Dispatches from Haiti

Rachele Stein is a ninth grader at Washington International School. Her father, Ian Stein, works for the World Health Organization and is currently in Haiti.  Rachele gathered questions from WIS students to put to her father, who replied from the field.

“How are people saving lives and healing the sick? What are the health challenges? What more is needed?  Haiti's earthquake has left no one unaffected in the Caribbean island. Tens of thousands have been killed and many more injured. And millions of people are having to live through yet another crisis in this impoverished country.” This statement is posted on the World Health Organization (WHO) website, and this is what my father, Ian Stein, is trying to deal with in Haiti.

My father works for the World Health Organization (WHO) and his skills in problem solving, speaking different languages, and building teams are why he was called upon for this job. With less than 24 hours notice he left DC, flying down to Haiti a week after the disaster hit. He was one of the many people that arrived in Port au Prince to try to meet the catastrophic health needs following the earthquake.

One of the lessons coming from him is this:  “When a disaster such as this takes place, immediately a ‘health cluster’ is activated to ensure there is a coordinated response to the needs.  One doesn't want 17 different groups all working in the same area, while others are unattended.  One doesn't want people bringing in the wrong types of assistance.  One needs to know who is doing what, where, and when they are doing it.  Teams from PAHO (Pan-American Health Organization) and WHO always lead the health cluster.”

The earthquake of course, affected the WIS community, and students compiled a few questions to ask my father from the field:

1)  How long do you think it will take to re-build the country?
“The city did not have many tall buildings, but a significant number of them collapsed or appear structurally unsafe. Assessments suggest that there are parts of the city, or nearby, that lost 80% of the buildings. With this in mind, it will take many years for the city to rebuild, and it is hoped that the investment will result in something that will be better than what was destroyed.  The greatest challenge is that the country continues to be the poorest in this hemisphere.”

2)  How long does a formal state of emergency last?
“It is my understanding that the government of Haiti, and most likely the President, declares a state of emergency for an indeterminate period of time - meaning that it can last as long as necessary.  The declaration of emergency usually allows the government to do things in a quicker manner, to be
able to respond faster.”

3)  What are some of the countries sending to help?
“In circumstances such as this, many countries are sending a huge variety of things, and this, too, becomes a challenge.  For an effective response, early priorities need to be established so that the urgent things arrive first, and the less important things do not clog the existing fragile system.  

Huge amounts of cargo are arriving at the airport, but getting the things out of the airport remains a challenge.  Massive convoys arrive overland from the Dominican Republic, but this also creates massive traffic problems.  The early crisis needs included people to both help find people hidden by the rubble and care for the thousands of injured.

“Now that two weeks have passed, and new phase changes the needs -- the urgent things that I've seen arriving include:  drugs and health supplies for hospitals, health centers, and clinics; food and water for distribution to people that have moved into temporary housing; tents, tarps, and plastic sheeting to provide shelter from the heat and possible rain (it hasn't rained since I've been here, but it will come eventually -- especially during the hurricane season); and sanitation equipment / supplies to ensure that the massive tent cities do not begin to spread disease.  More than anything the best thing that is being sent to Haiti is money - this will be the key toward the short
and long term needs.”

Here are some examples of the complicated coordination that is taking place around fuel, distribution of supplies and medical equipment to meet health needs.  This information comes in from my dad’s emails and have helped me understand this situation better.

The government of Venezuela donated fuel to Haiti to help supply health facilities' generators but where does one store thousands of gallons of gas? This is an example of what my dad and his colleagues deal with. The solution to this was as follows:  “Phase One:yes"">  10,000 gallon tanker to arrive from Dominican Republic and off loads the fuel to 10 thousand-gallon tankers.  The former beast goes back to the DR and the latter beasties go to the hospitals. 

Phase Two:  build a fuel facility at the UN compound.”

Another of my dad’s roles is to help with the assessing, coordination and delivery of drugs and medicine to hospitals or health centers that are still standing. His US Army 82nd Airborne friends evaluated the hospital near the presidential palace and asked for help from my father’s organization to get thousands of dollars of prescriptions filled as quickly as possible, considering the medicine was badly needed. After a going back and forth various times regarding logistics and needs an arrangement was made and the pharmacist was able to fill the order in a couple of hours.

This was a win-win for both sides; it ran smoothly and quickly, but sometimes it is the opposite. Here is another example of coordinating medical supplies, as Dad writes:  “Trying to solve a bottleneck in the Dominican Republic with urgent medical kits, these are kits that are ready to go to treat between 1,000 and 10,000.”  I am beginning to appreciate how difficult the day-to-day organization of donations can be.

On another day, his army contacts returned the cooperative spirit when my father asked them if they could clear and level 1,000 square meters of land for medical tents. These were needed for post-op patients. So many people have been injured and now are undergoing surgeries that the hospitals are filled to their breaking point. My dad writes, “I was out in a dusty field, about 1.5 kilometers from my office working with the 82nd Airborne to erect six medical tents, baking in the sun, covered in dust, and working many, long hours. It was a ridiculous effort, but complete by 4PM.”   It is
great to read how quickly people are responding and working together.

With donations piling up daily from around the world the task is huge and this leads to another area that is part of my dad’s work. For example, an enormous shipment showed up with supplies from USAID. My father, along with other organizations, is helping coordinate this effort. “Now we need help,” he writes, “(medical logisticians, warehouse specialists, and hands) to get this sorted, inventoried and into our warehouse.  We are expecting the military and US NGOs to show up to get this done…30 forty-foot containers is a LOT of stuff... Of course that will take various calls back and forth, but in the end of the long road it will worth it. They opened up one of the forty-foot containers and it looks like gold inside.” I can just imagine how pleased everyone was when he or she
saw the contents.

As I finish writing this article, my dad just shot me a quick email that he is flying in a Seahawk over Haiti to help deliver essential drugs to the thousands who left Port au Prince. I have discovered that every day brings a new challenge for all the women and men helping out with this huge relief effort. I know that Haiti will take a long time to rebuild, but as I look back on all of emails that my father has sent me, even though I would like him home, I am honored that he is a part of this colossal task.