing surveillance networks to detect outbreaks of communicable diseases.
“Up to now, we haven’t seen reports of outbreaks, and probably this is accurate because there are so many teams on the ground and reporting,” said Ugarte. “But it could also be because they are swamped with surgical cases and are not seeing, for example, diarrhea.”
He noted that diarrhea outbreaks were a particular threat, especially in the hundreds of spontaneous settlements where quake survivors have gathered. “Some settlements have 10,000 or 50,000 people in them. Those are the highest priority for outbreak identification and control.”
PAHO was established in 1902 and is the world’s oldest public health organization. It works with all the countries of the Americas to improve the health and quality of life of the people of the Americas and serves as the Regional Office for the Americas of the World Health Organization (WHO).
PAHO Disasters website:
Fact sheet: “Disasters, Disability, and Rehabilitation”