Public Health

Turning To Haiti's Longer-Term Health Needs

By Kevin Whitelaw

A patient is carried into surgery in Port Au Prince on Tuesday Jan, 19, 2010. i

A patient is carried into surgery in a field hospital which was set up in downtown Port Au Prince on Tuesday, Jan. 19, 2010. John W. Poole/NPR hide caption

itoggle caption John W. Poole/NPR
A patient is carried into surgery in Port Au Prince on Tuesday Jan, 19, 2010.

A patient is carried into surgery in a field hospital which was set up in downtown Port Au Prince on Tuesday, Jan. 19, 2010.

John W. Poole/NPR

In one small piece of good news coming out of Haiti, World Health Organization officials say there is no sign yet of any epidemics emerging in the wake of the massive earthquake.

"We've seen no reports of outbreaks of diseases," Paul Garwood, a spokesman for the World Health Organization, tells us by telephone from the group's Geneva headquarters. "We're not seeing conditions on the ground now as pushing us towards any such outbreaks."

For a country that has already buried 150,000 quake victims, according to Haitian government officials, this is an enormous relief. The most important factor helping to prevent outbreaks appears to be that the quake hit during the country's dry season, which helps minimize some of the risk factors for spreading disease.

Aid workers say that epidemics could still emerge, and therefore clean water and shelter remain urgent needs. But they are also starting to worry about many of the other longer-term challenges of trying to put Haiti's health care system back together.

For starters, doctors have conducted thousands of surgeries, including amputations and other serious operations, but most of these patients will require extensive care in the coming months or years. That won't be easy with so many hospitals and health clinics damaged or destroyed.

"These people will need care following the operations they have already undergone," Garwood says. "Now we have to look at getting them rehabilitated and getting their lives back together."

Then there are all the people who suffer from chronic diseases, such as diabetes, cancer, or HIV/AIDS. Garwood says that some 120,000 people in Port-au-Prince were receiving treatment for HIV/AIDS before the earthquake.

"There is a need to quickly resume these basic health services to ensure people with already existing conditions receive the treatment they require" says Garwood, noting that WHO is conducting an urgent assessment of Haiti's needs. "We're trying to make these changes now."

On the ground, most aid workers have simply been scrambling to deal with the immediate needs of patients.

NPR's Joanne Silberner spent 10 days with disaster medical assistance teams sent out by the U.S. Department of Health and Human Services. The teams got into place early in the second week.

The vast majority of the patients they treated were people with broken bones and infected wounds. Diarrheal diseases were starting as well, a situation of great concern to aid workers because many people are living in make-shift encampments.

The best treatment for infectious diarrhea is very cheap and easy to administer. It's called oral re-hydration, which involves having the patient drink clean water with salt and sugar mixed in to replace the lost fluid and electrolytes.

But clean water is in short supply in Haiti. Without water, people with diarrhea become severely dehydrated, and the only treatment then is intravenous fluids. IV therapy is being given in the temporary hospitals, but it's very labor-intensive.

The medical aid workers are hoping that as aid groups focus on setting up temporary living camps with adequate sanitation facilities, diarrhea will become less of a threat.

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