NHS involvement in the Haiti Earthquake

NHS involvement in the Haiti Earthquake

Posted on 03. Feb, 2010 by Erin in Latest News

Number 3: 29 January 2010
This note updates the DH’s note of 22 January 2010 and provides information for NHS staff and organisations, which can be found at: www.dh.gov.uk/en/News/Recentstories/DH_111200.

The situation now and the global health response
Descriptions can be found on the PAHO website www.paho.org. The information below is based on information from the Global Health Cluster lead (the Pan American Health Organization (PAHO-WHO)), the Haitian government, DFID and Merlin. International agencies tell us that we are entering the early recovery phase of the post-earthquake response.

Health

  • Most people with injuries have received initial medical attention. Many still require surgical care.
  • The current priorities of the Haitian Ministry of Health (MOH) include post-operative care (particularly nursing care) and rehabilitation of disabled people, primary care at internally displaced persons sites and provision of medical services outside of Port-au-Prince (PAP).
  • Reports suggest that there are over 2,000 amputees and that this number is likely to increase.
  • There have been reports of suspected measles cases by the health cluster yesterday. In addition, there have been reports of tetanus cases. Vaccination campaigns for diphtheria, tetanus and measles are starting next week.
  • Medical teams have also reported a growing number of people with diarrhoea in the last few days. The Haitian MOH supported by PAHO/WHO, CDC, the UN, Canada and Cuba along with other partners are setting up surveillance systems.
  • There are also reports of increasing mental health needs. The MOH has established a mental health group who will develop plans for providing psychological support with assistance from the International Medical Corps.

Shelter, Water and Sanitation

  • Shelter material is a clear need. Distributions of tents, shelter kits, and plastic sheeting have now reached around 35% of those that need them.
  • Sanitation continues to be a concern with a lack of toilet facilities in some settlements.

Logistics

  • Travel within PAP remains difficult. Repairs to the port are slow and the airport remains busy.
  • The security situation remains fragile.

Coordination

  • PAHO continues to lead the coordination of the health sector.

UK Government response

  • The United Kingdom government is supporting humanitarian activities. The Department for International Development (DFID) remains the lead government department. More information is available at www.dfid.gov.uk.
  • UK Fire and Rescue teams have now returned to the UK.

The NHS response

  • We know that a number of NHS staff have been working with UN bodies and NGOs.
  • Merlin for example have deployed 16 NHS staff from a range of locations including London, Leeds, Manchester, Cambridge, Bradford, Nottingham, Sheffield, and North Wales to Haiti, who provided critical support during the initial phase of the response.
  • International agencies now tell us that we are already entering the early recovery phase. While they still need the continuing support of NHS staff (especially surgical) it is becoming increasingly important for staff to be deployed for longer periods of time.
  • The reasons for this are:
    • It takes nearly a week to get staff into Haiti
    • Free flights will likely stop soon and therefore the costs of rapid staff turnover will become unacceptable
    • Project continuity for both the agencies concerned but also for the Haitian Ministry of Health staff.
    • Rapid staff turnover adds to an already very difficult coordination and management situation.
  • The Department of Health remain aware of the current need for specialised health professionals to participate in relief efforts. Current deployment arrangements should be through established agencies. We encourage employers to discuss oportunities to work with these agencies as and when requested by staff.
  • The national Terms and Conditions of Service for NHS Medical and Dental Staff make provision for special leave to be granted at the discretion of the employer.  The DH is supportive of this and recognise on this occasion there may be a requirement for NHS staff to be deployed for longer periods of time. We would encourage employers to look at any requests for extended periods compassionately bearing in mind the current circumstances.
  • Further advice on what you can do to help Haiti is provided on the 15 January update at http://www.dh.gov.uk/en/News/Recentstories/DH_111200

What the HPA is doing?

