Global Surgery & Anesthesia
Haiti
Hello.
I am just finishing a 2 week stay in Haiti- working at an amazing field hospital outside of Port au Prince. With this crisis, unlike previous complex emergencies, the need for surgical services was a large part of the acute response. As Haiti transitions out of the acute phase of the emergency, we must not forget that the need for providers with surgical expertise remains high- to avoid preventable complications from operations previously done, to treat those complications that are starting to be recognized, and to treat those patients in need of further surgery. The needs remain great.
When I return to the US I will make additional posts on this topic. And we invite all who have been working in Haiti, to offer their insights as well.
Robert Riviello
Nadine, great point about the ongoing surgical need. While the acute phase is over, the subacute and chronic phases will require their own share of surigcal services. Now in the subacute phase, external fixators will need to be removed. Malunions and nonunions will need to be addressed. Chronic osteomyelitis as a result of open fractures, non-sterile fixations, and early closures of wounds will drainage, debridement, sequestrectomies. And these are purely the orthopedic needs. They high surgical burden of disease (non-earthquake-related trauma, hernias, obstructed labor, complex wound care, acute abdomens, the surgery of pus, advanced tumors, etc.) will continue, but now with less infrastructure to address the needs.
Heading into the chronic phase, and even now, supporting our Haitian colleagues in the recovery and in training new cadres of providers will be paramount. For example, it is my understanding that there are currently no trauma trained Haitian orthopedic surgeons currently in Haiti. And the entire sencond year class of nursing students at the University Hospital was killed in the disaster. A number of academic and non-academic hospital systems and organizations are exploring longer-term partnerships to assist with this long-term training need.
9:59 PM, 28 Apr 2010 | Permalink
Lubna Samad
I agree entirely - the transition from management of acute problems to capacity building to meet long term health needs has to be thought through. Given the dearth of health professionals on the ground, might there be a role for shorter training programs to enable basic health needs to be delivered? Perhaps 1-2 year programs whereby an enrolled health worker is attached to a hospital/organization and attends core modules for training side by side?
4:41 AM, 10 May 2010 | Permalink