2010 Haiti earthquake

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The 2010 Haiti earthquake was a catastrophic magnitude 7.0 Mw earthquake, with an epicentre near the town of Léogâne, approximately 25km west of Port-au-Prince, Haiti's capital. The earthquake occurred at 16:53 local time on Tuesday, 12 January 2010 [1][2]. By 24 January, at least 52 aftershocks measuring 4.5 or greater had been recorded [3]. An estimated three million people were affected by the quake; the Haitian Government reported that an estimated 230,000 people had died, 300,000 had been injured and 1,000,000 made homeless [4][5][6]. It is estimated that 250,000 residences and 30,000 commercial buildings had collapsed or were severely damaged [7].

The earthquake caused major damage in Port-au-Prince, Jacmel and other settlements in the region. Many notable landmark buildings were significantly damaged or destroyed, including the National Palace Presidential Palace, the National Assembly building, the Port-au-Prince Cathedral, and the main jail. Among those killed were Archbishop of Port-au-Prince Joseph Serge Miot, and opposition leader Micha Gaillard [8][9][10]. The headquarters of the United Nations Stabilization Mission in Haiti (MINUSTAH), located in the capital, collapsed, killing many, including the Mission's Chief, Hédi Annabi [11][12].

Many countries responded to appeals for humanitarian aid, pledging funds and dispatching rescue and medical teams, engineers and support personnel. Communication systems, air, land, and sea transport facilities, hospitals, and electrical networks had been damaged by the earthquake, which hampered rescue and aid efforts; confusion over who was in charge, air traffic congestion, and problems with prioritisation of flights further complicated early relief work. Port-au-Prince's morgues were quickly overwhelmed with many tens of thousands of bodies having to be buried in mass graves [13]. As rescues tailed off, supplies, medical care and sanitation became priorities. Delays in aid distribution led to angry appeals from aid workers and survivors, and looting and sporadic violence were observed.

On January 22, 2010 the United Nations noted that the emergency phase of the relief operation was drawing to a close, and on the following day the Haitian government officially called off the search for survivors.

Background

The island of Hispaniola, shared by Haiti and the Dominican Republic, is seismically active and has a history of destructive earthquakes.

Haiti is the poorest country in the Western Hemisphere, and is ranked 149th of 182 countries on the Human Development Index [14][15]. The Australian government's travel advisory site had previously expressed concerns that Haitian emergency services would be unable to cope in the event of a major disaster, and the country is considered "economically vulnerable" by the Food and Agriculture Organization [16][17]. It is no stranger to natural disasters; in addition to earthquakes, it has been struck frequently by cyclones, which have caused flooding and widespread damage. The most recent cyclones to hit the island before the earthquake were Tropical Storm Fay and Hurricanes Hurricane Gustav, Hurricane Hanna and Hurricane Ike, all in the summer of 2008, causing nearly 800 deaths [18].

Infrastructure damage

Damage to infrastructure in the 2010 Haiti earthquake was extensive and affected areas included Port-au-Prince, Petit-Goâve, Léogâne, Jacmel and other settlements in southwestern Haiti. In February Prime Minister Jean-Max Bellerive estimated that 250,000 residences and 30,000 commercial buildings had collapsed or were severely damaged [19]. The deputy mayor of Léogâne, which was at the epicenter of the earthquake, reported that 90% percent of the buildings in that city had been destroyed and Léogâne had "to be totally rebuilt." buildings were significantly damaged or destroyed, including the National Palace, the National Assembly building, the Port-au-Prince Cathedral, and the main jail [20]. The Ministry of Education estimated that half the nation's 15,000 primary schools and 1,500 secondary schools were severely damaged or destroyed. In addition, the three main universities in Port-au-Prince were also severely damaged. Other affected infrastructure included telephone networks, radio station, factories, and museums. Poor infrastructure before the earthquake only made the aftermath worse [21]. It would take half a day to make a trip of a few miles. The roads would also crisscross haphazardly due to disorganized construction [22].

