Wednesday, January 27, 2010

Haiti Early Response Teams

This is a very important 1st hand account from a veteran of disaster response who has extensive training. Know that many volunteers will be needed long term, but take these words to heart:

"Hi everyone. Just back from Haiti and I wanted to put forth a few thoughts to those of you who would like to volunteer. I am still reeling a bit cognitively, so I might not be as smooth or mindful of feelings and such as some would like, so let me apologize if I seem a bit abrupt. My goal is to inform as much as I can so that people are not needlessly traumatized in ways that will either render them useless if they choose to go (and hence, a burden on the relief efforts since they will need assistance themselves) and/or psychologically scarred more than they imagine they could be.

1) It is absolutely key and essential that ONLY people who have had large-scale and severe disaster experience go over at this point, right now. Many of you know that I have been to Sichuan--have had many experiences with large hurricanes, Katrina, etc., but I cannot tell you how horrendous and very different this situation is right now. There is no infrastructure....if you run out of water, you face dehydration. If you run out of food you face hunger. If you get hurt, you risk high infection within a day or two, and no medical support. I was there with a team of doctors, in one of the few medical hospitals up and running, but there is essentially no ability for you to be care-flighted or returned to the US or Dominican Republic should an emergency arise. The airport is frequently shut down, and you will not be a priority for the military or anyone else to help you. "They" are busy doing the mission they have set out in front of them, and communication and the ability to get help is extremely limited.

2) Rehab needs. The docs I work with pretty much agree that head injuries are at a minimum, in that the people with them have essentially died, or will soon die, (if they are severe). Amputations: Yes...many, many, many. We were doing surgeries almost 24 hours a day....mostly amputations. Unfortunately many of the people who have had amputations have already become infected within a day or two of the surgery (remember essentially no aftercare...they are sleeping outside (which actually seems quite smart, given our earthquake the other day, which personally was terrifying being indoors for...)). Any how...many people who had amputations or wound care immediately after the earthquake are having to have higher amputations due to the infections. The docs I flew back with came to the consensus that if 30% of the people they operated on survive, they will be lucky. Spinal cord aftercare, no adaptive equipment, very limited family left to care for them (if any) can imagine the immediate outcome. EVERYONE I spoke to had family killed or missing.

As a rehab psychologist, I used all the skills I know. Suicide prevention, letting those with amputations know they will still be loved and beautiful or a "man".....holding the hand of someone yelling in pain and soothing them, etc., etc. However, these skills alone -- without disaster experience to help give you the emotional steel you need to cope with the situation you are in -- will not be sufficient. Not right now.

My recommendations are these: Those with SERIOUS disaster experience, consider deployment, but make it short. Know that it will be more severe than you can even imagine. Even the tsunami was in a country where you could find some infrastructure...somewhere. Here--there is nothing. For the first time in my life I truly had to consider survival situations. Yes, my organization had supplies and contacts, but water goes missing and the next shipment of water is on a plane not allowed to land in the airport...

If you do not have disaster experience, this is NOT the disaster to begin with. Volunteer stateside, providing support to people and organizations who are doing good work. OR -- think about deployment months and months from now, when (or if) an infrastructure is there, so you can have the support that is needed.

Bless you all with your desire to help. There will be a way to do sure you plug yourself into something that will allow you to function during and afterwards, rather than becoming another victim of this situation."

Cheers -- Jeanne

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