A summary of MSF's activities in Haiti four months after the earthquake.
Hospitals and Surgery
In Port-au-Prince:
Saint-Louis Hospital: Medical and surgical activities are ongoing in a 250-bed-capacity inflatable hospital, which includes three operating theaters, one of them specially designed to treat patients suffering from burns. MSF’s La Trinité hospital, de¬stroyed by the earthquake, was replaced by Saint-Louis, a trauma center providing surgical care for major trauma cases and burn victims. Saint Louis has also developed the services of a general hospital, complete with pediatric and medical emergency capabilities. The hospital also provides complete post-operative care, which includes medical and surgical follow-up, physiotherapy, and psychological care. Over 2,300 surgical operations have been performed since January 25, and 190 patients are currently hospitalized there.
Choscal Hospital in Cité Soleil: MSF intervened in this Ministry of Health hospital initially focusing on earthquake-related trauma. Currently two operating theaters are functioning for major surgery, and one for minor surgery. MSF also works in the emergency room and the maternity and pediatric wards. Medical and psychological care is also provided to victims of sexual violence. The hospital has a 100-bed capacity, all occupied and all under tents (the building has been repaired but patients are still too afraid to stay indoors). Rehabilitation works are ongoing to reduce the risks of flooding. The team has rearranged the facility into a general hospital, providing drugs to all the services and serving a population living in extremely precarious conditions. Psychological care continues for all patients and caretakers.
Bicentenaire: This post-operative, emergency, and surgical facility features two operating theaters, pediatric and obstetric services, and has a capacity of 70 beds. Mental health services are also provided.
Isaie Jeanty, Emergency Obstetrics Hospital: MSF is working in collaboration with the Ministry of Health in this 85-bed hospital, providing maternity, neonatal and emergency obstetric care. In April, 635 deliveries, including 131 c-sections, were done. This at the moment is the main referral hospital for Port-au-Prince for complicated births and eclampsia cases. In the next few weeks, MSF is going to build a flat-packed container hospital with a capacity of 130 beds, which will become a referral and training center for neonatal and obstetrical care. The partnership with the Ministry of Health at the level of Isaie Jeanty will continue.
MSF Orthopedic and Trauma Hospital in Carrefour: Around 18 surgical interventions are performed every day in this 135-bed trauma and post-operative hospital, which houses two operating theaters, a normal X-ray machine and one of the few C-arm x-ray machines in the city. Orthopedic surgery, including external and internal fixation, skin grafts, and muscle flaps are being performed and post-operative care and rehabilitation provided. The hospital is also functioning as emergency trauma hospital for the Carrefour area. Currently, 100 patients are hospitalized. Rehabilitation care is offered to patients in collaboration with Handicap International. Psychological care is offered to patients and families. The hospital has also an outpatient department for wound care treating around 50 patients per day.
Carrefour Grace Pediatric Hospital: This new hospital, located next to Grace Camp, is under construction. A pediatric ward (80 beds) and emergency services station are being constructed. As of May 1, the ITFC stabilization center for severely malnourished children in need of hospitalization with 30 beds is located in this hospital with an average of 20 children hospitalized.
Outside Port-au-Prince:
Léogâne: MSF has been working since the earthquake in this 120-bed hospital on the site of Chatuley Hospital. The hospital is providing emergency services including: maternity, obstetrics and gynaecology, general surgery and general medicine. Physiotherapy and mental health are also integrated. MSF has started to build a container hospital, with a capacity of 100 beds, as well as 60 additional beds in outside structures. The new hospital is expected to be ready between mid-July and mid-August and will be providing the same services as those mentioned above, plus radiology and laboratory facilities.
Jacmel: As the hospital was badly damaged in the earthquake, MSF has provided full outpatient and inpatient services under tents (81 beds). A team is finalizing the construction of new wooden structures where the surgery, maternity, and internal services have already been transferred. The team also provides services such as emergencies and mental health.
Post-Operative Care
Although a full range of post-operative care is offered in all MSF-supported structures where surgery is performed, some sites in Port-au-Prince are specifically dedicated to welcome patients after surgery.
Promesse: MSF has been working in this post-operative care structure with a capacity of 50 beds, where mental health support is also provided. This facility will close its doors by the end of the month and patients will be referred to other MSF facilities. By the end of May, this center will close after having provided post-operative care to a total 66 people.
Tabarre: This post-operative tented center located in the Port-au-Prince neighbourhood of Tabarre provides physiotherapy and mental health support with about 100 beds. It accommodates patients and their caretakers who are being transferred from the Saint-Louis Hospital. This structure has replaced MSF’s post-operative center in Delmas 30, which was closed in April.
Sarthe: In February, MSF opened a new post-operative center in a converted soft drink factory in the Sarthe area of Port-au-Prince, with a potential capacity of up to 300 beds. 160 patients are receiving post-operative care – wound care, more specialized orthopedic or reconstructive surgery – in this structure. Handicap International physiotherapists are working in collaboration with MSF to optimize rehabilitation and patient adaptation to prosthetics. Mental health care is also provided. In addition, there are also 100 external consultations per week for post-operative care.
