Jan. 29 Press Briefing
Dr. Jon Andrus
Deputy Director, PAHO
We are now 17 days out from the Jan. 12 earthquake that crushed Haiti. The situation on the ground continues to evolve and change. Medical teams are reporting a ‘big shift’ over the last few days in the types of cases they are seeing.
We have seen a substantial drop in trauma cases. Needs have shifted towards the care of those post-traumatic survivors.
Reports indicate that there have been over 2,000 amputee cases. All these people will require follow-on care, and we will work with other organizations such as Handicap International in planning long-term action to treat the wounded and support their recovery.
This week, PAHO/WHO added 6 tents near the PROMESS compound for post-surgical care that will be operated by Medecins Sans Frontieres Spain, and two more to a post-operative care site on the grounds of the organization Love A Child in Fond Parisien to accommodate patients recovering from surgery.
We are concerned about the high concentration of people living in resettlement camps under very precarious conditions that are ripe for a scourge of infectious diseases.
We will continue to work closely with partners and the Ministry of Health to prevent and control these diseases as we reestablish and improve health services. To maintain effective surveillance for communicable diseases, the Ministry of Health, PAHO/WHO, CDC, Canada, Cuba and other UN partners are setting up an emergency surveillance system in Haiti, with a situation room where national and international partners can monitor and investigate cases and provide information to decision makers to take appropriate action.
With respect to measles, endemic measles virus transmission was interrupted in Haiti in 2001. From November 2007 through November 2008, we also had a catch-up campaign against measles and rubella targeting the age group 1-19 years. Polio vaccine was added for children aged < 5 years. Subsequent surveys indicated that approximately 78 percent of the target populations were vaccinated.
The risk of a measles outbreak will depend upon the reintroduction of the measles virus into the population. Therefore, we are insisting that all aid workers going to Haiti should be vaccinated against both measles and rubella to prevent any well-meaning volunteer who is not immunized from bringing measles or rubella into the country.
We know of one suspect case of measles being reported in Port-au-Prince, but investigation revealed it was a case of chicken pox. This is excellent news because it demonstrates that the system is looking for infectious diseases and following up with the necessary epidemiologic investigations.
We are not recommending a national mass vaccination campaign at this time because it will divert resources from urgent care, life-saving activities. However, we will reconsider once vaccination becomes logistically feasible and the situation on the ground stabilizes.
High concentration in confined resettlement areas, with poor sanitary conditions, and low coverage before the earthquake requires urgent, but targeted vaccination strategies.
PAHO/WHO is supporting Haiti’s Ministry of Health doing everything possible to ensure that this can be done. Cold chain, distribution and deployment of vaccines, continue to remain challenges that we are working collectively together to overcome. Planning and organizing activities with local partners have already begun. These plans consider immediate, short-term, and long-term interventions.
Priority age groups (particularly children under 5) will be targeted first for vaccination. A pilot effort in one or more settlements next week, with PAHO/WHO and UNICEF supporting Haiti’s Ministry of Health will be done using vaccines against diphtheria, tetanus, whooping cough, measles, and rubella.
Restoring clean water and sanitation systems that were damaged during the quake is still a top priority for the Health Cluster.
There is a critical need to improve environmental conditions in the hundreds of temporary settlements where people have congregated. All this will be particularly important as the rainy season approaches, usually in April.
To that end, PAHO/WHO is working with Haiti’s national water authority (DINEPA) and other partners to chlorinate water in collapsible tanks that are supplying temporary settlements. Meanwhile, the national water authority (DINEPA) is delivering water to some 300,000 people through 133 distribution sites in metropolitan Port-au-Prince, and other partners are expanding into areas including Leogane and Jacmel.
On the sanitation front, there are nearly three dozen organizations in the U.N.-led Water and Sanitation Cluster that are building latrines and handling solid waste disposal. To complement these efforts, PAHO/WHO is developing hygiene messages for dissemination to the public.
PAHO/WHO’s PROMESS medical warehouse, located at the Port-au-Prince airport, continues to provide medicines and supplies to hospitals and medical teams in Haiti. PAHO/WHO staff are continuing to assess the real time needs for these supplies.
Based on these assessments, we track and deploy a supply of the medicines and supplies that are most urgently needed at any one time. Currently, the priority needs include among, other things: antibiotics, bandages and gauze compresses, exam and surgical gloves, and catheters and urine collection bags.
In addition, we have deployed 525 units of blood. Yesterday we received a shipment of 350 units of blood from the American Red Cross.
Potential donors can see the full list at paho.org/disasters or on the WHO.int websites.
One of the lessons we have learned over and over with each disaster is that not all donations are effective donations. In the case of Haiti, we have seen once again that, if donations are not based on identified needs or are not well coordinated, they can be ineffective and in some cases even do more harm than good.
We know that aircraft have arrived with unsolicited goods, without any provision for their storage or distribution. Because of the earthquake’s disruptive effects on transportation, communication, and the activities of the government and a host of organizations already working in Haiti, it has been enormously challenging to receive and distribute unsolicited aid in any efficient way.
We would like to remind the many well-intentioned volunteers that, before traveling to Haiti, they should check with the agencies or groups with whom they will be working to ensure that the necessary accommodations, communication, and security are in place to make their efforts useful and effective. We must avoid diverting any resources intended for the care of Haitian survivors.
As I mentioned, the hundreds of spontaneous settlements (600) where people have congregated have very precarious living situations. Food safety and clean water are major issues, but people living in these conditions are also more vulnerable to outbreaks, environmental hazards, including the weather—especially as the rainy season approaches—and violence, particularly against women and children.
On the latter issue, the United Nations stabilization mission in Haiti (MINUSTAH) is working with agencies such as UNIFEM, the International Red Cross, and the UN Population Fund to raise awareness about sexual exploitation and abuse.
Finally, PAHO and WHO have clear guidelines on how to be a ‘good donor.’ These guidelines are available on both the PAHO and WHO websites.
In general, the most effective way to help after a disaster is by making a cash donation to a reputable organization that is already on the ground in the affected country.
That said, we recognize that medical supplies and medicines are usually in urgent demand following disasters. But again, it is critically important that they be provided based on actual needs.
PAHO/WHO’s guidelines on drug donations emphasize that they should always be based on an expressed need and should not be sent unsolicited.
Donors who want to give medicines should respect the wishes and the authority of the receiving country, and should make sure their donation supports existing government health policies and administrative arrangements.
We should reinforce to the extent possible that there should never be a double standard about quality: if the quality of an item is unacceptable in the donor country, it is also unacceptable as a donation.
Good communication and coordination between the donor and the recipient on the ground is absolutely critical. PAHO/WHO is working to do this with its LSS/SUMA system for managing humanitarian supplies. It is operated out of the PROMESS warehouse coordinating the acquisition and distribution of donations and other supplies received through the Port-au-Prince airport. These efforts help ensure transparency and efficiency, as we can attempt to track what goes where.
I will end there and take any questions. Thanks again for coming.