Friday, August 27, 2010

Medical Officer of Health

We were thrilled to have Dr David Allison come to our meeting last Monday. He had just returned from Haiti where he had just completed a tour with the Canadian Red Cross. He was working in a field hospital which was set up by Germany.

He had much to tell us, about security, health care and much more and I have enclosed some of our minutes of this meeting.

Discussion:

  • Dr. Gillies welcomed everyone back and recognized that a number of our members were out of town and unable to attend.
  • Dr. Gillies introduced Dr. David Allison Medical Director for Eastern Health. Dr. Allison had just returned from a 7 week tour of duty in Haiti and provided a valued review of issues that we may face as we go forward.

Dr. Allison’s Presentation:

  • Dr. Allison had served with the German Red Cross in a field hospital located in a football stadium. He was very clear that what they were dealing is no longer earthquake related but a very inadequate health care system which was there before and still exists.

  • The current relief efforts are a short term solution to a long term problem. How does the Red Cross finish up and leave when there is so much that will still need to be done. It is a concern they have and a reality that we need to deal with as we make our plans to provide relief.

  • There is a high level of opportunism ongoing in Haiti. The high value of aid, supply and equipment coming into Haiti has developed a side economy based on fees and taxes to the process. An item may take months to clear customs and the fees could be very high. If we bring in donated equipment they will charge us an assessed value.

  • There is an issue of competition in providing health care. Down the block from the Field Hospital is a functional Haitian Obstetrics Hospital which is not being fully utilized while the field hospital is treating OB cases. The field hospital provides free drugs and supplies and thereby is more attractive. That is a very significant issue as we would be operating in a fee for service environment.

  • Crime and corruption is a real issue and needs to be dealt with on a very serious basis. The field hospital had armed guards at the entrance to the stadium plus inside armed guards at the compound where staff are accommodated. A goodly number of patients brought in are as a result of gun shots and stabbings. The Red Cross have a self imposed curfew of 6:00 just before sundown. Being kidnapped is a real possible thing if you go wander in the wrong place at the wrong time.

  • To work in Haiti licensure is not an issue at this time. This is possibly not because they are accommodating but more because they have not thought about the possible cash involved. To hire a local Physician or Surgeon the cost is approx 2,500 Gourdes or $66.00 Canadian. Approx $17,000 per year. A Dentist would be similar in price.

  • The actual destruction of building and homes is an issue which will take a long time to fix. There are buildings still standing but unsafe and others which are just a pile of rubble. Who cleans up and knocks down condemned buildings? The Government has not gotten to that level of order yet and that is one of the first things that need to be done.

Outcomes:

1. Mr. Patey and Mr. Winters will meet to set up an operating budget for the Foundation. Such will not just administrative but also projects.

2. Dr. Hiltz will contact Dr. Prophete in Haiti with regard to current needs and process of getting supplies in without the high level of fees, customs duties and theft.

3. The following positions were assigned;

· Dr. Gillies President

· Dr. Paul Walsh Vice-President

· Mr. Peter Winters Treasurer

· Dr. Hiltz Secretary

· Mr. Anthony Patey Executive Director

4. Next meeting September 9th 2010 7:30 NLDA Offices

After the summer

Well, the summer has come and is fast ending, I have been away on atrip for most of it. Alas all good things come to an end. The good news is that whilst I have been away, the committee has been busy.

The big news is that Ken Templeton has submitted the paperwork to the CRA and Industry Canada, such that we can move towards our charitable status. Thank you so much Ken, it is greatly appreciated, and we are waiting now to see if we are accepted by the authorities.

This will allow us to proceed with our canvassing the Membership for donations, and then we can move along with the aid.

We heard froma journalist, who has been going to Haiti, and who has written some good stuff, I will enclose some of her writing which I feel is worthy of the attention of interested parties.

One of the things she has advised us is that we believe 35 dental offices were lost in the earth quake.

We continue to correspond with Dr Prophete the Vice Dean of the dental school, and we are starting to get some dates together for travel to Haiti.

Thirty-five seconds.

Less time than I spend brushing my teeth in the morning. Or kissing my husband. Tucking my daughter into bed.

That’s how long the earth shook in southern Haiti in the early evening of Jan. 12. It took 35 seconds to crush mothers cooking dinner in their kitchens, smother students at their desks, buck terrified drivers into the air, shove buildings over cliffs onto buses packed with commuters.

