Haiti: The pressures are consuming work for many of MSF teams

January 26, 2010

Haiti: The pressures are consuming work for many of MSF teams

The dual pressures in Haiti, of continuing needs for surgery and of the growing requirement for post-operative care, are all-consuming work for many of Doctors Without Borders/ Médecins Sans Frontières (MSF) teams in the country. In the capital, Choscal hospital in the slum area of Cite Soleil is still operating around-the-clock on an average of 20 to 25 people each day. In the town of Leogane, where MSF has recently started doing surgery in the local hospital, 30 patients have already been operated on and there are now 40 patients on a waiting list. In Martissant, where the theatre has been working since shortly after the earthquake in Port au Prince, there are 20 people with open fractures in their waiting room.

But because so many people have now been operated on and they all need some form of continuing care, the pressure for beds and nursing resources is substantial. MSF has just identified a new building, a former nursery in central Port au Prince, that can be used to help accommodate these people, while another structure in the city at Bicentenaire is open for work with post-operative cases. A replacement for the old and damaged hospital at Carrefour has been found next door in a school building and patients have moved in. The major change in MSF's resources today has been the full opening of the inflatable hospital in a field in the city.

There teams have started performing surgeries and have space for around 180 patients in the tented wards. Terrible memories of what happened to solid buildings during the earthquake have made many patients fearful of staying inside a normal hospital. The soft, flexible walls of the new field hospital make a big difference.

"Patients feel less anxious here," said Veronica Chesa, a nurse at what is now called the Saint-Louis hospital. "They have less difficulty getting to sleep and I noticed a decrease in the sedative drug requests."

The psychological impact of the quake presents a huge challenge for everyone who was there and MSF has been building up its specialist staff. There are currently 18 psychiatrists and psychologists providing support to both patients and medical staff who worked through the disaster. “The first step is to provide basic psychological information, to explain that they’re not mad even if they are stressed,” says Dr.German Casas, an MSF psychiatrist. His fundamental message is that "It's normal to feel anxious, it¹s normal to be scared. It¹s useful to be scared, it protects you."

Outside of the city, in the town of Grand Goave, the early stages of distribution of households essentials like soap, buckets and blankets is well under way. Over 1,300 families received these essential in the past two days, while in Jacmel, the same number should be achieved by the end of today. Leogane is the next target with some 1,200 kits to be distributed there.

Back in Port au Prince , the nephrology team continues to administer kidney dialysis. They have completed over 50 procedures now. Stefaan Maddens is an MSF nephrologist who worked with some of the earliest cases and points to the need for finding patients across the city.

"The most important thing we have to do is communicate to all the surgeons, all the doctors that are working here in Port au Prince, not only MSF staff, of course, but to everyone now working with wounded patients, that there exists a possibility of treating renal failure,” Maddens said. “We have a total capacity of seven machines and this means we can do many patients a day and for most of those people this is really life saving."

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