Essential infrastructure services damaged

Amongst the widespread devastation and damage throughout Port-au-Prince and elsewhere, vital infrastructure necessary to respond to the disaster was severely damaged or destroyed. This included all hospitals in the northwest; air, sea, and land transport facilities; and communication systems. Due to this infrastructure damage and loss of organizational structures, a spokeswoman from the UN Office for the Coordination of Humanitarian Affairs called it the worst disaster the United Nations (UN) had ever confronted [23].

The quake affected the three Médecins Sans Frontières (Doctors Without Borders) medical facilities around Port-au-Prince, causing one to collapse completely [24][25]. A hospital in Pétionville, a wealthy suburb of Port-au-Prince, also collapsed, as did the St. Michel District Hospital in the southern town of Jacmel, which was the largest referral hospital in south-east Haiti [26][27][28].

The quake seriously damaged the control tower at Toussaint L'Ouverture International Airport and the Port-au-Prince seaport. Reported damage to the seaport included the collapse of cranes and containers into the water, structural damage to the pier, waterfront quay areas collapsing into the water with crevassing and slumping of level waterfront ship-unloading dock-work areas, and an oil spill, rendering the harbor unusable for immediate rescue operations [29][30]. The Gonaïves seaport, in the northern part of Haiti, remained operational [31].

The main road linking Port-au-Prince with Jacmel remained blocked ten days after the earthquake, hampering delivery of aid to Jacmel. When asked why the road had not been opened, Hazem el-Zein, head of the south-east division of the UN World Food Programme said that "We ask the same questions to the people in charge...They promise rapid response. To be honest, I don't know why it hasn't been done. I can only think that their priority must be somewhere else [32].

There was considerable damage to communications infrastructure. The public telephone system was not available, and Haiti's largest cellular telephone provider, Digicel, suffered damage to its network. It was operational by 14 January, but the volume of calls overwhelmed its capacity and most calls could not be connected [33][34]. Comcel Haiti's facilities were not severely damaged, but its mobile phone service was temporarily shut down on 12 January. By 14 January the company had re-established 70% of its services [35][36][37]. Service on the spur connection to the BDSNi cable system which provided Haiti with its only direct fibre-optic connectivity to the outside world, was disrupted, with the terminal in Port-au-Prince being completely destroyed [38].

According to Reporters Sans Frontières (RSF), most of the radio stations in the earthquake struck region went off the air after the earthquake and only 20 out of 50 stations in Port-au-Prince were back on air a week after the earthquake [39]. The stations that were completely destroyed include Radio TV Ginen, Radio Soleil, Radio Ibo and Tropic FM. RSF also reported that 12 radio stations in the southwestern town of Petit-Goâve and five of Léogâne's nine stations were badly damaged [40]. The Committee to Protect Journalists reported that several other stations, including Melodie FM, Radio Caraibes, Signal FM, and Radio Metropole, continued to operate [41]. The UN mission's station, Radio Minustah, was disabled by the quake, but returned to the air on 18 January. The Agence France-Presse office was in ruins, but within days of the earthquake the agency resumed operations from new premises [42]. The offices of the capital's two leading newspapers, Le Nouvelliste and Le Matin, were not severely damaged, but for more than a week after the earthquake they were unable to print [43].

General infrastructure damage

The buildings of the Ministry of Finance and Economy, the ministry of education, the Ministry of Public Works, Transportation and Communications, the ministry of communication and culture, the Supreme Court of Haiti (Supreme Court building), the Superior Normal School, the National School of Administration, the Institut Aimé Césaire, the National Assembly of Haiti (National Assembly building) and Port-au-Prince Cathedral were damaged to varying degrees [44][45]. The National Palace (Presidential mansion) was severely damaged, though President René Préval and his wife Elisabeth Delatour Préval, who were about to enter their house when it "just fell", escaped injury [46][47][48][49]. The Prison Civile de Port-au-Prince was also destroyed, allowing 4,000 inmates to escape into the streets [50]. As of 19 January only 12 had been rearrested [51]. Some of the escaped convicts were reported to have stolen official uniforms, vehicles, and weapons, after starting fires and killing four guards during the breakout [52].

