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Haitians badly injured in the earthquake are still being flown to U.S. hospitals in South Florida. They pushed trauma centers to what Florida's governor called the saturation point, so federal officials agreed this week to cover the costs and also to enlist other areas to help care for the injured.
Still, as NPR's Greg Allen reports, doctors and hospitals in South Florida remain deeply involved.
GREG ALLEN: For doctors caring for earthquake victims in Haiti, this was a week that began in crisis. After Florida Governor Charlie Crist warned that the disaster warned that the disaster was overtaxing the state's capacity for handling trauma patients, the military halted all medical evacuation flights from the Haiti. Doctors warned that unless flights were quickly resumed patients would die.
By Monday, the federal government responded, activating the National Disaster Medical System. It's a program that previously has only been used for domestic disasters like Hurricane Katrina.
In Florida, the head of the state's Department of Children and Families, George Sheldon, hailed the federal action.
Mr. GEORGE SHELDON (Secretary, Florida Department of Children and Families): This will take care of Florida's medical cost for the future. It will also distribute these patients around the country, which is not just a cost factor. That's also a quality of health care as you get them out.
ALLEN: In the first weeks after the earthquake, hospitals in Miami-Dade, Broward and Palm Beach counties provided care for more than 500 earthquake victims. At the Broward Memorial Health System, director of emergency services, Fred Keroff, says his hospitals have seen more than 100 patients from Haiti. Many arrived in critical condition, with multiple fractures, spinal and head injuries.
Dr. FRED KEROFF (Director of emergency services, Broward Memorial Health System): All these people are going to be in the hospital for some months to come and then require, once they get out of the hospital, some significant rehabilitation just to get back to functional status.
ALLEN: Doctors say treating severe injuries like these may end up costing $100,000 or more per patient.
Under the medical disaster designation, the federal government will reimburse hospitals at 110 percent of the Medicare rate. That's for hospitalization.
Jeanne Eckes, director of emergency preparedness for the Broward Health hospital system, says there are still lots of unanswered questions: Will the federal government cover costs of caring for earthquake victims who were admitted before the disaster designation? And will it pay for rehabilitation and the cost of long-term care?
Ms. JEANNE ECKES (Director of emergency preparedness, Broward Health): Some of this is unprecedented, uncharted waters. So the rules are being written as we go along as a result.
ALLEN: After three weeks of receiving medical evacuees, South Florida hospitals are in standby mode. Earthquake victims from Haiti are now being flown to Atlanta and are expected soon in the Tampa area.
Meanwhile in Haiti, doctors from the University of Miami Miller School of Medicine are still on the frontlines. Since the day after the earthquake, the university has staffed and run a field hospital in Port-au-Prince, with 150 doctors and nurses, and beds for 260 patients.
Dean of the medical school Pascal Goldschmidt says the effort has received good support from donors, but he's worried about the expense over the long term. In the first month along, he estimates costs at $10 million.
Mr. PASCAL GOLDSCHMIDT (Dean, University of Miami Miller School of Medicine): Once the problem is less in the news, the tendency for support is substantially reduced. And so I'm concerned that in the long run, we may end up with financial problems and at a time where patients will continue to have substantial problems that need to be cared for.
ALLEN: Over the past month, University of Miami doctors and volunteers from other institutions have rotated through Port-au-Prince doing procedures many haven't seen since their student days. William O'Neill, a cardiologist and top administrator at the medical school, was there just days after the earthquake.
Dr. WILLIAM O'NEILL (Cardiologist, University of Miami): Well I started putting IV lines in and starting to, you know, trying to figure out how to deal with people with pelvic fractures and leg fractures. I held a lady down while her foot was cut off. So, I mean, it's just stuff that you just don't think that you're going to do again. But it was just an absolutely a profoundly moving experience.
ALLEN: The University of Miami hospital in Port-au-Prince is still full. The school is beginning to work on a plan to turn the temporary facility now housed in four large tents into something more permanent. And within the next few months, the school hopes to turn the facility over to Haitian doctors and have its staff work mostly as trainers and consultants.
Greg Allen, NPR News, Miami.