Doctors Without Borders Steps Up Trauma Care in Haiti
By Tequila Minsky, Heritagekonpa Magazine
NY,
DEC. 24 - A large gingerbread house, built in 1913 in the well-to-do Port-au-Prince
neighborhood Pacot, was once the charming home for a Haitian businessman. Decades
later it was rented to the U.S. Army as the center for the Military Information
Support Team (MIST) to generate information during Operation Uphold Democracy
on Aristide's 1994 return to Haiti.
Now, sadly, its function is perhaps best served as a rehabilitation center for gunshot and other victims of Port-au-Prince's continuing street violence. This center, run by Medecins Sans Frontiers/Doctors Without Borders (MSF), provides follow-up after the surgery--part of the recovery process for those whose bones have been shattered.
In December 2004 Medecins Sans Frontiers/MSF opened a 56-bed trauma center at St. Joseph's Hospital in Port-au-Prince in order to provide free emergency medical and surgical services to the vast numbers of people caught in the crossfire who have little access to medical treatment.
Since the last week of December 2004 MSF surgical and medical teams have treated more than 2200 emergencies directly related to violence including machete and knife wounds, beatings and rape. 1,415 were gunshot wounds. Just this past November, 103 Haitians were treated for bullet wounds, though half the number than June, this still reveals a region in conflict and in fact, treatment for machete wounds are on the increase.
The MSF team of 10 foreign health providers-- including one surgeon, an anesthesiologist, two nurses, and a physical therapist--join with Haitian doctors, nurses, support staff and other health professionals as part of the trauma and rehabilitation staff.
At the start up of the trauma center a supervising operating nurse, Renilde Kanyange, came from Burundi to work with MSF for a nine month mission. She helped organize the hospital including ordering surgical supplies and setting up the surgery room.
Quickly she discovered that when patients reached the hospital, they were in real distress and shock. "You had to think very quickly and get to work. You had to respond fast. "she commented. "Often patients had lost a lot of blood and were extremely anemic when they arrived. There is a chronic shortage of blood in Haiti, and finding blood for transfusion was always a challenge. Since most of our patients were brought by the Haitian Red Cross or local taxis called tap-taps, they were usually not accompanied by any potential donor. Many times, we had to ask the staff or literally anyone we can find to give blood."
To date MSF has seen more than 5,000 patients.
One UN civilian policeman observed, "Haiti is not at war and is at war. We don’t exactly know our mission." The number of gun shot casualties in Haiti reflects a country at war, be it with itself. Medecins Sans Frontiers (MSF) knows its mission.
Doctors treat the increasing number of injuries caused by high velocity or exploding bullets, surgeries requiring four or five hours. These wounds are unusual for a city setting but common in war zones. They also treat other traumas, car accidents, burns, broken limbs.
In March 2005, the post-surgical physiotherapy rehabilitation center in Pacot opened with 27 beds. Among those treated and who stay in the rehab center are amputees and patients partially paralyzed.
MSF has been working in Haiti for many years brought there in the past by natural disasters such as hurricanes. Since the early 90’s they have continuously been working outside of Port-au-Prince especially in the St. Marc and Artibonite region posted to regional hospitals and supporting local health facilities.
In September 2004 MSF recognized an increase in urban violence that the local hospital couldn’t provide for and organized facilities to treat victims.
MSF estimates that 100 people from Sept to December in 2004 were killed each month based on visits to the morgue. Armed factions supporting and opposing exiled President J-B Aristide, gang rivalries, and police raids contribute to these numbers.
MSF patients say they have been targeted directly by factions in the "popular zones" for their perceived allegiance to one group or another, sometimes killed in areas controlled by rival factions for being considered "traitors."
A number of patients said they were wounded by the Haitian National Police (HNP) during police raids or during demonstrations. Patients were also wounded during UN Stabilization Mission in Haiti operations. Following a UN military action in Cite Soleil on July 6, 2005, MSF saw 27 victims of gunshot wounds on one day alone. More recently there has been a decrease in gunshot wounds and an increase in machete wounds.
MSF has some been accused of political agendas—they treat victims from the slums, some are gang members. The mission they promote, in fact, is to treat any and all wounded, no questions. They have no political bias. Nurse Ms. Kanyange acknowledges what it means in day-to-day operations to be an independent humanitarian organization. "We take care of all those wounded in conflict situations. MSF is a neutral organization and we ask all parties of a conflict to respect civilians caught in the crossfire."
MSF desk officer Ellen Rynshaw reiterates MSF’s neutrality, "We are unarmed, we treat them. Frequently there have been visits from HNP, They want to walk the floors, look at the records. We need a name. If they want to arrest someone, we need a warrant." At St. Joseph's, not unlike other hospitals that maintain neutrality in conflict zones, sometimes a gang member and a police officer will lay in beds next to each other... 1 out 2
