Tuesday, January 26, 2010

The U.S. response to the earthquake should be considered an embarrassment. Our operation received virtually no support from any branch of the U.S. government, including the State Department.

...As we ran out of various supplies we had no means to acquire more. There was no way to transfer patients we were poorly equipped to manage (such as a critically ill newborn with respiratory distress) to a facility where they would get better care. We were heartbroken having to tell patients suffering incredible pain we could not perform their surgery for at least a day.

Even after hearing gunshots outside the hospital, we had no protection for ourselves or our belongings—though we observed that a Jamaican medical team came with armed guards.

All these problems stemmed from ours being an isolated operation, a feature that may work in a humanitarian medical mission but not in a disaster situation. Later, as we were leaving Haiti, we were appalled to see warehouse-size quantities of unused medicines, food and other supplies at the airport, surrounded by hundreds of U.S. and international soldiers standing around aimlessly.

With an organized central command dedicated to medical relief, we could have done much better. A reconnaissance team, managed by government or U.N. officials in conjunction with medical and logistic specialists, could have immediately come to Haiti to evaluate local facilities. Preapproved groups of experienced civilian and military medical teams could have been consolidated in the U.S. from the Pensacola, Fla., military base or other locations, to avoid the airplane traffic clutter and delays that plagued landing of people and supplies into Port-au-Prince. Targeted teams with military support could then go to adequate facilities where they could be most effective.

After the disaster, certain roads should have been secured to allow the transfer of patients or supplies. A base hospital could have been established for patients requiring specialized services (such as a neonatal ICU and neurosurgery). A specialized, postoperative care center should have been established. In our case, however, we lacked the resources to ensure that patients were receiving basic wound care, antibiotics, nutrition or hydration.

The death toll from Katrina was under 2,000 people. Deaths in Haiti as of yesterday are at least 150,000. Untold numbers are dying of untreated, preventable infections. For all the outcry about Katrina, our nation has fared no better in this latest disaster.
Read the whole thing

Dr. Eachempati is a trauma surgeon and incoming president of the New York State Chapter of the American College of Surgeons. Drs. Lorich and Helfet are orthopedic surgeons. All practice at the Weill Cornell Medical Center in New York City.

[Printed in The Wall Street Journal, page A17, Tuesday, January 26, 2010]


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