Site “Mickey”, Crèche Angle rue Christ Roi et Bourdon: This site, which closed in April, received an average of more than 60 patients hospitalized for post-operative and medical care, mental health care, and physiotherapy. All who required further treatment were referred to other MSF facilities.
Psychological care has been routinely offered to patients who have been through major surgery in MSF-supported structures. While a team of psychologists is focusing on the patients and the caretakers inside the hospitals of Carrefour, Isaie Jeanty, Sarthe, Cité Soleil, and Martissant—with group counseling is available in some locations—these activities have also shifted towards providing counseling to displaced people living in makeshift camps around the structures, as well as to victims of sexual violence.
Primary Care
Port-au-Prince:
Martissant: This emergency ambulatory and stabilization center (operated by MSF since 2006) with a capacity of 40 beds sees approximately 100 patients new patients per day, 30 of them in need of immediate care. Pediatric care as well as internal medicine and maternal services are included.
Saint-Louis: Next to the inflatable hospital in Saint-Louis, a 24-hour service cared for 60 victims of sexual violence in April. There is also an outpatient department and ambulatory program, which provided more than 2,800 consultations over the same period. Services include antenatal consultations as well as follow-up of post-operative patients in ambulatory care (including dressings, physiotherapy and mental health).
Champs de Mars: This outpatient department is conducting approximately 140 consultations per day and referring patients requiring further medical care to other MSF facilities. An MSF post-operative center located in Champ de Mars was closed in April.
Petionville Golf Club camp: An MSF clinic offers basic health care and ante-natal care, rehabilitation (in collaboration with Handicap International), referral services, routine vaccination, and psycho-social counseling in the camp, where an estimated 45,000 people are living. About 150 consultations are provided every day.
Delmas 24: At this health center opened in February in the Delmas area of Port-au-Prince, about 150 consultations are offered every day.
Aviation Camp: MSF teams are currently in the process of installing latrines and showers in this 40,000-strong camp of displaced people. As well, several mobile clinics providing basic health care and antenatal consultations and community mental health services will soon be launched.
Sarthe hospital: The team is performing an average of 220 primary health care consultations per week.
Carrefour Feuille: MSF is running tented clinics in two sites – Carrefour Feuille and Tapis Rouge – close to four camps with 20,000 displaced people. From 200 to 250 consultations are carried out daily. The team is performing dressing changes and providing vaccinations. The team is providing clean water, sanitation and mental health services.
Village Grace IDP camp: The health center situated in tents includes basic health care, antenatal and post natal care, and a mental health component for a camp that is home to 10,000 displaced persons and for the surrounding urban area. Some 150 patients are seen daily while 250 dressings are done per week. Psychological care is offered to patients and families.
Shikina Clinic, Waney 87: A health center offering basic health care, antenatal and postnatal care, as well as mental health services, receives around 80 patients per day. This is an urban area with many displaced families living in small groups.
Outside Port-au-Prince:
Léogâne: MSF is currently providing 700 consultations per week in a temporary outpatient department located in Sainte Croix. Mental health and antenatal care are included in the services. In May, MSF will complete the construction of a new outpatient department.
Carrefour Dufort: Located at a fixed site, approximately 600 consultations are carried out each week at the clinic, with referrals to Léogâne when required.
Gressier and Petit Goave: MSF teams ended mobile clinic activities in locations between Gressier and Petit Goave. Medical teams were travelling three times per week, with referrals to Léogâne Hospital for patients requiring more extensive care.
Distributions
MSF has completed its distributions of tents, aimed at responding to the immediate needs of thousands of people living in the surroundings of MSF facilities. Distribution of basic necessities such as kitchen utensils and hygiene kits is still going on in a host of locations both inside and outside of the capital. All told, MSF has distributed more than 40,000 non-food items kits and nearly 28,000 tents in: Ecole Saint Louis, Delmas 33, Delmas 24, Tabarre, Sarthe, and Cite Soleil in Port-au Prince; in Carrefour; on the coast west of Carrefour in Petit Goave and Grand Goave; in Léogâne and in Jacmel. Tents and basic necessities were also recently distributed to about 200 families in remote villages of Léogâne region.
Water and Sanitation
MSF has joined other organizations working in the water and sanitation sectors in several locations both inside and outside of Port-au-Prince. All told, MSF has been distributing 714 cubic meters of water per day and has built 803 latrines and 200 showers in areas where tens of thousands of people are living. MSF is also cleaning and emptying latrines in order to guarantee minimal hygiene conditions for people living in makeshift camps.
Evaluations
MSF has conducted assessments to areas outside Port-au-Prince in order to identify potential emergencies. Recent evaluation missions have covered, among other areas, Gonaïves, Port-de-Paix, Cap Haïtien, Fort-Liberté, Saint-Marc, Belle Anse, Thiotte, Jérémie and Les Cayes. MSF teams also assessed the area along both sides of the border with the Dominican Republic, as well as in Santo Domingo, in the Dominican Republic. The evaluation teams identified mainly a lack of public health services. The cost of health care in private and semi-private structures is an obstacle to people’s access to healthcare, even for medical emergencies. MSF will further analyse the evaluations result and will then decide on a potential reinforcement of activities in some of these areas. In Port-au-Prince, additional medical facilities, mostly aimed at responding to obstetrical and surgical needs of the population, are planned for the next few months.