The headquarters of the and offices of the World Bank were destroyed. The building housing the offices of Citibank in Port-au-Prince collapsed, killing five employees [53][54]. Up to 200 guests at the collapsed Hôtel Montana in Port-au-Prince are presumed dead[55]. Despite the official search being called off, as of 24 January teams were continuing to look for survivors at the Montana. Most of Port-au-Prince's municipal government buildings were destroyed or heavily damaged in the earthquake, including the City Hall, which was described by the Washington Post as, "a skeletal hulk of concrete and stucco, sagging grotesquely to the left. City officials including Mayor Jean Yves Jason were left without facilities in which to conduct official business or coordinate recovery efforts [56]. Port-au-Prince had no municipal petrol reserves and few city officials had working mobile phones before the earthquake, complicating communications and transportation [57].

Minister of Education Joel Jean-Pierre stated that the education system had "totally collapsed" . About half the nation's 15,000 primary schools and 1,500 secondary schools were affected by the earthquake and the three main universities in Port-au-Prince were also "almost totally destroyed." [58]. The earthquake also destroyed a nursing school in the capital, one of three such schools in the country, and severely damaged the country’s primary midwifery school that provided essential training necessary to reduce Haiti’s maternal mortality rate, which is one of the highest in the world [59]. Several Catholic orders reported the destruction and damage of churches, schools and offices [60].

The clothing industry, which accounts for two-thirds of Haiti's exports, reported structural damage at manufacturing facilities in Haiti. U.S.-based Hanesbrands Inc. reported that three of its four factories had been affected by the quake, with one facility substantially damaged. The Canadian clothing company Gildan Activewear reported that one of the three textile factories that produce its products had been severely damaged [61]. The Palm Apparel factory complex in Port-au-Prince reported that 500 of its 1800 employees were killed when one of its buildings collapsed [62].

The Haitian art world also suffered great losses. Museums and art galleries were extensively damaged, among them Port-au-Prince's main art museum, Centre d'Art, where many art works were destroyed. The collection at College Saint Pierre also was devastated, as was the collection of priceless murals in the Holy Trinity Cathedral. Some private art galleries were also severely damaged, including the Monnin Gallery in Pétionville, and the Nader Art Gallery and Musée Nader in Port-au-Prince [63]. Composed of the personal collection of Georges Nader Sr., the Nader collection was worth an estimated US$30-US$100 million. Shortly after the earthquake struck, UNESCO assigned special envoy Bernard Hadjadj to evaluate damage to artwork [64].

Telehealth in the developing world

Telehealth can have positively impact health care delivery and ideally decrease the global burden of disease. There are many examples of the progress of telehealth in developing countries including- China, Pakistan, Chechnya and Ecuador.

Health care delivery is primarily about the practitioner-patient interactions. However, these interactions are facilitated by technical processes such as imaging, pathological testing, information gathering, research, etc. The task for every health care system is how to maximize the personal contact and technical input, while being financially sustainable.

Practitioners working in developing countries have to perform this task with additional challenges including- access to remote areas, supporting clinicians with limited skills, operation of technical information with limited services and complex circumstances. Here telemedicine offers help in meeting these needs while keeping costs low. In addition to facilitating medical education, administration and research, appropriate use of telehealth may improve:

  • health care access
  • service delivery quality
  • public health and primary care effectiveness
  • health professionals shortage through collaboration and training

Reference

Richard Wootton, N. G. (2009). Telehealth in the developing world. London: Royal Society of Medicine Press Ltd.

Telehealth response to earthquake

The health fallout from the earthquake is sure to be felt for many years. The next phase will be to coordinate volunteer efforts for ongoing health services in Haiti, once the initial shock has subsided. Many ATA members have volunteered services, hardware, software and networks for ongoing health issues. ATA will work to match these donations to the organizations and programs that can best use them.

