Saturday, August 14, at 8:30 am local time, the earth trembled in the southern peninsula of Haiti. A 7.2 magnitude earthquake caused severe damage to buildings, houses and main access roads in the three provinces of Grand'Anse, Nippes and Sud. Tremors were felt in other areas of Haiti, too.
The Haitian Civil Protection General Directorate (DGPC) says 137,000 families have been affected in the Grand'Anse, Nippes and Sud departments.
According to UN OCHA, about 650,000 people are in need of emergency humanitarian assistance.
The provisional death toll is now nearly 2,200, according to Haiti’s Office for Civil Protection, and more than 12,200 people have been injured.
In terms of buildings, nearly 53,000 houses were destroyed, and more than 77,000 houses were damaged in the 3 most affected provinces, according to Haiti’s Office for Civil Protection, leaving thousands without shelter.
Many public buildings, such as hospitals, schools, hotels, churches and private companies, suffered damage or collapsed.
Many hospitals had to evacuate their patients, and the facilities that continue to function are overwhelmed and experiencing a lack of medical equipment and medicines.
Following the earthquake, the area experienced aftershocks and landslides, causing additional damage. From Monday evening to Tuesday morning, Topical Storm Grace passed by the southern peninsula causing extremely heavy rains, up to 10 inches/25 centimeters, and flooding. The storm has complicated rescue efforts by making more areas inaccessible and endangering tents and temporary structures being used for urgent medical care, aid and shelter.
It is difficult at the moment to get a complete mapping of the disaster, but MSF has launched exploratory missions in several localities, and started interventions in the cities of Port-Salut, Les Cayes and Jérémie.
MSF has over 100 international staff members and over 1260 Haitian staff members working in Haiti on our regular programmes and emergency response.
In the first hours after the earthquake, the MSF team based in Port-à-Piment and an emergency medical team from Port-au-Prince began assisting injured patients in Sud province.
The hospital in Port-à-Piment where MSF runs a sexual and reproductive health (SRH) project was damaged.
The patients, most of them present for maternity services, were evacuated to a tent where our team continued to provide care, and MSF has been building a new structure to house the local hospital and our own services until a long-term solution is reached.
In Les Cayes, the capital of Sud province, an MSF team arrived at the general hospital, Hôpital Immaculée Conception (HIC), on August 20 to donate medical supplies, and an MSF medical team started working in the hospital on August 23.
As of August 31, the team has participated in 88 surgeries for earthquake survivors and for people with other surgical needs, MSF is also providing post-operative and mental health care.
MSF set up five tents outside the hospital to add 40 patient beds due to the high medical needs. MSF is also running mobile clinics and performing water and sanitation activities in several informal camps that serve thousands of people displaced by the earthquake and previous natural disasters.
MSF has provided donations, such as tents and medical supplies, to various hospitals in Les Cayes to ensure continuation of medical activities.
Since August 23, MSF has also been running daily mobile clinics to rural and remote areas that were more severely affected by the earthquake, where many people with injuries and other conditions have been unable to reach functioning health care centres for weeks.
MSF’s mobile clinics focus on providing primary health care services and transporting patients with more severe conditions to functioning facilities when possible.
In addition to injuries from the earthquake and related wounds and infections, mobile clinic patients often have respiratory and vaginal infections, skin conditions, signs of malnutrition and other illnesses associated with poor living conditions and lack of access to water and hygiene services.
MSF has also begun offering mental health consultations at our mobile clinics. MSF has provided donations of medical supplies to multiple health centres throughout Sud, to facilitate (free of charge) stabilisation and referral of patients.
Some access routes, such as the road between Les Cayes and Jérémie, are seriously damaged, and complicate the deployment of aid.
MSF is moving supplies by air and sea due to the difficulties with the road.
A medical team, including two surgeons and an operating room nurse, was able to travel to Jérémie on August 15 and began working in St. Antoine’s hospital, while also providing medical supplies.
As of August 29, the surgical team had provided care to 90 patients, performing 113 surgeries or applying casts or splints.
MSF is also providing post-operative and mental health care.
In the hard-hit commune of Pestel, a three-hour drive from Jérémie, MSF donated supplies to the local health center and referred several patients to Les Cayes or Jérémie.
On August 30, MSF carried out a mobile clinic in Carrefour Citron, about 20 minutes’ drive from Pestel, seeing 110 patients, mostly for health conditions not directly caused by the earthquake.
Initial assessments and response were focused on the Sainte-Thérèse hospital in Miragoâne, the town health centre of Petit Trou, the hospital in Baradères and then later the hospital in L’Asile (Hopital Communautaire L’Asile) as well as the hospital in Bonne Fin.
MSF teams donated medical donations and other supplies, as well as tents to set up temporary health care, and helped to ensure clean water supply to the affected communities (installation of motor pumps and bladders, water trucking etc).
Today the response is centred in and around Baradères, in the west of the Nippes Department, with a population of around 52,000. It is a remote mountainous area with challenging roads and therefore hard to access.
Damage to health infrastructure and water supply systems is extensive in Baraderes affecting the whole population. With no functioning water system left, people are forced to either collect water from the few functioning tap stands or buy drinking water in disposable sachets, depleting the little savings they have.
In addition to the damage to public infrastructure, around 6,120 families have had their homes damaged or destroyed, forcing people to sleep outside or under makeshift shelters. This is particularly difficult for vulnerable groups such as the elderly, disabled and pregnant women.
