January 13, 2010

"We have three general areas where we have been traditionally providing emergency care with infrastructure established to set up and provide for emergency services. All of those three centers have been severely affected in the earthquake and none of them are in a condition that we can use. One has completely collapsed and two others are so structurally damaged we cannot use them."

Doctors Without Borders/Médecins Sans Frontières (MSF) teams already working on medical projects Haiti have treated hundreds of people injured in the quake and have been setting up clinics in tents to replace their own damaged medical facilities. Paul McPhun, MSF’s operations manager for Haiti, described the current situation for MSF teams on the ground during a press conference on January 13.

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"Doctors Without Borders/Médecins Sans Frontières—we have three general areas where we have been traditionally providing emergency care with infrastructure established to set up and provide for emergency services. All of those three centers have been severely affected in the earthquake and none of them are in a condition that we can use. One has completely collapsed and two others are so structurally damaged we cannot use them.

As a result, in all three locations we've established temporary shelters and moved our operations outside of those referral hospital settings. The challenge, therefore, for our team, is that the level of care we can now provide without that infrastructure is very limited. So where we're focusing our energy is on the rapid influx of patients from the neighborhoods who know of our services.

The best we can offer them at the moment is first-aid care and stabilization. The reality of what we're seeing is severe traumas—head wounds, crushed limbs—severe problems that cannot be dealt with at the level of care we currently have available with no infrastructure really to support it. So our major priority and focus is to re-establish as soon as possible a secondary level of surgical capacity in the country.

That, I think, gives us a general snapshot of where we currently are. We have altogether around 800 medical staff working in Haiti. Thirty of those are international. We're currently putting rapid response plans into place based out of North America and out of Europe to have another 70 international staff available over the next few days with specialties to be able to respond to these more immediate emergency medical needs. Likewise, we're prepared now and have prepared freight, including an emergency inflatable hospital so we can set up exactly those services we're currently missing.

Teams are basically managing what comes to them. There's very little possibility to get out and do more than that at the moment. Already teams are getting overwhelmed. We're strongly identified in Haiti with emergency medical care—even our coordination offices are becoming centers of influx for people in neighborhoods with severe trauma wounds. So even in our capital offices where we're trying to maintain contact with our teams they're struggling to manage quite high case loads of patients seeking medical care.

So it’s a very chaotic situation. Communications, as you know, are down in terms of mobile systems. Information for us is very difficult to gather. It’s very difficult to be aware of exactly what our teams are up to, where and how things generally progress. So there are many constraints to being able to provide accurate information to you at the moment. You’ve got to bear in mind that we only had an hour of daylight last night and the teams have been working all night and we're still trying to catch up with what the teams have been able to find out since we had the advantage of daylight this morning.

Again, reports of our teams actually trying to get out this morning—people were sleeping on all the roads where would have liked to have been able to move last night, the roads that are not completely obstructed with rubble. Massive destruction, including much of MSF's infrastructure, and everywhere we go a massive demand from people to help them with trapped family members, with people who are suffering from major, major injuries. So, you know, you're on the streets, you're getting mobbed, particularly because we are identified with that kind of medical care.

We have not accounted for all of our staff. We're very concerned about the welfare and safety of our staff, both international and national. So we have not accounted for all of our staff and we're making every effort to do so. We're in direct contact with all of the family of those who have family members working with Doctors Without Borders/Médecins Sans Frontières in Haiti. And out of respect to them and with the gaps in information that we currently have I don't really have any more detail I can share, but this is a major focus, a major priority for the organization.

Likewise, for our national team members, many of them were involved, were working in structures that fell apart during the earthquake. Many have families who live in very precarious conditions anyway in Port-au-Prince, so it’s a major concern for them as well, what has happened to their families, so they're also trying to establish that in addition to supporting the emergency care of the organization. So it is, for us, one of the key pillars that we're trying to work on right now and I don’t have all the information yet to brief you more thoroughly."

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