November 21, 2008
Haiti 2008 © Francois Servranckx/MSF
Between August 16 and September 1, Haiti was ravaged by Tropical Storm Fay, Hurricane Gustav, Tropical Storm Hanna, and Hurricane Ike. On September 4, a Doctors Without Borders/Médecins Sans Frontières (MSF) emergency team of medical staff, logisticians, and water and sanitation experts began arriving in the northwestern city of Gonaïves, which had been particularly hard-hit.
“It’s a mess—it’s not a town any more, it’s really a mess,” said Max Cosci, head of MSF’s emergency response. Areas of Gonaïves and other parts of the country remained inaccessible long after the initial flooding. As the storms and rains continued, flood waters forced people to live on the roofs of buildings with no access to food, clean water, or sanitation. Others flocked to an estimated 150 overcrowded shelters and often lacked basic needs there, as well.
When the first MSF team arrived, health centers in Gonaïves were not functioning, and the team began cleaning out Rabouteau Health Center, where MSF worked in 2004 after Tropical Storm Jeanne. Even before the team found a place to work, however, the needs were obvious. “While we were looking for a suitable place, people started coming to us with their friends and family who had been injured in the storm,” Cosci said. “They were opening the doors of the ambulance and just putting in people with fractured limbs and open wounds.”
The following day, the MSF team performed 110 consultations, treated 49 injured people, and carried out 16 surgical procedures. When MSF medical staff had treated the majority of the wounded patients, they began to see people with conditions related to the dirty water that flooded large parts of the town, such as skin diseases, respiratory infections, and diarrhea.
As soon as they received water sanitation equipment, MSF staff established several clean water points in Gonaïves, and by late September they were providing 350,000 liters of water per day to approximately 150,000 people or half the city’s population. Staff filled water bladders and trucked them into areas without access to clean water, though the logistics of getting into some of the storm-affected areas were extremely challenging.
MSF also began holding mobile clinics, conducting consultations at the crowded and often unhygienic shelters. “One of the big problems is that there are no lavatories; they’ve been washed away,” said Cosci. “We cannot dig latrines because the ground is too waterlogged. We can only dig latrines in the small part of town that’s dry, but people will not cross the entire town to go to the toilet.”
As of late September, there were about 116 MSF staff in Gonaïves, and medical teams had performed more than 2,300 consultations through the Rabouteau Health Center and mobile clinics. In cooperation with the Ministry of Health, MSF opened a referral hospital in Gonaïves for the treatment of more severe cases. Although the floodwater had receded, medical staff were concerned about what the future would hold. “We’re starting to see things that really worry us, like bloody diarrhea,” Cosci said, “which could be the first sign of an epidemic in town.” MSF was also monitoring food security, which was already precarious before the storms, and treated some cases of malnutrition.
During exploratory assessments in areas outside of Gonaïves, MSF on September 30 reached Mamont, a town in the Arbonite region with a population of 17,000 who had been completely isolated for four weeks since the storms. The town was partially submerged, its roads cut off from major towns, and the residents were without clean water, food or medical care. MSF began providing emergency assistance in Mamont and called for other organizations to assist as well. On October 13, MSF denounced the ineffective response of international aid agencies in the areas of shelter and nutritional assistance. In the preceding days, some 10,000 people in Gonaïves were forced onto the rooftops of their flooded homes when authorities closed IDP shelters.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)