  • HPA activities are as described previously

Number 2: 22 January 2010
This note updates the DH’s note of 15 January 2010 and provides information for NHS staff and organisations which can be found at: www.dh.gov.uk/en/News/Recentstories/DH_111200

The situation now and the global health response
Descriptions can be found on the PAHO website www.paho.org or the BBC website www.bbc.co.uk. Reports continue to highlight the difficulties people are facing when accessing aid and medical support. The information below is based on information from the Global Health Cluster lead (the Pan American Health Organization (PAHO-WHO)), the Haitian government, this week’s WHO Executive Board in Geneva, DFID and Merlin. Aid efforts are becoming organised but remain extremely challenging. There is still limited information on the needs of the population. 

Health

  • Haitian authorities report that up to 200,000 people may have died.
  • An additional three million people have been affected by the earthquake with around 300,000 people are homeless.
  • At least 8 of the 11 hospitals and health centers have been damaged or destroyed in Port-au-Prince (PAP). However the total extent of the damage to Haiti’s health sector is still unknown and is currently being assessed. Remaining hospitals and health centres, field hospitals and makeshift clinics both in PAP and on the border with Dominican Republic (DR) are providing care. International and UK non governmental organizations (NGOs), such as the International Committee of the Red Cross (ICRC), Merlin, Save the Children, Oxfam and Help the Aged are providing additional capacity on the ground.
  • There have been difficulties finding open spaces for field hospitals and shelter hampering the use of supplies. However immediate life saving measure are going on now and some critically ill patients are being referred externally to other countries.

Logistics

  • Travel within PAP remains a huge challenge. The port is still damaged and road and air travel are difficult. This is partly due to fuel shortages and road blockages with rubble and displaced people.
  • Telephone networks remain disrupted affecting communication with agencies on the ground. Text messaging is often the only mode of communication.
  • The security situation remains fragile.

Coordination

  • PAHO is leading coordination in the health sector.
  • While PAHO highlights that the health needs are great, they continue to emphasise the importance of strong coordination if the relief effect is to be most effective.
  • PAHO highlights that agencies on the ground should share expertise, supplies and human resources.

UK Government response
The United Kingdom government is committing humanitarian assistance to Haiti. The Department for International Development (DFID) remains the lead government department and has currently pledged £20 million towards relief efforts.

A DFID humanitarian assessment team is now in PAP. They are identifying priorities, feeding their findings back to London. More information is available at www.dfid.gov.uk. UK Fire and Rescue Services have already been mobilised and have participated in search and rescue.

How the NHS is helping

  • NHS staff are already involved in the immediate response. This has been through a variety of  international agencies and NGOs such as Merlin. Such individuals have previous experience of working in disaster settings.
  • Merlin highlight that the response from the NHS has been extremely positive. They have sent a number of NHS staff including accident and emergency doctors, surgeons, anaesthetists and nurses to Haiti. A BBC video clip of one of Merlin’s initiatives can be accessed here: http://news.bbc.co.uk/1/hi/world/americas/8471903.stm.

What the HPA is doing?

  • The HPA is providing assistance to WHO’s International Programme on Chemical Safety (IPCS) on assessing the risk of potential chemical hazards following the Haiti earthquake.
  • In addition the HPA has provided guidance to UK personnel involved in the relief effort. This is available at http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1262705017346

What can I do now to help Haiti and what shouldn’t I do?

  • Advice on both these areas remains the same as on 15 January
    http://www.dh.gov.uk/en/News/Recentstories/DH_111200
  • It is clear that there will be increased health needs for many months and even years.
  • The type of heathcare needs will change over the months ahead. This will mean an increased need for health staff such as public health professionals, mobile health teams, physiotherapists and occupational therapists. 
  • Interested individuals should keep an eye on agency websites where postings and job descriptions may be advertised. NGOs are recommending that individuals approach their employing Trust/PCT before registering interest with the agencies.
  • Agencies are now looking at professionals who can commit to months rather than days or weeks.
  • DFID will continue to work closely with PAHO and DH to identify what additional support is required from the NHS.