Initial outreach

Despite conditions on the ground improving aid implementation is still chaotic. The country's ability to govern has been severely damaged. The critical priorities are emergency response, water, sanitation, food, shelter and medical supplies. The damage to Haiti's infrastructure and supply lines have severely challenged recovery efforts.

telehealth opportunities -mHealth (mobile health), telemedicine and distance learning could provide a measure of stabilization. Proper implementation could afford a operational and sustainable resource to meet needs and coordinate ongoing efforts on the ground. Medical needs most likely be focused on surgical/medical consultation, wound care, rehabilitation, orthopedics, primary care, and distance learning.

Continuing outreach

(add continuing telehealth aid and implementation)

Organizations involved in Haitian relief

  • Partners in Health [65] - Partners In Health staff in Boston and Haiti are working to collect as much information as possible about the conditions on the ground, the relief efforts taking shape, and all relevant logistics issues in order to respond efficiently and effectively to the most urgent needs in the field. At the moment, PIH’s Chief Medical Officer is on her way to Haiti, where she will meet with Zanmi Lasante leadership and head physicians, who are already working to ensure PIH’s coordinated relief efforts leveraging the skills of more than 120 doctors and nearly 500 nurses and nursing assistants who work at Zanmi Lasante’s sites.
  • Project HOPE [66] - Project HOPE is: 1) preparing an initial disaster relief shipment from our warehouse in Winchester, Virginia including bandages, gauze, tape and some pharmaceuticals valued at $170,000 that will ship out today; 2) working with corporate partners to explore opportunities to gather needed medicines and medical supplies to distribute to individuals and families in need, and; 3) sending a staff member to Haiti to assess the situation on the ground. In addition, HOPE is considering sending volunteers to help with the response effort and looking for volunteers.
  • Konbit Sante [67] - Cap Haitian Health Partnership - Started in 2000, Konbit Sante Cap-Haitien Health Partnership is a Maine-based volunteer partnership to save lives and improve health care in northern Haiti. Konbit Sante works with the Haitian Ministry of Health and with Haitian colleagues to build capacity within the public system for Haitians to care for Haitians.
  • Médecins Sans Frontières (Doctors Without Borders)[68] - MSF teams are setting up remote clinics to replace hospitals and clinics that were damaged by the earthquake.

Press Releases

  • Medweb Donates PACS to Haiti (18 February 2010)[69]
  • Technology Innovators Band Together for Haitian Relief (2 February 2010)[70]- A&D Engineering, Advanced Warning Systems, Digicel, MedApps and Nonin announced today that they are banding together as partners in a telehealth eco-system in order to donate medical health monitoring equipment and infrastructure solutions towards Haitian relief efforts. The companies plan to launch this program after rescue and recovery has been completed and long-term relief, in the form of ongoing medical services and support, can be implemented.
  • Local Telemedicine Firm Donates Equipment to 2 Medical Groups in Haiti (25 January 2010)[71]

Web resources

Telemedicine

  • ATA telemedicine Haiti relief [72]
  • Garshnek V, Burkle F, Jr. Applications of Telemedicine and Telecommunications to Disaster Medicine. JAMIA 1999;6:26-37. Retrieved July 20, 2010. [73]
  • Louden, Kathleen . Telemedicine Connects Earthquake-Ravaged Haiti to the World. Medscape. Retrieved July 25, 2010. [74]
  • Doarn, Charles R. (2010) Global Reach – Telemedicine Technology on an International Scale, World Medical & Health Policy: Vol. 2: Iss. 2, Article 9.Retrieved July 25, 2010. [75]
  • Doarn, Charles R. (2010) Global Reach – Telemedicine Technology on an International Scale, World Medical & Health Policy: Vol. 2: Iss. 2, Article 9.. Retrieved July 25, 2010. [76]

CDC

CDC Responds to the Haiti Earthquake. (2010, March 5). Retrieved July 20, 2010, from Centers for Disease Control and Prevention: [77]

