Mass Casualties in Haiti Following Earthquake are Destined to Increase
By Barbara Lock, MDJanuary 14, 2010
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The 2010 Haiti Earthquake, measured at a magnitude of 7.0 on the Richter Scale, has wreaked social havoc, devastated property and shelter, destroyed lines of communication and transport, disrupted food supply, and has caused an inestimable loss of life. Hospitals within Port-au-Prince have been destroyed or rendered structurally unstable. Hospitals in neighboring regions have dwindling or no supplies for medical personel to work with. While relief efforts have been mounted from nations around the world, loss of life is destined to continue.
Although accurate death estimates are lacking, it may be that no earthquake has created such a vast and pervasive humanitarian disaster since the 2004 Indian Ocean Earthquake which triggered a massive Tsunami, associated with 10 meter waves in Indonesia, and more than 225,000 people died in affected areas around the Indian Ocean. The North Pakistan Earthquake of 2005 caused more than 75,000 deaths.
During mass casualty events such as severe earthquakes, tsunamis, hurricaines, or acts of war or terrorism, first responders such as firefighters and paramedics are trained to assess for and avoid persistent danger, and then to manage victims according to a triage system. Triage is a method of sorting potential patients into groups for priority of care. Decisions regarding triage during a mass casualty disaster in which medical resources and capacity are vastly overwhelmed are different than triage that occurs under normal circumstances when, say, several people from a car accident show up a the same hospital at the same time. During a mass casualty disaster, many people who cling to life after the initial event will be expected to die, and even left for dead by medical personel on purpose.
This is a very hard concept for most people to understand, but it is crucial. During a mass casualty event, when medical supplies, personel, and capacity is vastly overwhelmed, health systems are obligated to make choices about how they use their vastly overwhelmed capacity. The principles of triage in mass casualty disasters are as follows:
1) Defer treatment of people who will live regardless of treatment. This includes people with scrapes, bruises, lacerations, and minor broken bones.
2) Withhold treatment from people who are likely to die despite treatment given the medical resources available. This includes patients who can't breathe on their own, people without a pulse, and sometimes people with truly catastrophic injuries and others, depending on the capacity of the medical system.
3) Treat people who have a reasonable chance of living if treated, given the medical resources available. The most critical of these would be treated first.
Let's imagine that the whole country has a limited number of ventilators, for example, which pump air into a patient's lungs who has become so injured or sick that they can't breath for themselves. Let's imagine that half of those ventilators were destroyed in the rubble of the hospitals in the eartquake zone. And let's say that most of the other half of mechanical ventillators were in use at the time of the earthquake supporting patients who were already in hospitals. What then happens when, all of a sudden, thousands of earthquake victims need the support of mechanical ventillation? Should health care workers who can barely meet their own personal survival needs be asked to ventillate severely injured patients for days by hand? It is not possible. Most, if not all, severely sick or injured patients who cannot breathe on their own will be left for dead. In triage parlance, these patients are termed "expectant".
After the North Pakistan earthquake of 2005, hospitals were overwhelmed with injured patients. This earthquake measured 7.6 on the Richter scale, and eventual loss of life was estimated at greater than 75,000 persons. 2.8 million people were left homeless. The Military Hospital in Rawalpindi received 1698 patients injured from the earthquake, not including those who had minor injuries and were turned away, or those deemed expectant (dead or nearly dead). New patients presented for care related to earthquake injures for more than six weeks. For these patients, 2289 operations were performed; that means that many patients required more than one operation. Of the patients who died in hospital, more died from tetanus than from direct complications of their injuries.
Haiti needs our help; please support relief efforts with your money, skill, and prayers.
MedPie.com will donate $.05 for every unique pageview of this article in the next month to Doctors without Borders. Please send this article to your friends and family by copying the tiny URL http://tiny.cc/N2nH2 and pasting it in to an email message, or link to it from your personal blog.
Americans trying to locate family members in Haiti are encouraged to contact the State Department at (888) 407-4747.
How to Help:
Donate Money:
1. To support medical and social work in Haiti:
Saint Boniface Foundation in Haiti http://www.haitihealth.org/ ; Catholic clinic and organization that does amazing work taking care of the medical and social needs of the whole family and village.
St. Boniface Haiti
Foundation 400 North Main St.
Randolph, MA 02368
781-963-7243
2. To support to sustainable development in Haiti: H.E.L.P Inc http://www.helpinconline.org/ A local Haitian relief organization dedicated to sustainable development in health, education, agriculture, animal husbandry, nutrition and irrigation.
Director: Michel Brutus mhbrutus85@hotmail.com 14 Impasse Heraux - Entrée Sylvio Cator, Port-au-Prince Haiti W.I.011 509 246-5710(Home)011 509 555-5410(Cellular)011 509 510-8238
3. To support children's relief in Haiti: World Vision http://www.worldvision.org/ 1-888-511-6593 One-time giving/Emergency relief P.O. Box 9716 Federal Way, WA 98063-9716 info@worldvision.org
4. To support Doctors without Borders: http://doctorswithoutborders.org/1-888-392-0392USAHeadquarters333
7th Avenue, 2nd
Floor New York, NY 10001-5004
Phone: 212-679-6800Fax: 212-679-7016
5. To Support Partners in Health: http://www.pih.org/home.html
Call your Congressman:
You can also help by calling your elected officials and ask them what they are doing to ensure a swift, sure and effective US government-led humanitarian response. You may find the contact information for your Senator or Representative by following this link http://www.contactingthecongress.org/. Or contact the White House at 202-456-1111 or 202-456-1414. Tell them that the world and the country are watching how the most powerful country in the world will respond to this crisis so near its shores.
Donate your Medical Expertise:
Below is a Letter from Partners in Health (http://www.pih.org/home.html)
"Wanted: Surgeons, nurses, and other medical personnel to help in Haiti
We are deeply grateful for the multitude of people who have contacted us wanting to provide medical assistance. As patients flood to our sites from Port-au-Prince, we're finding ourselves in need of both medical personnel and supplies. In particular, we need surgeons (especially trauma/orthopedic surgeons), ER doctors and nurses, and full surgical teams (including anesthesiologists, scrub and post-op nurses, and nurse anesthetists).
If you are a health professional interested in volunteering, please send an email to volunteer@pih.org with information on your credentials, language capabilities (Haitian Creole or French desired), availability, and contact information.
As phone lines in Haiti remain down and transportation and communication are difficult, PIH is still in the process of determining where we can set up operations in Port-au-Prince, and how we can transport patients and volunteers to our sites. We will be able to offer more concrete information after these logistical matters are resolved.
Once again – thank you for your support. Kenbe fèm."
Make Your Own Pledge:
If you would like to make your own pledge to Haiti relief based on page views or purchases from a website, MedPie.com will link to your website. Contact block@medpie.com for more information.
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