Number 1: 15 January 2010
On 12 January a strong earthquake struck Haiti,10 miles from the capital, Port au Prince. Haiti is a poor country with a population of around 9 million people.

The situation now
Descriptions of the current situation can be found on the BBC website. Reports indicate significant loss of life. The numbers of people dead injured or in need of humanitarian assistance are unknown. Estimates currently suggest:

  • Between 45,000 and 50,000 people have died
  • An additional three million people affected by the earthquake
  • Several hospitals and health centers have collapsed in the city
  • The airport and port have both been damaged making access incredibly difficult
  • There are numerous security concerns

The global health response
The global health response will be managed through the Global Health Cluster that leads on the assessment, monitoring and coordination of health related activity in emergency settings. In Haiti the Global Health Cluster is being led by the Pan American Health Organisation (PAHO). Currently:

  • At least 14 field hospitals with staff are on their way into Haiti.
  • An American hospital ship is also on it’s way.
  • Over 800 Cuban medics and a growing number of medical and health staff in country or waiting to enter.
  • Additional US military and civilian trauma ‘resources’ are arriving imminently. These are expected to be extensive.

UK Government response
The United Kingdom government has committed, as part of the international community, to provide humanitarian assistance to Haiti. The Department for International Development (DFID) is the lead government department for the UK response. It has made an initial £6 million available.

A DFID team is on route to Port au Prince. They will determine the priorities for urgent assistance from the UK. Fire and Rescue Services from the UK have already been mobilised. Until the teams get there it is impossible to know what the appropriate UK response should be.

Deployment of UK staff in humanitarian emergencies
The international agencies and non-governmental organisations (NGOs) that specialise in deploying health professionals, try to ensure that those deployed are trained and experienced in working in emergency environments. This includes security, which is particularly important in this case.

NGOs usually have a register of trained individuals who are available at short notice. For most emergencies, the capacity available through these channels is adequate. For some exceptional crises, it may be necessary for the international community to draw on NHS staff but we are not at that stage yet.

How the NHS can help
A number of NHS professionals are already registered to respond to humanitarian crisis with NGOs. A number of these individuals have local agreements with NHS trusts and other organisations for release in such circumstances. These individuals should keep in close contact with the agencies they are registered with.

Experience is that in the immediate emergency situation, very well directed and co-ordinated assistance is essential. Enthusiastic but misguided involvement can be detrimental to reflief efforts.

We recommend that if people are considering going to Haiti, they have the required skills, experience and speak French.  They should go only through established routes such as Médecins Sans Frontieres, Merlin, Save the Children or WHO/PAHO.

Health Protection Agency (HPA) is in contact with those leading on relief efforts. DFID and the Department of Health (DH) are liaising closely and more information will be made available when the situation is clearer.

What can NHS staff do now to help Haiti?

  1. If you already have links with established NGOs that are working in Haiti you may wish to discuss with your line manager whether there is an opportunity for assisting in the response. Examples of agencies include:
    1. Médecins sans frontiers
    2. Merlin
    3. Save the children
    4. Pan American Health Organisation
    5. International Health Exchange
  2. If you feel the need to make a financial contribution consider going through the Disasters Emergency Committee.
  3. Keep updated by looking at the DFID, WHO and PAHO websites (listed below) and other agency websites.

What should NHS staff avoid?

  1. Go to Haiti on your own. Why not?
    • It is currently very difficult to get to Haiti. The airport is functioning intermittently and flights are being prioritised.
  2. There is no or little shelter, electricity, food or water available. Anyone that goes must be 100% self sufficient- if you don’t bring supplies you will be dependant on others, who may need these more.
  3. For your own safety and to ensure co-ordination of the situation you must only go if registered with an agency.
  4. Send medical supplies. Why not?
    • Due to the difficulties accessing Haiti it is important that only appropriate standardised kits are sent as requested by the global health cluster/ PAHO.
  5. There is a risk of clogging up scarce entry points.