Médecins Sans Frontières (MSF) teams in Port-au-Prince are focusing their attention now on expanding their surgical capacity and two operating theatres are now working to help 300 patients who have been transferred to the MSF facility at Choscal hospital in the Cité Soleil district. The rest of the medical staff are still responding to the hundreds of people at their clinics who need immediate first aid and more basic care for their wounds. Equipment that could be salvaged from the damaged health facilities at Maternité Solidarité hospital has been taken to Choscal. The work is a race against time because infected wounds need rapid interventions. Inflatable operating theatres with more surgical specialists are en route. But there are major issues of access and transport, with staff delayed in the air and on the roads. Medical care under tents continues in front of what was the Trinité trauma hospital and rehabilitation center in Pacot. More than a thousand patients have received primary medical care there. “Triage, stabilization of the wounded and referrals for surgical needs are the medical priorities,” says Dr. Mego Terzian, part of an MSF emergency team. “The dead bodies represent a medical issue in the sense that it’s a factor of stress for the survivors. But in this context, as the cause of the death is not an infectious factor, there is no risk of epidemics linked to bodies.” Some of the biggest problems at the moment are with basic supplies and with transport access. Food is running very short and water is a major concern. MSF is starting to truck drinkable water to Choscal hospital for the patients and the people nearby. There are overwhelming needs across the city and the MSF teams are getting reports of very serious damage and casualties from the smaller towns near the capital. They will be trying to get out into those areas to figure out what MSF might contribute. Mobile clinics are being planned. The teams are also looking at obstetric care, which has always been a priority for MSF and which needs sustaining. Mental health in the wake of this scale of disaster is another area where provision needs to be made. MSF has managed to get two cargo planes directly into Port-au-Prince airport but others have had to go to neighbouring Santo Domingo, often because of the lack of aviation fuel in Haiti. The people and material then have to come overland. Twenty five new MSF staff are expected to join teams in Port-au-Prince by the end of today.

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