Jan. 26 Press Briefing
Dr. Jon Andrus
Deputy Director, PAHO
Since January 12, the Pan American Health Organization, the global WHO family, and our partners have been mobilizing resources at all levels to meet the overwhelming challenges of bringing humanitarian relief to Haiti.
This past weekend, PAHO’s Director, Dr. Mirta Roses, travelled to Haiti to observe the relief efforts and assess health needs in person. She visited hospitals in Port-au-Prince and in Jimaní, on the border with the Dominican Republic. She spoke with Haitians and with representatives of international organizations, the government—the Ministry of Health—about the current situation and what needs to be done going forward.
At this point in the relief effort, the need for emergency surgical care has declined substantially.
We are seeing many fewer traumatic injuries, fractures, wounds and burns, and internal injuries.
The pressing needs now are clearly for post-operative care and follow-up of patients who have already had surgery, and basic primary healthcare services to meet the ongoing health needs. These needs include maternity care, post-operative care (as I mentioned), and chronic health problems including diabetes, heart disease, HIV, and tuberculosis.
Haiti’s Ministry of Public Health has developed a strategy for meeting these needs, which includes community-based facilities and mobile clinics to provide post-operative and primary care.
PAHO/WHO and other international health partners are supporting the Ministry’s efforts in this strategy. Brazil, as just one of many examples, is providing US$70 million for 10 urgent care units, 50 mobile units for emergency care, a laboratory, and a hospital, among other health services.
Part of the shift in focus involves improving logistics for transferring patients and supplies, and identifying needs for medicines and equipment.
It also requires assessing the emerging needs for healthcare personnel. For example, it is clear now that more nurses, physical therapists, and mental health providers are needed and fewer medical doctors, especially surgeons, who were so vitally important during those first days after the quake.
Some of the foreign medical teams that are preparing now to go home will need to be replaced. We must ensure that those who replace them are the kinds of healthcare providers that are most in need.
One of the most urgent needs is for follow-up care for thousands of Haitians who have had amputations. PAHO/WHO is working closely with Handicapped International to develop a plan for healthcare services for the large number of amputees.
For amputees, the seriousness of their disabilities over the long term will depend very much on the follow-up care—and the quality of that care—they receive now, including physical therapy. Supportive mental health services will also be critically important for their recovery.
While disability itself is a hardship, it also brings with it economic and mental health problems that can seriously impact people’s lives. These types of challenges are even greater in a country like Haiti.
Many other injuries also have the potential to cause long-term disability unless they receive proper care, including proper self-care. We know that patients who fail to exercise injured arms and legs, for example, are likely to lose mobility and the usefulness of their limbs, resulting in long-term disability.
Re-establishing and strengthening primary healthcare services in Haiti remains a top priority, including rehabilitation therapy.
PAHO is working hard to strengthen surveillance networks to ensure that outbreaks of communicable diseases, if they occur, are identified early for more rapid control and saving of lives. We are particularly concerned about water-born diseases and respiratory illness.
The earthquake that came crashing down on Haiti paralyzed its immunization program.
Diphtheria, virtually eliminated in all other countries of the Western Hemisphere, still sporadically caused outbreaks in Haiti even before the earthquake, so plans for maintaining routine vaccinations with the routine schedule in the reconstruction of primary care services are vital.
To that end, the Ministry of Health has announced that immunization will be resumed again, with the support of PAHO/WHO and UNICEF. The first vaccines to be administered will be against diphtheria and tetanus, DTT, measles and rubella.
In the hundreds of spontaneous settlements where quake survivors have gathered, measles-rubella vaccinations will also be provided through special campaigns in the months to come.
This is excellent news, because only around half of the population has been immunized against tetanus, for example. Priority groups -- in particular, children under 5 -- will be targeted first.
WHO/PAHO will continue to maintain its long-term staff and commitment in Haiti plus an additional team of more than 20 international experts from around the world in coordination, logistics, epidemiology, surveillance, communicable disease control, water and sanitation.
One of the main areas where we have been able to make a substantial difference has been in supplying hospitals with medicines for treating the sick and wounded. WHO/PAHO runs PROMESS -- the national stockpile of medicines and vaccines, a warehouse located in the capital – which, luckily, at the time of the earthquake, was stocked with medicines and supplies such as bandages, plaster for making casts, gloves, and so on.
In the last 11 days, we have provided almost 200 palettes full of medicines to hospitals in the affected areas of Haiti.
In all our actions, we are placing high priority on reaching the most vulnerable populations, doing things like talking to mothers of young children about breastfeeding, hygiene and sanitation.
I am also pleased to announce that starting this week, women in the informal settlements are being trained as breastfeeding counselors. They will identify pregnant and lactating mothers in their areas, and support them to continue breastfeeding, which is essential for good health and nutrition for babies, particularly in emergency settings. This will help prevent future cases of malnourished children.
I would like to end by saying that reconstruction is on everyone’s minds, and rightfully so. Our response to Haiti cannot be an unsustainable, one-off effort.
To that end, I just returned from Montreal where yesterday a Ministerial Preparatory Meeting was held to focus on Haiti’s reconstruction. Besides the President of Haiti, high-level representatives from United Nation agencies, partner countries from around the world, non-governmental agencies, and Haiti’s Diasphora pledged to commit themselves to a long-term plan that addresses the following:
- The Haitian government will take the lead and ownership for development and implementation of the reconstruction plan of action,
- Coordination among all partners will be well-organized and effective,
- It will be at least a 10-year plan of action grounded in sustainability,
- External aid that is effective and that builds on lessons learned,
- Aid that is inclusive, that involves other entities such as the diasphora, civil society, and nongovernmental organizations. In particular we will need to be prepared and ready to encourage and support what individual Haitians can do in their reconstruction response. It was Secretary Clinton who said yesterday in Montreal that it must be the Haitian people themselves who lift up their country with the support of a well-coordinated effort of partners, sensitive to the fact that when Haiti suffers we all suffer, and when Haiti thrives, we all thrive.
And finally: Accountability so that products are delivered according to achievable milestones. These will need to monitored and evaluated every step of the way.
I think I will stop there and entertain any questions.
Thank you for coming.