United States Government response

State Department

  • Clinton, H. (2010, March 31). Remarks After the Haiti Donors Conference. Retrieved July 20, 2010, from US Department of State: [78]
  • Cragg, J. (2010, March 5). U.S. Military’s Medical Role in Haiti Declines . Retrieved July 20, 2010, from United States Department of Defense: [79]
  • Fisher-Thompson, J. (2010, February 26). Haitians Receive Emergency Housing Assistance: Plastic sheeting vital part of safe, temporary housing for quake victims. Retrieved July 20, 2010, from America.gov: [80]
  • Joint Communique of the Governments of the United States and Haiti. (2010, January 17). Retrieved July 20, 2010, from US Department of State: [81]
  • Kaufman, S. (2010, March 31). U.S. Offers $1.15 Billion for Haitian Recovery. Retrieved July 20, 2010, from America.gov: [82]
  • Secretary of State Hillary Rodham Clinton at the International Donor's Conference Towards a New Future for Haiti. (2010, March 31). Retrieved July 20, 2010, from UN News Centre: [83]
  • U.S. Government Officials and Haitian Ministry of Health Discuss Next Phase of Medical and Public Health Support in Haiti. (2010, February 24). Retrieved July 20, 2010, from US Department of Health and Human Services: [84]
  • United States Government Haiti Earthquake Disaster Response Update. (2010, January 17). Retrieved July 20, 2010, from US Department of State: [85]

HHS

  • Goodman, A. (2010, March 3). Ministry of Touch — Reflections on Disaster Work after the Haitian Earthquake. Retrieved July 20, 2010, from US Department of Health and Human Services: [86]
  • Haiti - USNS Comfort Medical and Surgical Support. (2010, March 9). Retrieved July 20, 2010, from US Department of Health and Human Services: [87]
  • Sebelius, K. (2010, March 10). Haiti – HHS Relief and Support Activities. Retrieved MJuly 20, 2010, from US Department of Health and Human Services: [88]
  • HHS Activates Additional Components of National Disaster Medical System to Help U.S. Hospitals Treat Survivors of Earthquake in Haiti. (2010, February 1). Retrieved July 20, 2010, from US Department of Health and Human Services: [89]
  • HHS Deploying U.S. Medical Personnel to Haiti. (2010, January 14). Retrieved July 20, 2010, from US Department of Health and Human Services: [90]
  • HHS Medical Teams Providing Medical Care in Haiti. (2010, January 18). Retrieved July 20, 2010, from US Department of Health and Human Services: [91]
  • National Disaster Medical System Helping U.S. Hospitals Treat Survivors of Earthquake in Haiti. (2010, February 2). Retrieved July 20, 2010, from US Department of Health and Human Services: [92]

USAID

  • Adams, D. (2005). The Development Challenge: Haiti. Retrieved July 20, 2010, from USAID: [93]
  • USAID Responds to Haiti Earthquake. (2010, April 2). Retrieved July 20, 2010, from USAID: [94]
  • USAID to Provide Emergency Food Aid for Haiti Earthquake Victims. (2010, January 13). Retrieved July 20, 2010, from USAID: [95]
  • USAID to Provide Shelter for Haitians: Frontlines-March 2010. (2010, March). Retrieved July 20, 2010, from USAID: [96]
  • USG Humanitarian Assistance to Haiti for the Earthquake. (2010, January 15). Retrieved July 20, 2010, from USAID: [97]

The Kaiser Family Foundation

  • Haiti Rebuilding Assessment Calls For Health Improvements; U.S., International Donors Continue Long-Term Reconstruction Efforts. (2010, March 19). Retrieved July 20, 2010, from Kaiser Daily Global Health Policy Report: [98]

United Nations and International consideration

  • International Donors' Conference Towards a New Future for Haiti. (2010, April 6). Retrieved July 20, 2010, from UN News Centre: [99]
  • PAHO Basic Health Indicator Data Base. (2005). Retrieved January 20, 2010, from Pan American Health Organization: [100]
  • Sahoo, S. (2010, January 28). UN Envoy: Haiti Quake Aid Mission is Falling Behind. McClachy Newspaper.