In 35 seconds, a country was brought to its knees.

I often think of that. In less than a minute, you can lose everything. That’s one lesson Haiti has taught me.

I have travelled to Haiti four times since the earthquake. It’s been an emotional roller coaster, cranking me up to hope before careening me toward despair.

On my first trip, shortly after the 7.0 magnitude earthquake, I was overwhelmed with sorrow. The rubble I stepped over was decorated with high heel shoes, computer chairs, framed baby pictures — intimate mementoes of all the lives lost. Death was everywhere. I carried toothpaste to smear under my nose when its overripe smell became sickeningly pungent. During an interview down one rubble-choked alley, a woman hobbling past said she’d lost two children and kept going. It was as if she was mentioning a TTC breakdown.

I noticed a sense of optimism almost immediately after arriving the second time. Where a single airport employee had roused to stamp my passport and wave me through a dark, abandoned terminal the first time, I was greeted by a four-man band. A stroll through the country’s biggest refugee camp revealed beauty parlours, restaurants, health clinics, bathroom areas where spigots spurted water from giant bladders. Schools had just reopened under tarps, many at the expense of principals like Marie Florvie Dorestand, who emptied her family’s bank account to remove the rubble. Stepping into her schoolyard, I was greeted by hundreds of little girls, white ribbons in their hair, bouncing and singing. They went on for more than an hour.

The country’s first post-disaster action plan, presented at the international donors conference in New York, painted an idyllic Haiti of the near-future: universal health care, free education, reforested countryside, decent housing for all, a strong economy with dependable clean electricity.

I returned from my most recent visit last month. By then, much of that optimism was gone. You can pee in a bucket in your sweltering shelter at night for fear of being raped enroute to the latrines only for so long before your spirit is crushed. The free bags of rice were long gone; replaced by “cash for work” programs, which pay men and women around $5 (U.S.) a day to throw rubble into dump trucks by hand or, if they’re lucky, shovel.

A doctor pulled me aside at that throbbing refugee camp and whispered, “Want the real story? Write about hunger. People are starving.”

The government hadn’t made good on its promise to pay teachers’ salaries, and many principals were threatening to close their schools.

Some 1.6 million people are still displaced, most crowded into impromptu camps along the sides of the road with no hope of a real home. Landowners squabble over the rubble removal, many demanding to be compensated. So, the roads remain clogged.

The UN estimates 135,000 temporary shelters of wood and metal need to be built to house the homeless. So far, only 5,660 have gone up.

I met a 2-pound baby who was rushed to one of the city’s main for-profit hospitals. The hospital lost $180,000 in the first month after the earthquake, treating patients for free. To survive, it started charging again and the baby’s panicked parents were told to pay $400 for ten days of treatment — more than many Haitians make in a year. We scrambled to find the money — volunteer nurses and pediatricians throwing in $20 each, knowing that otherwise, this baby would die.

All this makes me angry. There are many people to blame: the Haitian government for not taking enough leadership, international aid agencies set on heroism over cooperation, international donors that haven’t delivered on their promises.

I can’t understand why the Interim Reconstruction Committee, headed by former U.S. president Bill Clinton and Haitian Prime Minister Max Bellerive, has managed to meet only once in the months since the earthquake. What is taking them so long?

I concede a few points. Nigel Fisher, the deputy special representative of the UN secretary general in Haiti, who I met in a dusty resettlement camp, told The New York Times: “What hasn’t happened is worth noting. We haven’t had a major outbreak of disease. We haven’t had a major breakdown in security.”

Haitian President Rene Préval was visiting the camp that same day. He pointed out that recovering from natural disasters take rich countries years. Case in Point: Hurricane Katrina, where people were still homeless two years later.

“We are doing our best. You have to understand and be patient,” he said. “It’s not that easy to make good conditions right away.”

He is right. Except, it’s hard to be patient when your 2-pound baby is going to die without care you can’t afford.

Most experts I’ve spoken to predict it will take 10 years for Haiti to get back on its feet. Ten years to recover from 35 seconds.

That is too long. We must all do better.

Catherine Porter’s column usually appears Tuesday, Thursday and Saturday. She can be reached at cporter@thestar.ca.