Two weeks after the earthquake, the teams were still identifying patients in need of referral due to injuries from the earthquake and facilitating those referrals.
At this moment, the response has three main components:
1. First, ensuring access to healthcare by supporting health facilities and running mobile clinics in the remote locations in the surrounding villages and mountains. Focusing on the most affected areas, we are providing support to damaged facilities experiencing interruption of services, with the priority structures Centre Avec Lit (CAL) de Baraderes, Hôpital Communautaire (HCR) l’Asile, Dispensaire Changieux and Dispensaire Gauthier Civile.
Support to these health facilities is focused on donations of medical supplies, ensuring an appropriate temporary space for the continuation of services (tents), and financial support, while mobile clinics will provide a basic package of care to enable treatment of the main morbidities and dressings, as well as emergency referrals.
Next to this, we are working to set up a surveillance system to monitor potential outbreaks of diseases, in order to respond quickly if cases of epidemic prone diseases are identified. Before the earthquake, vaccination rates in Nippes were among the lowest in the country. Destruction and damage to homes, health centres and sanitation facilities raises concerns about potential outbreaks in the aftermath of the earthquake for infectious diseases such as measles, diphtheria, cholera and respiratory tract infections.
2. The provision of clean water. We are starting an emergency surface water treatment plant to provide clean water immediately and next to that, we are looking at repairing water infrastructure that has been damaged by the earthquake.
3. The provision of shelter and Non-Food Items (NFI), such as jerrycans, plastic sheeting, ropes, blankets and soap, to families who have had their homes damaged or destroyed. We focus initially on the most vulnerable families and once our full supplies are in place, we will aim to distribute the NFIs more broadly.
Additionally, the teams are focusing on community engagement as well as health promotion to understand the needs of the community, build awareness and acceptance of MSF’s work, and to share health messages related to infectious diseases and water and sanitation.
"Our current priorities are, above all else, to get a precise idea of the medical situation and to provide direct care to the injured when we can or to refer them to functional medical structures once we ensure they are stabilised,"
says Alessandra Giudiceandrea, Head of Mission for MSF in Haiti.
Depending on the reality we find on the ground, MSF may deploy other medical teams, start distributing essential items or begin water and sanitation activities.
Whenever they can, MSF’s medical teams help refer the injured to functional health facilities.
The transport of medical teams and equipment is one of the main challenges today. Several roads were cut off, notably those between Les Cayes and Jérémie and between Port-à-Piment and Les Anglais.
Landslides, which have damaged access roads, slow down and complicate the deployment of relief supplies and the delivery of aid.
MSF hired a helicopter to gain faster access to remote areas, transport equipment and refer injured people. Travel by sea is also a possibility.
"Several health facilities have had to evacuate their patients from their buildings due to structural damage or for fear of aftershocks, such as at St. Antoine Hospital in the city of Jérémie, where we are working."
"Many patients are outside or in tents, and now heavy rains are expected tonight. Not to mention all the Haitians who have lost their homes,"
says Michel-Olivier Lacharité, head of emergencies at MSF.
Finally, the security situation in Haiti is a factor that cannot be ignored.
The main road to southwestern Haiti passes through Martissant, a neighborhood of Port-au-Prince particularly affected by violence between armed groups.
Although armed gangs have declared a ceasefire there, the general insecurity in Haiti is complicating the deployment of relief supplies.
Even before the earthquake, health facilities in the provinces of Haiti's southern peninsula were experiencing numerous malfunctions and supply problems.
In Port-au-Prince, the earthquake fortunately did not damage any infrastructure or buildings.
However, injured patients from affected areas have come to the city for care.
On August 15, MSF began providing stabilization care to injured patients at a new emergency centre in the Turgeau neighborhood of Port-au-Prince at the Integrated Diagnosis and Treatment Centre (CDTI), commonly known as the Sacré-Cœur Hospital, which wasn’t scheduled to open until later in the week.
To address potential blood shortages, MSF quickly launched a blood collection campaign in Turgeau on August 14 just hours after the earthquake, in partnership with local authorities.
MSF is treating injured people in our trauma hospital in Tabarre. When the earthquake struck, most of the beds at the Tabarre hospital were already occupied with its existing burns and trauma patients.
The hospital then received a total of 70 earthquake survivors in a matter of days, 48 of whom were admitted for surgery or other treatment.
The needs exceeded the hospital's normal capacity of 70 beds, and so the staff add 19 beds in covered areas of the courtyard and elsewhere inside the building to accommodate the additional patients.
Strengthening our intervention
International emergency staff, including emergency coordinators, medical teams (including trauma surgeons) and WATSAN/logistical experts have arrived in Haiti.
The weekend of August 20, MSF’s Supply team in Brussels sent 100 tons of material to Haiti via two planes.
The cargo includes items for setting up emergency medical structures and offices for our operations using tents; materials to install emergency drinking water supply systems for at least 30,000 people; and medical supplies for the care of 30,000 patients, including items for stabilisation, first aid, vaccination and blood collection.
MSF’s supply team in Amsterdam sent 58 tonnes of material to Haiti via plane and by sea (36 tonnes via plane, 22 tonnes via sea). The first cargo by plane arrived on August 24.
This cargo includes medical supplies, drinking water supply systems, non food items and logistical material like communication equipment, vehicles etc.
Watch the interview with Hussein Choker, Freight Operator at MSF Supply ⬇